This document discusses the use of radiology in endodontics. It begins with a brief history of x-rays and their use in dentistry. The different types of intraoral and extraoral radiographs are described, along with techniques for taking intraoral periapical radiographs. Common anatomical landmarks are identified. The use of radiographs for diagnosis, working length determination, post-treatment evaluation, and follow-up is explained. Digital radiography and recent advances like CBCT are also covered. In conclusion, radiographs provide important information for examining hard tissues beyond normal vision and setting standards for endodontic diagnosis, treatment and prognosis.
This document discusses the use of radiology in endodontics. It begins with a brief history of x-rays and their use in dentistry. The different types of intraoral and extraoral radiographs are described, along with techniques for taking intraoral periapical radiographs. Common anatomical landmarks are identified. The use of radiographs for diagnosis, working length determination, post-treatment evaluation, and follow-up is explained. Digital radiography and recent advances like CBCT are also covered. In conclusion, radiographs provide important information for examining hard tissues beyond normal vision and setting standards for endodontic diagnosis, treatment and prognosis.
This document discusses the use of radiology in endodontics. It begins with a brief history of x-rays and their use in dentistry. The different types of intraoral and extraoral radiographs are described, along with techniques for taking intraoral periapical radiographs. Common anatomical landmarks are identified. The use of radiographs for diagnosis, working length determination, post-treatment evaluation, and follow-up is explained. Digital radiography and recent advances like CBCT are also covered. In conclusion, radiographs provide important information for examining hard tissues beyond normal vision and setting standards for endodontic diagnosis, treatment and prognosis.
This document discusses the use of radiology in endodontics. It begins with a brief history of x-rays and their use in dentistry. The different types of intraoral and extraoral radiographs are described, along with techniques for taking intraoral periapical radiographs. Common anatomical landmarks are identified. The use of radiographs for diagnosis, working length determination, post-treatment evaluation, and follow-up is explained. Digital radiography and recent advances like CBCT are also covered. In conclusion, radiographs provide important information for examining hard tissues beyond normal vision and setting standards for endodontic diagnosis, treatment and prognosis.
Disadvantages of Radiographs 2D image only suggestive
Bucco-lingual dimension cannot be assessed
The bacterial status of the hard and soft tissues cannot be determined Chronic inflammatory tissues cannot be differentiated from healed fibrous scar tissue
Lesions of the medullary bone are undetected in
the radiographs till there is substantial bone loss
and the involvement of cortical bone
For a hard tissue lesion to be evident on a radiograph, there should be at least a mineral loss of 6.6 % Over exposure
Techniques Employed for IOPA
Paralleling Technique Bisecting Angle Technique
ParallelingTechnique Film is placed
parallel to the
long axis of the
tooth to be radiographed The film is exposed using X rays which are perpendicular to its surface Requires special
Film Holding Devices
10
Bisecting Angle Technique
The X rays pass perpendicular to the
angular bisector of the angle formed
by the long axis of the tooth and the X
ray film
No film holding devices are required
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Normal Anatomical Landmarks
12
Enamel, Dentin &
Pulp
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Cervical Burnout
14
Radical Pulp
15
Lamina Dura
16
Lamina Dura (extracted tooth)
17
Periodontal Ligament Space
18
Intermaxillary Suture
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Incisive Foramen
20
Soft Tissue Shadow of the Nose
21
Inferior Border of Maxillary Sinus
22
Zygomtic Process of Maxilla
23
Shadow of Nasolabial Fold
24
Genial Tubercles
25
Lingual Foramen
26
Mental Foramen
27
Mental Foramen
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Mandibular Canal
29
Nutrient Canals
30
Mylohyoid Ridge
31
Coronoid Process of Mandible
32
IOPA Radiographs in Endodontic Therapy
Diagnostic Radiographs Working Radiographs
Post operative Radiographs
Follow up Radiographs
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Diagnostic Radiographs
Ideally, these radiographs should be taken using paralleling
angle technique
They should be of high quality without any foreshortening or
elongation
They help for proper diagnosis of the case
These radiographs helps in determining the prognosis by
comparison with post operative and follow up radiographs 34
35
Comparison between Diagnostic and Follow up Radiographs
Periapical Cyst Before RCT
Complete Bony repair after RCT
36
Working Radiographs
These radiographs are used for determining the position of
instruments files etc during the procedure
These radiographs are to be taken without removing the rubber
dam as it can cause contamination of the operating field
Bisecting angle technique can be used
A better alternative is the use of a hemostat as a film holding
device
37
Radiograph showing Endodontic
Instruments & Rubber Dam Clamp
38
Working Radiograph with Master Cone
39
Working Radiographs of same
tooth using Different Angulations
40
Postoperative Radiographs
They are used to evaluate the endodontic
treatment They are taken after removing the rubber dam Ideally paralleling angle technique should be used They can be compared with the diagnostic radiograph
41
Post Operative Radiograph
42
Follow-up Radiographs
These radiographs are taken to evaluate the
prognosis of the endodontically treated tooth After obturation, the tooth may have to undergo procedures like core build up, crown fabrication etc The follow up radiograph gives the health of the periodontium and the tooth by evaluating the presence of root resorption, other treatment failures etc 43
44
External Root Resorption
Before Bleaching
2 Years After Bleaching
45
Follow up Radiographs After
RCT
46
Vertical Angulation
Elongation Corrected by increasing the
vertical angle of the central ray
Foreshortening Corrected by decreasing the
vertical angle of the central ray
47
Horizontal Angulation Clarkes Rule (S.L.O.B Rule)
The object that moves in the SAME direction as
the cone is located toward the LINGUAL
The object that moves in the OPPOSITE direction
as the cone is located toward the BUCCAL
48
49
Central Ray Perpendicular to
the Film
50
Central Ray directed 20
Mesial to film
51
Working Radiographs with
Instruments inside the Root Canals
Superimposition of Files
4 separate Files in root
canals
52
X-ray Beam passing
through Two Thicknesses of Root Structure
53
X-ray Beam aimed 20 Mesially
through Single Thicknesses of Hourglass Root
54
Digital Radiography
55
The digital systems relies on an electronic detection of an X ray generated image that is electronically processed and reproduced on a computer screen
56
Advantages
Reduced exposure to radiation
Increased speed of obtaining the image Possibility for digital enhancement Storage as digital data in computers Ease of transmissibility Elimination of manual processing steps
57
Intraoral X ray Sensors
58
Digital Image Enhancement
59
Inversion
60
Contrast
61
Measurement of Angle of Root
Curvature
62
Flash Light
63
Magnification
64
Pseudocolour
65
Linear Measurement
66
RECENT ADVANCES
CBCT MRI Nuclear imaging
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Conclusion
Radiograph is a very powerful tool for a dentist,
especially an Endodontist with which he are able to examine the status of hard tissue which are beyond the field of his naked eyes Application of radiology gives new standards for the diagnosis, treatment and prognosis of a dental problem
