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  • 29 March, 2022

Diagnostic Imaging in Dental Practice - A Quick Overview

Diagnostic imaging is an integral part of the diagnostic process in clinical dentistry. Radiographs are often obtained as part of a  complete examination. Appropriate radiographic interpretation is used along with clinical information and other tests to formulate a differential diagnosis. A radiograph is a two dimensional image of a three dimensional object. 

Role of radiographs 

  • Clinical examination phase 
  • Diagnosis( confirm/exclude)
  • Treatment planning
  • During treatment
  • Follow up

Guidelines for suggesting Dental Radiographs 

  • Its important to make radiographs only after a clinical examination. 
  • Order only radiographs that directly benefit the patient in diagnosis &treatment. 
  • Use the least amount of radiation exposure . 

Clinical situations that need radiographic examinations 

  • Deep/ proximal Dental Caries 
  • Periodontal Diseases 
  • Dental Anomalies 
  • Growth&Development assessment
  • Dental Malocclusion 
  • TMJ Disorders 
  • Implants 
  • Paranasal Sinuses 
  • Trauma 

RADIOGRAPHIC INTERPRETATION depends on:

  • Clinical examination. 
  • Quality of diagnostic image. 
  • Number &type of available images. 
  • Viewing conditions. 

Step 1: Localize the abnormality 

  • Localized or generalized 
  • Position in the jaws 
  • Single or multifocal 
  • Size 

Step 2: Assess the periphery &shape 

  • Is the periphery of lesion well defined or ill defined 
  • Shape of lesion 

Step 3: Analyze the internal structure 

  • Air,Fat,or Gas 
  • Fluid 
  • Soft tissue 
  • Bone marrow 
  • Trabecular bone 
  • Cortical bone &dentine 
  • Enamel 
  • Metal 

Step 4: Analyse the effects of the lesion on surrounding stuctures. 

  • Teeth,lamina dura,periodental membrane space. 
  • Inferior alveolar canal&mental foramen. 
  • Maxillary antrum. 
  • Surrounding bone density&trabecular pattern. 
  • Outer cortical bone&peiosteal reaction. 

Viewing Conditions  

  • This should be done in a quiet, darkened room. 
  • At least two good, evenly-lit viewing boxes are required. 
  • A bright light illuminator is required for relatively over-exposed areas. 
  • Mounted in holder. 
  • Appropriate size of viewbox to accommodate film. 
  • Magnifying glass-detailed examination of small regions. 

Routine assessment of radiographs

  • Ensure that the radiograph is the one of the patient being examined,  check the date, card number. 
  • Ensure two orthogonal projections are available. 
  • The radiographic views are named according to the direction the primary beam enters and leaves the tissue and the body part being examined. 
  • The position of the patient during exposure should be known, and left/right markers should be identified. 
  • The radiograph should be of high technical quality with respect to positioning, centring, collimation, exposure and development, and should be free from artefacts. 

 

 Article by Dr. Siri P. B.

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