Embed Size (px)
Citation preview
Caries
Bitewing Film primarily
Periapical film also used
Low kVp, high contrast
(short scale)
Approximately 50 % demineralization is required for radiographic detection of a lesion. The thickness of the tooth buccolingually masks the carious lesion when it is small.
The actual depth of penetration of a carious lesion is deeper clinically than radiographically.
Proximal caries susceptible zone
caries
Factors affecting caries diagnosis: Buccolingual thickness of tooth
Two-dimensional film
X-ray beam angle
Exposure factors
Radiographic Caries
I
M = Moderate
I = Incipient
A = Advanced
S = Severe
S
A M A
Incipient Interproximal Caries I
Up to half the thickness of enamel
Cone-shaped radiolucent area
Treat or no treat ?
Usually not restored: * Unless patient has high caries activity
Incipient Interproximal Caries
I
Incipient
Moderate Interproximal Caries
M
More than half-way through the enamel (up to DEJ)
Moderate
Advanced Interproximal Caries
A A
From DEJ to half-way through the dentin
Advanced
Advanced
Advanced
Advanced
Incipient
Moderate
Advanced
Severe Interproximal Caries
More than halfway through the dentin
S
Severe
Anterior interproximal caries can usually be diagnosed by directing bright light through the contact areas.
Transillumination
Must have penetrated into dentin Diagnosed from clinical exam Radiographs are not a reliable diagnostic aid for the detection of occlusal caries.
Occlusal Caries
The apex of the triangle is toward the outer surface of the tooth and the base is at the dentino-enamel juncition.
Occlusal Caries
Occlusal
Occlusal
Use clinical exam
Can’t determine depth
Appears as round dots
Buccal/Lingual Caries
Buccal/lingual
Older patients with recession or periodontitis
Root Caries
Root caries
Root caries
Cervical burnout appears as a collar or wedge-shaped radiolucency on the
mesial and distal root surfaces near the CEJ of a tooth.
The tissue density at the cervical region of the tooth is less than the regions
above and below it. (variable penetration of X-ray)
Burn-Out:
*Mainly located at the neck of the tooth (Demarcated above
by enamel cap or restoration and below by the alveolar
bone)
**Usually all teeth are affected esp. smaller premolars.
***it is more obvious when the exposure factors are
increased!
Root caries may be confused with cervical burnout
Anterior Cervical Burnout
bone level
cervical burnout area
Radiolucency seen above left (arrow) disappears on periapical film of same tooth (above right).
Cervical burnout
Cervical burnout in the anterior region due to gap between enamel (red arrows) and alveolar bone over root.
May be due to high caries rate, poor oral hygiene, failure to remove all the caries, defective restoration or a combination.
Recurrent Caries
Is not always easy to detect radiographically:
1. Location of caries lesion relative to restoration.
2. Angulation of X-ray beam.
Recurrent Caries
Recurrent caries (red arrows)
Recurrent caries
Recurrent caries
Rampant Caries
* Usually found in children and teens with poor diet and inadequate oral hygiene. * Patients with xerostomia
Found in head/neck radiation therapy patients with xerostomia Fluoride used for control
Radiation Caries
Before radiation
1 year after radiation
