Radiology Chapter 25

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diseases that affect both soft tissues (gingiva) and bone around the teeth

periodontal diseases

inflammation of the gingiva and limited to the soft tissue

gingivitis

_____________ is also the result of infection, but includes loss of ______ __________

Periodontitis
alveolar bone

The uses of radiographs in the assessment of the periodontal diseases include

1. imaging supporting bone
2. imaging local contributing factors
3. imaging anatomical configurations
4. evaluating the prognosis and treatment intervention needs
5. Serving as a baseline and as a means for evaluating the results of treatment

What are some periodontal bone changes recorded by radiographs?

crestal irregularities
interdental alveolar bone changes
pattern of bone loss (horizontal/vertical)
distribution of bone loss (localized/generalized)
severity of bone loss (slt, mdr, advanced)
furcation involvement

changes of alveolar bone changes between teeth

interdental septa

height loss around adjacent teeth in a region

horizontal bone loss

Horizontal bone loss occurs in a plane parallel to

CEJ

sometimes called angular bone loss, occurs in a vertical direction where resorption of one tooth root sharing the interdental septum is greater than the other tooth

vertical bone loss

local areas

localized bbone loss

occurs throughout dental arches

generalized bone loss

appears slightly radiopaque, and must be significantly calcified to be recorded on radiographs

calculus

does not cause periodontal disease, but has been shown to hinder the body's response to the disease

occlusal trauma

The effects of excessive occlusal forces show up on radiographs as a widening of the periodontal ligament space

triangulation

What are some limitations?

-radiographs are a two-dimensional image of three-dimensional objects
-changes in soft tissue not imaged
-cannot distinguish treated versus untreated disease
-actual destruction more advanced clinically

For examining the periodontium, what type of bitewings are used?

vertical

Case Type I

Gingivitis

Case Type II

Slight Chronic Periodontitis

Case Type III

Moderate Chronic or Aggressive Periodontitis

Case Type VI

Advanced Chronic or Aggressive Periodontitis

what appears as an unbroken, dense radiopaque line around the roots of the teeth?

lamina dura

What appears as a thin radiolucent line between the lamina dura and the root of the tooth?

periodontal ligament space

Each of the following may be determined from a dental radiograph EXCEPT one, which one is the EXCEPTION?
a. bone loss
b. pocket depth
c. furcation involvement
d. local contributing factors

b. pocket depth

Which of the following terms describes bone loss that occurs in a plane parallel to the CEJ of adjacent teeth?
a. irregular
b. vertical
c. horizontal
d. periapical

c. horizontal

significant bone loss that results in a radiolucency observed in the area between the roots of multirooted teeth is called
a. localized bone loss
b. interdental septa
c. local contributing factor
d. furcation involvement

d. furcation involvement

radiographs may help to locate each of the following local contributing factors EXCEPT one, which one is the EXCEPTION?
a. calculus
b. poorly contoured crown margin
c. deep pocket
d. amalgam overhang

c. deep pocket

Excessive occlusal force may result in a widening of the periodontal ligament space.
Widening of the periodontal ligament space is called furcation involvement T/F

First statement true, second statement false

Dental radiographs are important because they document the location and depth of periodontal pockets.
Dental radiographs may serve as a baseline and as a means for evaluating the outcome of periodontal treatment T/F

First statement false, second statement true

Which of the following would be best for imaging a slight, but generalized periodontal status?
a. select perioapical radiographs using the bisecting technique
b. select periapical radiographs using the paralleling technique
c. posterior horizontal bitewing radiographs
d. posterior and anterior vertical bitewing radiographs

d. posterior and anterior vertical bitewing radiographs

Correct horizontal angulation is needed to accurately image interdental bone levels

Altering the horizontal angulation can reveal additional information regarding interdental bone levels T/F

Both are true

Alveolar crests pointed in the anterior region and a radiopaque flat, smooth lamina dura 1.5 to 2.0 mm below the CEJ in the posterior region describes
a. Case Type I: Gingivitis
b. Case Type II: Slight Chronic Periodontitis
c. Case Type III: Moderate Chronic or Aggressive Periodontitis
d. Case Type IV: Advanced Chronic or Aggressive Periodontitis

a. Case Type I: Gingivitis

Radiolucent changes observed on a radiograph such as a fuzzy, cuppingout of the crestal bone and a blunted appearance of the lamina dura in the anterior region describes
a. Case Type I: Gingivitis
b. Case Type II: Slight Chronic Periodontitis
c. Case Type III: Moderate Chronic or Aggressive Periodontitis
d. Case Type IV: Advanced Chronic or Aggressive Periodontitis

b. Case Type II: Slight Chronic Periodontitis

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