radio graphic landmarks (2)

8/6/2019 Radio Graphic Landmarks (2)

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Maxillary and Mandibular

Anatomic Radiographic

Landmarks

Intraoral Radiography



© William C. Scarfe

� Radiographs are

two-dimensionalrepresentations of

objects that occupy

three dimensions.

� Facial, central andlingual features are

superimposed.

� All landmarks are

NOT clearlydemonstrated on

radiographs from all

individuals.Image(s) courtesy © Dr. Allan G. Farman




Tooth and

supporting

structures

� Enamel

" radiopaque

� Dentin andCementum

" radiopaque

� Pulp space

" radiolucent

� Lamina dura

" radiopaque

� Periodontal ligamentspace

" radiolucent

� Alveolar bone

" radiopaque




Enamel

Dentin

Dentin-enamel

junction

Cemento-enamel junction

Pulp space

Lamina dura

pdl space

Alveolar boneImage(s) courtesy © Dr. Allan G. Farman




Anatomic

Landmarks

MAXILLA

ZYGOMATIC BONE




Central incisor region: maxilla

� Premaxillary/median

palatal suture

" radiolucent

� Incisive fossa /foramen

" radiolucent

� Incisive canal

" Radiolucent withradiopaque lines

� Nasal passages

(fossa or cavity)

" radiolucent

� Nasal septum

" radiopaque

� Anterior nasal spine

"

radiopaque� Inferior concha

" radiopaque

� Soft tissues of nose

and lips" radiopaque




Central incisor region: Features Anterior Nasal Spine




Central incisor region: FeaturesIncisive Fossa / Foramen




Central incisor region: FeaturesNasal Septum




Central incisor region: FeaturesPre-maxillary / Median Palatine Suture




Central incisor region: FeaturesInferior Concha / Turbinates




Central incisor region: FeaturesNasal Fossa / Cavity / Meatus




Central incisor region: FeaturesIncisive / Nasopalatine Canal




Central incisor region: Features Ala Cartilage Nose & Lip Line




Anterior nasal

spine

Nasal septum

Premaxillary

suture

Nasal passage

Maxillary Anterior Image(s) courtesy © Dr. Allan G. Farman




Incisive fossa

Premaxillary

suture

Anterior MaxillaImage(s) courtesy © Dr. Allan G. Farman




Premaxillary suture

Incisive fossa

Anterior nasal spine

Pulp

Lamina dura

Periodontal ligament

space

Anterior MaxillaImage(s) courtesy © Dr. Allan G. Farman




Dental caries

Premaxillarysuture

Soft tissue

shadow of nose

Anterior nasal

spine

Nasal passage

Nasal septum

Nasal passage

Image(s) courtesy © Dr. Allan G. Farman




Incisive fossa or periapical lesion?

� The periodontal

ligament spaces

" intact.

� SLOB Rule

" Same LingualOpposite Buccal

" The incisive fossa

being lingually

situated moves on

the resulting image

in the same direction

as the movement of

the tubehead.





Lateral/Canine region: FeaturesCanine Fossa




Lateral/Canine region: Features

Antral /³Inverted´

Y




Lateral/Canine region: Features

Anterior Sinus




Anterior wall of

nasal passage

Soft tissue shadow

of nose

Canine µfossa¶





Maxillary sinus

Anterior wall of

maxillary sinus

Lateral wall of nasal fossa

Inverted µY¶

Image(s) courtesy©

Dr. Allan G. Farman




Lateral wall of nasal fossa

Anterior wall of

maxillary sinus

(antrum)

Inverted µY¶





Inverted ³Y´

Locule in maxillary

sinus: note tooth

periodontal ligament

space intact

Septum in maxillary

sinus

Bridge unit in porcelain

fused to metal

Radiolucent anterior

filling materialImage(s) courtesy © Dr. Allan G. Farman




Premolar region: maxilla

� Maxillary sinus

" radiolucent

� Maxillary sinus floor and septae

" radiopaque

� Nutrient canals

" radiolucent

� Occasionally: lateral

wall of nasal

passage" radiopaque

� Soft tissue shadow

of lips/cheeks.

" Nasolabial fold




Premolar region: FeaturesNasolabial Fold




Premolar region: FeaturesMaxillary Sinus




Premolar region: FeaturesNutrient Canals




Premolar region: maxilla





Floor of maxillary sinus





Maxillary molar region showing septum in sinus


Septum insinus

Zygomatic

process of

maxilla

Soft tissue

over

tuberosity





1st / 2nd molar region: maxilla

� Maxillary sinus floor and septae

" radiopaque

� Maxillary sinus

" radiolucent

� Nutrient canals

" radiolucent

� Zygomatic processof the maxilla

" ³U´- shaped

" radiopaque

� Zygomatic

arch/zygoma

" radiopaque

� Less commonly:" Lateral wall of nasal

passage

" radiopaque




Zygomatic

bone

Zygomaticprocess of

maxilla

Zygomatic process (temporal bone)

Articular eminenceStructures anterior

to green line seen

on intraoralradiographs

Molar region: maxilla

Zygomatic

Arch





Pterygoid

hamulus

(medialPterygoid)

Lateral

pterygoid

plate

Maxillary tuberosity

Molar region: maxillaImage(s) courtesy © Dr. Allan G. Farman




Pterygoid hamulus

Molar region: maxilla





Zygomatic process

of the maxilla

Zygomatic

arch

shadow

Floor of

maxillary

sinus

Maxillary

tuberosity

Endodontically

treated tooth





Zygomatic process

of the maxilla

Floor of maxillary

sinus

Shadow of

zygomatic arch

Coronoid

Process

(mandible)Image(s) courtesy © Dr. Allan G. Farman




Zygomatic

arch

Zygomatic process

of maxilla

Floor of

maxillary

sinus

Nutrientcanal





2nd /3rd molar region: maxilla

� Coronoid process of mandible\

" radiopaque

� Maxillary tuberosity

" radiopaque)

� Posterior wall of

maxillary sinus

" radiopaque

� Maxillary sinus" radiolucent

� Pterygoid hamulus

" radiopaque

� Pterygoid notch

" radiolucent

� Lateral pterygoid

plate" radiopaque




Coronoidprocess of

mandible

Zygomatic

processof maxilla

Zygomatic

arch

3rd molar region: maxilla





Maxillary tuberosity Maxillary sinus




© William C. ScarfeZygomatic process of the maxilla

Dentalfollicle

space

Tuberosity





Pterygoid

hamulus

Air space

Posterior wall of maxillary sinus





Coronoid

process of mandible

Zygomatic process of maxilla


Zygomatic

arch

Pterygoidhamulus

Pterygoid

plate





Pterygoid

hamulus

Coronoid process of mandible

Maxillary

tuberosity

Shadow of zygomatic arch





Anatomic Landmarks

MANDIBLE




Incisor region: mandible

� Lingual foramen" radiolucent

� Genial tubercles

"

radiopaque� Soft tissue shadow of lower lip

" radiopaque

� Mental ridges" radiopaque

� Nutrient canals

" radiolucent




Facial

Mental

depression

Mental

ridge

Lingual

groove

Genial

tubercles

Lingual





Mental ridge

Soft tissue

shadow of lower lip

Cortex of

lower border of

mandible





Lingual foramen

Mental ridge

Genial tubercles

Cortical plate of

lower border of mandible

Soft tissue shadow of

lower lip





Second shadow of

periodontal ligament

space due to shape

of root

Periodontal ligament

space





Nutrient canals




©William C. Scarfe

Nutrient canals




©William C. Scarfe

Nutrient canals inanterior mandible




©William C. Scarfe

Canine/Premolar region: mandible

� Mental foramen" Radiolucent

" usually situated between and just beneath

roots of the premolars.� Soft tissue shadow of reflected cheek

" radiopaque

� Mandibular canal" radiolucent



©William C. Scarfe

Periapical granuloma, abscess or cyst

(periodontal ligament space not intact)

Mental

foramen

Image(s) courtesy©

Dr. Allan G. Farman




©William C. Scarfe

Molar region: mandible

� Mandibular canal" radiolucent

� External oblique

ridge

" radiopaque

� Mylohyoid ridge

(internal oblique

ridge)" radiopaque

� Submandibular fossa

" radiolucent

� Cortex of lower

border

" radiopaque

Image(s)courtesy © Dr Allan G Farman




Submandibular fossa

Lower

cortex of

mandible

External

obliqueridge

Internal

obliqueridge






Lower cortex of mandible

External

oblique

ridge

Internal

oblique

ridge





Lower cortex of mandible

External

oblique

ridge

Internal

oblique

ridge

A t i l V i ti




Anatomical Variations

� Mandibular torus.� Palatal torus.

� High vs. low mandibular canal.

� ³Double´ mandibular canals.*

� Stafne¶s bone cavity (static bone cyst).*

*usually seen only on extra-oral radiographs.

Mandib lar tor s




Mandibular torus Syn: lingual exostoses, torus mandibularis

Mandibular torus






Mandibular torus




Maxillary torus Syn: torus palatinus

Maxillary torus

radio graphic landmarks (2)

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