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injury produced by an external force, may affect crowns, root and alveolar bone; may result in fractures of teeth and bone; may result in injuries such as intrusion, extrusion and avulsion


breaking of a part; may affect crowns and roots or bones of max/mand

crown fractures

most often involve ant teeth, most from accidents, may be enamel only, enamel/dentin, or enamel dentin and pulp

root fractures

less common, from accident or traumatic blow, most on max centrals,

jaw fractures

results from accidents, sports injuries and assaults,


abnormal displacement of teeth; intrusion or extrusion


abnormal displacement of teeth INTO bone


abnormal displacement of teeth OUT of bone


complete displacement of tooth from alveolar bone; from trauma assoc w assault or fall

physiologic resorption

process seen with normal shedding of primary teeth

pathologic resorption

regressive alternation of tooth structure when tooth subjected to abnormal stimuli

external resorption

seen along periphery of the root; often associated with: reimplanted tooth, abnormal mechanical forces, trauma, chronic inflammation, tumors, cysts, impacted teeth or idopathic (I don't know) causes

internal resorption

within crown or root; pulp chamber pulp canals and surrounding dentin; from trauma, pulp capping, and pulp polyps, asymptomatic, appears as round-to-ovoid radiolucency in midcrown midroot section of tooth

pulpal sclerosis

diffuse calcification of pulp chamber and pulp canals; pulp cavity of decreased size; assoc w aging; incidental radiographic finding

pulpal obliteration

attrition, abrasion, caries, restorations, trauma or abnormal mechanical forces act as irritants to pulp and stimulate production of secondary dentin which annihilation of pulp cavity

pulp stones

calcifications found in pulp chamber or pulp canals; cause unknown, appear as round, ovoid (shaped like an egg) or cylindrical radiopacities


Periapical lesions can not be dxed on clinical basis alone!!!

periapical granulomas, cysts, and abscesses

what are common radiolucencies on radiographs?

No way jose

Can periapical radiolucencies be dxed on radiographic appearance alone?

radiographic appearance, clinical features and microscopic appearance

DX of periapical radiolucencies are based on what?

periapical granuloma

localized mass of chronically inflammed granulation tissue @ apex of a NONVITAL tooth; results from pulpal death and necrosis;

periapical cyst

lesion that develops over a long pd of time; cystic degeneration takes place w/in a periapical granuloma and results in cyst; 50-70% all cysts in mouth

periapical abscess

localized collection of pus in periapical region; results in pulpal death; may be acute or chronic

acute periapical abscess

painful-intense, throbbing, constant; nonvital tooth, sensitive to pressure, heath, percussion, increased widening of PDL

chronic periapical abscess

asymptomatice-pus drains through bone or PDL space; gumboil (parulis) may be seen in apical region @ site of drainage; lamina dura can't be seen between root apex and radiolucent lesion

Periapical abscess

infection in pulp

periodontal abscess

results from a bacterial infection with walls of perio tissues from preexisting perio condition; pain is most common symptom

radiographic appearance, clinical info, pt hx

Periapical radiopacities can be dxed based on:

condensing osteitis

most common radiopacity seen in adults!!! tooth most freq involved is mand 1st molar; tooth nonvital-usually has a large carious lesion or restoration; no tx necessary

sclerotic bone

osteosclerosis, iopathic periapical osteosclerosis; below apices of vital, non carioius teeth, cause unknown; lesion not attached to tooth; asymptomatic


excess deposition of cementum on root surfaces, from supraeruption, inflammation or trauma, apical area MOST affected, teeth vital, lamina dura and pdl space are normal


only 40-50% calculus is detected on a radiograph

ring like or pointed and irregular

How can calculus appear on radiograph?

potential food traps, accumulation of food and debris, and bacterial deposits, contribute to perio disease,

Defective restorations can negatively lead to what?

pit amalgams

One surface amalgam restoration

amalgam tattoo

amalgam fragments in soft tissue may be seen radiographically also

stainless steel and chrome crowns

temporary restorations; thin and don't absorb xrays, outlines and margins may appear smooth and regular, do not appear to fit tooth well

post and core restoration

seen in endodontically treated teeth. cast metal, radiodense, appears radiopaque,, _____extends into pulp canal

porcelain restorations

radiopaque, resembles radiodensity of dentin

porcelain crowns

thin radiopage line outlining prepared tooth may be evident thru the slightly radiopaque ________; line represents cement

porcelain fused to metal

has to radiographic components

composite restorations

careful visual and digital exam enables clinician to distinguish this restoration


often used in temp crown or filling, this is least dense of all the nonmetal restorations and appears radioluicent and is barely visible

zinc phosphate, cement, zinc-oxide eugenol paste;

What are the base materials used as cavity liners?

Metallic pins

used to enhance retention of amalgam or composite, appears screw like or cylindrical radiopacties

complete dentures

appear rootless and floating

removable partial dentures

appear densely radiopaque or slightly depending on construction materials

dark stains, chalky white, discoloration on interproximal ridge

Various color changes may be detected for caries..

Interproximal caries

caries between two teeth, seen just below the contact point, difficult to impossible to examine with explorer


As interproximal caries proceed it has a _____ configuration

incipient interproximal caries

beginning to exist; extends less than half way thru enamel, class I

moderate interproximal caries

extends more than halfway into the enamel but does not involve DEJ, class II

advanced interproxmial caries

extends to or thru DEJ, and into dentin but does not go through dentin more than halfway to the pulp, class III

severe interproximal caries

extends thru enamel thru dentin and more than halfway twd pulp, class IV, involves both dentin and enamel and may appear clinically as a cavitation into tooth

Occlusal caries

involving chewing surfaces in post teeth; method of choice is clinical exam, early caries hard to detect radiographically

Incipient occlusal caries

can't be seen on radiograph

moderate occlusal caries

extends into DEJ; very thin radiolucent line, located under enamel of occlusal surface,

severe occlusal caries

extends into dentin and appears as large radiolucency; extends under enamel of occlusal surface, apparent clinically, appears as a cavitation in tooth

buccal and lingual caries

caries difficult to detect on radiograph bc of superimposition of densities of normal tooth structure; best detected clinically with explorer

root surface caries

cementum and dentin located just below cervical region involved, enamel NOT involved, bone loss and recession precede caries process; easily detected clinically

man pm and man molar area

Most common locations of exposed roots are the roots of _______ and _______.

recurrent caries

secondary caries, occurs adjacent to existing restorations, due to inadequate cavity prep, defective margins, or incomplete caries removal prior to placement of restoration

beneath interproximal margins of restorations

where do recurrent caries happen most often?

rampant caries

advanced or severe caries that affects numerous teeth; children with poor dietary habits and adults with decreased salivary flow.

descriptive terminology

describing what is seen without implying a diagnosis

unilocular radiolucent lesions

one compartment, tend to be small and nonexplansible, corticated or noncorticated

unilocular lesion with corticated borders

thin, well-demarcated radiopaque rim of bone at edges, usually benign and slow growing

unilocular lesion with noncorticated borders

does not have a thin radiopaque rim of bone @ edges, edges appear fuzzy or poorly defined, may be either benign or malignant

mulilocular radiolucent lesions

multiple radiolucent compartments, frequently expansible, usually benign with potential aggressive growth

lateral periodontal cyst

This lesion is located inter-radicular

dentigerous cyst

this lesion is located pericoronal

Focal opacity

well defined, localized: large caries, restorations, pulpitis, man 1st molar is the most common

target lesion

well-defined localized radiopaque area surrounded by a uniform radiolucent halo : benign cementoblastoma (young adults, mand molar or premolar)

multifocal confluent

multiple radiopacities that appear to overlap or flow together: Osteitis deformans(Pagets-men over 50) or florid osseous dysplasia (middle aged black women over 40, asymptomatic, bilateral post man region)

irregular ill-defined

irregular, poorly defined pattern, may represent a malignant condition: osteosarcoma(most common, swelling, pain, lose teeth, age 10-25, most is mand area.. sunburst affect) or chondrosarcoma (malignant neoplasm, RARE, poor prognosis)

Ground glass

granular or pebbled radiopacity, resembles pulverized glass or texture of an orange peel, Fibrous dysplasia, osteitis deformans and osteopetrosis (rare, oblidterates bone in marrow, starts at infancy, child becomes deaf and blind)

Developer solution chemicals

hydroquinone, antioxidant sodium carbonate, potassium bromide

Fixer solution chemicals

sodium thiosulfate or amonium thiosulfate, sodium sulfite, potassium alum

acidifier chemical

acetic acid or sulfuric acid

acetic acid

neutralizes the alkaline developer, produces acidic environment required by fixing agent

potassium alum

hardens and shrinks the gelatin in emulsion

sodium sulfite

prevents chemical deterioration of fixing agent

sodium thiosulfate or ammonium thiosulfate

removes the unexposed crystals from film emulsion

potassium bromide

controls developer, prevents it from developing the exposed and unexposed silver halide crystals, most effective in stopping development of unexposed crystals, prevents image fogging

alkali sodium carbonate

activates developing solution agent- only active in alkaline, softens gelatin

antioxidant sodium sulfite

extends life of elon and hydroquinone, prevents developer from oxidizing in presence of air


not temp sensitive, converts crystals quickly (black tones)


inactive less than 60 degrees; very active greater than 80 degrees, opt temp is 68, converts crystals to black slowly (gray tones)

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