Lecture 5 b_radiographic_interpretation_dental_caries_2012

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  • 1. Dr MUMENA C.H
  • 2. * One of the most common disease seen in radiographs* Rec pathogenesis* Radiographs are used to detect lesions that are not easily observed in the clinical examination* Carious lesion appears radiolucent in the radiographs* Carious lesions are usually larger than their radiographic appearance * Reason: For density changes to be observed radiographically, 30-50% demineralization must have occurred
  • 3. * Proximal caries: * Occur on proximal surfaces * Detection: Bitewing radiographs * Radiographic appearance: * Notching of the enamel usually in area of 1-2 mm apical to the contact point. * Forms a traingular pattern to the dentinoenamel junction (rec pathogenesis) into dentin * Spread out in dentin, undermining enamel * Becomes more diffuse in radiographic appearance as they advance into dentin
  • 4. * Occlusal caries: * Occur on occlusal surface of premolars and molars * Detection: Clinical examination more reliable * Reason: radiographic superimposition of normal structures, hard to detect early lesions * Use of radiographs: when occlusal caries have extended into dentin
  • 5. * Occlusal caries cont… * Radiographic appearance: * First thin radiolucent line between the enamel and dentin * More diffuse radiographically when in dentin * Thin radiopaque band of secondary dentin between dentin and pulp chamber in advanced lesions
  • 6. * Buccal and lingual caries: * Detection is best with clinical examination * Reasons: superimposition of structures * Radiographic presentation: * Difficulty to distinguish buccal, lingual and occlusal caries radiographically * Buccal and lingual caries have a well defined radiopaque band that can not be found in occlusal caries
  • 7. * Root surface caries: * Occur on surface where attachment has migrated apically (Gingival recession) * Detection: Careful clinical examination, radiographs * Radiographic appearance: * No particular pattern * Diffuse scooping out of the tooth structure * N.B root surface caries cannot occur where there is gingival attachment: evaluate bone level
  • 8. * Recurrent caries: * Occur at the margin of the existing restorations * Detection: radiographic for occlusal and proximal restorations, large restorations may obscure early recurrent lesions * Radiographic presentation: * Radiolucency at the margin of existing restorations * Similar in appearance to primary carious lesions
  • 9. * Appreciate radiographic appearance of restorations such as: * Amalgam * Gold and other metals * Pins * Calcium hydroxide base * Gutta percha * Composite e.t.c * N.B: Distinguish them from the discussed appearences
  • 10. * After completion of this part: Follow radiographic presentation of periodontal diseases in part 3