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Advacedradiographicaids 140620002204 Phpapp01
Advacedradiographicaids 140620002204 Phpapp01
in
periodontology
Radiographs & imaging
Introduction
A better understanding of the
periodontal disease process
challenged usefulness of traditional
clinical and radiographic methods for
diagnosis and prompted revision of
outdated diagnostic aids.
DIAGNOSIS
Evaluation of
patient history
Physical
examination
Laboratory
investigations
PRINCIPLES OF DIAGNOSIS
True negative
Bone levels
Bone loss – even or angular patterns
Intra(infra) – bony defects
Root morphologies ⁄ topographies
Furcation radiolucencies
Endodontic lesions
Endodontic mishaps
Developmental anomalies
Root length and shape(s) remaining in bone
CONVENTIONAL
RADIOGRAPHS AND
DIGITAL
IOPA,BITEWINGS
OPGS
&OCCLUSAL
CONVENTIONAL RADIOGRAPHS
Paralleling technique
Also called as “right angle” or “long cone technique”.
X-ray film is placed parallel to long axis of tooth and
central ray of x-ray beam is directed at right angle to teeth
& film.
Preferable technique for periodontal use.
Bisecting angle technique
USES
1)To study height & contour of interdental alveolar bone.
(2)To detect interproximal calculus.
(3)To detect periodontal changes
Useful for evaluating large areas of the skull and jaws but
are not adequate for detection of subtle changes such as
the early stages of dental caries or periodontal disease.
Conventional panoramic
imaging/Pantamography
LIMITATIONS OF OPG
Image distortion
Lingual structures would be projected higher than buccal
surfaces
Use of screen film combination results in less details than
intral oral images
Production of ghost images
It can be used as a alternative for intra oral full mouth series when
combined with bite wing radiographs
Tugnait et al. 2000,2005
The periodontal structures of interest noted on periapical
radiographs are also noted on panoramic radiographs.
Pepallasi EA et al 2000
Panoramic radiographs may not reveal alveolar bony defects as
accurately as periapical radiographs.
latest version
Conventional radiographic
source used to expose sensor
Early detection
Quantitative assessment
3 D imaging
Digital subtraction radiography
Zeidses des Plantes (1935) : 1st demonstrated use of
subtraction imaging
Depends up on conversion of serial radiographs
into digital images.
Overall contrast is
improved no objective description
Trabecular marrow High standardization of x
spaces are visualized rays
Enhancement of low No reduction in exposure
and high density
images
COMPUTER ASISTED DENSITROMETRIC
Deas et al 1991
Introduced in 1989
DETECTORS
B. BEZAK et al 2010
Assessed reliability and accuracy of Cone Beam Computed Tomography
(CBCT) against CAL
.
CBCT measurement protocol is reliable.
Accuracy of CBCT measurements correlates with CAL gold standard
measurements.
Brently A. et al 2009
The term micro the pixel sizes of the cross-sections are in the
micrometer range
.
Uses
Advantages:
• assessment of bone volume,
bone height &quality
• proper length of implant can be
selected
• Clear visualization of inferior
alveolar canal
Digital tomosynthesis (DTS)
Digital tomosynthesis (DTS) is a limited-angle tomographic
technique
Caries detection
Vertical root fracture
Helps to detect osseous defects around implants
Detection and localization of osseous changes in crestal
bone
Onanong Chai-U-Dom in 2002
Nair M K et al in 2002
Reconstruction of image
USES IN HEAD AND NECK REGION
Tumour staging
Investigation of the TMJ to show both the bony and soft tissue components
Implant assessment
Schara et al 2009
In an invitro study evaluated the used the use of MRI to characterize
inflammation and healing process in periodontal tissues
It was concluded that MRI can characterize the type and healing process of
inflammation
BONE SCANNING or RADIONUCLIDE
IMAGING
IN contrast to X-ray, CT, MRI which require
structural or anatomic changes to be recorded,this
technique assesses biochemical alteration in body
DENTAL-IMPLANT ASSESSMENT
• PANORAMIC RADIOGRAPHY
RECOMMENDATION 1 SHOULD BE USED AS AN
IMAGING MODALITY
RECOMENTATION 5
CBCT considerd as the imaging modality of
choice for imaging implant sites
RECOMMENDATION 6
CBCT should be considered if need for
augmentaion or other site development
procedure is present
Postoperative imaging
Transmission and
persistence of Query and retrieval
complete objects of objects
Eg images,docs
Quality and
consistency of image
apperance
RADIOGRAPHS IN PERIODONTAL
DISEASE DIAGNOSIS & MANAGEMENT
Features of periodontal
diagnostic interest are
apparent on radiographs
Tugnait et al 2000