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Radiology -interpretation of dental caries

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What is the most frequent reason of taking dental radiographs?
dental caries
What is the definition of tooth decay?
localized destruction of the teeth by microorganisms
mineralized tooth structure is altered and destroyed
What tooth structures can be destroyed by caries?
enamel, dentin and cementum
Cavity referes two what two terms?
cavitation or hole in the tooth
How can we detect cavities clinically?
by using light - visually, we can see shadow or discoloration
by using explorer- visually, sticky surface
How can we detect cavities on radiographs?
decreased density allows greater penetration of xrays in the carious area
How do cavities appear on the radiograph?
radiolucent
decay is a soft lesion- radiolucent
enamel is very hard - appears radiopaque
What are some factors influencing interpretation of decay?
1. radiographs must be diagnostic - proper exposure, processing, handling
2. films must be properly mounted
3. films must be viewed in proper lightening and under proper conditions ( viewbox, magnification source)
4. correct horizontal and vertical angulation
5. proper film size
6. proper film position
7. proper pt position
8. proper machine settings
Can decay lesions be missed even if there is small overlap?
yes
What is the most important factor affecting intepretation of dental caries?
film must be diagnostic
What are interproximal caries?
caries that form between two teeth
Where interproximal caries are typically located?
located at or just below contact point
As interproximal caries progress what kind of shape is assumed?
triangular
What are 4 classifications of interproximal caries?
1. incipient
2. moderate
3. advanced
4. severe
Describe incipient interproximal decay?
extends less than 1/2 way through the thickness of the enamel
THIS LESION IS SEEN IN THE ENAMEL ONLY
Describe moderate interproximal decay?
extends more than 1/2 way through enamel but DOES NOT involve DEJ
THIS LESION IS SEEN ONLY IN THE ENAMEL
Describe advanced interproximal decay?
extends through the enamel, through the DEJ and into the dentin
THIS LESION DOES NOT EXTENDS THROUGH MORE THAN 1/2 WAY TO THE PULP
Describe severe interproximal decay?
extends through the enamel, dentin and more than 1/2 the distance to the pulp
VIEWED EASILY IN MOST CASES CLINICALLY
What does "occlusal"mean?
chewing surface of the teeth
Clinical examination of occlusal caries is the technique of choice. True or false?
true
What are 3 classifications of occlusal decay?
1. incipient
2. moderate
3. severe
THERE IS NO ADVANCE CLASSIFICATION
Why is it hard to see occlusal decay in radiographs?
-due to pits, grooves, cusps that are overlapping
- 2D view
Describe incipient lesion of occlusal caries?
cannot be viewed on dental radiograph
must be detected clinically
Describe moderate lesion of occlusal decay?
extends into dentin
appears as thin radiolucent line ( NOT A TRIANGLE)
little if any radiographic change is seen
Describe severe lesions of occlusal decay?
extends into the dentin
appears as large radiolucency
view clinically easily
Why is it hard to determine radiographically carious lesion on B /L surfaces?
due to superimposition of the 2 surfaces involved
How can we detect B/L decay?
through clinical examination
What are some other carious lesions?
1. root surface caries
2. recurrent caries
3. rampant caries
Describe root surface caries?
involve only root surfaces of the teeth
dentin and cementum below CEJ are involved
no involvment in the enamel occurs
Describe recurrent decay?
occurs adjacent to a preexisting restoration
What is another name of recurrent decay?
secondary decay
What are some causes of recurrent decay?
defective margins,
incomplete removal of caries
poor homecare
inadequate cavity preparation
Describe rampant decay?
advanced and severe caries that affect numerous teeth
Where rampant decay are typically seen?
children with poor homecare and diet and or adults with decreased salivary flow
What are some things that mimic caries on radiograph?
1. attrition ( tooth to tooth)
2. cervical abrasion ( bruxism, acids, brushing too hard)
3. cervical burnout
4. older composite restoration materials
Where can wee see cervical abrasion?
neck of the tooth
oval in shape
Where is it common to see cervical burnout?
on BWXs
occurs due to different densities
optical illusion
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