RADIOLOGY QUIZ 4

35%

for caries to be visible on radiograph, at least X% of mineral needs to be demineralized

false

T/F these are root caries

mach band effect

cause of this thin dark line at the root of #13

radiolucent composite

most likely cause of this radiolucency

false

T/F one can determine from this periapical if the lesion. is a periapical granuloma or cyst

widened PDL, moderately well defined periapical radiolucency

radiographic features of rarefying osteitis

false

T/F vertical bone loss at #19 mesial

vertical bitewings

best tool to view bone loss in patient with moderate to severe periodontitis (pocket ≥ 6mm)

estimating interproximal bone loss

what are radiographs useful for in periodontal disease

intraoral xray

highest spatial resolution imaging, best for disease involving teeth and supporting structure

CBCT/MDCT

best for evaluating anatomy in multiple dimensions without anatomical superimposition

periapical xray

main image for periapical diagnosis

bitewings

best for interproximal caries

no

would you consider this image diagnostic?

non-analytic strategy

diagnostic reasoning through deliberate search for features that support the hypothesis

analytical strategy

diagnostic reasoning through step-by-step analysis of features

location, edge, shape/size, internal content, other structures, number (LESION)

analytical strategy for lesion description

epicenter

geometric center of lesion

neural/vascular origin

lesion WITHIN inferior alveolar canal

odontogenic origin

lesion ABOVE inferior alveolar canal

non-odontogenic/osseous origin

lesion BELOW inferior alveolar canal

left posterior mandibular pericoronal lesion

how would you descrribe the location on this lesion

poorly defined

how would you describe the border of this lesion

well defined, corticated

how would you describe the border of this image

poorly defined

border that tends to be malignant

corticated

thin, radioopaque line of bone at lesion periphery

sclerotic

well-defined wider more diffuse zone of transition at lesion borders

radiolucent periphery

rim of radiolucency indicating soft tissue, generally with corticated outer border

radiolucent periphery

how would you describe the BORDER of this lesion

invasive

wide zone of transition with few or no trabeculae between periphery and normal bone

blending

poorly defined gradual wide zone of transition

entirely radiopaque

how would you describe the internal structure of this lesion

idiopathic osteosclerosis

most likely diagnosis

well defined mildly sclerotic

how would describe the border of this lesion

mixed (radiolucent and radiopaque)

how would you describe the internal structure of this lesion

multilocular

lesion with multiple compartments or septations

dystrophic calcification

mineralization in damaged soft tissue

amorphous bone

dense often cortical-like poorly organized bone

rarefaction

decrease in bone density, causing radiolucency

sclerosis

abnormal hardening or thickening of bone, causing radiopacity

benign lesions

tend to have smooth borders of resorption with lesion

malignancies

likely to have thinning or spiked root appearance

pulpal origin

PDL widening with epicenter at apex

periodontal origin

PDL widening with coronal epicenter

irregular PDL widening

what are the arrows pointing to

closure

visual connection or continuity between sets of elements which do not actually touch each other

class 2 and 3 (interproximal)

radiographs are most helpful for detecting which type of caries

true

T/F CBCT is NOT recommended to be used as a routine method of caries diagnosis

primary

caries on unrestored tooth structure that involves DEJ or EXTENDS through

E1

caries classification?

E2

caries classification?

D1

caries classification?

D2

caries classification?

D3

caries classification?

#29 M E1

caries classification?

cavitation, D2, or high risk

what justifies surgical management of caries

at contact

susceptible zone for interproximal caries

caries (bone loss and irregular shape)

what is this lesion

incipient

caries that DO NOT extend into DEJ (E1 and E2)

root caries

what is this lesion

rampant caries

caries with rapid progression and severe widespread involvement

recurrent caries

caries that occur at margins of existing restorations

residual caries

areas of demineralization that remain after incomplete removal of caries

recurrent caries

what are these lesions

recurrent caries

what is the dark shadow the arrow is pointing at

cervical burnout

most common cause of false positive caries diagnosis

cervical burnout

what are these lesions

caries

what are these lesions?

mach band effect

An optical illusion that creates the perception of increased contrast at the boundaries of two different shades

false

T/F demineralization on xray can determine if caries are active

extent in buccolingual plane (how wide the caries are)

what determines the degree of radiolucency of caries

superimposition

why might caries depth relative to the pulp be inaccurate?

greater

true depth of lesion is often ___ than visible on image

angulation (restoration superimposition)

why can recurrent caries be seen on image A but not image B

vertical angulation

why are PAs NOT ideal for visualizing caries?

pulp necrosis

most common cause of periapical inflammatory lesions

abscess

collection of pus

granuloma

formed when body attempts to isolate and eliminate inflammatory responsee

cyst

entrapped epithelial cell rest of malassez stimulated to proliferate

true

T/F abscess, granuloma, and cyst CANNOT be differentiated on xray

apical periodontitis

inflammation of apical periodontium of PULPAL origin

rarefying osteitis

inflammatory bone resorption at tooth apex, localized radiolucency

sclerosing osteitis

inflammatory bone deposition around tooth apex, localized radiopacity

rarefying osteitis

what type of lesion is shown here

sclerosing osteitis

what type of lesion is shown here

periapical radiolucency

how would you describe this lesion

fully radiolucent (no internal mineralization)

how would you describe the internal structure of this lesion

can lead to osteonecrosis (due to decreased blood supply)

what is the danger of sclerosis over time

periosteal reaction

enlarged or extended bone border due to periapical inflammation

onion skin pattern (due to periosteal reaction)

how would you describe the appearance of this lesion on the ramus

odontogenic mucositis

thickening of mucosal lining stimulated by periapical inflammatory disease

odontogenic mucositis

what is this lesion

external resorption

outer layer of a tooth root is destroyed, often due to periapical inflammation from adjacent teeth.

hypercementosis

bulbous roots due to excess cementum, associated with periapical disease

periapical cemento-osseous dysplasia

periapical radiolucency of VITAL tooth

dense bone island

periapical radiopacity of VITAL tooth

malignancy

periapical lesion with irregular PDL widening and variable sized regions of bone destruction

biopsy (cyst epithelial lining)

needed to distinguish cyst vs. granuloma

periapical scar

radiolucent lesion due to fibrous healing defect

periodontitis

inflammatory disease affecting the supporting structures of the teeth, leading to gum recession and bone loss