radiographic aids in dx of periodontol ds_part a

7/25/2019 Radiographic Aids in Dx of Periodontol Ds_Part A

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- DR. IBRAHIM SHAIKH

MDS III

DEPT. OF PERIODONTOLOGY & IMPLANTOLOGY

SEMINAR NO. - 8

Radiographic Aids In Diagnosis ofPeriodontal Diseases Part A

DATE : 17/05/2016


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CONTENTS

1. Introduction.

2. Histor.

!. Radiographs.

". Interpretation of radiological e#a$ination.

%.Interpretation in relation to periodontaldiseases.

&. Ad'ances in radiographs.

(. )i$itations of radiographs.

*. I$plant i$aging +Brie,-.. /onclusion.

10.References.

2


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Int!"#$t%!n!


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%'t!(

"


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ISTORY Disco'er of Ras 3o'e$4er *th5 1*%

Forms of tube used by Roentgen in 18951896 for theproduction of X rays.

)%*+,* C!n" R!,nt,n185 1324

%


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ISTORY 6irst Dental Radiograph 12th7anuar5 1*&

D. Ott! )*!1860 134

&


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ISTORY 6irst Intraoral Dental Radiograph 8arl 1*&

D. E"#n" ,**'1856 1328

(


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ISTORY 6irst Intraoral Dental Radiograph 8arl 1*&

*


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R"%!9+'


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It is the traditional $ethod to asses thedestruction of al'eolar 4one associated 9ith

periodontitis.

CONVENTIONAL RADIOGRAPH CAN BE USEDTO EVALUATE

Bone le'els Bone loss e'en or angular patterns Intra+infra- 4on defects Root $orphologies : topographies 6urcation radiolucencies 8ndodontic lesions 8ndodontic $ishaps De'elop$ental ano$alies

Root length and shape+s- re$aining in 4one10


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RADI;I3


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Int O* P,%9%$*R"%!9+'

Paralleling technique

Also called as right angle or long conetechniCue.

ra l$ is placed parallel to long a#is of toothand central ra of #ra 4ea$ is directed at right

angle to teeth ? l$. Prefera4le techniCue for periodontal use.

1!


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Int O* P,%9%$*R"%!9+'

Bisecting angle technique

/entral ra is directed at right angles to a plane4isecting the angle 4et9een long a#is of teeth ?l$.

MaEes the 4one $argin appear $ore closer to the

cro9n.

1"


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Et O* P,%9%$*R"%!9+'

Ne!an An" #rie"!an $%%&

Li!itati'ns ith intra'ral (eria(ical ra"i'gra(hici!aging) Ad'ancing age Anato$ical diFculties liEe large tongue5 shallo9

palate5 restricted $outh opening5 3eurological diFculties5 and siGe of radiographicsensor

1%


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Et O* P,%9%$*R"%!9+'

Chen et al in $%%*

De'eloped a sensor 4ea$ align$ent ai$ing de'ice forperfor$ing radiographs using this techniCue

1&


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;%t,


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;%t,


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O$$*#'* R"%!9+'

Intraoral occlusal radiographs ena4le 'ie9ing of arelati'el large seg$ent of dental arch.

=he are useful in patients 9ho are una4le to open$outh 9ide enough for periapical radiographs

1


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Et!* R"%!9+'

>hen large areas of the sEull or a9 $ust 4e e#a$inedor5

>hen patients are una4le to open their $ouths for l$place$ent.

@seful for e'aluating large areas of the sEull and a9s

4ut are not adeCuate for detection of su4tle changessuch as the earl stages of dental caries or periodontaldisease.

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Ot+!9nt!!9+

=echniCue for producing single to$ographic i$age offacial structures including $a#illar and $andi4ulararches 9ith their supporting structures.

Based on principle of the reciprocal $o'e$ent of #rasource and i$age receptor around a central plane

Eno9n as i$age laer.

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Ot+!9nt!!9+

I$age distortion )ingual structures 9ould 4e proected higher than

4uccal surfaces )ess details than intraoral i$ages Production of ghost i$ages

Li!itati'ns '- OPG

It $n =, #'," ' *t,nt%>, ?! %nt !*

?#** !#t+ ',%,'


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Panora$ic radiographs $a not re'eal al'eolar 4on

defects as accuratel as periapical radiographs.

But Cuestion is 9hether there is an additionaltherapeutic ield fro$ greater accurac fro$ I;PAs

=he periodontal structures of interest noted on

periapical radiographs are also noted on panora$icradiographs.

=he radiographic features of interest on a panora$icradiograph supple$ented 9hen necessar 4 a s$all

nu$4er of intraoral 'ie9s5 is suFcient for the$anage$ent of periodontal diseases

Tugnait et al. $%%%/$%%0

Pe(allasi EA et al. $%%%

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Deter$ined the eFcac of panora$icradiographs in the preoperati'e planningof posterior $andi4ular i$plants .

Mental ner'e parasthesia follo9ingi$plant place$ent in 1%2( patients 9ith

2%*" i$plants 9ith onl ;P


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I$age can 4e instantl 'ie9ed 4 patient ? dentist.

Reduction in radiation recei'ed 4 patient 4 as $uch%0J to *0J

I$ages can 4e altered to achie'e tasE specic i$agecharacteristics for e.g. densit ? contrast can 4elo9ered for e'aluation of $arginal 4one and increasedfor e'aluation of i$plant co$ponents.

8na4les the dental tea$ to conduct re$oteconsultations.

/o$puteriGed i$ages can 4e stored5 $anipulated ?

corrected for under ? o'ere#posure

D%%t* R"%!9+(

A"1antages

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Based on use of /harged /ouple De'ice.

R"%! ra generator connected to sensor. @%'%! storage of inco$ing signals during e#posure and

con'ersion to gre le'els. G9+( digital $ass storage unit connected to 'arious

'ideo printout de'ices.

R"%!>%'%!9+(

Duret # et al 2344

2&


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R"%!>%'%!9+(

5echanis! '- I!age Dis(la6

Radiographic digitaldetector

/on'entionalradiographic source

used to e#pose sensor

Detector con'erts ras to 'isi4le i$age

I$age displa on$onitor 2(


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/o$parati'e stud for $arginal 4one 4et9een R,nt%!n* T!!9+(

G'"-re6 H'uns9el" an" Allan

5acLe'" C'r!ac: 23*3

!%


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!&


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/o$puter algorith$s use photon counts to constructdigital /S i$ages

I$ages are displaed in indi'idual 4locEs ;8)S

8ach sCuare of the i$age is $atri# PI8)S

8ach pi#el is assigned a /= nu$4er representing tissue

densit

/= nu$4er H;@3S6I8)D unitsRange 1000 to 1000

C!n>,nt%!n* T!!9+(

CT I!age C'nstructi'n

!(


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8li$inates superi$position of i$ages of structuresoutside area of interest

High contrast resolution diLerences 4et9een tissues

that diLer in densit N 1J can 4e distinguished

I$ages can 4e 'ie9ed in a#ial coronal and sagittalplanes

C!n>,nt%!n* T!!9+(

A"1antages

!*


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@sed /o$puted to$ograph +/=- in studies in relation toperiodontal defects.

/= does not oLer an fa'oura4le cost 4enet5 dosee#posure or therapeutic ield ad'antage in periodontal

practice and is unliEel to nd a routine.

Nait' T et al. 2334;Pist'rius A et al. $%%2

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@tiliGes cone shaped source of ioniGing radiation ? 2Darea detector #ed on a rotating gantr.

Multiple seCuential i$ages are produced in one scan.

Rotates !&0O around the head.

Scan ti$e tpicall N 1 $inute.

C!n, ;, C!9#t,"T!!9+(

"0


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INTER#ACE CONE


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8'aluation of the a9 4ones.

I$plant place$ent and e'aluation.

8'aluation =M7.

Bon ? Soft tissue lesions.

Periodontal assess$ent.

8ndodontic assess$ent.

Al'eolar ridge resorption.

;rthodontic e'aluation.

!D reconstructions.

C!n, ;, C!9#t,"T!!9+(

In"icati'ns

"2


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PA3;RAMI/ /B/=

@ndistorted

/S5 A#ial5 /oronalSagittal 'ie9s

Separated structures

Distorted i$ages

;nl one laer 'ie9

Superi$position

"!


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/= S /B/=

/on'entional /= scanners$aEe use of a fan4ea$ andPro'ides a set ofconsecuti'e slices ofi$age.

/on'entional /= $aEes useof a liedo9n $achine 9itha large gantr.


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/= S /B/=

Artefacts arising fro$ $etalrestorations are $orese'ere using con'entional/=.

Artefacts that arise fro$$etallic restorations are lessse'ere.

"%

> ll A 5i h t l $%%?


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/o$pared radiographs 9ith /B/=

ResultsQ =hreedi$ensional capa4ilit of /B/= oLers asignicant ad'antage in linear $easure$ents forperiodontal defect

All defects can 4e detected and Cuantied.

>ell6 A. 5isch et al . $%%?

5'l A an" Balasun"ara! $%%4

8'aluated =he 3e9=o$ 000 /B/= scanner ResultsQ Better diagnostic and Cuantitati'e infor$ation

on periodontal 4one le'els in three di$ensions thancon'entional radiograph can 4e o4tained

"&

B tl A t l $%%3


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/o$pared the $easure$ents fro$ digital IR and /B/=i$ages to direct surgical $easure$ents for thee'aluation of regenerati'e treat$ent outco$es.

/o$pared to direct surgical $easure$ents5 /B=signicantl $ore precise and accurate than IRs.

/B= $a o4'iate surgical reentr as a techniCue forassessing regenerati'e therap outco$es

Brentl6 A. et al $%%3

=alter C et al. $%22

Suggests that cone4ea$ /=$a pro'ide detailedinfor$ation a4out furcationin'ol'e$ents in patients 9ithchronic periodontitis and so

$a in,uence treat$ent

"(


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Int,9,tt%!n !? R"%!9+'"*


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Detailed understanding of three di$ensional anato$and ho9 structures appear radiologicall.

Kno9 the diLerences in radiologic anato$ in a 2D ? a

!D radiograph.

Must possess Eno9ledge of diseases 9hich arepotentiall assosciated 9ith all structures in the 6;.

Must 4e a9are and Eno9ledga4le of all diLerenti$aging $odalities.

;pti$al 'ie9ing conditions are essential.

Int,9,tt%!n !? R"%!9+'

Basic Prerequisites

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RecogniGing the presence of an a4nor$alit.

Radiologic e'aluation of a lesion o )ocation.o Shape and /ontour.o Border.o Internal appearances.

Adacent anato$ic structures

Interpretation of the ndings.

Int,9,tt%!n !? R"%!9+'

>e6 Ste(s in Inter(retati'n

%0

R ?


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R,?,,n$,'

1. /linical Periodontolog And I$plant Dentistr 7an

)indhe &th

8dn2. ;ral Radiologprinciples And Interpretation Stuart /.

>hite %th8dn

!. /linical Periodontolog 3e9$an5 =aEei5 KloEEe'old5/arranGa 10th8dn

". Radiolog In Periodontics A Re'ie9 7. Indian

Acade$ ;f ;ral Medicine ? Radiolog 201! 2% +1-

2"2.

%. P.6. an Der Stelt Modern Radiographic Methods In =he

Diagnosis ;f Periodontal Disease Ad' Dent Res

(+2-Q1%*1&25 August5 1!

&. Bragger @Q Digital I$aging In Periodontal Radiograph

%1

PART ;


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PART ;

1. Interpretation in relation to periodontal

diseases.

2. Ad'ances in radiographs.

!. )i$itations of radiographs.

". I$plant i$aging +Brie,-.

%. /onclusion.

&. References.

%2


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3e#t Presentation ;n

=hursda 19/05/2016

7ournal /lu4 Presentation B

1.Dr. Leena Parmar

2.Dr. Reshma Avadh

=HA3K;@

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radiographic aids in dx of periodontol ds_part a

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