ESSENTIAL ANATOMICAL

LANDMARKS AS APPLIED
TO DENTAL RADIOGRAPHY
MALE JUDE
 CONTENT OUTLINE

• Anatomical landmarks of maxilla

• Anatomical landmarks of mandible
• Clinical significance of these landmarks
• References
 ANATOMICAL LANDMARKS OF MAXILLA

Intermaxillary suture
Anterior nasal spine
Nasal fossa and nasal septum
Incisive foramen
Superior foramina of nasopalantine canal
Lateral fossa
Nose
Nasolacrimal canal
Maxillary sinus
Zygoma and zygomatic process of maxilla
Nasolabial
Pterygoid plates
 INTERMAXILLARY SUTURE

• Also called as median suture

• In IOPA, this appears as a thin radiolucent line in the midline between the two portions of
premaxilla
• It extends from the alveolar crest between the central incisors superiorly through the anterior
nasal spine and continues posteriorly between the maxillary palatine process to the posterior
aspect of the hard palate
 ANTERIOR NASAL SPINE

• Mostly seen in IOPA of maxillary central incisors

• Located in midline 1.5-2cm above the alveolar crest
• It is radiopaque and usually V-shaped
 NASAL FOSSA AND NASAL SEPTUM

• The nasal cavity shows hazy shadow of the inferior nasal conchae extending from the right and
left lateral walls
 INCISIVE FORAMEN

• Also called as nasopalatine or anterior palatine foramen

• Transmits the nasopalatine vessels and nerves
• Lies in the midline of palate behind central incisors at the junction of the median palatine and
incisive sutures
• It is frequently the potential site of cyst formation
 SUPERIOR FORAMINA OF THE
NASOPALATINE CANAL
• The nasopalatine canal originates as two foramina in the floor of the nasal cavity
• Radiographically, it can be recognized as two radiolucent areas above the apices of the central
incisors in the floor of the nasal cavity near its anterior border and both the sides of septum
 LATERAL FOSSA

• Also called incisive fossa

• Appears as depression in the maxilla near the apex of lateral incisor
• Appears diffusely radiolucent in the IOPA
 NASOLACRIMAL CANAL

• Nasal and maxillary bones of the nasolacrimal canal

• It runs from the medial aspect of the Antero inferior border of the orbit inferiorly, to drain under
the inferior conchae into the nasal cavity
 NOSE

• The soft tissue of the nose is frequently seen in the projections of the maxillary central and
lateral incisors superimposed over the roots of these teeth
• Image appears uniformly opaque with the sharp border
 NASOLABIAL FOLD

• An oblique line demarcating a region that appears to be covered by a slight radio opacity
frequently traverses periapical radiographs of the premolar region
 MAXILLARY SINUS

• This is an air containing cavity lined by mucous membrane

• Appears as the three sided pyramid;
• Base- formed by mesial wall adjacent to nasal cavity
• Apex- extending laterally into the zygomatic process of maxilla
• On the IOPA, maxillary sinus appears as a thin, delicate radiopaque line
• It extends from the distal aspect of the canine to the posterior wall of the maxilla above the
tuberosity
• Around the age of puberty, its floor coincides with floor of the nasal cavity
 CONT

• In response to the loss of function(associated with the loss of posterior teeth) the sinus may
expand further into the alveolar bone , occasionally extending to the alveolar ridge
 ZYGOMATIC PROCESS AND ZYGOMATIC
BONE
• Zygomatic process of the maxilla is an extension of the lateral maxillary surfaces that arises in
the region of the apices of the first and second molars and serves as articulation for the
zygomatic bone
• Appears as a u-shaped radiopaque line with rounded ends projected in the apical region of the
first and second molars
 PTERYGOID PLATES

• The medial and lateral pterygoid plates lies immediately posterior to the tuberosity of maxilla
• They cast a single radiopaque shadow without any evidence of trabeculation
• Extending inferiorly from the medial pterygoid plate , the hamular process may be seen
 ANATOMICAL LANDMARKS OF THE
MANDIBLE
• Symphysis

• Genial tubercles

• Lingual foramen

• Mental ridge

• Mental fossa

• Mental foramen

• Mandibular canal

• Mylohyoid ridge

• Submandibular gland fossa

• External oblique ridge

• Inferior border of mandible

• Coronoid process
 SYMPHYSIS

• In infants it demonstrates as a radiolucent line through the midline of the jaw between the images
of the forming deciduous central incisors
• The suture usually fuses by the end of 1st year of life and is no longer radiographically apparent
 GENIAL TUBERCLES

• These are tiny of bone that serve as attachment for the genioglossus and geniohyoid muscles
• Present on the lingual side
• Om IOPA, appears as ring shaped radiopacity below the apices of mandibular incisors
 LINGUAL FORAMEN

• It’s a hole or tiny opening located on the internal surface of mandible and surrounded by genial
tubercles
• Radiographically, appears as a radiolucent dot inferior to the apices of mandibular incisors
 MENTAL RIDGE

• It is a linear prominence of cortical bone located on the external surface extending from the
premolar region to the midline and slopes upward
• Radiographically, appears as a radiopaque band that extends from the premolar region to the
incisor region
 MENTAL FOSSA

• Located above the mental ridge

• On peri apical radiograph, appears as a radiolucent area above the mental ridge
 MENTAL FORAMEN

• Located on the external surface of the mandible as an opening in the region of mandibular
premolars
• Mental nerves and blood vessels exit through it
• Radiographically, it appears as a small ovoid radiolucent area located below the apices of the
premolars.
 MANDIBULAR CANAL

• This is a tube like passage extending from the mandibular foramen to the mental foramen and
contains inferior alveolar nerves and blood vessels
• Appears as a radiolucent band outlined by two radiopaque lines of cortical plate
 MYLOHYOID RIDGE

• Linear prominence of bone located on the internal surface of the mandible

• Extends from the molar region downward and forward towards the lower border of mandibular
symphysis
• On IOPA, appears as radiopaque band extending downwards from molars
 EXTERNAL OBLIQUE RIDGE

• Linear prominence of bone located on external surface of mandible extending downwards and is
a continuation of anterior border of ramus
• It appears as a radiopaque band extending downwards and forwards from anterior border and
ends in 3rd molar region
 SUBMANDIBULAR GLAND FOSSA

• Depressed area of bone located on the internal surface of mandible

• Submandibular salivary gland lies in the fossa
• Appears as a radiolucent area in the molar region below mylohyoid ridge
 INTERNAL OBLIQUE RIDGE

• Linear prominence of bone located on internal surface of mandible extending downwards and
forwards from ramus
• It appears as a radiopaque band extending downwards from ramus
 INFERIOR BORDER OF THE MANDIBLE

• Occasionally, seen as a dense broad radiopaque band of bone.

 CORONOID PROCESS

• Marked prominence of bone on the anterior ramus of the mandible

• Not seen on a mandibular IOPA but appears on a maxillary molars IOPA
• It is seen as a triangular radiopacity superimposed over or inferior to maxillary tuberosity
 CLINICAL SIGNIFICANCE

• The radiographic recognition of diseases requires a sound knowledge of the radiographic

appearance of normal structure
• Intelligent diagnosis mandates an appreciation of the wide range of variation in the appearance of
normal anatomic structure
• Most patients demonstrate many of the normal radiographic landmarks, but it is rare for a patient
to show all of them
• Accordingly, the absence of one or two or even several landmarks in any individuals should not
necessarily be considered abnormal
 REFERENCES

• Essentials of dental radiology

• Internet
• NCBI