radiographic interpretation and record findings Flashcards
radiographic report
why
clinical evaluation of the outcome of each exposure is (must be) recorded in accordance with the employer’s procedures
* requirement of IRMER 2017
* must be recorded
by the dentist
3 aspects of using radiographs
Observation - look and see
Interpretation - listen and think
Management - patient’s needs
what to say about the view seen
List the views you are looking at
Bitewings
Periapicals
list teeth shown
OPTs
* indicate if full or sectional
* If sectional, which part of the jaws
gradings for radiographs
A - diagnostically acceptable
N - diagnostically unacceptable (state why)
systematic way of constructing radiographic report
type of radiograph
grade
symmetry
margins
bone consistency
dentition
supporting bone
any other features?
summary
proposals
dentition comments for radiographic report
No need to specify teeth and restorations if they match your clinical charting BUT general statement
* Adult dentition
* Mixed
* Deciduous or primary
Heavily/moderately/minimally restored
Retained roots/associated pathology
List RCTs and comment on obturation/condensation
Comment on defects in restorations
Detail caries that is evident, and depth
supporting bone comments for radiographic report
General statement, unless doing perio dx
e.g. good bone levels, moderate horizontal bone loss – can use BSP stagings
* Angular defects
* Furcation involvement
* Use descriptive terms
Check your observations match your previous clinical findings – want to match
periradicular changes comments for radiographic report
Location
Size
Margins – clearly defined or not?
What do these changes signify?
* If appropriate suggest further investigation or treatment
report these radiographs for adult male
4 bitewings, grade A; periapicals of 11, 21 and 36, all grade A
Moderately restored dentition, including RCT 11 & 21
Unerupted 48, distoangular – if treatment indicated a periapical will be required
Mild, horizontal bone loss, stage I
Caries 27M, probably involving pulp; periapical required if endo being considered
11 and 21 RCT, good obturation length, appropriate filling length and condensation; no periradicular changes
report these PAs
periapicals 23-27
Ant grade 1, posterior grade 2, due to tilt of occlusal plane
24 pinned restoration; circular periapical radiolucency, approx. 6 mm diam., indicating periapical periodontitis, and probable periapical granuloma
opacity around root of 25, indicative of hypercementosis (harder extraction)
report this CBCT section for impacted 48
48 mesioangular, partially erupted and grossly carious
2 roots, curving towards each other; mesial root apical portion curves under distal apex
46 RCT with evidence of poor obturation
46 clear periapical radiolucencies, approx. 5-7 mm., probable periapical granulomas, re-root treatment indicated
discuss these PAs of 25 and 26
Periapical showing 25 and 26 – grade 1, widened periodontal ligament space (indicative of inflammatory change)
? Adequate obturation
Second radiograph shows only 1 root, perforation mesially and ? where else
* Parallax - Move image receptor back, Perforation moved from in front to within root (SLOB)
Mesiopalatal perforation??
related bone change
report OPT
Panoramic problem – is it diagnostically acceptable?
*Artefacts anterior maxilla and over 26 crown *
Radiopacities between 16 and 26 are:
* Retained roots
* Out of focus teeth
* Ghost image from cervical spine
* Denture teeth
Clasp on 26 – likely denture teeth, forgot to ask them if they had anything in their mouth prior to taking image
Partially dentate, extensive restorations
Moderate to severe periodontal bone loss (stage II to III); angular around 16 with furcation involvement
Calculus deposits lower incisors
report these PAs
4 periapicals upper anteriors, 2 grade A, 2 boderline grade A – overlaps
Crowns of 12-22 more radiolucent in lower half
suggests erosive changes (NCTSL)
