Lecture twelve

Radiographic Interpretation
 :Interpretation of Caries
interproximal caries: a /1
triangular radiolucency at or just
below the contact point of the
tooth with the tip of the triangle
toward DEJ. Interproximal caries
can be classified according to the
depth of penetration of the lesion
:through enamel and dentin into
A/incipient: extends less than
halfway through the thickness of
.enamel
B/Moderate: extends
more that halfway
through the thickness of
enamel but does not
.involve the DEJ
C/advanced: extends to
or through the DEJ and
into the dentin but does
not extend through the
dentin more than half the
.distance toward the pulp
D/severe: extends
through enamel,
through the dentin,
and more than the half
the distance toward
.the pulp
Occlusal caries: a radiolucent lesion on/2
chewing surfaces of the posterior teeth. Because
of the superimposition of the dense buccal and
lingual enamel cusps, early occlusal caries is
difficult to see on a dental radiograph,
consequently it not seen until there is
.involvement of the DEJ
:Occlusal caries can be classified as

A/incipient: can not

be seen
radiographically and
only detected
.clinically
B/ moderate: extends
into dentin and
appears as a very thin
.radiolucent line
C/ Severe: extends into
dentin and appears as
.a large radiolucency
Buccal and lingual /3
caries: because of the
superimposition of
buccal and lingual
surfaces of the tooth,
these caries are difficult
to be detected on a
radiograph. When
viewed on a radiograph,
it appears as small,
.circular radiolucent area
root surface caries: it /4
appears as a cupped-out or
crater-shaped radiolucency
just below the
cementoenamel junction
(CEJ)
recurrent (secondary) /5
caries: it appears as a
radiolucent area just
beneath a restoration. It
occurs most often beneath
the interproximal margins
.of a restoration
rampant caries: its /6
advanced severe caries
that affects numerous
teeth. It seen mostly in
children with poor
dietary habits or in
adults with decreased
.salivary flow
 Interpretation of periodontal
:disease
Periodontal disease results in bone
loss which can be classified as
slight, moderate, or severe. The
severity of bone loss is
measured by the clinical
.attachment loss (CAL)
CAL is a measurement of the
distance in millimeters from the
CEJ to the base of the sulcus or
.periodontal pocket
.slight bone loss: 1-2 mm /1
.moderate bone loss: 3-4 mm /2
severe bone loss: 5mm or/3
.greater
 :Calculus
It appears as pointed or
irregular radiopaque
projections extending
from the proximal root
.surfaces
 Radiographic changes caused
:by trauma
Trauma may result in fractures of teeth and
bone and injuries such as intrusion,
.extrusion, and avulsion
 :Crown fracture
It may involve the
enamel only, the
enamel and dentin, or
the enamel, dentin,
.and the pulp
:Root fractures
It appears as a sharp
radiolucent line on a
.periapical radiograph
:Jaw fractures
It appears as a
radiolucent line at the
site where the bone
.has separated
 :Pulp stone
It appears as round, ovoid,
cylindrical radiopacities,
some pulp stones may
conform to the shape of
the pulp chamber or
canal. it do not cause
symptoms and do not
require treatment
 Radiographic features of
:periapical lesions
Periapical Granuloma: it/1
is initially seen as a
widened periodontal
ligament space at the root
apex. With time, the
widened periodontal
ligament space enlarges
and appear as a round or
ovoid radiolucency. The
lamina dura is not visible
between the root apex
.and the apical lesion
Periapical Cysts: /2
appear as a round or
ovoid well outlined
.radiolucency
condensing osteitis: /3
is a well-defined
radiopacity that is seen
below the apex of a
non vital tooth with a
history of long-standing
.pulpitis
Sclerotic bone: is a /4
well-defined
radiopacity that is seen
below the apices of
vital, non carious teeth.
The margins may
appear smooth or
irregular and diffuse.
The borders are
continuous with
.adjacent normal bone
 Dental anomalies
It include variations in normal
number, size, eruption or
morphology of the teeth.
Dental anomalies can be divided
into developmental and acquired
abnormalities
 Developmental abnormalies
Supernumerary .1
teeth: it also
named
hyperdontia,
mesiodens,
distodens,
peridens and
.parateeth
Missing teeth.2
It names
hypondontia,
oligodondia and
anodontia
Macrodontia .3
In macrodontia the
teeth are larger
than
.normal
Microdontia.4
In microdontia the
involved teeth
are smaller
.than normal
Transposition .5
Transposition is
the condition in
which two teeth
have exchanged
.positions
Fusion .6
Fusion of teeth
results from the
combining
of adjacent tooth
germs, resulting in
union of the
developing
.teeth
Concrescence .7
Concrescence occurs
when the roots of two or
more teeth are united
by cementum. It may
involve either primary or
.secondary teeth
Gemination .8
Gemination is a rare anomaly
that arises when the tooth
bud of a single tooth attempts
to divide.The result may be
an invagination of the crown,
with partial division, or in rare
cases complete division
throughout the crown and
root
Taurodontism .9
Taurodont teeth have
longitudinally
enlarged pulp
chambers. The
crown is of normal
shape and size, but
the body is
elongated and the
.roots are short
Dilaceration .10
is a disturbance in
tooth formation that
produces a sharp
bend or curve in the
.tooth