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© l.m.brocklebank The clinical value of X-ray images of the teeth and jaws Laetitia BROCKLEBANK University of Glasgow, Scotland
© l.m.brocklebank Wilhelm Roentgen Lennep Wurzburg
© l.m.brocklebank von Köllikers hand
© l.m.brocklebank why X-ray the teeth and jaws ?
© l.m.brocklebank Abnormalities affecting the teeth and jaws developmental traumatic inflammatory cystic neoplastic osteodystrophies metabolic/systemic idiopathic foreign bodies
© l.m.brocklebank Presentation plan what is a radiographic image? radiographic views for teeth and jaws critical production factors types of abnormalities normal dental development examples
© l.m.brocklebank 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
© l.m.brocklebank Dental radiographic views Intra-oral bitewings periapicals occlusals Extra-oral panoramic
© l.m.brocklebank Bitewings side teeth (premolars and molars) symmetry of upper and lower teeth minimal overlap of adjacent teeth inter-dental bone
© l.m.brocklebank Periapical shows the full length of at least one tooth peri = around apical - the apex or tip of the tooth surrounding anatomical features
© l.m.brocklebank Periapical similar to a zoom image
© l.m.brocklebank Panoramic like a wide-angle view
© l.m.brocklebank Occlusal radiography
© l.m.brocklebank 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
© l.m.brocklebank Abnormalities affecting the teeth and jaws - examples developmental traumatic inflammatory cystic neoplastic osteodystrophies metabolic/systemic idiopathic foreign bodies artefacts iatrogenic
© l.m.brocklebank Normal dental development permanent - 32: – incisors - 8 – canines - 4 – premolars - 8 – molars - <12 deciduous - 20: – incisors - 8 – canines - 4 – premolars - 0 – molars - 8
© l.m.brocklebank Dental development and abnormalities number – increase or decrease position form – individual or multiple
© l.m.brocklebank Inflammatory lesions tooth - dental caries (decay) supporting structures – periodontal disease - bone level – around the root tip bone - inflammation and infection
© l.m.brocklebank Cystic lesions of the jaws odontogenic – radicular – dentigerous – keratocyst non-odontogenic – nasopalatine – solitary bone cyst – Stafne cavity
© l.m.brocklebank Neoplastic, odontogenic benign – cementomas – cementifying fibroma – myxoma ameloblastoma * adenomatoid odontogenic tumour calcifying epithelial odontogenic tumour
© l.m.brocklebank Neoplastic, odontogenic ameloblastoma * male, 15, clinical expansion definite root resorption thinning of cortex lingually no cortex evident buccally findings suggest a locally aggressive lesion
© l.m.brocklebank What do you see?
© l.m.brocklebank family group Bart van der Leck The family, 1921
© l.m.brocklebank Hidden pathology
Without reference, identify principles relating to Intraoral X-Ray with at least 70 percent accuracy.
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