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Radiographs

Radiographs (x-rays) – significant tool to diagnose our patients’ dental and periodontal health.

Radiographs are able to identify many conditions that may otherwise go undetected.

We use radiographs to examine:

  •  Terminal end of the roots of the teeth and surrounding bone (radiolucent halo around the apices of the roots)
  •  Crowns of the teeth and interproximal surfaces for caries (decay)
    “Bite-wings” x-rays are the best way to detect interproximal caries. Thise area is difficult if not impossible to examine clinically with an explorer
  • Bone level – we check for pattern, distribution and severity of bone loss. The most coronal portion of the bone is called alveolar crest which typically is located 1.5-2.0 mm below the junction of the crown and the root surface.  Anything greater than 2mm is considered bone loss ( see examples in our x-rays gallery below)
  • Widening of PDL
    The space between the root of the tooth and supporting bone is filled by periodontal ligament-connective tissue, fibers, blood vessels and lymphatics. In the healthy periodontium, on the dental radiographs the PDL space appears as a fine continuous radiolucent line of uniform thickness around the root of a tooth. Widening and thickening of PDL indicates disease
  • Furcations
    Furcation is a separation between the roots of multirooted teeth. Furcation involvement means that there is exposition of a furcation due to bone destruction and loss of attachment
  • Crown: Root ratio
    Root to crown ratio is a crown height in relation to the root height. In health there is no bone loss and the root within the surrounding bone is sufficient to support the tooth. After some bone loss is present, more root structure is visible outside of the supporting bone and there is an increased height of revealed tooth structure above the gingiva. It causes less effective root support. The ideal crown-to-root ratio is 1:2. Any less support provided by the roots drastically reduces the prognosis of the tooth and its restoration.
  • Tartar deposit below gumline – the best way to detect tartar deposit under gumline is using instrument called explorer, however, large tartar pieces may be visible on a radiographs (see gallery below)
  • Faulty restoration – In many cases, faulty restorations can be detected on  radiographs. Inadequate dental restorations and prosthesis are common causes of gingival inflammation, gum disease and bone resorption

Some of the more common diseases, lesions, and conditions found on dental radiographs include the following:

  • Missing teeth
  • Extra teeth
  • Impacted teeth
  • Periodontal disease
  • Tooth abnormalities
  • Retained roots
  • Cysts and tumors

Types of Radiographic Examinations at our Office:

  • Periapical X-ray is used to examine entire tooth ( crown and root) and supporting bone
  • Interproximal X-ray (Bite wing) is used to examine the crowns of both the upper and lowers teeth on a single film. This radiograph is useful in diagnosing dental decay and checking bone level
  • Full Mouth X-rays can be defined as a series of intraoral dental radiographs that shows the entire tooth – bearing areas of the upper and lower jaws. FMX consists combination of periapical and interpoximal radiographs
  • Panoramic X-ray is a radiographic inspection of large areas of the skull or jaws. Extraoral film is placed outside the mouth
Sources:
“Dental Radiography” Joen M. Lannucci