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The clinical value of X-ray images of the teeth and jaws
Laetitia BROCKLEBANK University of Glasgow, Scotland © l.m.brocklebank 1
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Wilhelm Roentgen 27.03.1845 Lennep 8.11.1895 Wurzburg
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von Kölliker’s hand © l.m.brocklebank
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why X-ray the teeth and jaws
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Abnormalities affecting the teeth and jaws
developmental traumatic inflammatory cystic neoplastic osteodystrophies metabolic/systemic idiopathic foreign bodies © l.m.brocklebank
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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
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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
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Dental radiographic views
Intra-oral bitewings periapicals occlusals Extra-oral panoramic © l.m.brocklebank 39 25
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Bitewings side teeth (premolars and molars)
symmetry of upper and lower teeth minimal overlap of adjacent teeth inter-dental bone © l.m.brocklebank
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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
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Periapical similar to a zoom image
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Panoramic like a wide-angle view
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Occlusal radiography © l.m.brocklebank
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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
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Abnormalities affecting the teeth and jaws - examples
developmental traumatic inflammatory cystic neoplastic osteodystrophies metabolic/systemic idiopathic foreign bodies artefacts iatrogenic © l.m.brocklebank
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Normal dental development
deciduous - 20: incisors canines premolars - 0 molars permanent - 32: incisors canines premolars - 8 molars <12 © l.m.brocklebank
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Dental development and abnormalities
number increase or decrease position form individual or multiple © l.m.brocklebank
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Inflammatory lesions tooth - dental caries (decay)
supporting structures periodontal disease - bone level around the root tip bone - inflammation and infection © l.m.brocklebank
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Cystic lesions of the jaws
odontogenic radicular dentigerous keratocyst non-odontogenic nasopalatine solitary bone cyst Stafne cavity © l.m.brocklebank
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Neoplastic, odontogenic
benign cementomas cementifying fibroma myxoma ameloblastoma * adenomatoid odontogenic tumour calcifying epithelial odontogenic tumour © l.m.brocklebank
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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
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What do you see? © l.m.brocklebank
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family group Bart van der Leck The family, 1921 © l.m.brocklebank
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Hidden pathology © l.m.brocklebank
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© l.m.brocklebank
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