Download - Radiology for periodental diseases
Bitewings best for diagnosis. Some feel that paralleling PA’s are best.
Higher kVp recommended (long scale, low contrast).
Compare images from differentvisits (using same technique).
Periodontal Disease
Two-dimensional film with overlapping bony walls, superimposed roots
Clinical picture more advanced
Relationship of hard to soft tissues not evident
Limitation of Radiographs
Radiographs do not demonstrate incipient disease, as a minimum of 55-60% demineralization must occur before radiographic changes are apparent.
Limitation of Radiographs
Periodontitis
Normal Anatomy:
Alveolar crest corticated
Thin & even width of PDL
1-1.5 mm from crest to CEJ
Parallel to line between CEJ’s
Crest is pointed anteriorly
Corticated alveolar crests
1-1.5 mm
CEJ
Alveolar crests morepointed anteriorly
Contributing Factors• Occlusal trauma• Open contacts• Overhangs, poor contours• Calculus• Post-extraction defects• Systemic involvement (diabetes, blood disorders, hormonal changes, stress, AIDS)
Horizontal bone loss: Parallel to line drawn between adjacent CEJ’s
Vertical (Angular) bone loss: More bone destruction on interproximal aspect of one tooth than on the adjacent tooth
Gingivitis
No bone loss
No radiographic signs
Involvement:
LocalizedGeneralized
Periodontitis
Periodontitis
Periodontitis
Mild Moderatesevere
Mild Adult Periodontitis
Loss of cortical density
Rounding off of junction between alveolar crest and lamina dura
Blunting of crest anteriorly
Mild adult periodontitis
Mild Adult Periodontitis
Horizontal bone loss or vertical osseous defects
Total extent of bone loss not evident
May have slight mobility
Moderate Adult Periodontitis
Moderate adult periodontitis(red arrows point to calculus)
Moderate adult periodontitis
Severe Adult Periodontitis
Tooth mobility
Extensive horizontal bone loss or vertical osseousdefects
Furcation involvement
Severe adult periodontitis
Severe adult periodontitis
Severe adult periodontitis