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BDS4 Radiology > Radiographic Interpretation > Flashcards

Radiographic Interpretation Flashcards

1
Q

What abnormalities are less commonly seen on radiographs?

A
  • jaw lesions
    • cysts
    • tumours
    • benign neoplasms
    • developmental abnormalities
  • supernumeraries
  • foreign bodies
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1
Q

What abnormalities are commonly seen on radiographs?

A
  • caries
  • periodontal bone loss
  • periapical granulmas
  • impacted teeth
  • missing teeth
  • skeletal relationships
  • monitoring root canal treatment
  • monitoring traumatised teeth
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2
Q

Are the majority of lesions radiolucent or radiopaque?

A

radiolucent

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3
Q

What are the three options in the first step of differential diagnosis pf any lesion radiographically?

A
  • anatomical
  • artifactual
  • pathological
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4
Q

What are the 7 sections that should be included in a lesion description?

A
  1. site
  2. size
  3. shape
  4. margins
  5. internal structure
  6. effect on adjacent anatomy
  7. number
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5
Q

When describing the site of a lesion, what should be included?

A
  • where is it?
    • alveolar bone or basal bone
    • mandible or maxilla or other
  • is there a notable relationship to structures?
    • teeth
      • whole tooth
      • root
      • apex
      • follicle
    • inferior alveolar canal
    • nasopalatine canal
  • what is its position relative to structures
    • inferior alveolar canal
      • below are unlikely odontogenic
    • maxillary sinus floor
      • above are unlikely to be odontogenic
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6
Q

When describing the size of a lesion, what should be included?

A
  • measurement of dimensions
  • description of boundaries
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7
Q

When describing the shape of a lesion, what should be included?

A
  • general
    • rounded
    • scalloped
    • irregular
  • jocularity
    • unilocular
    • pseudolocular
    • multilocular
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8
Q

When describing the margins of a lesion, what should be included?

A
  • well defined
    • corticated
      • suggested benign
    • non-corticated
  • poorly defined
    • blending into adjacent normal anatomy
    • moth eaten
      • suggests malignancy
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9
Q

When describing the internal structure of a lesion, what should be included?

A
  • entirely radiolucent
  • radiolucent with some internal radiopacity
  • radiopaque
    • homogenous
    • heterogeneous
  • amount
    • scant
    • multiple
    • dispersed
  • bony septae
    • thin or coarse
    • prominent or faint
    • straight or curved
  • particular structure
    • enamel and dentine radiodensity
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10
Q

What can make jaw lesions radiolucent?

A
  • resorption of bone
  • reduced mineralisation of bone
  • reduced thickness of bone
  • replacement of bone with abnormal tissue
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11
Q

What can make jaw lesions radiopaque?

A
  • increased thickness of bone
  • osteosclerosis of bone
  • presence of abnormal tissue
  • mineralisation on non-mineralised tissue
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12
Q

When describing involvement of a tooth in a jaw lesion, what should be included?

A
  • position
    • apices
    • at the side of the root
    • around the crown
    • around the entire tooth
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13
Q

When describing the effect of a jaw lesion on adjacent anatomy, what should be included?

A
  • bone
    • displacement of cortices
    • perforation of cortices
    • sclerosis of trabecular bone
  • inferior alveolar canal/maxillary sinus/nasal
    • displacement
    • erosion
    • compression
  • teeth
    • displacement/impaction
    • resorption
    • loss of lamina dura
    • widening of PDL space
    • hypercementosis
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14
Q

When describing the number of jaw lesions, what should be included?

A
  • majority occur alone
  • some pathologies occur bilaterally
  • if multiple lesions present, suspect syndrome
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15
Q

What are the potential causes of a periapical radiolucency?

A
  • periapical granuloma
  • periapical abscess
  • radicular cyst
  • perio-endo lesion
  • cemento-osseous dysplasia (early stage)
  • surgical defect (after peri-radicular surgery)
  • fibrous healing defect (resolution of lesion)
  • ameloblastoma occurring next to tooth §
16
Q

What must be used along side radiographs to diagnose a periapical radiolucency?

A
  • clinical signs and symptoms
  • condition of tooth, treatment history
  • periodontal condition
  • patient demographic
17
Q

When might a benign cyst mimic a malignancy radiographically?

A
  • infection
    • can lose well-defined, corticated margins
  • clinical features of secondary infection
    • pain
    • soft tissue swelling, redness, hotness
    • purulent exudate
18
Q

Most lesions appear radiolucent, when which structure is affected does the lesion become radiopaque and why?

A
  • expansion into maxillary sinus
    • lesion surrounded by air
19
Q

What are 5 important points to note when attempting to diagnose jaw lesions?

A
  1. infected cysts can lose their well-defined, corticated margins
  2. most jaw lesions will inevitable be near a tooth, it does not mean a tooth is associated
  3. early lesions are small regardless of pathology
  4. the term radiolucent is relative
  5. be flexible with pathology presentations
20
Q

In what way might jaw lesions present differently from the textbook definition?

A
  • any cyst can become symptomatic
    • infected/inflamed
  • well-defined corticated margins can be lost
    • lesion infected or inflamed
  • external root resorption can occur
    • most lesions is abutting a tooth for long
  • internal ‘dystrophic’ calcification
    • can form in any chronic cyst
    • especially if inflamed
21
Q

What radiopacities might be picked up incidentally on a radiograph?

A
  • idiopathic osteosclerosis
  • sclerosis osteitis
  • hypercementosis
  • buried retained roots
  • unerupted teeth, including supernumeraries
22
Q

What is idiopathic osteosclerosis?

A
  • localised area of increased bone density with an unknown cause
    • no association with inflammatory process
    • asymptomatic
    • potential relevance to orthodontist
      • challenging to move tooth through
      • increased risk of root resorption
  • may be called dense bone island or enostosis
  • most common in premolar-molar region of the mandible
23
Q

What is the radiographic presentation os idiopathic osteosclerosis?

A
  • well defined radiopacity
    • often homogenous
      • slightly radiolucent internal areas
    • no radiolucent margin
  • variable shape
    • round
    • elliptical
    • irregular
  • usually <2cm in size
  • not associated with teeth
    • often appears next to teeth
    • teeth not displaced
    • no effect on PDL
24
Q

What is sclerosis osteitis?

A
  • localised area of increased bony density in response to inflammation
    • low grade, chronic inflammation
    • may have concurrent symptoms
      - usually from source of inflammation
    • no expansion or displacement
      • adjacent structures
  • can also be called condensing osteitis
25
Q

What is the radiographic presentation of sclerosis osteitis?

A
  • well-defined or poorly defined
  • variable shape
  • directly associated with source of inflammation
    • apex of necrotic tooth
    • infected cyst
26
Q

How can idiopathic osteosclerosis and sclerosing osteitis be told apart?

A

if there is a source of inflammation, it is sclerosing osteitis, if not it is idiopathic osteosclerosis

27
Q

What is hypercementosis?

A
  • excessive deposition of cementum around the root
    • non-neoplastic and asymptomatic
    • tooth vital
      • necrosis due to another reason
  • cause unknown
    • more common in certain conditions
      • Paget’s disease
      • acromegaly
  • extractions more challenging
28
Q

How does hypercementosis present radiographically?

A
  • single or multiple teeth involved
    • entirety of root
    • section of root
  • homogenous radiopacity continuous with root surface
    • radiodensity subtly different to dentine of root
  • PDL space of tooth extends around periphery
  • margins well-defined and often smooth
    • can be irregular
29
Q

Why might retained roots occur and how are they managed?

A
  • remnants of failed extractions or heavily broken-down teeth
  • management only required if infected, symptomatic or hampering treatment (e.g. implant placement)
30
Q

How do retained roots present radiographically?

A
  • can become unclear in case of inflammation
    • external root resorption
    • sclerosis osteitis of adjacent bone
    • diffuse radiopacity

BDS4 Radiology (3 decks)

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