Radiology Review with Dr.

Dagdevirin
Tuesday Feb 19th, 2019

The most effective way of minimizing a patient’s radiation dose is

A. a lead apron and thyroid collar.
B. prescription radiography.
C. fast emulsion film.
D. intensifying screens.

In dental radiography, the most effective method of reducing patient somatic exposure is to use
A. a lead apron.
B. high speed film.
C. added filtration.
D. collimation.

The most common soft tissue calcification or ossification found on a panoramic radiograph is
(a)
A. lymph node.
B. sialolith.
C. phlebolith.
D. stylohyoid ligament.

When a radiographic examination is warranted for a 10 year old child, the most effective way to
decrease radiation exposure is to
A. use a thyroid collar and lead apron.
B. apply a radiation protection badge.
C. use high speed film.
D. decrease the kilovoltage to 50kVp.
E. take a panoramic film only

Mean x-ray beam energy is a function of

A. exposure time.

B. tube current.

C. tube voltage.

D. collimation.

Which radiographic finding supports the diagnosis of lingual displacement of the root of an
intruded primary incisor?

A. Elongation.

B. Foreshortening.

C. Increased opacity.

D. Widened periodontal ligament space.

1
Which of the following exposure factors will result in the most penetrating x-rays?
A. 10kVp - 65mA.
B. 85kVp - 5mA.
C. 90kVp - 10mA. – higher kvp the more penetrating the xray!! Always look for the highest
KVP! mA changes the number of photos, exposure time is mAs
D. 65kVp - 15mA.
E. 75kVp - 40mA.

Need to know the age of each tooth calcification age! Remember that wisdom teeth
start calcifying at 8-10 years old!

For maxillary sinus

Pterygoid maxillary fissure, remember fissures and sutures are radiolucent!

Ghost image – higher and on the opposite side of the image! Ex. Earrings! We also
have the spine shadow when the patient is slouching.

If something is VERY radiopaque it could be a LEAD APRON!

Focal osteoporotic bone marrow defect – will should up as a radiolucent defect in

the posterior mandibular region. Can be due to trauma, doesn’t have very specific.
Enlarged trabeculation, doesn’t require any treatment. No effect on the tooth.

Post extraction socket – you’ll see the outline of the extraction socket, look for
retained root time (look for PDL space and lamina dura around it! If it’s a retained
root tip you will see these features! Look for pulp canals too!)

Odontoma
Compound (maxillary anterior most common, will have tooth features), and
complex (doesn’t look like tooth structures in it). Usually in younger patients, will
have a SCLEROTIC RIM!

Cementoblastoma also has a radiolucent capsule with a sclerotic rim, usually in

premolar region, attached to root surface! And the tooth is vital. These patients have
pain

Rarefying osteotitis – need to do a biopsy, the tooth is non vital

Radicular cyst, the tooth is always non vital

POF – anterior mandibular teeth, female, African American, middle aged. TOOTH IS
VITAL. In mature stage it’s completely radiopaque! REMEMBER THE TOOTH IS
VITAL!! IF IN MORE THAN 3 QUADRANTS IT’S FLORID DYSPLASIA!!

2
OSTEOMYLITIS WILL BE DEAD BONE. Ill defined appearance, patient will have a
history of extractions that got infected.
SEQUESTRA IS THE MOST IMPORTANT FEATURE!!
YOU’LL SEE EXTRA LAYER OF BONE IN THE MANDIBLE.
WILL SEE AN ONION SKIN APPEARANCE IN CHRONIC OSTEOMYLITIS!!

OKC – more common in the posterior mandible. Tends to grow along the internal
aspect of the bone. May have scalloping borders! May have septations. May have
keratin. Gorlin Goltz is associated with multiple OKCs

Sialolith is most common in the submandibular gland!! Swelling and pain

before eating! Can sometimes see sialolith superimposed over the roots of the
mandibular teeth. Sometimes won’t show up on a radiograph since they aren’t
calcified enough to show up on the image!

Malignancy – ill-defined, root resorption, bone destruction, destruction of the

cortical bones. Osteosarcoma will have a sun ray appearance!

Ddx for a tooth with a lesion around the crown in the posterior mandible:
dentigerous cyst, OKC and ameloblastoma (grows B-L)

CEOT = Pindborg tumor

Gardener’s syndrome = multiple osteomas and intestinal polyps

Cleidocranial dysplasia = multiple supernumerary teeth!

Dense bone island = radiopacity in bone, no border really, it blends in with the
surrounding bone. No treatment required. Very common finding.

****For OSCE: You don’t treat anything in the outer half of enamel, for
restorative purposes for the exam!!! Only once beyond outer 1/3 of dentin!