ORAL MEDICINE AND RADIOLOGY

1. Dr Raj AC
Prof and Head
Dept of Oral Medicine and Radiology
Mahe Institute of Dental Sciences

3.  ?? Best radiographic technique for diagnosis
of dental caries:

5.  Dental caries may occur at:
› Occlusal
› Proximal
› Buccal or lingual pit
› Root surface

6.  Radiographic appearance of dental caries
may be:
› Incipient
› Moderate
› Advanced
› Severe

7.  Occlusal caries:
› Incipient lesion:
 starts as pit and fissure caries.
 Usually not detected in the radiograph

8. › Moderate lesion:
 Triangular shaped radiolucency in the enamel with its base in the
DEJ
 A radiolucent zone in the dentin with little or no change in the
enamel
 Dental caries spreads along the DEJ and undermines the enamel.
 Optical phenomenon of mach band effect must be
ruled out. So clinical correlation is a must.
 Overlapping of a buccal pit lesion should be ruled out.

10.  Advanced lesion:
› Clinically evident
› Radiograph helps to know the proximity of the
lesion with pulp.
 Severe lesion:
› Clinically evident.
› Radiograph helps to evaluate the remaining hard
tissue structure and also to evaluate the
periapical area.

13.  Proximal caries lesion:
› Incipient:
 A triangular shaped radiolucent lesion in the
enamel with its base at the tooth surface.
 Lesion starts just below the contact point
 Half of the incipient proximal lesions cannot be
detected radiographically.

15. › Moderate:
 The lesion reaches DEJ and spreads along
the junction.
 Actual depth of penetration of caries lesion
is often deeper than seen radiographically.
(radiographic change will be evident only
with 30- 40 % of demineralisation.

17. › Advanced:
 The lesion spreads along the DEJ and forms base
of a second triangle with apex directed towards the
pulp chamber.
 This triangle has a wider base than the enamel.
› Severe:
 Radiograph helps to know the extend of the caries
lesion beyond the interdental bone.

20.  Buccal and lingual caries:
› it is difficult to differentiate in radiograph.
› Early lesions are round. As it enlarges, it become
elliptical or semilunar with sharp well defined
borders.
› Clinical evaluation is recommended.

22.  Root surface caries:
› Clinical diagnosis is important.
› Difficult to distinguish from cervical burnout
radiographically.

23.  Secondary caries:
› Differentiate from radiolucent base materials
(CaOH, GIC)
 Rampand caries:
 Check the mandibular anterior region
 Radiation caries:
› Radiolucency at the neck of the tooth

26.  To check the amount of bone present
 To check the condition of alveolar crest
 To check the boneloss in furcation area
 Width of periodontal ligament space
 Local irritating factors (calculus, overhanging
restoration)
 Crown root ratio
 Pathologic considerations ( caries, periapical
lesion, root resorption)

27.  It is a two dimensional view
 Doesn’t show actual amount of bone loss
 Do not demonstrate relationship with soft
tissues

28.  Erosion of interproximal alveolar bone crest

29.  Horizontal bone loss
 Vertical bone loss

31.  Extensive bone loss.

33. Thank you