Radiography of periodontal disease Flashcards
Describe the process for diagnosis
HIstory
Examination
BPE
Evaluation for historic periodontitis
Once the presence of periodontal disease has been established, radiographs can be sued to determine the severity and rate of progression of the disease
Describe radiographic features off a healthy peridontium
- relationship between crestal bone margin and the comet enamel junction (CEJ)
- If this distance is 2-3 mm and there is no clinical sign s of loss of attachment then there is no periodontitis
- Thin smooth, evenly corticated margins to the interdental crystal bone in posterior regions
- Thin, even well defined margins to the interdental bone in the anterior regions
- the interdental crystal bone Is continuous with he lamina dura of the adjacent teeth. the junction of the 2 forms a sharp angle
- thin even width to the medial and distal periodontal membrane spaces
what are the limitations of radiographs
- 2D view of 3D situation
- Bony defects may be hidden
- Only onterpoximal bone seen clearly
- Radiogrpahs dîner estimate bone destruction
(30-50% of the bone mineral content must be lost before changes are detected radiogrpahiclaly)
-no information on soft tissues
what do radiographs show
- bone loss
- mobility
- occlusal trauma
- calculus and marginal overhangs
- crown -root raitos
-Sclerosis
What 3 factors are used to measure bone loss
EXTENT- extent na pattern of bone loss
STAGING- bone loss at the worst site is used to determine the severity of the disease
GRADING- % bone loss / patient age is used to determine the rate of progression of the disease
List the different patterns of bone loss
- Generalised
-Localised - Molar- incisor pattern
- horizontal
- vertical
- furcation movement
What is vertical bone loss
discrepancy in degree of bone loss at 2 adjacent sites
- might indicate rapid bone loss
- can be due to anatomy
- Intrabony defect: 3,2,1 walled
- Combined lesions
What is horizontal bone loss
- Crest is horizontal relative to occlusal plane
- Positioned apical to the normal level
- Loss of buccal and lingual cortices and intervening trabecular bone
Describe furcation involvement
- Local plaque retention factors
- May be detectable by probing
- Radiolucency at furcation
- Upper moalrs- radiolucent arrow head
What are combined lesions
- Combined periodical and periodontal bone loss
- Can be primarily periodical or primarily periodontal
what is mobility
- widening of the periodontal membrane space may imply tooth mobility- normal occlusal forces overload the reduced periodntium leading to mobility
- BUT teeth may be mobile without any radiographic changes
List types of occlusal trauma
marginal widening
angular defect
root resopriotn
Hypercemetosis
Root fracture
Loss/thickening of lamina dura
Bone sclerosis
Can calculus be seen on radiographs
- may or may not be seen radiogrpahiclaly depending on size, location and degree of calcification of deposit
- careful probing more accurate
what do poorly contoured restorations possess
- overhang amalgams
- crown margins
- occasiional pin perforation
what re crown root ratios
- radiographs are the only meat whereby the crown - root ratio, root length and morphology can be document ed
