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Rubens SpinRubens SpinRubens SpinRubens Spin----NetoNetoNetoNetoDepartment of Dentistry
Section of Oral RadiologyAarhus University
Radiographs in periodontal assessment
04.sep.201412:45 – 14:15Aud. 3
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Anatomic and histologic knowledge
Spin-Neto et al., 2010
Contact point
Interdental papilla
Free gingival margin
Attached gingivaMucogingival juntionAlveolar mucosa
Physiologic knowledge ���� Dentistry knowledge
Spin-NetoLindhe, 2010
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Clinical diagnosis
Bleeding Suppuration Attachment loss
Spin-Neto et al., 2010
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Radiographic diagnosis
Bone levels / Bone loss / Bone gain
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Guidelines
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Radiographic diagnosis
The diagnosis of periodontal diseases depends on a thorough clinical examination supplemented by radiographs, in those cases in which they may
provide additional information that could potentiallychange patient treatment and prognosis
Selection criteria for dental radiography (UK, 2013)
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Radiographic diagnosis
Existing radiographs should be used as far as possible to define if other (more appropriate) radiographic
views are necessary (e.g. images taken for caries diagnosis can aid the assessment of the periodontal hard tissues)
Selection criteria for dental radiography (UK, 2013)
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When should we take new images?
There is no clear evidence supporting any recommendations on the frequency of radiographs taken for periodontal reasons
Selection criteria for dental radiography (UK, 2013)
ALARAAs Low
As Reasonably
Achievable
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Types of images – Digital periapical (PAs)
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Types of images - Bitewing
?
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Types of images - Panoramic
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Types of images – Panoramic x Full mouth PAs
1. ALARA (1Pan = 4PAs)
2. Sharpness
3. Geometric distortion
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Remember: we are producing documentation !
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Overtime reproducibility
Geometric reproducibility of radiographs taken at different time points allows more accurate evaluation
of radiographic bone level changes over timeSelection criteria for dental radiography (UK, 2013)
Baseline 1 month 3 months 6 months
Anatomic structures
Compact bone
Spongious bone
Anatomic structures
Compact bone
Spongious bone
Lamina dura
Anatomic structures
Compact bone
Spongious bone
Lamina dura
CEJ
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Bone level and bone loss
Bone level
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Bone level and bone loss
Bone loss ?
“Rule of thumb” ≥ 4mm bone loss
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Horizontal bone loss
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Vertical bone loss / gain over time
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Bone loss / gain over time
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But remember...
Røntgen kan ikke fortælle om der er parodontitis marginalis: kun knogletab
+
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2D x 3D (Cone beam CT) images
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2D x 3D (Cone beam CT) images
CBCT is not indicated as a routine method for imaging periodontal bone support
Selection criteria for dental radiography (UK, 2013)
[email protected]@[email protected]@odont.au.dk
