1. The upper jaw (maxillae)
Radiographic Anatomy
First lecture
The upper jaw (maxillae)
Leif Kullman
Assoc. Prof.
OMF Radiology

2. As you know is x-rays an important tool to diagnose
different diseases
The radiographic recognition of disease requires a sound knowledge of the radiographic appearance of normal structures That’s why we will start already now with anatomy

3. First some definitions
Radio-opaque
=White or gray areas
Metal – enamel – dentin - bone
Radiolucency
=Black areas
Less grey than neighboring area
white

4. Findings in radiographs
Hard tissues, such as bones and teeth
=radiopaque view
Anatomic landmarks
foramens, cavities are radiolucent
and bone ridges radiopaque
Cysts
bone lesion visible as cavity = radiolucency
Fillings
amalgam as white areas
composites as grey areas, less radio-opaque than teeth
root canal filling as grey, more radio-opaque than tooth
Prosthodontic appliances
crowns =radiopaque

5. Facial bones and some landmarks visible in dental radiographs of the upper jaw. We will concentrate on the upper jaw today
Upper jaw region----some basic structures to start with
Maxilla
Zygomatic bone
Nasal cavity
Maxillary Sinus
Orbit

7. Different dental radiographs
Periapical x-ray
Bite wing
small x-ray showing crowns of teeth
Occlusal x-ray
showing teeth from above, along the axis of teeth
Panoramic view
OPG showing all teeth, jaws and surroundings
Lateral view
Posterior-anterior view
Tomographic methods
especially
CT= computed tomography, based on radiation
MRI= magnetic resonance imaging, based on magnetic fields
All these intraoral x-rays
All these extraoral x-rays…..what’s that?

8. Extra-oral Radiography
Include all views made of the orofacial region with the film positioned extra-orally.
Used to visualize the skull and facial structures, for detection of disease or injury or to evaluate skeletal growth.
All extra oral radiograph require screen film and intensifying screen, that’s why
they will only give us a low radiation dose
even if they are quite big
(the screen will enhance the ‘small’
radiation coming)

9. Occlusal view but nor normal anatomy!

10. Periapical x-ray (intraoral ones)

11. A FMS or CMS can be taken
9 in the upper and 7 in the lower jaw
and 4 bitewings

12. Normal findings in x-rays
Teeth
dentin and enamel have different shades
due to variation in mineralization
radiopacity: enamel – dentin – pulp
cemento-enamel junction should be recognized
Periodontium
lamina dura
thin layer of dense bone surrounding the root
periodontal ligament space
thin radiolucent area between root and lamina dura
alveolar crest
bone that extens between the teeth
normal level no more than 1,5 mm from cemento-enamel junction

13. Normal bone findings in x-rays
cortical bone
superficial layer of all bones
better visible in mandible than in maxilla
dense and hard bone
cancellous bone
s.c. trabecular bone
trabeculation varies
net-like appearance

14. Today the upper jaw!!

15. Normal findings in x-rays, upper jaw
Intermaxillary suture
visible in occlusal radiographs
Anterior nasal spine
visible in periapical radiograph
Incisive foramen
visible in periapical or occlusal radiograph
Maxillary sinus
in OPG and periapical x-rays
Zygomatic process
in opg and periapical x-rays

17. A1 j i k L a c b d e f g h Name the following structures a enamel
b dentin
c enamel-dentin junction
d pulp horn
e pulp chamber
f root canal
g furcation area
h cancellous bone between the roots
i furcation area…..enamel pearl?
j lamina dura
k PDL space
l lamina dura (approximal) i k L a c b d e f g h

18. Locate the radiographic apices of these teethb a
Identify the teeth: 21, 22, 23
(24, 25)
Locate the radiographic
apices of these teeth c d
Name the structures:
a floor of nasal fossa
b inverted Y (crossing sinus max-nasal cavity)
c floor of sinus max
d soft tissue of the nose

19. The lateral fossa
between the lateral
and the canine

20. Upper anterior

21. a d c b e 12, 11; 21 22 a nasal septum b nasal mucosa g c nasal fossa
Identify the teeth and name the
structures e d
12, 11; 21 22
a nasal septum
b nasal mucosa
c nasal fossa
d floor of the nasal fossa
e anterior nasal spine
f intermaxillary suture
g incisive foramen
h soft tissue of the nose g f h

22. a
Identify the teeth and
name the structures b f
Identify the teeth: 14, 13, 12
a floor nasal cavity
b floor sinus max
c filling, plastic
d filling in plastic
e PDL of the second root
f Lateral fossa e d c

23. Canine view/x-ray

24. Identify the teeth:
and name the structures a b d
Identify the teeth:
21, 22, 23, 24, 25, 63, 64, 65
Estimate the age: 8-9 y
a floor nasal fossa
b bony crypt
(developing tooth)
c follicular space
d not fully formed root . c

25. Premolar and
molar view

26. B1 a c b d Locate the radiographic apexes of these teeth.
Name the structures
a zygomatic arch
bZygomatic bone inferior border
c tooth bud
d follicular space

27. B2 a c d b Locate the radiographic apexes of these teeth.
Name the following structures
a lateral part of floor of nasal fossa
b sinus max inferior border
c septum in sinus max
d posterior wall of SM

28. d c a b Identify the teeth and name the strucures Identify the teeth:
17 to 27 (55 to 53, 63 to 65)
Name the following structures
a Nasal septum, intermaxillary suture
b superior foramina of the nasopalatine canal
c sinus max
d nasolacrimal duct

30. B4 d d c b a b tuberosity a Proc. Coronoideus c pterygoid plates
d proc. Zygomaticus
Locate the radiographic apices of these teeth
Name the following structures

31. B5 a b f c e d Identify the area and name structures
Identify the area:upper anterior (midline), edentulous patient
Name the following structures
a nasal fossa
b mucosa of nasal fossa
c floor of nasal cavity
d nose
e nose opening
f anterior nasal spine e d

32. Thanks for today….now answer this question!!