The clinical value of X-ray images of the teeth and jaws Laetitia BROCKLEBANK University of Glasgow, Scotland © l.m.brocklebank 1
Wilhelm Roentgen 27.03.1845 Lennep 8.11.1895 Wurzburg © l.m.brocklebank
von Kölliker’s 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 39 25
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: 60-70 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 deciduous - 20: incisors - 8 canines - 4 premolars - 0 molars - 8 permanent - 32: incisors - 8 canines - 4 premolars - 8 molars - <12 © 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 * Neoplastic, odontogenic 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 © l.m.brocklebank
© l.m.brocklebank