Radiographic Examination

Question 1

T/F - Radiographs are diagnostic of periodontal disease

Answer 1

False - Radiographs can help us see clinical attachment loss that is caused by periodontitis

Question 2

T/F - Radiographs are diagnostic of periodontal disease

Answer 2

False - Radiographs can help us see clinical attachment loss that is caused by periodontitis

Question 3

What can radiographs tell us about the alveolar bone/bone loss

Answer 3

Amount of bone loss

Condition of the alveolar bone

Pattern of bone loss

Bone with loss in furcation areas

Width of the PDL space

Pathogenics

Anatomical considerations

Root proximity and C/R ratios

Question 4

How do you calculate bone loss?

Answer 4

(CEJ - Crest) / (CEJ - apex) = bone loss percentage

Question 5

What percentage of bone loss is considered ‘slight’?

Answer 5

<20%

Question 6

What percentage of bone loss is considered ‘moderate’?

Answer 6

21-49%

Question 7

What percentage of bone loss is considered ‘severe’?

Answer 7

≥50%

Question 8

Why is correct Vertical beam angulation important?

Answer 8

If vertical angulation is incorrect, it can make the bone levels appear different than they actually are

Question 9

What is the normal height of the alveolar crest?

Answer 9

2mm below the level of the CEJs on adjacent teeth

Question 10

Why do crestal changes occur during inflammation?

Answer 10

Pathogens start to destroy the alveolar crest

Question 11

When looking at the crestal lamina dura, how do we determine if it “has integrity”

Answer 11

If the crestal lamina dura is continuous, then it has integrity

Question 12

When looking at the crestal lamina dura, how do we determine if it “has integrity”

Answer 12

If the crestal lamina dura is continuous, then it has integrity

Question 13

What can radiographs tell us about the alveolar bone/bone loss

Answer 13

Amount of bone loss Condition of the alveolar bone Pattern of bone loss Bone with loss in furcation areas Width of the PDL space Pathogenics Anatomical considerations Root proximity and C/R ratios

Question 14

How do you calculate bone loss?

Answer 14

(CEJ - Crest) / (CEJ - apex) = bone loss percentage

Question 15

What percentage of bone loss is considered ‘slight’?

Question 16

What percentage of bone loss is considered ‘moderate’?

Answer 16

21-49%

Question 17

What percentage of bone loss is considered ‘severe’?

Answer 17

≥50%

Question 18

Why is correct Vertical beam angulation important?

Answer 18

If vertical angulation is incorrect, it can make the bone levels appear different than they actually are

Question 19

What is the normal height of the alveolar crest?

Answer 19

2mm below the level of the CEJs on adjacent teeth

Question 20

Why do crestal changes occur during inflammation?

Answer 20

Pathogens start to destroy the alveolar crest

Question 21

T/F - We can use the integrity of the crestal lamina dura on radiographs to indicate the need for periodontal treatment

Answer 21

False - We have to use this information and also observe clinically before we can make an assessment

Question 22

When looking at the crestal lamina dura, how do we determine if it “has integrity”

Answer 22

If the crestal lamina dura is continuous, then it has integrity

Question 23

Vertical bone loss v horizontal bone loss

Answer 23

Horizontal = bone loss occurs on the same plane Vertical = bone loss occurs steeper in one area

Question 25

How can you determine if an osseous defect is a 1, 2, or 3-walled defect?

Answer 25

Count the remaining osseous walls (ones that haven't been destroyed) If there is 1 remaining wall = 1 walled-defect If there are 2 remaining walls = 2-walled defect If there are 3 remaining walls = 3-walled defect

Question 26

What is an osseous crater?

Answer 26

A two-walled defect where the buccal and lingual walls are intact, but the proxmial bone is deficient

Question 27

What type of radiographs can you view osseous craters?

Answer 27

Periapical film (may not show up on BW)

Question 28

What is a Moat-like defect

Answer 28

An intrabony resorptive lesion involving one or more surfaces of supporting bone

Question 29

Bone loss in the furcation areas

Answer 29

Pathologic resorption of bone within a furcation Shows up radiographically as a radiolucency in the furcation areas

Question 30

How can you detect furcation involvment?

Answer 30

Gutta-percha point on X-ray film

Question 31

What does a normal PDL look like on a radiograph?

Answer 31

The space between the tooth root and alveolar bone containing the PDL The PDL appears as the PDL space of 0.4-1.5 mm on radiographs Tends to be wider at the apex and alveolar crest Tends to be narower in the mid-root areas

Question 32

What is a thickend radicular lamina dura and a widened PDL space a sign of?

Answer 32

Occlusal Trauma

Question 33

Where in the mouth are there more trabeculae?

Answer 33

Anteriorly and Superiorly

Question 34

What do vessels within interdental bone look like radiographically?

Answer 34

They appear as thin lines bordered by radiopaque lines in the bone traveling up towards the teeth

Question 35

Why can the maxillary sinus be an issue?

Answer 35

IF the maxillary sinus is close to or has invaginate among the roots of the maxillary teeth, there may be difficulties with surgical treatment of the periodontal problems

Question 36

Mandibular Tori radiographical image

Answer 36

A bony exostosis on the lingual aspect of the mandible Seen generally in the premolar-molar area bilaterally

Question 37

Where is the mental foramen seenradiographically?

Answer 37

The image of the mental foramen can be seen as far forward as the distal of the first premolar and as far posteriorly as the mesial of the first molar

Question 38

What is a potential issue of roots in close proximity?

Answer 38

If roots are less than 2.5 mm apart, periodontal bone loss will affect the entire interproximal area

Question 39

What can Crown-Root ratio help us determine?

Answer 39

Can help us determine the patient's prognosis related to periodontitis 1: 2 C:R ratio is ideal, and is favorabole 2: 1 ratio is unfavorable

Question 40

What are the different types of root resorption

Answer 40

Internal resorption External resorption

Question 41

Internal resorption

Answer 41

Tooth resorption beginning from within the pulp

Question 42

External resorption

Answer 42

Reorption of tooth structure beginning on the external surface

Question 43

If a radiograph shows an implant with blurred threads, what does this indicate?

Answer 43

Unacceptable angulation of the X-ray tube