Dental Radiographs

Question 1

What is the #1 health problem in SA?

Answer 1

Periodontal disease

Question 2

What is the gold standard for dental radiographs?

Answer 2

Clinical assessment (probing) as well as full mouth radiography

Question 3

What are indications for dental radiographs?

Answer 3

75% of tooth structure is below the gum line
70% of cats and 80% of dogs have some periodontal disease by age 2

Question 4

What is endodontic disease?

Answer 4

Disease inside the tooth

Question 5

What are some barriers to dental radiographs?

Answer 5

Cost of equipment and lack of training

Question 6

Generator/tube

Answer 6

Generates the X-rays. Can be wall mounted or mobile

Question 7

What are the most common sizes of dental films used?

Answer 7

2 & 4
4 is for bigger dogs

Question 8

What is digital radiography sensor?

Answer 8

Digital sensor/plate, size 2 only, images in seconds, and easy to make small adjustments

Question 9

What is Computed radiographs (CR)?

Answer 9

Phosphor screen, image in 10-60 seconds, more expensive, multiple sizes of dental film can be used

Question 10

What are advantages of Digital radiography?

Answer 10

Quality equal or superior to analog
Reduced exposure
Decreased anesthesia time
Minor adjustments much easier
Large image on screen
Can manipulate image
Easy storage
No degradation

Question 11

What are the disadvantages of digital radiography?

Answer 11

Quality dependent on equipment used
Lack of size 4 sensor (DR)
Cost of replacement sensor (DR)

Question 12

For the maxilla, what position should the patient be in?

Answer 12

Sternal

Question 13

For the mandible radiographs, what position should the patient be in?

Answer 13

Lateral

Question 14

For the mandibular incisors, canines, and pre-molars/molars, what position should the patient be in?

Answer 14

Dorsal (on their back)

Question 15

What are the two intra-oral radiography techniques?

Answer 15

Parallel and bisecting angle

Question 16

What way should the dimple on the film go?

Answer 16

Towards the X-ray beam

Question 17

What are some common mistakes when taking radiographs?

Answer 17

Foreshortening (too vertical, too far above)
Elongation (too long)

Question 18

What happens if you place the film backwards?

Answer 18

The film will be underexposed with grid lines, will see film on radiograph or jagged squiggles on radiograph

Question 19

How do you tell if you are on the mandible or maxilla?

Answer 19

Mandible - roots will be down, crown up
Maxilla - roots up, crown down

Question 20

How do you know which side of the mouth you are on?

Answer 20

Check teeth - canines/incisors “shake hands” so images right is left side and vice versa
Premolars - look at which way is the nose
If front of the mouth is on the left side of image, then left side of mouth

Question 21

What should normal roots/root canals look like?

Answer 21

Roots of multi-rooted teeth should be divergent
Root canal should appear regular and smooth
Root canals should be similar in width

Question 22

What is the crown of the tooth covered in?

Answer 22

Thin layer of dense enamel

Question 23

Is dentin/cementum more dense than bone?

Answer 23

Yes slightly

Question 24

How does alveolar bone look like on radiographs?

Answer 24

Gray, uniform, darker than tooth roots, slightly mottled
Less dense than mandibular bone but gets more dense with age

Question 25

What should the tooth/bone interface look like?

Answer 25

Alveolar bone should completely fill area between roots
Periodontal ligament space should go completely around roots and should be uniform width around root

Question 26

What happens to periodontal ligament width with age?

Answer 26

It decreases

Question 27

Widening of the periodontal ligament space indicates what?

Answer 27

Indicative of disease

Question 28

What is the chevron effect?

Answer 28

Sharper demarcated, very smooth, V-shape
There is slight widening of periodontal ligament at apex of tooth where vessels and nerves enter

Question 29

What can holes around the apex of the roots be confused with?

Answer 29

Can confuse disease for a forming and vice versa

Question 30

What does a widened pulp chamber indicate?

Answer 30

Disease, likely a dead tooth

Question 31

What are the 3 types of bone loss?

Answer 31

Crestal bone loss, horizontal bone loss, and vertical bone loss

Question 32

What is crestal bone loss?

Answer 32

Loss of bone height between teeth or in furcation

Question 33

Horizontal bone loss

Answer 33

Bone loss across several roots or teeth in flattened or scalloped loss

Question 34

What is vertical bone loss?

Answer 34

Bone loss extending down axis of root(s)

Question 35

What should you do post extractions?

Answer 35

Make sure you got all the root tips by taking post-extraction radiographs?