Radiographic Examination

Question 1

What are the six important radiographic features that should be studied during radiographic examination?

Answer 1

1. Crestal Lamina Dura
2. Furcation
3. PDL space
4. apex
5. CEJ
6. Radicular Lamina Dura

Question 2

True or False: Radiographs are appropriate for diagnosing periodontal disease.

Answer 2

False: NOT DIAGNOSTIC

Question 3

What are the CAL values for slight, moderate, and severe?

Answer 3

1-2 slight
3-4 moderate
>=5 severe

Question 4

What could a widened PDL potentially indicate?

Answer 4

occlusal trauma

Question 5

What is the formula for calculating the bone loss percentage?

Answer 5

%bone loss = (CEJ to crest-2mm) / (CEJ to apex-2mm)

CEJ is always the reference point: 
-->crest (top)
-->apex(bottom)
severe bone loss =>50%
moderate bone loss 21-49%

Question 6

Calculating the amount of bone loss can be skewed if the ________ is incorrect.

Answer 6

angulation of the vertical beam of the x-ray

Question 7

The height of the alveolar crest should lie approximately ____ apical to the CEJs of adjacent teeth.

Answer 7

2 mm (…notice “adjacent” teeth)

Question 8

The normal crest of alveolar bone follows the ______.

Answer 8

CEJ (remember, just because it is slanted doesn’t mean there is vertical bone loss)

Question 9

True or False: The integrity of crestal lamina dura can be used as an indicator for periodontal treatment.

Answer 9

FALSE: using crestal lamina dura is NOT appropriate; it is not related to the presence or absence of inflammation, BOP, pocketing, or attachment loss

Question 10

What are the two patterns of bone loss?

Answer 10

vertical(angular) and horizontal

Question 11

Osseous defects are classified by the number of ______ ______.

Answer 11

Remaining Walls (3,2,1)

Question 12

What is a “hemiseptal defect”?

Answer 12

a vertical defect in the presence of adjacent roots, thus half a septum remains on one tooth (bone loss is greater on one tooth than the other) = ONE WALLED defect

Question 13

When pocket depths on the buccal and lingual line angles remain at height but the area under the contact is much deeper (bowl or crater), a _____-walled defect is present.

Answer 13

two

Question 14

A shallow crater in the interalveolar bone would be indicative of _____; whereas, deep craters would indicate ______.

Answer 14

osseous surgery

GBR

Question 15

True or False: Craters show up on periapical films.

Answer 15

True

Question 16

An intrabony resorptive lesion involving one or more surfaces of supporting bone is referred to as a ______ defect.

Answer 16

moat-like

Question 17

Radiolucency between two roots indicates pathologic resorption of bone within a ______.

Answer 17

furcation

Question 18

PA radiographs are seen in 2-dimensions, what is the 3D method of detection that is currently in use?

Answer 18

CBCT

Question 19

Furcation involvement appears differently on maxillary and mandibular molars. Mandibular appear as radiolucent _______.

Answer 19

arrows (pointing upward)

Question 20

What endo device can be used to detect furcation involvement on xray film?

Answer 20

gutta-purcha points

Question 21

What is “normal” PDL space?

Answer 21

PDL is the space between the tooth root and alveolar bone; the PDL appears as 0.4 to 1.5 mm ON RADIOGRAPHS, it is wider at the apex and alveolar crest and narrow in the mid-root areas

Question 22

The presence of ________ and _______ would indicate possible occlusal trauma.

Answer 22

Thickened radicular lamina dura

widened PDL space

Question 23

The trabecular pattern and gradient is describes as either ____ or _____.

Answer 23

loose (rarified) or dense

Question 24

There is more trabecular patterning in the ______ and _____ portion of the mandible.

Answer 24

superior

anterior

Question 25

A loose trabecular pattern is possibly indicative of _______ but not an indicator of periodontal disease.

Answer 25

sickle-cell anemia

Question 26

How do vessels within interdental bone appear on a radiograph?

Answer 26

as radiolucent lines bordered by thin radiopaque lines

Question 27

If the ________ is close to or has invaginated among the roots of the maxillary teeth, there may be difficulties with surgical treatment of periodontal problems (fistula)

Answer 27

Maxillary sinus

Question 28

Mandibular tori are lingual exostostes that are commmonly located in the _______-_____ region.

Answer 28

premolar-molar | usually bilateral

Question 29

How far forward can the mental foramen be found? How far posterior can it be found?

Answer 29

as far anterior as the DISTAL of the 1st PREMOLAR as far posterior as the MESIAL of the 1st MOLAR (a little different from what Dr.I said)

Question 30

If roots are less than ______mm apart, periodontal bone loss will affect the entire interproximal .

Answer 30

2.5 mm

Question 31

The crown to root ratio is a _____ measurement and does not take into account other morphological factors such as _____ and ______.

Answer 31

linear root number shape

Question 32

What is the difference between internal and external root resorption?

Answer 32

Internal resorption: resorption beginning from within the pulp external resorption: resorption beginning on the external surface

Question 33

_______ _______ Radiography can give you as much as 5% bone change detection compared to 30% using other methods.

Answer 33

Digital Subtraction

Question 34

When observing a PA film, how should implants appear?

Answer 34

you should be able to see the threads of the implant sharply. Blurring of the lines indicates an incorrect angulation