assessing and analysing BW & PA's

Question 1

Indications For Bitewings:

Answer 1

• Detect caries
• Monitor progression of caries
• Assess Exsisting Restorations
• Bone levels? (to a certain extent) - because according to guidelines you wont be able to perform a proper periodontal diagnosis from it

Question 2

How often should you take Bitewings?

Answer 2

> The higher the risk the shorter the intervals<
keep reporting the bitewing until no or active lesions are apparent and the individual has entered a new risk category
High risk caries > Bitewings taken six-monthly
Moderate risk caries > Bitewing taken anually
Low risk caries > Bitewing taken every two years

Question 3

Analysing a Bitewing?

Answer 3

1. Trace the outline of the enamel and EDJ - looking for radiolucencies
2. Check the interproximals and cervical burnouts
3. Check for root and dentine caries
4. Check exsisting restorations (overcountoured, undercontoured, contact point, ledges/overhangs, secondary caries, marginal fit)
5. Pulp

Question 4

Main reasons for taking periapicals:

Answer 4

HABIT-PR

• Heavily restored teeth
• Apical pathology
• Bone levels
• Implants
• Trauma
• Pre- extraction
• Root canal treatment

Question 5

Assessing PA’s:

Answer 5

1. Periodontal ligament space (PDL)
2. Lamina dura
3. Surrounding bone

Question 6

Reporting/ Presenting Radiographs:

Answer 6

• Type of radiograph (PA, BW, DPT)
• Location = LHS, RHS, UR5 e.g.
• Grade 1 = excellent, no errors
• Grade 2 = diagnostically acceptable, but some errors
• Grade 3 = unacceptable
• Report =
  Caries: site and depth
  Restorative = deep fills, indirect restorations, margins
  Endodontic: RCT quality, root morphology, resorption
  Periapical: PDL, lamina dura, Bone resorption
  Structures: Bone levels, vital structures, pathology