Rkg Prosto radiologi kesehtsns

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Resorption can be so severe as to require augmentation with bone

grafts in order to prevent pathologic fracture of the mandible.



There is no justification for radiography of

edentulous patients without a specific indication

such as :* clinical signs or

* symptoms or

* medical & dental history or

* implant treatment



EKSTRA ORAL

PANORAMIK

INTRA ORAL

PERIAPIKAL OKLUSAL

RA dan RB





TANPA PERGESERAN

DEVIASI DENGAN PERGESERAN

DISLOKASI

FRAKTUR



Radiological features of mandibular fractures



Fractures of the mandible

Tempat yang sering mengalami fraktur









T M

Temporo mandibular joint











Classification Diagnosis Literature references

Developmental

abnormalities

Hyperplasia of coronold processCondylar hyperplasia Condylarhypoplasia Condylar aplasia

Congenital syndrome

Gross etal 1997 Isberg and

Eliasson 1990 Nakata etal. 1995Krogstad 1999 Polley and

Figueroa 1997 Posnick 199? 1998Inflammations Bacterial arthritis Rheumatoid

arthritis Juvenile chronic arthritisFree intra-articular bodies

Leighty etal, 1993 Scutellari and

Orzinolo 1998 Larheim etal. 1992Sarma and Dave 1991ikebeetaL1998 Duvoism etal 1990

Fractures Classification of condylarfractures Classification of disk

displacements associated withcondylar fractures

Spiessl and Schroll 1972 Bumann

etal 1993

Ankylosis Fibrous ankylosis Bony ankylosis Nitzan and Dolwick 1989Mo$esandlo1995 McCain etal.1992 Lelfo 1990

TumorsPrimary benign tumor Primarymalignant tumor Metastases

Bavitz and Chewning 1990Kreutzinger 1994 DeBoom etal1985 Claser etal 1997 Jchal etal

1994

Cysts

Ganglionic cyst Synovial Chang etal 1997

cyst Epidermoid cyst Bonanacdetal 1996 Weinberg

Aneurysmal bone cyst and Kryshtalkyi 199S Svenssonand Isacsson 1993

Other

Systemic lupus erythematosus Avascular necrosis AkromegalyGout

Jonsson etal 1983 Donaldson1995 Schellhas etal 1989Hampton 1987 Gross etal 1987

T M J



Unilateral / Bilateral Failure of Condylar

Development













T M J



T M J

Radiographic

investigation

Area of joint shown

Transcranial Lateral aspect of:Glenoid fossa, Articular eminence,

Joint space,

Condylar head

Transpharyngeal Lateral view of:

Condylar head and neck,

Articular surface

Panoramic Lateral view of

both condylar heads and neck

Reverse Towne's Posterior view of

both condylar

heads and necks

Tomography (CT) All aspects of:

Glenoid fossa

Articular eminence

Joint space

Condylar head



Transcranial

Main indications

The main clinical indications include:

• TMJ pain dysfunction syndrome

clicking and limitation in opening

• To investigate the size and position of the disc

• To investigate the range of movement in the joints.



Transcranial





TranspharyngealMain indications



• To investigate pathological conditions affecting

the condylar head, including cysts or tumours

• Fractures of the neck and head of the condyle



Transpharyngeal



Transpharyngeal



Panoramic

Main indications

The main clinical indications are generally the

same as the transpharyngeal views and include:


• To investigate pathological conditions affecting

the condylar heads

• Fractures of the condylar heads or necks



Panoramic



Reverse towne's

Main indications


• To investigate the articular surface of the

condyles and disease within the joint

• Fractures of the condylar heads and necks



Reverse towne's





Tomography

Main indications


• Full assessment of the whole of the joint to

determine the presence and site of any

bone disease or abnormality





• Proyeksi apakah ?

• Posisi apakah

A,B & C ?

• Struktur anatomi

apakah

D,F,G & H ?



Panoramic TMJ



Radiography in implantology

Pre-operative planning

During Surgery

Postoperative

osteointegration

bone healingperiodically review the fixture





IMAGINGTECHNIQUE ADVANTAGES DISADVANTAGES

Lateral

cephalometric

radiography

May be useful in anterior jaw regions.

Cross-sectional image of mid-line of

jaws gives information on:

Tooth inclination

Bone quantity

Image has known magnification

Images of structures not

in mid-line are

superimposed





Pre-operative planning

The quality and quantity of bone

The bucco-lingual width and height of available bone

The inclination of bony contours The presence of osseous undercuts

Evidence of atypical anatomy such as enlarged marrow spaces

Presence of pathology

Exact location of certain anatomic structures

(the maxillary antrum, inferior alveolar canal, mental foramen etc)











During Surgery

If any radiography is needed then

periapical radiographs are readilyavailableand use of digital imaging should beconsidered which offers the benefits of'real-time’ imaging



Postoperative

Radiography has been recommended to evaluate the implant postoperatively. During the healing phase, if the patient has clinical symptoms. If not, at 12 months and is considered essential to assess marginal bone levels. Review intervals range from annual reviews to once every three years.











Michael J. Pharoah; Stuart C. White : ORAL RADIOLOGY: PRINCIPLES AND INTERPRETATIONSt. Louis, Missouri , Mosby Inc, 2004

Radiation Protection 136 : European guidelines on radiation protection in dental radiology

Luxembourg: Office for Official Publications of the European Communities 2004

Hiroshi Muraoka : A color Atlas of complete denture Fabrication, Osaka Japan,

Quintessence pablishing company, 1989

Mac Entee, Michael I : The complete denture : A clinical Pathway, Quintessence Publishing

Company, Inc. Illinois 1999

Kepustakaan

Eric Whaites : Essentials of Dental Radiography and Radiology, 3th edition, Edinburg London

Newyork Oxfort Philadelphia St.Louis Sydney Toronto, Churchill Livingstone, 2003



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Rkg Prosto radiologi kesehtsns