And Their Radiographic Appearance

1. BONES And Their Radiographic Appearance

2. 22 Bones make up the skull Cranial bones include: • Occipital (one) • Frontal (one) • Parietal (two) • Temporal (two) • Sphenoid (one) • Ethmoid (one) Cranial bones surround the brain

4. Facial bones include: • Mandible (one) • Maxilla (two) • Zygomatic (two) • Lacrimal (two) • Nasal (two) • Inferior nasal conchal (two) • Vomer (one)

5. Terms that describe bone anatomy • Process – general term for any prominence • Fossa - depression on the surface of the bone • Suture – where two bones join • Tuberosity – bony prominance, usually where muscle attaches, ie maxillary tuberosity suture Mastoid process Temporal fossa

6. Terms that describe bone anatomy • Notch – indentation on the edge of a bone • Ridge – elongated prominence • Foramen - opening Mental foramen External oblique ridge Mandibular notch

7. Two types of Bone – compact and cancellous • Cancellous bone (also called spongy bone) makes up center of bones • Contains bone marrow spaces (called “trabeculation” on radiographs) • More radiolucent than compact bone trabeculation

8. Compact Bone • Compact bone- forms plates that form outside of bones, linings for alveolus, foramina, etc… • Is more radiopaque because of its density Compact bone Cancellous bone

9. Compact Bone Lines Alveolus (socket) It is also called (*and means same thing): • Lamina dura(on radiographs only) • Cribriform plate • Cortical bone • Alveolar bone proper

10. Compact bone outlines alveolar crest (when no bone has been lost due to periodontal disease!) Alveolar crest (radiopaque) Periodontal ligament space(radiolucent lining) Lamina dura(radiopaque lining)

11. Do you see any compact bone outlining the alveolar crest?

12. Lateral View Identification • Mandible • Maxilla • Zygomatic arch • Condyle • External auditory meatus • Temporal bone

13. Lateral closeup • Condyle • Articular eminence • Coronoid process • Ramus • Articular fossa • Mandibular notch • Coronoid notch 6 7

14. Temporomandibular Joint Articular or gleniodfossa Articular eminance • Mandibular condyle articulates with temporal bone in the articular fossa (also called glenoid fossa, mandibular fossa) • Most anterior border of articular fossa is the articular eminance • If someone opens wide and the condyle slides anterior to the eminance, the person has “lockjaw”

15. Lateral closeup • Dehiscence • Fenestration • Mental foramen • Zygomatic process of maxilla • Alveolar bone • Alveolar crest • External oblique ridge 7

16. Dehiscence vs Fenestration • Bony defects of unknown cause • Neither can be found radiographically, only during surgery • Fenestration, defect completely surrounded by bone • Dehiscence, alveolar crest bone absent fenestration dehiscence

17. Bones of the Orbit In order of appearance • Frontal • Zygomatic • Maxillary • Palatine • Sphenoid • Lacrimal • Ethmoid

18. Nasal Cavity Orbit Maxillary Sinus

19. Zygomatic Arch • Commonly called the “cheekbone” • Comprised of three bones, temporal, maxilla, zygoma temporal zygoma maxilla sutures

20. Zygomatic Arch Maxillary process of zygoma joins with zygomatic process of maxilla Zygomatic process of temporal bone joins with temporal process of zygoma Zygomatic Arch

21. Radiographically, the zygomatic arch appears as a radiopaque horseshoe shaped structure above maxillary molars (not always seen)

22. Maxillary Sinus – an opening in the maxillary bone, acts as a filter for inhaled air Location of the sinus Inside of sinus with bony covering removed

23. Inverted Y • Maxillary sinus meets nasal cavity in area of canine • On radiographs, wall of sinus crosses wall of nasal cavity (both are radiopaque because they are compact bone) • Result is the “inverted Y”

24. Inverted Y Nasal cavity Inverted Y Maxillary sinus

25. Septa of maxillary sinus (divides cavity) Zygomatic Arch Floor of maxillary sinus(radiopaque)

26. Frontal View Identification • Frontal bone • Orbit • Mental protuberance

27. Skull Identification • Midline suture • Anterior Nasal spine • Nasal septum • Infraorbital foramen • Lateral fossa • Superior nasal conchae 6

28. Anterior Radiograph • Median palatal suture (radiolucent) • Noseline(cartilage) • Nasal spine (radiopaque V-shaped prominence) • Nasal conchae • Nasal septum (elongated, thicker radiopacity) 5

29. Lateral Fossa – a depression between the maxillary cuspid and incisor Exercise – feel your lateral fossa with your finger

30. Inferior nasal conchae Nasal septum (divides nasal cavity) Anterior Nasal spine (V-shaped) Lateral fossa (Radiolucency inside circle)

31. Internal Oblique ridge- (slightly inferior to external oblique ridge) Mandibular foramen Mental ridge- see figure 27-56 Iannucci Lingula – a bony projection that partially covers the mandibular foramen

32. Lingual foramen Genial tubercles (muscles attach here) Submandibular fossa (depression for submandibular Salivary gland)

33. Coronoid process Coronoid notch Mandibular (sigmoid)Notch Condyle Ramus External oblique ridge Angle of the mandible

34. External oblique ridge (thicker radiopaque band) Note: External/internal ridges often “superimposed” over each other radiographically;therefore difficult to differentiate between the two; external always superior to internaloblique ridge (mylohyoid muscle attachment); internal usually runs below roots of mandibularmolars (see figure 26-62 Haring)

35. Internal on “inside” or lingual

36. A- external oblique ridgeB- internal oblique ridge C- submandibularfossa D- mandibular canal A B Hyoid bone

37. Mandibular foramen Mandibular canal Soft tissue outline- retromolar area Submandibular fossa (large radiolucency within the circle)

38. External oblique ridge Mandibular canal

39. Submandibular fossa

40. Nutrient canals – passageways to teeth for vessels (arrows on film), often seen around maxillary premolars Genial tubercles (Radiopacities) Lingual foramen (radiolucency)

41. Mental Foramen Mylohyoid ridge or internal oblique ridge(see down by roots of teeth)– actually on lingual of mandible

42. Palate Nasopalatineor Incisive foramen Median palatine suture Anterior or Greater palatine foramen Posterior or Lessor palatine foramen Hamulus

43. Palatal Radiographs Median Palatal suture Nasopalatine or Incisive foramen

44. Sphenoid Bone • A butterfly shaped cranial bone posterior to the palate • It forms part of the orbit • It’s hamulus can sometimes be seen on third molar radiograph • Some muscles of masticaton attach to Pterygoid plate Hamulus Lateral pterygoid plate

45. Temporal bone • A cranial bone that articulates with mandible in its articularfossa • Other landmarks include styloid process, mastoid process • Forms part of zygomatic arch Mastoid process Articularor glenoidfossa(where condyle sits)

46. Infratemporal Space (skull with mandible removed) Articularor Glenoidfossa Styloidprocess (can sometimes beseen on a panoral) Maxillary tuberosity

47. Coronoid process Condyle and glenoidfossa Hard palate (horizontal thicker radiopaque line)

48. Maxillary tuberosity External oblique ridge Nasal spine Inverted Y