This document discusses principles of radiographic interpretation in dentistry. It describes interpretation as explaining what is seen on dental radiographs based on the ability to read what is revealed. The objectives of interpretation are detection, description, and differentiation of diseases using a systematic LOGIC method of localizing images, observing shadows, considering radiographic facts, formulating interpretations, and correlating findings with history and exam. Essential requirements include knowledge of normal anatomy, variations, and pathological appearances as well as optimal viewing conditions.

1. Principles of
Radiographic
Interpretation

2. Interpretation
An explanation of what is viewed on dental
radiograph
The ability to read what is revealed in
dental radiograph

3. Diagnosis
The identification of disease by examination
or analysis

4. Objectives of radiographic
interpretation
3D

5. Objectives of radiographic
interpretation
Detection: presence or absence of
disease
Description: providing information on the
disease according to systematic approach
Differentiation: diseases of similar
radiographic appearance

6. Essential requirements for
interpretation

7. Optimum viewing
conditions
Essential requirements for
interpretation

8. Knowledge of what the radiograph should
look like
Essential requirements for
interpretation

9. Knowledge of appearance of normal
anatomical landmarks as well as
variations of normal.
Essential requirements for
interpretation

10. Knowledge of radiographic appearance of
pathological conditions affecting the
maxillofacial region.
Essential requirements for
interpretation

11. How to interpret a
radiographic image?

12. L O G I C

13. LOGIC
Localize the radiograph
Observe the shadows of the radiograph
General consideration of radiographic
facts
Interpretation formulation
Correlation of radiographic interpretation,
history, and clinical findings

14. Localize the radiograph

15. Observe the shadows of the
radiograph

16. General consideration of
radiographic facts

17. Interpretation formulation
Systematic description and analysis of
findings revealed in the radiograph

18. Interpretation formulation
Site (Location)
Shape and Periphery
Internal structure
Effects on surrounding structures
Size
Number

19. Site (Location)
Localized

20. Site (Location)
Localized
Generalized

21. Site (Location)
Localized
Generalized
Multiple

22. Site (Location)
Unilateral
Bilateral

23. Site (Location)

24. Site (Location)

25. Shape and Periphery
1. Border
2. Margin
3. Shape

26. Shape and Periphery
1. Border
Well defined
Ill defined

27. Shape and Periphery
1. Border
Well defined

28. Shape and Periphery
1. Border
Ill defined

29. Shape and Periphery
2. Margin
Corticated
Non corticated
Sclerotic
Radiolucent rim

30. Shape and Periphery
3. Shape
Round
Oval
Scalloped
Irregular
Inverted pear
Heart shape

31. Internal structure
Radiodensity
Radiolucent Radiopaque Mixed (RL-RO)

32. Radiolucent

33. Radiopaque

34. Mixed (RL-RO)

35. Radiolucent
Unilocular Multilocular
Soap bubble Honey comb Tennis Racket

36. Internal structure
Unilocular Multilocular

37. Internal structure
Soap bubble
Honey comb
Tennis Racket

38. Radiopaque or Mixed
Sunray
Orange peal
Ground glass
Cotton wool
Driven snow

39. Internal structure
Associated with
impacted tooth

40. Effects on surrounding structures
Teeth
Bone

41. Effects on surrounding structures
Teeth
Widening of Periodontal
membrane space
Loss of lamina dura
Root resorption
Tooth displacement
Root divergence
Hindering of tooth
eruption

42. Effects on surrounding structures
Bone
Expansion
Thinning
Erosion &
perforation
Displacement of
cortices
Obliteration of max.
sinus

43. Size
Small – medium –
large – Huge
Measured in
centimeters

44. Number
Single
Multiple:
Systemic (blood or
endocrinal diseases)
Syndromes

45. Again
Interpretation does not equal diagnosis

46. Diagnosis
History
Clinical Examination
Special Investigations

47. Special Investigations
Conventional radiographs (periapical-
occlusal- panoramic-lateral oblique-etc…)
Advanced imaging modalities (CT-MRI-
US-etc….)
Biopsy (aspiration-smear-incisional-
excisional)
Blood analysis
Urine analysis

48. Diagnosis
Non differential diagnosis
Differential diagnosis

49. Diagnosis
Non differential
diagnosis

50. Diagnosis
Differential diagnosis
How to differentiate between different
lesions which have similar radiographic
appearance

51. Wood and Goaz Classification
Radiolucencies
Periapical
Pericoronal
Interradicular
Solitary cyst-like
lesions
Multilocular
Ill defined
Multiple separate
Generalized
rarefaction
Mixed (RL-RO)
Periapical
Pericoronal
Not necessarily
contacting the
teeth
Radiopacities
• Periapical
• Not necessarily
contacting the
teeth
• Multiple
• Generalized