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Endo I > L6 Endodontic Radiology > Flashcards

L6 Endodontic Radiology Flashcards

1
Q

how much bone do you need to see above an apices on a diagnostic radiograph

A

5mm above apex

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2
Q

what are paramount to determine a correct diangosis in a radiograph

A

optimization of image quality and relationship

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3
Q

what does a diagnostic radiograph include

A
  • areas of concern
  • no cone cuts
  • no overlapping
  • no elongation or foreshortening
  • 5mm above apex
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4
Q

what radiographs do posterior teeth require

A

2 P/A radiographs: one straight on and 20 degrees angled

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5
Q

why is it a good idea to take multiple angles of radiographs

A

to help guess the 3D anatomy

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6
Q

what qualifies as a current radiograph

A

1-2 months

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7
Q

what could indicate a new vertical root fx

A

drop off perio pocket or a DST

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8
Q

when should you take new radiographs

A

-if its not current
- a new restoration or any new information or complaint

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9
Q

what is the historical value of radiographs

A

a series of radiographs over time with similar angulation and exposure can be very helpful when following a new developing or healing lesion

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10
Q

what are the benefits of endodontic radiology

A
  • suggests LEOs and other pathosis
  • may indicate unseen canals and proximal anatomy
  • largely locates most curvatures
  • assists in working-length determination
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11
Q

if apex locator is wrong what would it tell you about your working length

A

working length will actually be longer

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12
Q

what are the risks of endodontic radiology

A

there are none

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13
Q

radiographs help develop a:

A

mental image

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14
Q

what are the 3 biggest risks of endodontic radiology

A
  • attempting to diagnose from radiographs alone
  • seeing something on the film that is not there
  • failure to see something on the film that is there
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15
Q

are mesio distal curvatures easier to notice or bucco lingual

A

mesio distal

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16
Q

what does a bullseye on a radiograph mean

A

you are seeing a facial or lingual root tip on end but you dont know if its curving lingual or facial

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17
Q

what population has a higher incidence of 4th distolingual root of the 1st molar

A

native american popularions and asian populations

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18
Q

what way does the extra 4th DL root in 1st molar curve

A

sharply to the facial

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19
Q

we want to work and fill at ______ short of the canal exit in most cases

A

1.0mm

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20
Q

how do you tell which canal in a radiograph

A
  • could take separate XR of each canal with a single file in a known canal and label XR (wastes time)
  • place files of varying radiographic appearance in each of the canals and remember which file went in each canal (only 1 file available in clinic)
  • increase the vertical angle of the radiograph, lingual canal will be longer and buccal shorter however lengths would be distorted
  • take a straight on radiograph then a shift shot of 20 degrees and remember which direction the xray cone was moved
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21
Q

SLOB RULE: as the angle of the XR cone is shifted, the object furthest from the XR cone will move ____ the XR cone

A

with

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22
Q

what are the common periapical lesions of endodontic origin (LEOs)

A
  • thickened PDL
  • P/A radiolucency
23
Q

what is the differential dx for a LEO shown by a thickened PDL

A

trauma from occlusion

24
Q

what are all of the things we need to know to make a dx

A
  • diagnostic XRs
  • history
  • clinical exam
  • clinical testing
  • etiology
25
Q

a radiolucency of endodontic origin is often but not always associated with:

A

a pulpal dx of necrotic pulp

26
Q

how do you tell the difference between an abscess, granuloma, and a cyst

A

biopsy

27
Q

why cant you see a VRF on radiograph

A

crack is either in the plane of the film or obscured by the root itself

28
Q

what might be a clue to root fractures

A

mobility of the tooth

29
Q

what is a distinguising characteristic of a radiographic lesion of endodontic pathosis

A

the radiolucency stays at the apex regardless of cone angulation

30
Q

what is an anatomical landmark that gets confused for a LEO

A

mental foramen

31
Q

what are the differential dx for LEOs

A
  • anatomical landmarks
  • radiographic artifact
  • another non endodontic lesion
  • oral manifestation of systemic disease
32
Q

what are the common anatomical landmarks

A
  • maxillary sinus
  • nasal cavities
  • incisive canal
  • mental foramen
  • mandibular depression
33
Q

what is the maxillary sinus superimposed over

A

maxillary posterior apices

34
Q

what should the PDL look like in a healthy tooth

A

distinctly uniform width and un interrupted

35
Q

where are nasal cavities seen

A

superimposed over the central and lateral apices especially when high bisecting angle technique is used

36
Q

what should you do to see if anatomical landmarks move away from apices

A
  • pulp testing
  • percussion
  • palpation
  • angled radiographs
37
Q

lamina dura remains intact in:

A

healthy teeth

38
Q

pathology is seldom:

A

bilaterally symmetrical

39
Q

what are key to diagnosing LEO

A

lamina dura and pulp tests

40
Q

how do you tell if a radiolucent area is not associated with apex

A

if radiolucent area moves away from the apex on multiple films

41
Q

why should you test vitality of teeth in area of interest

A

we must pulp test every tooth which we plan to restore

42
Q

what is the most common anatomical landmark that gets confused with LEO

A

mental foramen

43
Q

what are non endodontic radiolucencies which may mimic LEOs including oral manifestations of systemic disease

A
  • lateral periodontal cyst (abscess)
  • PCOD
  • FOD
  • hyper parathyroidism
  • central giant cell granuloma
  • neoplasias
44
Q

what symptoms would lateral periodontal cyst (abscess) mimic

A
  • may be asymptomatic or
  • symptoms of SAP
  • symptoms of AAA
  • CC: pain, swelling, palpation positive, percussion positive, PARL not present
  • vital pulp
  • LD may or may not be intact
45
Q

what is the etiology of lateral periodontal cyst

A
  • infected perio pocket
  • if able to drain- aysmptomatic
  • if unable to drain - symptomatic
46
Q

what are other names ofr periapical cemental osseous dysplasia (PCOD)

A
  • cementoma
  • periapical fibrous dysplasia
  • periapical cemental dysplasia
47
Q

describe periapical cemental osseous dysplasia

A
  • a dysplastic rather than pathologic or inflammatory condition
  • all teeth were vital and asymptomatic
  • mixed radiolucent and radiopaque
48
Q

what is a central giant cell granuloma

A
  • a benign intraosseous lesion found in the anterior of the maxilla and the mandible in tounger people
  • characterized by large lesions that expand the cortical plate and can resorb roots and move teeth
  • composed of multi nucleated giant cells
  • more common in females slightly
  • appears as multilocular radiolucencies of bone
49
Q

what does metastatic breast cancer do to teeth

A
  • causes spiking and resorption of roots
  • poorly defined borders of lesion
  • loosening of teeth
  • pulp may still be vital
  • symptoms of neoplasia, esp in mandible may be pain as well as paresthesia
  • VIP lesion is usually ragged and asymmetrical
50
Q

what are some other less common non endodontic radiolucencies

A
  • osteosarcoma
  • ameloblastoma
  • ameloblastic fibroma
  • dentigerous cyst
  • globulomaxillary cyst
  • keratocyst
  • median palatine cyst
  • nasopalatine cyst
  • residual cyst
  • scar tissue
  • traumatic bone cyst
51
Q

what does CBCT show

A
  • creates multiple sections of an area to display:
  • unusual or extra canals
  • location and extent of cracks
  • aberrant anatomical features
  • otherwise unseen pathology
52
Q

what should you treat first in multiple presentations of issues

A

the most serious or the chief complaint or most symptomatic tooth first

53
Q
A

Endo I (13 decks)

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