brd rev intraoral anat

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    Maxillary Incisor

    Nasal septum

    Inferior concha

    Nasal fossa

    Nasal spine

    Incisive foramen

    Nose

    Median palatine suture

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    e

    f

    a = nasal septum

    b = inferior concha

    c = nasal fossa

    d = anterior nasal spine

    e = incisive foramen

    f = median palatal

    suture

    b

    ad

    c

    facial view palatal view

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    a

    Inferior concha

    facial view

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    Nasal fossa

    facial view

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    Anterior nasal spine

    facial view

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    palatal view

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    palatal view

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    Soft tissue of the nose

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    Red arrow points to

    periapical lesion

    (post-endo).

    ab

    e

    a

    db

    Red arrows = lip line

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    g

    Red arrow = mesiodens

    (supernumerary tooth)

    d

    f

    Blue arrow = chronicperiapical periodontitis.

    Tooth # 9 is non-vital

    (trauma) and needs endo.

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    Superior foramina of the nasopalatine canals (red

    arrows). These foramina lie in the floor of the nasal

    fossa. The nasopalatine canals travel downward to join

    in the incisive foramen.

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    d

    b a

    The red arrows point to an

    incisive canal cyst; the

    orange arrow identifies

    the root of tooth # 7.

    All the incisors are non-vital

    and have periapical lesions. The

    purple arrows point to external

    resorption; the blue arrow

    identifies internal resorption.

    f

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    The red arrows point to the soft tissue of the nose.

    The green arrows identify the lip line.

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    Maxillary Canine

    Floor of nasal fossa

    Maxillary sinus

    Lateral fossa

    Nose

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    a = floor of nasal fossa

    b = maxillary sinus

    c = lateral fossa

    (a & b form inverted Y)

    a

    c

    b

    a

    c

    b

    facial view

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    Floor of nasal fossa (red arrows) and anterior

    border of maxillary sinus (blue arrows), forming the

    inverted (upside down) Y.

    facial view

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    Lateral fossa. The radiolucency results from a

    depression above and posterior to the lateral

    incisor. To help rule out pathology, look for an

    intact lamina dura surrounding the adjacent teeth.

    facial view

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    Soft tissue of the nose

    Red arrows point to nasolabial fold.

    Also note the inverted Y.

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    The red arrow identifies the lateral fossa. The pink

    arrow points to CPP (chronic periapical periodontitis =

    abscess, granuloma, etc.).

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    Zygomatic

    process

    Sinus septumSinus recess

    Maxillary sinus

    Maxillary Premolar

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    a = malar processb = sinus recess

    c = sinus septum

    d = maxillary sinus

    b

    a cd

    b

    dca

    facial view

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    Malar (zygomatic) process. U or j-shaped

    radiopacity, often superimposed over the rootsof the molars, especially when using the

    bisecting-angle technique. The red arrows

    define the lower border of the zygomatic bone.

    facial view

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    Sinus septum. This septum is composed of folds

    of cortical bone that arise from the floor and wallsof the maxillary sinus, extending several

    millimeters into the sinus. In rare cases, the

    septum completely divides the sinus into separate

    compartments.

    facial view

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    Sinus recess. Increased area of radiolucency

    caused by outpocketing (localized expansion)of sinus wall. If superimposed over roots, may

    mimic pathology.

    facial view

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    Maxillary Sinus. An air-filled cavity lined with

    mucous membrane. Communicates with nasal

    cavity through 3-6 mm opening below middle

    concha. Red arrows point to neurovascular

    canal containing superior alveolar vessels and

    nerves.

    facial view

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    Blue arrows identify

    radiopacity which is a

    mucous retention cyst.

    Note relatively recent

    premolar extraction sites.

    Green arrow points to

    neurovascular canal.

    The red arrows point to

    the nasolabial fold. The

    thicker cheek tissue

    makes the area more

    radiopaque posterior to

    the line.

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    Pneumatization. Expansion of sinus wall into

    surrounding bone, usually in areas where

    teeth have been lost prematurely. Increaseswith age.

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    g

    d

    a

    e

    f

    a = maxillary tuberosity* e = zygoma (dotted lines)

    b = coronoid process f = maxillary sinus

    c = hamular process g = sinus recess

    d = pterygoid plates

    * image of impacted third molar superimposed

    c

    b

    facial view

    d

    b

    a

    e

    c f

    g

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    Maxillary Tuberosity. The rounded elevationlocated at the posterior aspect of both sides of

    the maxilla. Aids in the retention of dentures.

    facial view

    facial view

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    Coronoid process. A mandibular structure

    sometimes seen on the maxillary molar periapicalfilm when using the bisecting angle technique

    with finger retention (The mouth is opened wide,

    moving the coronoid down and forward). Note the

    supernumerary molar.

    facial view

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    Hamular process (white arrows) and pterygoid plates

    (purple arrows). The hamular process is anextension of the medial pterygoid plate of the

    sphenoid bone, positioned just posterior to the

    maxillary tuberosity.

    facial view

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    Zygomatic (malar) bone/process/arch. The

    zygomatic bone (white/black arrows) startsin the anterior aspect with the zygomatic

    process (blue arrow), which has a U-shape.

    The zygomatic bone extends posteriorly

    into the zygomatic arch (green arrow).

    facial view

    facial view

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    Maxillary sinus. As seen in the above film, the floor of the

    maxillary sinus flows around the roots of the maxillary molars

    and premolars. The walls of the sinus may become very thin.

    As a result, sinusitis may put pressure on the superioralveolar nerves resulting in apparent tooth pain, even though

    the tooth is perfectly healthy. Note coronoid process (green

    arrow), zygomatic bone (blue arrow), sinus septum (yellow

    arrow) and neurovascular canal (orange arrows).

    facial view

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    The maxillary sinus is evident

    anterior to the second molar

    (black arrows) but it

    disappears posteriorly due to

    the superimposition of the

    zygomatic bone. The orange

    arrows identify a mucous

    retention cyst (retention

    pseudocyst) within the sinus.

    This film shows the

    coronoid process (green

    arrow) and a distomolar

    (blue arrow) that has erupted

    ahead of the third molar (redarrow). A distomolar is a

    supernumerary tooth that

    erupts distal (posterior) to

    the other molars.

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    The zygomatic process (green arrows) is a prominent U-

    shaped radiopacity. Normally the zygomatic bone

    posterior to this is very dense and radiopaque. In thispatient, however, the maxillary sinus has expanded into

    the zygomatic bone and makes the area more

    radiolucent (red arrows). The coronoid process (orange

    arrow), the pterygoid plates (blue arrows) and the

    maxillary tuberosity (pink arrows) are also identified.

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    This film shows the expansion of the borders of the

    maxillary sinus through pneumatization (red arrows). This

    expansion increases with age and it may be accelerated as

    a result of chronic sinus infections. It is most commonly

    seen when the first molar is extracted prematurely, as inthe film at right (the second and third molars have

    migrated anteriorly to close the space). The coronoid

    process is seen in the lower left-hand corner of each film.

    The green arrow identifies a sinus recess. Note the two

    distomolars in film at right (blue arrows).

    Mandib lar Incisor

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    Mandibular Incisor

    Mental ridge

    Genial tubercles Lingual foramen

    Mental fossa

    facial viewlingual view

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    b = genial tubercles

    a = lingual foramen c = mental ridge

    d = mental fossa

    a

    b

    cd

    facial viewlingual view

    lingual view

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    Lingual foramen. Radiolucent hole in center of

    genial tubercles. Lingual nutrient vessels pass

    through this foramen.

    lingual view

    lingual view

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    Genial tubercles. Radiopaque area in the midline,

    midway between the inferior border of the mandible and

    the apices of the incisors. Serve as attachments for the

    genioglossus and geniohyoid muscles. May have

    radiolucent hole in center (lingual foramen), but not on

    this film. Note double rooted canine (red arrows).

    lingual view

    facial view

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    Mental ridge. These represent the raised portions of the

    mental protuberance on either side of the midline. More

    commonly seen when using the bisecting angle

    technique, when the x-ray beam is directed at an upward

    angle through the ridges.

    facial view

    facial view

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    Mental fossa. This represents a depression on the

    labial aspect of the mandible overlying the roots of

    the incisors. The resulting radiolucency may be

    mistaken for pathology.

    facial view

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    The radiolucent area above

    corresponds to the location

    of the mental fossa. However,this slide represents chronic

    periapical periodontitis; these

    teeth are non-vital, due to

    trauma.

    The orange arrows above

    identify nutrient canals.

    They are most often seen inolder persons with thin

    bone, and in those with high

    blood pressure or advanced

    periodontitis.

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    facial view lingual view

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    b2

    a = mental ridge

    c = mental foramen b2 = lingual foramen

    b1 = genial tubercles

    dc

    da

    db1

    db2

    facial view

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    Mental ridge. The raised portions of the mental

    protuberance, sloping downward and backward

    from the midline.

    lingual view

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    Lingual foramen/genial tubercles. (See

    description under mandibular incisor

    above).

    lingual view

    facial view

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    The red arrows identify the mandibular canal

    and the blue arrow points to the mental

    foramen.

    facial view

    Mandib lar Premolar

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    Mandibular Premolar

    Mylohyoid ridge

    Mandibular canal

    Mental foramen

    Submandibulargland fossa

    facial view lingual view

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    c

    b = mandibular canal

    d = mental foramen

    a = mylohyoid ridge

    (internal oblique)c = submandibular gland

    fossa

    facial view lingual view

    c

    add b

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    facial view

    Mandibular canal. (Inferior alveolar canal). Runs

    downward from the mandibular foramen to themental foramen, passing close to the roots of the

    molars. More easily seen in the molar periapical.

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    lingual view

    Submandibular gland fossa. The depression below

    the mylohyoid ridge where the submandibular glandis located. More obvious in the molar periapical film.

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    The mental foramen (blue

    arrow) is adjacent to a

    periapical lesion associated

    with tooth # 21 (red arrow).

    There is slight externalresorption on # 21.

    The green arrow points to the

    mental foramen. The yellow

    arrow identifies a periapical

    lesion on # 30. Note the

    overextension of the silver pointin the distal root, the perforation

    of the mesial root and the

    amalgam protruding through

    the perforation from the pulp

    chamber.

    Mandibular Molar

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    Mandibular Molar

    External oblique

    ridge

    Submandibular

    gland fossa

    Mandibular canal

    Mylohyoid ridge

    (internal oblique)

    facial view lingual view

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    facial view lingual view

    b

    c

    ab

    a = external oblique ridge

    c = mandibular canal

    b = mylohyoid ridge

    d = submandibular gland

    fossa

    dd

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    ab

    cdd

    a = external oblique ridgeb = mylohyoid ridge

    c = mandibular canal

    d = submandibular gland fossa

    facial view

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    External oblique ridge. A continuation of the anterior

    border of the ramus, passing downward and forward

    on the buccal side of the mandible. It appears as adistinct radiopaque line which usually ends

    anteriorly in the area of the first molar. Serves as an

    attachment of the buccinator muscle. (The red

    arrows point to the mylohyoid ridge).

    lingual view

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    Mylohyoid ridge (internal oblique). Located on the

    lingual surface of the mandible, extending from thethird molar area to the premolar region. Serves as

    the attachment of the mylohyoid muscle.

    lingual view

    f i l i

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    facial view

    Mandibular (inferior alveolar) canal. Arises at the

    mandibular foramen on the lingual side of the ramus andpasses downward and forward, moving from the lingual

    side of the mandible in the third molar region to the

    buccal side of the mandible in the premolar region.

    Contains the inferior alveolar nerve and vessels.

    lingual view

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    Submandibular gland fossa. A depression on the

    lingual side of the mandible below the mylohyoid

    ridge. The submandibular gland is located in this

    region. Due to the thinness of bone, the trabecularpattern of the bone is very sparse and results in the

    area being very radiolucent. The fact that it occurs

    bilaterally helps to differentiate it from pathology.

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    The external oblique ridge (red arrows) and the

    mylohyoid ridge (blue arrows) usually run parallel

    with each other, with the external oblique ridge

    always being higher on the film.

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    The mandibular canal (red arrows identify inferior border

    of canal) usually runs very close to the roots of the

    molars, especially the third molar. This can be a problemwhen extracting these teeth. Note the extreme dilaceration

    (curving) of the roots of the third molar (green arrow) in

    the film at left. The film at right shows kissing

    impactions located at the superior border of the canal.

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    Identify the anatomical structures

    on the following eight slides.

    Enter answers on the

    accompanying answer sheet.

    Slide # 1

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    A. The red arrows identify the ?

    Slide # 2

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    A. The red arrow points to the ?B. The white arrows identify the ?

    C. The blue arrow points to the ?

    D. The yellow arrow identifies the ?

    Slide # 3

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    A. The small radioluceny identified by

    the green arrow is the ?

    Slide # 4

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    A. The radiopacity identified by theblue arrows is the ?

    B. The orange arrow identifies the ?

    Slide # 5

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    A. The yellow arrows point to the ?

    B. The red arrows identify the ?

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    Slide # 7

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    A. The red arrows point to the ?

    Slide # 8

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    A. The red arrows identify the ?

    B. What is the name of the radiolucent

    area surrounding the canal?