radiographs in periodontal assessment -...
TRANSCRIPT
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Rubens SpinRubens SpinRubens SpinRubens Spin----NetoNetoNetoNetoDepartment of Dentistry
Section of Oral RadiologyAarhus University
Radiographs in periodontal assessment
04.sep.201412:45 – 14:15Aud. 3
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Spin-Neto
Anatomic and histologic knowledge
Spin-Neto et al., 2010
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Contact point
Interdental papilla
Free gingival margin
Attached gingivaMucogingival juntionAlveolar mucosa
Physiologic knowledge ���� Dentistry knowledge
Spin-NetoLindhe, 2010
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Spin-Neto
Clinical diagnosis
Bleeding Suppuration Attachment loss
Spin-Neto et al., 2010
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Spin-Neto
Radiographic diagnosis
Bone levels / Bone loss / Bone gain
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Spin-Neto
Guidelines
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Spin-Neto
Radiographic diagnosis
The diagnosis of periodontal diseases depends on a thorough clinical examination supplemented by radiographs, in those cases in which they may
provide additional information that could potentiallychange patient treatment and prognosis
Selection criteria for dental radiography (UK, 2013)
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Spin-Neto
Radiographic diagnosis
Existing radiographs should be used as far as possible to define if other (more appropriate) radiographic
views are necessary (e.g. images taken for caries diagnosis can aid the assessment of the periodontal hard tissues)
Selection criteria for dental radiography (UK, 2013)
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Spin-Neto
When should we take new images?
There is no clear evidence supporting any recommendations on the frequency of radiographs taken for periodontal reasons
Selection criteria for dental radiography (UK, 2013)
ALARAAs Low
As Reasonably
Achievable
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Spin-Neto
Types of images – Digital periapical (PAs)
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Spin-Neto
Types of images - Bitewing
?
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Spin-Neto
Types of images - Panoramic
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Spin-Neto
Types of images – Panoramic x Full mouth PAs
1. ALARA (1Pan = 4PAs)
2. Sharpness
3. Geometric distortion
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Spin-Neto
Remember: we are producing documentation !
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Spin-Neto
Overtime reproducibility
Geometric reproducibility of radiographs taken at different time points allows more accurate evaluation
of radiographic bone level changes over timeSelection criteria for dental radiography (UK, 2013)
Baseline 1 month 3 months 6 months
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Anatomic structures
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Compact bone
Spongious bone
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Anatomic structures
Compact bone
Spongious bone
Lamina dura
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Anatomic structures
Compact bone
Spongious bone
Lamina dura
CEJ
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Spin-Neto
Bone level and bone loss
Bone level
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Bone level and bone loss
Bone loss ?
“Rule of thumb” ≥ 4mm bone loss
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Spin-Neto
Horizontal bone loss
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Spin-Neto
Vertical bone loss / gain over time
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Spin-Neto
Bone loss / gain over time
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But remember...
Røntgen kan ikke fortælle om der er parodontitis marginalis: kun knogletab
+
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Spin-Neto
2D x 3D (Cone beam CT) images
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Spin-Neto
2D x 3D (Cone beam CT) images
CBCT is not indicated as a routine method for imaging periodontal bone support
Selection criteria for dental radiography (UK, 2013)
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[email protected]@[email protected]@odont.au.dk