Lec 6 Flashcards
(29 cards)
what must diagnostic radiographs have?
-must be distinct
-no overlap or cone cuts
-no elongation or foreshadowing
-must include all teeth
-5 mm apical to end of root
what is considered current for radiographs?
1-2 months
(unless something has changed)
benefits of endodontic radiology? (4)
-suggests LEO or pathology
-indicates unseen canals/anatomy
-locates most curvatures
-determines working length
what is SLOB
Same Lingual
Opposite Buccal
risks of endodontic radiology
artifacts
poor resolution
wrong angle
can lead to inaccurate dx
3 biggest risks of endodontic radiology
- diagnosing from radiographs alone
- see something on film that is not there
- failing to see something on film that is there
what is a “Bullseye” on an x-ray
a facial or lingual root tip curving towards x ray
what population often has a 4th DL root
Native American and Asian populations
how to determine length of canal
place file of known length into canal and take radiograph
work and fill 1 mm short of canal exit!
how to determine which canal you are seeing on radiograph?
take straight on PA and a shift shot PA
-remember the direction x ray tube moved
lower molar XR cone shifted mesially
what will you see?
the MB canal will shift distal (OB)
the ML canal will shift mesially (SL) in the same direction as cone
lower molar XR cone shifted distally
what will you see?
MB canal shifts mesial
ML canal shifts distal (w/ the cone)
SLOB
what are 2 common LEOs
thickened PDL
PARL
thickened PDL proves a LEO
NO
must see whole tooth to determine LEO, plus clinical tests
-could be bc of caries or trauma
PARL means LEO
As long as clinical testing and other indications show along w/ radiographs, then yes
- A LEO is often associated w/ necrotic pulp (but not always)
if the LEO does not shift when shifting the cone, what does this mean?
the LEO is associated w/ the tooth it is on
-this is characteristic of LEOs!
what are possible LEOs
abscess
cyst
granuloma
-must perform biopsy to actually dx, not just x ray
where do we see maxillary sinus
often superimposed on maxillary posterior apices
-examine lamina dura carefully at apex, PDL should be uniform for WNL
where do we see nasal cavities
often superimposed over max central and lateral incisors, both sides
-pathology is seldom bilaterally symmetrical
lamina dura and pulp tests are key to differential diagnosis
YES, must determine if LEO or normal anatomical landmark
incisive foramen/canal will move away from apex when cone is shifted
YES
-if the radiolucency moves w/ the cone on multiple films, then probably not a PARL
what is the most common landmark mistaken for a LEO
mental foramen
-it will move away from apex if cone shifts
-confirm w/ pulp test, intact lamina dura
if a radiolucency moves with the apex on multiple films, what does this mean?
the radiolucency might be a LEO and is associated w/ the apex of that tooth
bilateral lesions often indicate a LEO
no, most LEOs are not bilateral until proven otherwise
