Radiographs are an ________ to clinical examination, not a _________ for it.
adjunct
substitute
Radiographs reveal alterations in calcified tissue, showing the effects or past or current cellular activity?
PAST
Most everything on a radiograph is affected by what?
the way the film is exposed
Why is it so important to used standardized and reproducible techniques while taking radiographs?
in order to obtain reliable radiographs especially for comparison over time
What is the most reliable technique for taking radiographs?
Long cone
paralleling technique
XCP device
Benefits of conventional radiographs are that they DO show:
______ alveolar bone levels
clinical _____ to ______ ratio
______ on proximal root surfaces
Metallin/porcelain __________
some ________ restorations
morphology of _________
crestal
crown to root
calculus
restorations
composite
roots
Some limitations of conventional radiographs include that they do NOT show:
____ periodontal pockets
_____ and _______ plates of bone
_____ to _____ tissue relationship
a ________ treated patient
bone loss until about ___-___% of loss of mineralization occurs
all
buccal and lingual
hard to soft
successfully
30-50%
Howcome radiographs do NOT show internal morphology, depth of craterlike interdental defects, and extent of the involvement on the facial and lingual surfaces?
because facial and lingual bone loss is obscured by the dense root structure and dense mylohyoid ridge
There are 4 criteria to determine adequate angulation of periapical radiographs; they are:
should show the tips of the ______ ______ with little to none of the _________ surfaces showing
______ and ______ chambers should be distinct
_________ spaces should be open
_________ contacts should not overlap unless teeth are anatomically out of line
molar cusps
occlusal
enamel and pulp
interproximal
proximal
What is the thin radiopaque border adjacent to the PDL called?
lamina dura
The width, shape, and angle of the crst of the interdental septa varies according to what?
the convexity of the proximal teeth and the level of their respective CEJs
T or F. Radiographs reveal minor changes in the bone
FALSE! They do NOT
T or F. Slight radiographic changes mean that the disease has progressed beyond the earliest stages
true
T or F. Earliest signs of periodontal disease must be detected clinically.
true
T or F. Radiographic images tend to show more severe bone loss than is actually present.
FALSE. They show LESS
Are radiographs a direct or indirect method of determining bone loss?
indirect
The distance from the CEJ to the alveolar crest in normal healthy bone has been shown to be approximately __ - __ mm.
1-3
(but really 2)
Changes from bone loss affect the interdental septa in what 3 ways?
lamina dura
crestal radiodensity
height and contour of the bone
Which type of bone loss is described?
Interdental septa are reduced in height, with the crest horizontal and perpendicular to the long axis of the adjacent teeth
horizontal
Which type of bone loss is being described?
interdental septa are angled, or arcuated
vertical
From looking at radiographs, why must we assume that bone loss continues in either the facial or lingual aspects creating a trough like lesion?
because of the density of the cortical bone and root of the tooth, the facial and lingual bone levels can not be detected on radiographs
T or F. It is possible to have a deep crater between the F and L plates without radiographic indications.
true
true lesions on the facial and lingual side can only be detected by what?
clinical probing
What are irregular areas of reduced radiopacity on the alveolar bone crests that are generally not sharply demarcated, blend gradually, and are not accurately depicted on radiographs?
interdental craters
The definitive diagnosis for furcation involvement is made by what?
clinical examination
Radiographs are helpful in detecting furcation involvement, but why aren't they the best?
because artifacts allow for furcation involvement to be present without detectable radiographic changes
T or F. A tooth may present marked furcation involvment in one film and uninvolved in another.
If there is marked bone loss in relation to a single molar root, it may be assumed that what?
the furcatino is also involved
When seen radiographically this usually appears as a discrete area of radiolucency along the lateral aspect of the tooth.
periodontal abscess
Radiographic picture of a periodontal abscess is usually not seen because of what 3 things?
stage of the lesion
extent of destruction
location of abscess
In localized aggressive periodontitis, where does the bone loss initially occur?
in the maxillary and mandibular incisor and/or 1st molars, usually bilateral in vertical destruction
T or F. Localized aggressive periodontitis may become generalized, but remains less pronounced in the premolar areas
true
What is seen radiographically during the injury phase of trauma from occlusion?
loss of lamina dura
What is seen radiographically in the repair phse of trauma from occlusion?
widening of the PDL (may be generalized or localized)
Occlusal trauma in addition to periodontal disease can result in deep _______ bone loss
angular
Occlusal trauma does not cause periodontal disease, but it what?
hinders the body's response to disease
What is the term for widening of the periodontal ligament space, bordered by the lamina dura and the root surface of the tooth, and when crestal bone between two adjacent teeth has a pointed triangular appearance?
triangulation
Triangulation is widening of the periodontal ligament space, and is indication of what?
occlusal trauma
T or F. Root fractures are typically easy to see on radiographs.
FALSE. HARD to see
Can root fractures be horizontal or vertical?
yes, both
Probe depths associated with vertical fractures are often _____ and very ______
narrow
deep
What is the bes determinant in differentiating between treeted and untreated periodontal disease?
