02 radio anatomy 1 dentistry)
TRANSCRIPT
Radiographic Anatomy
First lectureThe upper jaw
(maxillae)
Leif KullmanAssoc. Prof.
OMF Radiology
The radiographic recognition of disease requires a sound knowledge of the radiographic appearance of normal structuresThat’s why we will start already now with anatomy
As you know is x-rays an important tool to diagnose different diseases
First some definitions
Radio-opaque =White or gray areas Metal – enamel – dentin - bone
Radiolucency =Black areas Less grey than neighboring area
white
Findings in radiographs Hard tissues, such as bones and teeth
=radiopaque view Anatomic landmarks
foramens, cavities are radiolucentand bone ridges radiopaque
Cysts bone lesion visible as cavity = radiolucency
Fillings amalgam as white areas composites as grey areas, less radio-opaque than teeth root canal filling as grey, more radio-opaque than tooth
Prosthodontic appliances crowns =radiopaque
Facial bones and some landmarks visible in dental radiographs of the upper jaw. We willconcentrate 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
small x-ray showing crowns of teeth Occlusal x-ray
showing teeth from above, along the axis of teeth Panoramic view
OPG showing all teeth, jaws and surroundings Lateral view Posterior-anterior view Tomographic methodsespecially
CT= computed tomography, based on radiation
MRI= magnetic resonance imaging, based on magnetic fieldsAll these extraoral x-rays…..what’s that?
All these intraoral x-rays
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, that’s why
they will only give us a low radiation doseeven 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 jawand 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
Periodontium lamina dura
thin layer of dense bone surrounding the root periodontal ligament space
thin radiolucent area between root and lamina dura alveolar crest
bone that extens between the teeth normal level no more than 1,5 mm from cemento-enamel junction
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
a
bd
c
fe
g
h
i
j
kL
A1Name the following structures
a enamelb dentinc enamel-dentin junctiond pulp horne pulp chamberf root canalg furcation areah cancellous bone between the rootsi furcation area…..enamel pearl?j lamina durak PDL spacel lamina dura (approximal)
a b
c
d
• •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
•Identify the teeth: 21, 22, 23 (24, 25) •Locate the radiographic apices of these teeth
The lateral fossabetween the lateraland the canine
Upper anterior
cb
d
a
e
f
g
h
•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
Identify the teeth and name thestructures
a
b
cd
e
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
•Identify the teeth andname the structures
Canine view/x-ray
c
ba
d•Identify the teeth: •21, 22, 23, 24, 25, 63, 64, 65
•Estimate the age: 8-9 y• •a floor nasal fossa•b bony crypt (developing tooth)•c follicular space•d not fully formed root .
•Identify the teeth:and name the structures
Premolar andmolar view
Locate the radiographic apexes of these teeth.Name the structures
a
b cd
B1
a zygomatic archbZygomatic bone inferior borderc tooth budd follicular space
a
b
c
d
Locate the radiographic apexes of these teeth.Name the following structures
B2
a lateral part of floor of nasal fossab sinus max inferior borderc septum in sinus maxd posterior wall of SM
a
b
c
d
•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
Identify the teethand name the strucures
abc
d
B4
a Proc. Coronoideusb tuberosityc pterygoid platesd proc. Zygomaticus
Locate the radiographic apices of these teethName the following structures
d
a
b
c
d
e
Identify the area:upper anterior (midline), edentulous patient Name the following structuresa nasal fossab mucosa of nasal fossac floor of nasal cavityd nosee nose openingf anterior nasal spine
f
B5Identify the areaand name structures
Thanks for today….now answer this question!!