Normal

Radiographic
Anatomy

Dr .Hidayah Elyas
► The radiographic recognition of disease requires a
sound knowledge of the radiographic appearance of
normal structures.

► Intelligent
diagnosis mandates an appreciation of
the wide range of variation in the appearance of
normal anatomic structures.
 Teeth
► Teeth are composed primarily of dentin, with an
enamel cap over the coronal portion and a thin layer
of cementum over the root surface.
► Enamel cap appears the most radiopaque.
► Dentin is less radiopaque and is roughly comparable
to the bone.
► The enamelo-dentinal junction appears as a distinct
interface that separates those two structures.
► Cementum is not usually apparent.
► The pulp of the normal teeth is composed of
soft tissue consequently appears radiolucent.
► It is composed of pulp chamber and root
canals.
► The apical foramen opens at the end of the
root apex. Sometimes it is not recognizable.
So it may open on the side of the root.
• In a mature tooth, the shape of the pulp
chamber and canals may change, with aging
occurs a gradual deposition of secondary
dentin which begins apically, proceeds
coronally and may lead to pulp obliteration.

• Trauma to the teeth also may stimulate

dentin production.

► Caries, restoration, attrition or erosion may

cause pulp obliteration.
 Cervical Burnout
► It is a diffuse radiolucent
areas with ill-defined
borders on the mesial or
distal aspects of teeth in
the cervical region
between the enamel cap
and the crest of the
alveolar ridge.
► It is not to be confused
with root caries.
 Supporting Structures
Radiolucent
Radiopaque

► Lamina
Periodontal
duraligament space
► Alveolarcrest
► Cancellous bone
 Periodontal Ligament Space
► PDL is composed primarily of collagen.
► Varies in width from patient to patient and from
tooth to tooth, even from location to location in the
same tooth.
► The thickness of the ligament correspond to the
degree of function.
► It is thin in embedded teeth and those that have lost
their antagonists.
► The shape of the tooth creates the appearance of a
double PDL space.
 Lamina Dura
► Lamina dura means Hard Layer
► It surrounds the tooth socket
► It is only slightly thick but not more
mineralized than the cancellous bone
► The thickness varies with the amount of
occlusal stress.
► Wider in heavy occlusion.
► Its presence is of valuable diagnostic feature
 Alveolar Crest
► It is a thin radiopaque
line that extends between
the teeth.
► The level of the alveolar
crest is considered
normal when it is not
more than 1.5mm from
the cemento-enamel
junction.
► In anterior region it is
reduced to a point.
► Posteriorly, it is flat.
 Cancellous bone
► Also called trabecular bone or spongiosa.
► Lies between the cortical plates in both jaws.
► It is composed of a thin radiopaque plates and rods
surrounding many small radiolucent pockets of
marrow.
► There is considerable variation between patients and
in the same patient.
► To evaluate a trabecular pattern, the practitioner
should examine the trabecular distribution, size and
density and compare them throughout both jaws.
 Maxilla
Radiolucent Radiopaque
Landmarks Landmarks

1- Intermaxillary 1- Anterior nasal spine

suture 2- Shadow of the nose
2- Nasal Fossa 3- Zygomatic process
3- Incisive foramen and zygomatic bone
4- Lateral Fossa 4- Nasolabial fold
5- Superior foramina 5- Pterygoid plates
of the nasopalatine
 Intermaxillary Suture
► Appears on intraoral radiographs as a thin
radiolucent line in the midline between the
two portions of the premaxilla.
► Bordered by two radiopaque borders.
► Its appearance depends on both anatomic
variability and x-ray angulation.
► Misinterpreted as fracture.
 Anterior Nasal Spine
► Demonstrated on a periapical radiograph of
the maxillary central incisors.
 Shadow of the Nose
► The soft tissue of the tip of
the nose may appear as a
radiopaque sharp border in
the projections of the
maxillary and lateral
incisors, superimposed over
the roots of these teeth.
 Nasolabial Fold
► It appears at the canine-
premolar region as a
radiopaque line extending
obliquely and the area of
increased radiopacity is
posterior to the line.
 Nasal Fossa
► Itappears in the central incisors projection.
► Nasal septum may appear.
► The shadow of the inferior chonchae may
appear extending laterally toward the nasal
septum.
► Misinterpreted as periapical pathosis
 Incisive Foramen
► Also called anterior palatine or nasopalatine
foramen.
► It lies in the midline of the maxilla behind the
central incisors.
 Lateral Fossa
► Also called incisive fossa, is a
gentle depression in the
maxilla near the lateral
incisor.
► On periapical projection of
this region, it may appear
diffusely radiolucent.
► Misinterpreted as pathosis.
 Superior Foramina of the
Nasopalatine Canal
► Appears just lateral to
the nasal septum
 Nasolacrimal Canals
► The nasal and the maxillary bones form the
nasolacrimal canal.
► Sometimes it appears on periapical canine
projection or on maxillary occlusal
projection.
 a

a: Floor of nasal fossa

b: Maxillary sinus
c: Lateral fossa
 Zygomatic Process and Zygomatic
Bone
► Extension of the lateral maxillary surface in
the region of the apices of the first and second
molars.
► On periapical radiographs it appears a U-
shaped radiopaque line.
 Maxillary Sinus
► The sinus is considered as a three sided
pyramid. The base (medial wall) adjacent to
the nasal cavity and the apex extending
laterally into the zygomatic process.
Maxillary sinus :

The maxillary sinus with

Its thin bony walls, its
thin mucosa, and its vast
Air space, produce an
Extremely dark image
Deep to the maxillary
Teeth.

Its outlines, particularly

its
Floor, are clearly
delineated
By delicate radio-opaque
lines
Pneumanization :expansion of sinus wall into
surrounding bone, usually in an area where
teeth have been lost prematurely.

It increases with age .

 Pterygoid Plates
► Themedial and lateral plates lie immediately
posterior to the tuberosity of the maxilla.
 Mandible
Radiolucent Landmarks
Radiopaque

► Genial
Symphysis
Tubercles
► Mental Ridge
Fossa
► Mylohyoid
Mental Foramen
ridge
► External
Mandibular
oblique
Canal ridge
► Inferior
Nutrientborder
Canalsof the mandible
► Coronoid
Submandibular
processgland Fossa
 Symphysis
► It appears in infants
radiographs.
► Occurs in the midline of
the jaw.
► Fuses by the end of first
year of life.
► If it occurs in adults, it
suggests a fracture or
cleft.
 Genial Tubercles
► Also called mental spine.
► Divided right and left,
superior and inferior
promineneces.
► Appears on occlusal
radiographs.
► On peripaical radiographs
it appears as round
radiopacity surrounding
the lingual foramen.
Lingual foramen : radiolucent ‘hole ’ in centre of genial tubercles.
Lingual nutrient vessels pass through this foramen .
Genial tubercles: They appear as radio Opaque circle that
surrounds the lingual foramen just below the apices of the Of
the incisors.
 Mental Ridge
► May appear as two radiopaque lines
sweeping bilaterally forward and upward
toward the midline.
Nutrient canals :

The arrows above

identify nutrient
Canals.
They are most often seen
in
Persons with thin bone
and in
Those with high blood
pressure
Or advanced
periodontitis.

Nutrient canals
 Mental Fossa
► Itis a depression on the labial
aspect of the mandible.
► Sometimes mistaken as a
periapical disease.
 Mental Foramen
► It is the anterior limit of the inferior alveolar
canal.
► It doesn’t appear on every radiograph
because its opening is directed superiorly
and posteriorly.
► It may be round, oblong, slit-like or very
irregular and partially or completely
corticated.
► The foramen is seen about half way between
the lower border of the mandible and the
crest of the alveolar process usually in the
region of the apex of the second premolar.
► Misinterpreted as a periapical pathosis.
mental

foramen
 Mandibular canal
► It is a dark linear shadow with thin
radiopaque superior and inferior borders.
► Sometimes the borders are seen only partially
or not at all.
► The relationship of the canal to the roots of
the lower teeth may vary.
► If lamina
projected over the root apices, the
dura will be overexposed and
misinterpretation may occur.
 Submandibular Gland Fossa
► It occurs on the lingual surface of the
mandibular body just below the myelohyoid
ridge.
► May be misinterpreted as a bony lesion.
 Myelohyoid Ridge
► Irregular crest of bone on the lingual
surface of the mandibular body.
► Extending from the lower third molars
to the lower border of the mandible in
the region of the chin.
 External Oblique Ridge
► It is the continuation of
the anterior border of the
mandibular ramus.
► It follows an antero-
inferior course lateral to
the alveolar process.
Inferior Border of the Mandible
► Sometimes it appears on periapical
radiographs as a dense, broad radioapque
band of bone.
 Coronoid Process of the
Mandible
► It appears on radiographs of maxillary
posterior region as a triangular radiopacity.
 Restorative Materials

► Restorative materials vary in their

appearnce, depending on their
thickness, density and atomic number.

► The atomic number is the most

important factor.
 Restorative Materials
Radiopaque Radiolucent
► Amalgam ► Silicate
► Gold ► Composite
► Stainless steel ► Porcelain but it is
pins fused to metal
► Calcium ► Orthodontic
Hydroxide. Appliances
► Gutta-percha
► Silver points