DH Radiology

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sthomp88
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48803
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DH Radiology
Updated:
2010-11-10 20:49:16
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Chapter thirty three
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Interpretation of periodontal disease
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  1. The tissues that invest and support the teeth such as the gingiva and alveolar bone
    periodontium
  2. What are 2 tissues that make up the periodontium?
    • gingiva
    • alveolar bone
  3. What are the 3 anatomic landmarks of the alveolar bone?
    • lamina dura
    • alveolar crest
    • periodontal ligament space
  4. In health, this structure around the roots of the teeth, appears as a dense radiopaque line
    lamina dura
  5. In health, this structure is located approximately 1.5 to 2.0 mm apical to the cementoenamel junctions of adjacent teeth
    alveolar crest
  6. Where is a healthy alveolar crest located in relation to the CEJ of adjacent teeth?
    1.5-2.0 mm apical to them
  7. How does the Alveolar area appear in the anterior area?
    pointed, sharp, and very radiopaque
  8. How does the alveolar crest appear in the posterior area?
    flat, smooth, and parallel to a line between adjacent teeth, also it is slightly less radiopaque then in anterior areas
  9. Normally appears as a thin radiolucent line between the root of the tooth and the lamina dura, in health it is continuous around the root structure and is of uniform thickness
    periodontal ligament space
  10. around a tooth
    periodontal
  11. refers to a group of diseases that affects the tissues around the teeth
    periodontal disease
  12. Gingival tissue affected by periodontal disease exhibits varying degrees of inflammation. Describe their appearance.
    swollen, red, and bleeding, and soft tissue pocket formation is seen
  13. True or False. The gingival tissues affected by periodontal disease appear stippled, pink, and firm.
    false
  14. true or false. periodontal disease includes destruction of the supporting bone and periodontal ligament.
    true
  15. In periodontal disease, the alveolar crest is no longer located at 1.5 - 2.0 mm apical to the CEJ's, and the alveolar crest no longer appears radiopaque.
    both statements are true
  16. true or false. In periodontal disease, the alveolar crests appear indistinct, bone loss is seen, and it may result in sever destruction of bone and loss of teeth.
    true
  17. true or false. Both clinical and radiographic examination is necessary in the detection of periodontal disease.
    true
  18. clinical examination provides information about________________, and radiographic examination provides information about__________________in detection of periodontal disease
    • soft tissue
    • the bone
  19. A clinical examination for interpretation of periodontal disease must be performed by who?
    The dentist and/or the dental hygienist
  20. In a clinical examination of interpretation for periodontal disease, what is the evaluation of the soft tissues (gingiva) for?
    inflammation - redness, bleeding, swelling, pus
  21. true or false. clinical examination for interpretation of periodontal disease must include periodontal probing, and whenever there is evidence of periodontal disease, radiographs must be taken
    both statements are true
  22. What are 4 things that can be examined radiographically with interpretation of periodontal disease?
    • amount of bone present
    • pattern of bone loss
    • distribution of bone loss
    • severity of bone loss
  23. True or false. Dental radiographs allow the dental professional to document periodontal disease
    true
  24. What films and with what technique are the best choice for interpretation of periodontal disease?
    • PA's
    • paralleling technique
  25. What type of films are the best for follow-up visits of a patient with periodontal disease?
    vertical bitewings
  26. Why is it not a good idea to use the bisecting technique, or panoramic x-rays for the interpretation of periodontal disease?
    • bisecting technique may result in films that show more or less bone loss than is actually present because of dimensional distortion
    • panoramic x-ray has little diagnostic value in the identification of periodontal disease
  27. What are the limitations in viewing furcation areas on a radiograph?
    bone loss may not be detected because of the superimposition of buccal and lingual bone
  28. a radiograph allows the dental professional to view the amount of bone________________rather than the amount of bone_______________
    • remaining
    • lost
  29. in documenting bone levels, is the amount of bone lost, or amount of bone remaining recorded?
    amount of bone lost
  30. The amount of bone loss can be estimated as the difference between the______________and the___________________
    • physiologic bone level
    • height of bone remaining
  31. what are 3 terms used to describe bone loss?
    • pattern
    • distribution
    • severity of loss
  32. What are 2 different patterns of bone loss?
    • horizontal
    • vertical
  33. What is another name for vertical bone loss?
    angular bone loss
  34. bone loss occurs in a plane parallel to the CEJ's of adjacent teeth
    horizontal bone loss
  35. bone loss that does not occur in a plane parallel to the CEJ's of adjacent teeth, with less than 30% of the sites involved
    vertical (angular) bone loss
  36. Bone loss that occurs in isolated areas
    localized
  37. bone loss that occurs everywhere throughout the dental arches with more than 30% of the sites involved
    generalized
  38. What are the 3 classification terms for bone loss severity?
    • slight
    • moderate
    • severe
  39. How is the bone loss measured?
    • by the clinical attachment loss (CAL)
    • from the base of the sulcus or pocket with a probe
  40. 1-2 mm pocket
    slight bone loss
  41. 3-4 mm pocket
    moderate bone loss
  42. 5 mm or greater pocket
    severe bone loss
  43. ADA case type I
    gingivitis
  44. ADA case type II
    mild or slight periodontitis
  45. ADA case type III
    moderate periodontitis
  46. ADA case type IV
    advanced or severe periodontitis
  47. How many ADA case types of periodontal diseases are there? name them from least to most advanced
    • 4
    • gingivitis
    • mild or slight periodontitis
    • moderate periodontitis
    • advanced or severe periodontitis
  48. In this case type no bone loss or radiographic changes are seen, only the gingival tissues are affected by the inflammatory process
    • ADA case type I
    • gingivitis
  49. In this case type, there are mild crestal changes, the lamina dura becomes unlcear and fuzzy and no longer appears as a radiopaque line, horizontal bone loss is seen more often, the alveolar bone level is about 3-4 mm apical to the CEJ, and bleeding may occur on probing, pocketing, and recession may be present clinically
    • ADA case type II
    • mild or slight periodontitis
  50. In what case type does the lamina dura become fuzzy and unclear, and no longer appears to be a continuous radiopaque line?
    • Case type II
    • mild or slight periodontitis
  51. In this case, horizontal or vertical bone loss is present, it can be localized or generalized, alveolar bone level is about 4-6 mm apical to the DEJ, furcation involvement may be present, clinically- pocketing, attachment loss up to 6 mm, recession, furcation areas, and slight mobility possible
    • ADA case type III
    • moderate periodontitis
  52. In what case type might slight mobility start being a possibility?
    • ADA case type III
    • moderate periodontitis
  53. In this case type there is horizontal or vertical bone loss, alveolar bone level is 6 mm or more from the CEJ, furcation involvement is readily viewed on posterior radiographs, clinically - pocket depths and attachment loss is greater than 6 mm, furcation involvement and mobility are more than severe
    • ADA case type IV
    • advanced or sever periodontitis
  54. alveolar bone level at 6 mm or more from the CEJ
    • case type IV
    • advanced or sever periodontitis
  55. Alveolar bone level is 4-6 mm from the CEJ
    • case type III
    • moderate periodontitis
  56. Alveolar bone 3-4 mm apical to CEJ
    • case type II
    • mild or slight periodontitis
  57. Name 3 predisposing risk factors of periodontal disease
    • effects of certain medications
    • tobacco use
    • diabetes
  58. ________________play a major roll in the detection of local irritants
    dental radiographs
  59. name 2 local irritants that are important to detect and eliminate
    • calculus
    • defective restorations
  60. a stone-like concretion forms on crowns and roots of teeth due to calcification of bacterial plaque
    calculus
  61. Does calculus appear radiolucent or radiopaque?
    radiopaque
  62. calculus has a_______________or_________________projection
    • pointed
    • irregular
  63. calculus extends from the_______________
    proximal root surfaces
  64. name 3 different ways that calculus may appear on the teeth
    • ring-like radiopacity encircling cervical portion
    • nodular radiopaque projection
    • smooth radiopacity on root surfaces
  65. This predisposing factor for periodontal disease may act as potential food traps, accumulate food debris and bacterial deposits, and contribute to periodontal disease
    defective restorations
  66. true or false. defective restorations can be detected both radiographically and clinically.
    true
  67. What 4 things do radiographs help identify with defective restorations?
    • open or loose contacts
    • uneven marginal ridges
    • overhangs
    • inadequate margins

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