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Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
Radiographic interpretation
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Radiographic interpretation

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Radiology II …

Radiology II
Forth Year

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  • 1. Oral & Maxillofacial Radiographic x- ray film interpretation By Dr. Hassan M. Abouelkheir BDS, MSc, PhD
  • 2. Systematic approach • It should apply to : • A- Entire radiograph. • B- specific Lesions.
  • 3. 
 A- Entire radiograph
 • 1- type of radiograph: A- Extraoral : - panoramic . - cephalometric. - Oblique lateral. B- Intra-oral: - periapical. - Bite-wing. - Occlusal.
  • 4. 2- general overview of the entire film i- Teeth: – Number. – Chronologic and development age. – Position. – Condition of crowns(crowns/ restorations). – Condition of the roots(length, fillings, resorption, c/r ratio)
  • 5. 2- general overview of the Entire film ii- The apical tissues: - Integrity of Lamina dura. - Apical radiolucency or radiopacitiy. iii- The periodontal tissue: - PDL space width. - level & quality of alveolar crest. - vertical or horizontal bone loss. - Furcation involvement. - Calculus deposits.
  • 6. 2- General overview of the Entire film IV- OTHER STRUCTURES: - BODY & RAMUS OF THE MANDIBLE: - SHAPE & OUTLINE. - THICKNESS OF LOWER BORDER. - TRABECULAE PATTERN. - ANY RADIOLUCENT OR RADIOPAQUE AREAS. - CONDYLAR HEAD.
  • 7. 1- site: 2- size & shape: 3- outline / edge (periphery). 4- Internal structures (relative radiodensity). 5- Effect on surrounding structures. Specific lesions:
  • 8. 1- Site (Location): • Maxillary/ Mandibular. • Localized or generalized. • Originating from a point or epicentre relative to surrounding structures e.g; – Above or below ID canal. – In bone or soft tissue. – In or outside a tooth max. ant. – Odontogenic lesions (above ID canal) / non- odontogenic lesions (above/ within or below the canal).
  • 9. 
 2- size & shape:
 • 2.1-Size: A- measuring dimensions in cm (e.g. 2cm×3cm). B- Describing the boundaries; - Extension from … to… in one dimension. - Extension from … to… in other dimension.
  • 10. 
 2- size & shape:
 2.2- Shape: • Unilocular. • Multilocular. • Oval. • Round. • Scalloped. • Irregular.
  • 11. 3- Outline/ edge (periphery): A) Discrete or well defined outlines; – Smooth. – Punched out( no peripheral bone reaction). – Corticated: thick or thin surrounding radiopaque (white) cortex. – Sclerotic: non uniform radiopaque boundary. – Encapsulated: surrounded by radiolucent line partially or completely.
  • 12. B) Non Discrete or Poorly defined outlines: • blend in with normal anatomy. • Moth- eaten or ragged. 3- Outline/ edge (periphery) cont.:
  • 13. 4- Internal structures(relative radiodensity): • Uniformly radiolucent. • Mixed lesion . • Radiopaque. • Internal structures; – Ground glass. – Honeycomb. – Cottonwool patches. – Homogenous/ discrete bony septa. – Cementum. – Dental tissue. – No specific pattern.
  • 14. 5- effects on surrounding structures: 1- Teeth: – Resorption. – Displacement. – Delayed eruption. – Disrupted development. – Loss of lamina Dura. – Increase width of PDL space. – Hypercementosis. – Alteration in size.
  • 15. 2- surrounding bone: – Expansion Buc./ling./ Other directions . – Displacement. – Raged destruction. – Sclerosis. – Subperiosteal bone formation. – Increase width of ID canal. – Irregular bone remodeling. 5- effects on surrounding structures:
  • 16. Differential diagnosis 1- Normal anatomical structures. Maxilla / Mandible. 2- Artefactual:e.g overexposure or air shadow. 3- Pathological: a- Radiolucent lesions b- lesions with variable radiopacity (mixed lesions). c- Radiopaque lesions.
  • 17. Differential Diagnosis of Radiolucent lesions: 1- Normal anatomical structures. Maxilla / Mandible. 2- Artefactual:e.g overexposure or air shadow. 3- Pathological: a- Congenital: abnormal hereditary lesions at birth. b- Developmental. c- Acquired.
  • 18. C- Acquired lesions 1- Localized infection . 2- Spreading Infection. 3- Trauma . 4- A cyst and cystic like lesions. 5- A tumour or tumor like lesion. 6- A bone Related lesions; - A Giant cell lesion. -An Osseous Dysplasia. - Another lesion.
  • 19. Localized infection • A- Periapical : • Periapical abcess. • Acute apical periodontitis. • Periapical granuloma • Rarifying osteitis. • Sclerosing osteitis. B- Pericoronitis.
  • 20. Spreading infection A- Osteomyelitis ( Acute/ chronic). B- Osteoradionecrosis. C- Bisphosphanates related osteonecrosis (BRON).
  • 21. Trauma • A- teeth 1- Concusion. 2- Laxation. 3- Avulsion. 4- Fracture of teeth. - Enamel (Crack). - Enamel & Dentine (uncomplicated fracture). - E &D (complicated fracture). - Root fracture a- horizontal b- vertical or oblique.
  • 22. Trauma (cont.) B) bone fracture: 1- mandible: - body. - condyle. - Alveolar process. 2- Maxilla : - Midface: Le Fort I /II/III. - zygomatic fracture.
  • 23. Cyst & cystic like lesions A) Odontogenic : • Radicular. • Residual. • Lateral Periodontal. • Dentigerous. • Odontogenic Keratocyst. B) Non- Odontogenic -Nasopalatine duct/ incisal canal cyst. - simple bone cyst. - Stafne’s bone cyst
  • 24. Tumours and Tumour like lesions 1- Benign Odontogenic: - ameloblastoma. - ameloblastic fibroma. - calcyfing odontogenic cyst. - odontogenic fibroma. - odontogenic myxoma. 2- Malignant odontogenic: - odontogenic carcinoma. - odontogenic sarcoma. 3- Non-odontogenic primary bone diseases. 4- Squamous cell carcinoma. 5- Multiple myloma.
  • 25. Bone Related Lesions 1- Giant cell lesion: -Central giant cell lesion. - Brown tumour of hyperparathyriodism. - cherubism. - Aneurysmal bone cyst. 2- Osseous dysplasia: - periapical cemental dysplasia. - Focal osseous dysplasia. - Florid osseous dysplasia. - Familial gigantiform cementoma. 3- Other lesions: - Ossifying fibroma. - fibrous dysplasia. - simple bone cyst. - Stafne’s bone cyst.
  • 26. Case 1
  • 27. Case 2
  • 28. Case 3
  • 29. Case 4
  • 30. Case 5
  • 31. The End

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