Normal Anatomical Landmarks

Anterior Maxilla Nasal fossa Nasal septum Anterior nasal spine Nasal cartilage Inferior conche Median palatine suture

Intraoral Radiographs : Case 1 Maxillary Centrals: 1 = Anterior nasal spine 2 = Right lateral wall of nasopalatine canal 3 = Mid palatal suture 4 = Inf. Floor of nasal fossa (cavity) 5 = Nasopalatine foramen 6 = Shadow of the soft tissue of the nose 7 = Alveolar crest Stuart C. White, DDS, PhD., UCLA School of Dentistry Normal Radiographic Anatomy Online Course in Oral Radiology (DS451c) Identify the following radiographic features labeled 1-7: Incisive foramen

Floor of nasal fossa (red arrows) and anterior border of maxillary sinus (blue arrows), forming the inverted (upside down) Y. Y facial view

Premolar Maxilla Sinus septa Floor of maxillary sinus maxillary sinus

Molar Maxilla Malar bone Maxillary tuberosity Pterygoid plates Coronoid process

The zygomatic process (green arrows) is a prominent U- shaped radiopacity. Normally the zygomatic bone posterior to this is very dense and radiopaque. In this patient, however, the maxillary sinus has expanded into the zygomatic bone and makes the area more radiolucent (red arrows). The coronoid process (orange arrow), the pterygoid plates (blue arrows) and the maxillary tuberosity (pink arrows) are also identified.

Alveolar Features Anterior Mandible 1 = Alveolar crest 2 = Lamina dura 3 = Mesial root surface 4 = Trabeculae Provided and reproduced with kind permission of Stuart C. White, DDS, PhD., UCLA School of Dentistry Normal Radiographic Anatomy Online Course in Oral Radiology (DS451c)

Lingual foramen. Radiolucent “hole” in center of genial tubercles. Lingual nutrient vessels pass through this foramen. Radioopaue circle around it is the genial tubercles. Mental ridge

Anterior Mandible Lingual foramen Genial tubercles Lower lip line Lower border of mandible

Nutrient canals

Mental fossa

Mental foramen

a b c dd a = external oblique ridge b = mylohyoid ridge c = mandibular canal d = submandibular gland fossa

Molar Mandible Berry HM. Radiologic Anatomy of the Jaws. University of Pennsylvania Press, Philadelphia 1982.

Mylohyoid ridge (internal oblique). Located on the lingual surface of the mandible, extending from the third molar area to the premolar region. Serves as the attachment of the mylohyoid muscle. Radiolucent area under it is the submandibular salivary gland fossa. lingual view

Lesions related to the teeth and their investing structures

Advanced caries

Recurrent caries

Occlusal caries

Recurrent caries

Full metal crowns causing periodontal local problem between first premolar and canine (moderate periodontitis) Severe caries

Occlusal caries Severe caries Advanced caries Moderat caries

Moderate caries

Moderate caries and moderate periodontitis around premolar

ROOT SURFACE CARIES: as result of moderate periodontitis, Horizontal alveolar bone loss

example of a composite restorative material that appears radiolucent and resembles dental caries on a radiograph. The appearance of an anterior cavity preparation restored with this material differs from the appearance of interproximal decay and can be identified by the well-defined, smooth outline.

Moderate to severe periodontitis (buccal and lingual cortical plates resorbed unequally)

Mild adult periodontitis

Loss of bone in the furcation area: severe periodontitis

Local aggressive periodontitis : vertical alveolar bone loss)

Severe periodontitis: calculus deposits – horizontal alveolar bone loss)

Internal resorption

Gutta percha and silver points

Periodontal abscess

Lateral periodontal cyst

Radiographic Interpretation

Radiolucent Lesions

Mixed, periapical, well-defined, non corticated (Periapical cemental dysplasia)

Infected radicular cyst

Infected radicular cyst

radicular cyst, or granuloma

Radiolucent, poorly defined border, periapical, resorption, irregular : infected cyst or chronic abcess

Radiolucent, corticated border,periapical cyst or granuloma

Radiolucent, well defined border, periapical, resorption Infected cyst or periapical scar

Radicular cyst

Radicular cyst, grauloma, Periapical scar due to endo ttt

Surgical defect

Periapical scar or surgical defect: Healing lesion

Condensing ostitis

Follicular space

Dentigerous cyst

Mixed, pericoronal, unilocular, well-defined borders (Adenomatoid odontogenic tumor)

Multilocular, radiolucent, corticated, pericoronal (Dentigerous cyst)

Unicystic Ameloblastoma

Calcifying epithelial odontogenic tumor: has several radiographic appearances usually mixed

Pericoronal odontogenic keratocyst

Lateral radicular cyst radicular cyst

Lateral periodontal cyst

Globulomaxillary or lateral radicular cyst

Globulomaxillary cyst (vital teeth) OR lateral radicular (non-vital teeth)

Traumatic bone cyst

Incisive canal cyst

Median palatine cyst

Residual cyst

Multilocular dentigerous cyst: Multilocular cysts may also be keratocyst, primordial, residual cyst

Soap-bubble (ameloblastoma)

Ameloblastoma

Ameloblastoma : soap-bubble or honeycomb

Central giant cell granuloma

Odontogenic keratocyst

Odontogenic myxoma: Fine intra-lesional trabeculations

Central Hemangioma : coarse, linear Trabeculae that appear to radiate from the center of the lesion.

Cherebism

Mixed Lesions

PeriapicalCementoossous dysplasia dysplasia

Compound Odontoma

Complex odontoma

Calcifying epithelial odontogenic tumor

Mixed, pericoronal, unilocular, well-defined borders (Adenomatoid odontogenic tumor)

Radioopaque Lesions

Condensing ostits

Periapical idiopathic idiopathic osteoscelerosis osteoscelerosis

Unerupted tooth

Hypercementosis

Mature periapical cementoosseous dysplasia cementoosseous dysplasia

Mature periapical cementoosseous dysplasia

Supernumary teeth

Mature focal cementoosseous dysplasia

Proliferative periostitis: New reactive buccal layers of bone formation (onion skin appearance)

Osetoma

Cementyfing ossifying fibroma: Various bone patterns

Calcified salivary gland