lecture 5 b_radiographic_interpretation_dental_caries_2012
TRANSCRIPT
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Dr MUMENA C.H
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*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
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*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
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*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
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*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
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*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
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*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
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*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
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*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
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*After completion of this part: Follow radiographic presentation of periodontal diseases in part 3