Radiographic Anatomy First lecture The upper jaw (maxillae)

Leif Kullman
Assoc. Prof. OMF Radiology

As you know is x-rays an important tool to diagnose different diseases

The radiographic recognition of disease requires a sound knowledge of the radiographic appearance of normal structures Thats why we will start already now with anatomy

First some definitions



Radio-opaque
 

white

=White or gray areas Metal enamel dentin - bone =Black areas Less grey than neighboring area

Radiolucency
 

Findings in radiographs
 

Hard tissues, such as bones and teeth

=radiopaque view

Anatomic landmarks


foramens, cavities are radiolucent and bone ridges radiopaque bone lesion visible as cavity = radiolucency

Cysts


Fillings
  

amalgam as white areas composites as grey areas, less radio-opaque than teeth root canal filling as grey, more radio-opaque than tooth crowns =radiopaque

Prosthodontic appliances


Facial bones and some landmarks visible in dental radiographs of the upper jaw. We will concentrate on the upper jaw today


Upper jaw region----some basic structures to start with

    

Maxilla Zygomatic bone Nasal cavity Maxillary Sinus Orbit

Different dental radiographs

    

Periapical x-ray Bite wing All these intraoral x-rays



small x-ray showing crowns of teeth showing teeth from above, along the axis of teeth OPG showing all teeth, jaws and surroundings

Occlusal x-ray


Panoramic view


Lateral view All these extraoral x-rays..whats that?  Posterior-anterior view  Tomographic methods especially

CT= computed tomography, based on radiation MRI= magnetic resonance imaging, based on
magnetic fields

Extra-oral Radiography
Include all views made of the orofacial region with the film positioned extra-orally.  Used to visualize the skull and facial structures, for detection of disease or injury or to evaluate skeletal growth.  All extra oral radiograph require screen film and intensifying screen, thats why they will only give us a low radiation dose even if they are quite big


(the screen will enhance the small radiation coming)

Occlusal view but nor normal anatomy!

Periapical x-ray (intraoral ones)

A FMS or CMS can be taken

9 in the upper and 7 in the lower jaw and 4 bitewings

Normal findings in x-rays



Teeth


dentin and enamel have different shades



due to variation in mineralization

 

radiopacity: enamel dentin pulp cemento-enamel junction should be recognized lamina dura


Periodontium


thin layer of dense bone surrounding the root thin radiolucent area between root and lamina dura bone that extens between the teeth normal level no more than 1,5 mm from cemento-enamel junction

periodontal ligament space



alveolar crest
 

Normal bone findings in x-rays



Bone


cortical bone  superficial layer of all bones  better visible in mandible than in maxilla  dense and hard bone cancellous bone  s.c. trabecular bone  trabeculation varies  net-like appearance

Today the upper jaw!!

Normal findings in x-rays, upper jaw



Intermaxillary suture  visible in occlusal radiographs Anterior nasal spine  visible in periapical radiograph Incisive foramen  visible in periapical or occlusal radiograph Maxillary sinus  in OPG and periapical x-rays Zygomatic process  in opg and periapical x-rays

A1

Name the following structures j

a enamel b dentin c enamel-dentin junction d pulp horn e pulp chamber f root canal g furcation area h cancellous bone between the roots i furcation area..enamel pearl? j lamina dura k PDL space l lamina dura (approximal)

i L k

c d e g h

a b

b c

Identify the teeth: 21, 22, 23 (24, 25) Locate the radiographic apices of these teeth Name the structures: a floor of nasal fossa b inverted Y (crossing sinus max-nasal cavity) c floor of sinus max d soft tissue of the nose

The lateral fossa between the lateral and the canine

Upper anterior

a
Identify the teeth and name the structures

12, 11; 21 22 a nasal septum b nasal mucosa c nasal fossa d floor of the nasal fossa e anterior nasal spine f intermaxillary suture g incisive foramen h soft tissue of the nose

g f h

a Identify the teeth and name the structures b f

Identify the teeth: 14, 13, 12 a floor nasal cavity b floor sinus max c filling, plastic d filling in plastic e PDL of the second root f Lateral fossa

d c

Canine view/x-ray

Identify the teeth: and name the structures

a b

d Identify the teeth: 21, 22, 23, 24, 25, 63, 64, 65 c Estimate the age: 8-9 y a floor nasal fossa b bony crypt (developing tooth) c follicular space d not fully formed root .

Premolar and molar view

B1

c d

Locate the radiographic apexes of these teeth. Name the structures

a zygomatic arch bZygomatic bone inferior border c tooth bud d follicular space

B2
b

a c d

Locate the radiographic apexes of these teeth. Name the following structures
a lateral part of floor of nasal fossa b sinus max inferior border c septum in sinus max d posterior wall of SM

Identify the teeth and name the strucures

d c a b

Identify the teeth: 17 to 27 (55 to 53, 63 to 65) Name the following structures a Nasal septum, intermaxillary suture b superior foramina of the nasopalatine canal c sinus max d nasolacrimal duct

B4
c b a

dd

a Proc. Coronoideus

b tuberosity
c pterygoid plates d proc. Zygomaticus Locate the radiographic apices of these teeth Name the following structures

B5
Identify the area and name structures

a b f c

Identify the area:upper anterior (midline), edentulous patient Name the following structures a nasal fossa b mucosa of nasal fossa c floor of nasal cavity d nose e nose opening f anterior nasal spine

Thanks for today.now answer this question!!