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Chapter 31

Chapter 31. Descriptive Terminology. Dental Radiography. Questions What is the difference between a radiograph and an x-ray? What is the difference between radiolucent and radiopaque? What terms may be used to describe radiolucent and radiopaque lesions?. Dental Radiography.

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Chapter 31

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  1. Chapter 31 Descriptive Terminology

  2. Dental Radiography • Questions • What is the difference between a radiograph and an x-ray? • What is the difference between radiolucent and radiopaque? • What terms may be used to describe radiolucent and radiopaque lesions?

  3. Dental Radiography • Chapter 31 Reading • Iannucci & Howerton (pp. 372-382)

  4. Dental Radiography • Chapter 31 Outline • Descriptive Terminology • Definition and uses • Review of basic terms

  5. What is Descriptive Terminology? • Descriptive terminology is terms used to describe the appearance, location, and size of a lesion. • This information should be documented for all lesions viewed on dental images.

  6. Why Use Descriptive Terminology? • Descriptive terminology allows dental professionals to describe and discuss what is seen on a dental image intelligently and to communicate using a common language. • It eliminates the chance for miscommunication. • It allows for documentation that images were reviewed.

  7. Descriptive Terminology versus Diagnosis • Descriptive terminology allows the dental hygienist to describe what is seen on an image without implying a diagnosis. • The patient’s medical and dental history, clinical findings, signs and symptoms, laboratory tests, and biopsy results are necessary for the dentist to make a definitive diagnosis.

  8. Review of Basic Terms • Radiograph/dental image versus x-ray • Radiolucent versus radiopaque • Terms used to describe radiolucent lesions • Terms used to describe radiopaque lesions

  9. Radiograph/Dental Image versus X-ray • Radiograph • An image that is produced on photosensitive film by exposing the film to x-rays and then processing the film so that a negative is produced • Not applicable with digital radiography, in which term digital image used instead • X-ray • A beam of energy that has the power to penetrate substances and to record shadow images on photographic film

  10. Radiolucent versus Radiopaque • Iannucci & Howerton (pp. 373-374) (Figs. 31-1, 31-2,31-3) • Radiolucent • This that portion of a processed image that is dark or black. • Caries appears radiolucent because the area of tooth with caries is less dense than surrounding structures. • Radiopaque • This is that portion of a processed image that appears light or white. • A metallic restoration appears radiopaque because it is very dense and absorbs the radiation.

  11. Terms Used to Describe Radiolucent Lesions • Appearance • Location • Size

  12. Appearance • Iannucci & Howerton (pp. 374-375) (Box 31-1) • Unilocular radiolucent lesions • One compartment • Tend to be small and nonexpansile • Have borders that may appear corticated or noncorticated on image

  13. Appearance • Iannucci & Howerton (pp. 374-375) (Figs. 31-4, 31-5) • Unilocular lesion, corticated borders • The lesion exhibits a thin, well-demarcated radiopaque rim of bone at the periphery. • Usually indicative of a benign, slow-growing process. • Unilocular lesion, noncorticated borders • The lesion does not exhibit a thin radiopaque rim of bone at the periphery. • The periphery appears fuzzy or poorly defined. • May represent either a benign or a malignant process.

  14. Appearance • Iannucci & Howerton (pp. 374-375) (Fig. 31-6) • Multilocular radiolucent lesions • A lesion that exhibits multiple radiolucent compartments • Frequently expansile • Typically benign lesions with aggressive growth potential

  15. Location • Iannucci & Howerton (pp. 375-376) (Box 31-2) • May appear in a periapical, inter-radicular, edentulous, or pericoronal location. • May appear as alveolar bone loss.

  16. Periapical Location • Iannucci & Howerton (pp. 375-376) (Fig. 31-7) • A lesion located around the apex of a tooth • Example • Periapical cyst secondary to pulpal necrosis

  17. Inter-radicular Location • Iannucci & Howerton (p. 376) (Fig. 31-8) • A lesion located between the roots of adjacent teeth • Example • Lateral periodontal cyst

  18. Edentulous Zone • Iannucci & Howerton (pp. 376-377) (Fig. 31-9) • A lesion located in an area without teeth

  19. Pericoronal Location • Iannucci & Howerton (p. 377) (Fig. 31-10) • A radiolucent lesion located around the crown of an impacted tooth • Example • Dentigerous cyst

  20. Alveolar Bone Loss • Iannucci & Howerton (p. 377) (Fig. 31-11) • Loss of bone in the maxilla or mandible that surrounds and supports the teeth • Appears radiolucent

  21. Size • Iannucci & Howerton (p. 377) (Fig. 31-12) • Can vary in size from several millimeters in diameter to several centimeters in diameter • Can be measured on an image with a millimeter ruler

  22. Terms Used to Describe Radiopaque Lesions • Appearance • Location • Size

  23. Appearance • Iannucci & Howerton (pp. 377-378) (Box 31-3) • Can be described as focal opacity, target lesion, multifocal confluent, irregular, ground glass, or mixed lucent-opaque. • Radiopaque lesions occur not only in bone but in soft tissue as well.

  24. Focal Opacity • Iannucci & Howerton (pp. 377-378) (Fig. 31-13) • A well-defined, localized radiopaque lesion on an image • Example • Condensing osteitis

  25. Target Lesion • Iannucci & Howerton (p. 378) (Fig. 31-14) • A well-defined, localized radiopaque area surrounded by a uniform radiolucent halo • Example • Benign cementoblastoma

  26. Multifocal Confluent • Iannucci & Howerton (p. 378) (Fig. 31-15) • Multiple radiopacities that appear to overlap or flow together • Example • Osteitis deformans, florid osseous dysplasia • Multifocal confluent radiopacities involving multiple quadrants of the jaws usually represent benign fibro-osseous disorders.

  27. Irregular Ill-Defined • Iannucci & Howerton (pp. 378-379) (Fig. 31-16) • A radiopacity may exhibit an irregular, poorly defined pattern. • It may represent a malignant condition. • Examples • Osteosarcoma and chondrosarcoma

  28. Ground Glass • Iannucci & Howerton (p. 379) (Fig. 31-17) • A granular or pebbled radiopacity that resembles pulverized glass • Often said to resemble the appearance or texture of an orange peel • Examples • Fibrous dysplasia, osteitisdeformans, and osteopetrosis

  29. Mixed Lucent-Opaque • Iannucci & Howerton (p. 379) (Fig. 31-18) • Exhibits both a radiopaque and a radiolucent component • Often represent calcifying tumors • Example • Compound odontoma

  30. Soft Tissue Opacity • Iannucci & Howerton (p. 379) (Fig. 31-19) • Appears as a well-defined, radiopaque area located in soft tissue • Examples • Sialolith • Calcified lymph node

  31. Location • Iannucci & Howerton (pp. 379-380) (Box 31-4) • Radiopaque lesions may appear in the same places as radiolucent lesions: in a periapical, inter-radicular, edentulous, or pericoronal location.

  32. Periapical Location • Iannucci & Howerton (p. 380) (Fig. 31-20) • Periapical refers to a radiopaque lesion located around the apex of a tooth. • Example • Benign cementoblastoma

  33. Inter-radicular Location • Iannucci & Howerton (p. 380) (Fig. 31-21) • A radiopaque lesion located between the roots of adjacent teeth • Example • Sclerotic bone

  34. Edentulous Zone • Iannucci & Howerton (p. 380) (Fig. 31-22) • A radiopaque lesion located in an area without teeth • Example • Complex odontoma

  35. Pericoronal Location • Iannucci & Howerton (p. 380) (Fig. 31-23) • A radiopaque lesion located around the crown of an impacted tooth • Example • Adenomatoid odontogenic tumor is a mixed lucent-opaque lesion.

  36. Size • Radiopaque lesions can vary from several millimeters to several centimeters in diameter. • They can be measured on an image with a ruler.

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