1. CLINICAL PEDIATRIC DENTISTRY I Radiology in Pediatric Dentistry Sunday lecture 4\11\2012 1:00 pm-2:00 pm clinic: 2:00pm- 5:00pm Attendance sheets are signed at the beginning of each lecture and clinical sessions. Thursday, April 30, 2015 OTHMAN AL-AJLOUNI 1

2. Lecture outline OBJECTIVE OF LECTURE YOU SHOULD BE ABLE TO ANSWER THE FOLLOWING QUESTIONS AT THE END OF THIS LECTURE : 1.WHEN TO TAKE RADIOGRAPHS IN PEDIATRIC DENTISTRY? 2.WHY RADIOGRAPHS ARE TAKEN IN PEDIATRIC DENTISTRY? 3.WHAT TO LOOK FOR IN THE RADIOGRAPHS? 4.WHICH FILMS TO USE AND THE VIEWS USED IN PEDIATRIC DENTISTRY? 5.HOW TO POSITION THE CHILD PATIENT TO GET NEEDED IMAGES?

3. RADIOGRAPHIC PRINCIPLES RADIOGRAPHS ARE NECESSARY TO MAKE A PROPER AND ACCURATE DIAGNOSIS 1.WHEN A RADIOGRAPHS IS INDICATED, HAVE THE PARENT HOLD FILM AND RESTRAIN CHILD DURING X-RAY EXAM IF NECESSARY 2.HAVE YOUR ASSISTANT HOLD THE FILMM AND REQUIRE THAT HE\SHE WEAR A LEAD APRON DURING THE FILM EXPOSURE

4. PARENT AND CHILD POSITION

5. WHEN DOES A DENTIST DETERMINE TO TAKE RADIOGRAPHS IN PEDIATRIC DENTISTRY? CURRENT AAPD ( AMERCAN ACADEMY OF PEDIATRIC DENTISTRY ) GUIDELINES REQUIRE A CLINICAL EXAMINATION PRIOR TO X-RAY EXPOSURE. WHEN TO TAKE X-RAYS ?

6.  RADIOGRAPHS SHOULD BE TAKEN ONLY WHEN THERE IS AN EXPECTATION THAT THE DIAGNOSTIC YIELD WILL AFFECT PATIENT CARE  TAKING RADIOGRAPHS SHOULD NOT BE AN AUTOMATED REACTION FOR ROUTINE CARE. WHEN TO TAKE X-RAYS ?

7. RADIOGRAPHS ARE TAKEN FOR THE FOLLOWING REASONS: INITIAL OR PERIODIC EXAMINATION - WHEN POSTERIOR PROXIMAL SURFACES CANNOT BE VIEWD. - THE TIMING OF THE INIATIAL RADIOGRAPHIC EXAMINATION SHOULD NOT BE BASED UPON THE PATIENT ´S AGE, BUT UPON EACH CHILD´S INDIVIDUAL CIRCUMSTANCES. POST-OP EVALUATION SPECIFIC CLINICAL INDICATIONS SELECTION CRITERIA FOR DENTAL RADIOGRAPHS

8. RADIOGRAPHS ARE INDICATED FOR THE FOLLOWING REASONS: 1.SUSPECTED OR VISIBLE CARIES 2.SUSPECTED PULPAL AND\OR PERIAPICAL PATHOLOGY 3.TRAUMATIC INJURIES 4.PROBLEMS IN ERUPTION 5.DEVELOPMENTAL ANOMALIES 6.UNEXPLAINED DISCOLORATION OF TEEH 7.ORTHODONTIC EVALUATION 8.EVIDENCE OF SWELLING\FISTULA 9.UNEXPLAINED MOBILTY OF TEETH SPECIFIC CLINICAL INDICATIONS

9. 1.BITE-WING 2.PERIAPICAL 3.OCCLUSAL 4.PANORAMIC TYPES OF DENTAL RADIOGRAPHS

10. 1.BITE-WING - USED PRIMARLY FOR INTERPRIXIMAL CARIES DETECTION - OCCLUSAL CARIES THAT HAVE PENETRATED INTO THE DENTIN - POSSIBLE CAREIS UNDER EXISTING RESTORATIONS TYPES OF DENTAL RADIOGRAPHS

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12. 2. PERIAPICAL: USED PRIMARLY TO DETECT BOTH NORMAL CONDITIONS AND PATHOLOGY INVOLVING THE ROOTS OF THE TEETH AND THEIR SUPPORTING STRUCTURES A PERIAPICAL RADIOGRAPH WILL SHOW: 1.FURCATION OR APICAL INVOLVEMENT. 2.PRESENCE OF CALCIFIED TISSUES. 3.EXTERNAL ROOT OR BONE RESORPTION. 4.INTERNAL ROOT RESORPTION. 5.ANOMALIES OF THE SUPPORTING BONE AND ASSOCIATED STRUCTRES. TYPES OF DENTAL RADIOGRAPHS

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14. Example: BWX Thursday, April 30, 2015Professor Othman Al-Ajlouni 14

15. 3- OCCLUSAL: USED PRIMARLY FOR -EVALUATION OF SUPERNUMERARY TEETH -IMPACTED CANINES -TRAUMA TO THE ANTERIOR TEETH TYPES OF DENTAL RADIOGRAPHS

16. 4- PANORAMIC: USED PRIMARLY TO PROVIDE BASELINE DATA FOR GROWTH AND DEVELOPMENT AND TO EVALUATE CHANGES THAT ARE OCCURING OVER TIME. A PANORAMIC RADIOGRAPH WILL SHOW: 1.PRESENCE OR ABSENCE OF PERMANENT TEETH 2.POSITIONS OF THE PERMANENT TEETH IN RELATION TO THE PRIMARY TEETH 3.EVALUATION OF BONY LESIONS AND THE TMJ TYPES OF DENTAL RADIOGRAPHS

17. Post-Operative OPG: Thursday, April 30, 2015Professor Othman Al-Ajlouni 17

18. 4- ATION OF BONY LESIONS AND THE TMJ GUIDELINES FOR PRESCRIBING RADIOGRAPHS

19. EXAMPLE CASE

20. Intraoral Swelling - Fistula Thursday, April 30, 2015Professor Othman Al-Ajlouni 20