1. The clinical value of X-ray images of the teeth and jaws
Laetitia BROCKLEBANK
University of Glasgow, Scotland
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2. Wilhelm Roentgen 27.03.1845 Lennep 8.11.1895 Wurzburg
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3. von Kölliker’s hand
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4. why X-ray the teeth and jaws?
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5. Abnormalities affecting the teeth and jaws
developmental
traumatic
inflammatory
cystic
neoplastic
osteodystrophies
metabolic/systemic
idiopathic
foreign bodies
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6. Presentation plan what is a radiographic image?
radiographic views for teeth and jaws
critical production factors
types of abnormalities
normal dental development
examples
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7. Image - radiographic image
a pictorial representation of a part of the body
a record of the pattern of attenuation of the X-ray beam after it has passed through matter
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8. Dental radiographic views
Intra-oral
bitewings
periapicals
occlusals
Extra-oral
panoramic
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9. Bitewings side teeth (premolars and molars)
symmetry of upper and lower teeth
minimal overlap of adjacent teeth
inter-dental bone
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10. Periapical shows the full length of at least one tooth peri = around
apical - the apex or tip of the tooth
surrounding anatomical features
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11. Periapical similar to a zoom image
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12. Panoramic like a wide-angle view
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13. Occlusal radiography
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14. Critical production factors
adequate kV: for intra-orals
fastest image receptor available – F, E or digital
correct positioning: use of film holders
correct horizontal and vertical angulation
appropriate collimation
correct exposure time
proper processing facilities
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15. Abnormalities affecting the teeth and jaws - examples
developmental
traumatic
inflammatory
cystic
neoplastic
osteodystrophies
metabolic/systemic
idiopathic
foreign bodies
artefacts
iatrogenic
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16. Normal dental development
deciduous - 20:
incisors
canines
premolars - 0
molars
permanent - 32:
incisors
canines
premolars - 8
molars <12
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17. Dental development and abnormalities
number
increase or decrease
position
form
individual or multiple
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18. Inflammatory lesions tooth - dental caries (decay)
supporting structures
periodontal disease - bone level
around the root tip
bone - inflammation and infection
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19. Cystic lesions of the jaws
odontogenic
radicular
dentigerous
keratocyst
non-odontogenic
nasopalatine
solitary bone cyst
Stafne cavity
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20. Neoplastic, odontogenic
benign
cementomas
cementifying fibroma
myxoma
ameloblastoma *
adenomatoid odontogenic tumour
calcifying epithelial odontogenic tumour
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21. Neoplastic, odontogenic
ameloblastoma *
Neoplastic, odontogenic
male, 15, clinical expansion
definite root resorption
thinning of cortex lingually
no cortex evident buccally
findings suggest a locally aggressive lesion
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22. What do you see?
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23. family group
Bart van der Leck
The family, 1921
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24. Hidden pathology
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25. © l.m.brocklebank