Prelegere Metode Stomat ENG

7/24/2019 Prelegere Metode Stomat ENG

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MEDICAL IMAGING METHODS

IN STOMATOLOGY


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MEDICAL IMAGING METHODS IN STOMATOLOGY

Radiological methods: Intraoral radiography

Extraoral radiography

Special methods: With contrast media (artrography, sialography)

Panoramic Radiography

C

!ltrasonography

"RI


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Intraoral Dental Radiographs

Periapicalpro#ection sho$s all o% a tooth,incl&ding the s&rro&nding 'one, %or optim&m

depiction o% apical or periapical lesions

Bitewing (coronal, interproximal) pro#ection sho$s only the cro$ns o% teeth and the ad#acent

aleolar crests, this is partic&larly indicated %or

interproximal caries detection

Occlusalpro#ection sho$s an area o% teethand 'one larger than periapical radiograph, %or

depicting the #a$s in the third dimension


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he lo$est leel o% distortion and the highest leel o%image clarity $ill al$ays 'e %o&nd in the region o% the

central ray pro#ection

he clinical indicationact&ally sets the priority %or

selection o% the indiid&al types o% intraoral radiographs,

and the radiographic *&ality o% other str&ct&res is o%

secondary importance

he image receptor (%ilm) sho&ld 'e as perpendic&lar as

possi'le to the central ray and as parallel as possi'le to

the tooth long axis in order to g&arantee optim&m

radiographic interpreta'ility



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Periapical projection

Pro#ection techni*&es

Paralleling techni*&e (right+angle or long+conetechni*&e)

isecting+angle techni*&e



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Paralleling technique

he x+ray %ilm is s&pported parallel to the long axis o% the teeth he central ray o% the x+ray 'eam is directed at right angles to the

teeth and %ilm

his orientation o% the %ilm, teeth, and central ray minimi-esgeometric distortion o red&ce geometric distortion %&rther, the x+ray

so&rce sho&ld 'e located relatiely distant %rom the teeth



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.ilm+holding instr&ments



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.ilm+holding instr&ments



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i!ecting"angle technique Cies-yns/i0s r&le o% isometry (geometric theorem): t$o triangles are

e*&al $hen they share one complete side and hae t$o e*&alangles

Position the %ilm as close as possi'le to the ling&al s&r%ace o% theteeth, resting in the palate or in the %loor o% the mo&th



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i!ecting"angle technique he plane o% the %ilm and the long axis o% the teeth %orm an angle

$ith its apex at the point $here the %ilm is in contact $ith the teeth Constr&ct an imaginary line that 'isects this angle and direct the

central ray o% the 'eam at right angles to this 'isector his %orms t$o triangles $ith t$o e*&al angles and a common side

(the imaginary 'isector)



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i!ecting"angle technique Conse*&ently, $hen these conditions are satis%ied, the images cast

on the %ilm theoretically are the same length as the pro#ected o'#ecto reprod&ce the length o% each root o% a m&ltirooted toothacc&rately, the central 'eam m&st 'e angled di%%erently %or eachroot 1nother limitation o% this techni*&e is that the aleolar ridgeo%ten pro#ects more coronally than its tr&e position



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i!ecting"angle technique

Angulation o# the tu$e hea%

$hen the occl&sal plane is oriented parallel $ith the %loor

23E: With a positie (4) ang&lation the aiming t&'e is pointeddo$n$ard, and $ith a negatie (+) ang&lation it is pointed &p$ard



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Angulation of the tube head


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Angulation of the tube head


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ite&ing projection Pro#ection techni*&e

Place the %ilm 'et$een the tong&e and the teeth, %ar eno&gh

%rom the ling&al s&r%ace o% the teeth to preent inter%erence 'ythe palate on closing and parallel to the long axes o% the teeth

Pro#ect the central ray to the center o% the %ilm



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Occlu!alprojection Pro#ection techni*&e %or maxilla

he patient5s head is straight &p and the central ray entersperpendic&larly thro&gh the region o% the maxillary %irst molars



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Occlu!alprojection Pro#ection techni*&e

he patient5s head is tipped %ar 'ac/$ard and the central ray istargeted perpendic&larly thro&gh the region o% the mandi'&larmolars onto the %ilm



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"o&nted %&ll+mo&th set o% radiographs consisting o% 67 periapical ie$s

and %o&r 'ite$ing ie$s


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Extraoral radiography

Posteroanterior Skull Proection

!ateral Skull Proection

Axial Skull Proection

"andibular Radiograph


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Posteroanterior Skull ProectionI! u!e% #or %ocu'entation o# !(ull an% #acial !(eletal a!)''etrie!*


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!ateral Skull ProectionI! u!e% #or %ocu'entation o# !(ull an% #acial !(eletal a!)''etrie!*


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Axial Skull ProectionA! an initial ra%iograph to chec( the con%)lar a+e!, or a! a !upple'ent to a

panora'ic ra%iograph #or locali-ation o# e+tre'el) laterall) i'pacte%

'a+illar) thir% 'olar!*


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"andibular Radiograph.or the clear %epiction o# the angle o# the 'an%i$le, the ra'u!, an% the

'an%i$ular canal*


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Panora#ic radiography$orthopantography $OP%& or panora#ic to#ography&

he 8+ray t&'e (right) and the %ilm holder (le%t) moe inthe cloc/$ise direction aro&nd the s/&ll


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Panora#ic radiography

"a/es it possi'le to depict in a single image a completerepresentation o% the #a$s, teeth, temporomandi'&lar #oints ("9),and the aleolar recess o% the maxillary sin&ses

ies dentists the opport&nity to record and analy-e all componentso% the masticatory system and their interrelationships


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Sialography Inoles the in#ection o% a small amo&nt o% a $ater+sol&'le contrast

medi&m into the saliary d&cts o% a single gland, %ollo$ed 'y ro&tine8+ray pro#ections

Indications: since the adent o% contrast C, sialography and&ltrasonography are rarely indicated in the inestigation o% thepatient $ho has parotid disease Sialography is help%&l in s&spectedcases o% d&ctal strict&re, calc&li or sialectasia


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'o#puted (o#ography Reprod&ces only those anatomic and pathologic details that lie $ithin

the selected slice

3%%ers the possi'ility o% m&lti+planar reconstr&ctions o% the region


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"RI he method o% choice %or determining the position o% the artic&lar dis/

and %or examination o% the intra+artic&lar so%t tiss&e str&ct&res


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)ltrasonography .or the examination o% #oints, artic&lar dis/, the intra+artic&lar so%t

tiss&e and saliary glands

R di hi A t


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Radiographic Anato#y 6 3r'it ; Cerical erte'rate, $ith tooth axis < asal compact 'one o% the opposing #a$ = 2asal sept&m > In%erior nasal concha

? "axillary sin&s ('orders) 7 1nterior nasal spine @ Aori-ontal osseo&s palatal lamina B atero'asal 'order o% the nasal caity 6D Palatal el&m 66 Pterygopalatal %ossa 6; ody o% the -ygomatic 'one, $ith innominate

line 6< ygomatic arch

6= asal compact 'one 6> "ylohyoid line 6? "andi'&lar canal 67 "ental %oramen 6@ Figastric %oea or mental %oea, depending &pon

the positioning o% the mandi'&lar anterior segmentin the plane o% %oc&s 6B External ear, $ith a&ditory opening ;D "andi'&lar artic&lar process (condyle) ;6 "&sc&lar process o% the mandi'le ;; Styloid osseo&s temporalis process ;< Ayoid 'one ;= ase o% the tong&e

R di hi A t


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Radiographic Anato#y

6 Enamel cap enhanced 'y the tangential e%%ect ; Cerical region 'et$een the enamel cap and the

aleolar crestG '&rn+o&t e%%ects < Periodontal ligament space and lamina d&ra

= Root canal > Hesti'&lar crest o% the aleolar 'one ? Palatal crest o% the aleolar 'one 7 So%t tiss&es o% the nose @ Entrance into the nose B "edian s&t&re, incisie %oramen, nasopalatal

(incisie) canal

6D .oramen o% the nasal nasopalatal canal 66 Piri%orm apert&re 6; atero'asal 'order o% the nasal caity 6< Palatal root, tooth 6=

6= Palatal c&sp, tooth 6= 6> Hesti'&lar c&sp, tooth 6= 6? 1nterior lo'e o% the maxillary sin&s 67 "axillary nasal crest $ith anterior nasal spine 6@ atero'asal 'order o% the maxillary sin&s 6B .loor o% the maxillary sin&s ;D hree+rooted tooth ;=

R di hi A t


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(incisie) canal



R di hi A t


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(incisie) canal



Radiographic Anato#


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Radiographic Anato#y 6 atero'asal 'o&ndary o% the nasal caity ; .loor o% the nasal sin&s < atero'asal 'order o% the maxillary sin&s = .loor o% the maxillary sin&s > Intrasin&s sept&m

? 1nterior lo'e o% the maxillary sin&s 7 1leolar lo'e o% the maxillary sin&s @ ygomatic lo'e o% the maxillary sin&s B ygomatic process o% the maxilla 6D ody o% the -ygomatic 'one 66 ygomatic arch 6; 1leolar ridge

6< ateral lamina o% the pterygoid process 6= Aam&l&s o% the medial lamina o% the pterygoid

process 6> Pyramidal process o% the palatal 'one 6? "axillary t&'erosity

67 ygomaticomaxillary s&t&re 6@ Coronoid (m&sc&lar) process o% the mandi'&lar

ram&s 6B Root tips o% the maxillary %irst premolars he

longer root is the palatal root ;D &rn+o&t e%%ect ;6 Secondary caries



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Radiographic Anato#y 6 atero'asal 'o&ndary o% the nasal caity ; .loor o% the nasal sin&s < atero'asal 'order o% the maxillary sin&s = .loor o% the maxillary sin&s > Intrasin&s sept&m ? 1nterior lo'e o% the maxillary sin&s 7 1leolar lo'e o% the maxillary sin&s @ ygomatic lo'e o% the maxillary sin&s B ygomatic process o% the maxilla 6D ody o% the -ygomatic 'one 66 ygomatic arch 6; 1leolar ridge








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Radiographic Anato#y 6 atero'asal 'o&ndary o% the nasal caity ; .loor o% the nasal sin&s < atero'asal 'order o% the maxillary sin&s = .loor o% the maxillary sin&s > Intrasin&s sept&m ? 1nterior lo'e o% the maxillary sin&s 7 1leolar lo'e o% the maxillary sin&s @ ygomatic lo'e o% the maxillary sin&s B ygomatic process o% the maxilla 6D ody o% the -ygomatic 'one 66 ygomatic arch 6; 1leolar ridge








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Radiographic Anato#y 6 Hesti'&lar interdental 'ony sept&m tip ; ing&al 'ony interseptal tip < "ental spine = Hertically co&rsing asc&lar canal > Hasc&lar canal in cross+section

? "ental %oea 7 &rn+o&t e%%ect @ Radiopacity d&e to the chin prominence B asal compact 'one o% the mandi'le 6D Periodontal ligament space irreg&larities d&e to

ariations in the cross+sectional pro%ile(depressions)

66 ra'ec&lar 'one o% the aleol&s in thedepression o% the root cross+section

6; Slender root tip massiely s&perimposed 'ytra'ec&lar 'one

6< 1leolar crest

6= Root %ragment 6> "andi'&lar canal 6? "ental %oramen 67 Incomplete root canal %illing $ith chronic apical

periodontitis



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6< 1leolar crest


periodontitis



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6< 1leolar crest


periodontitis



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6 ypical tra'ec&lar str&ct&re in the aleolarprocess o% the mandi'le

; Radiol&cency (s&'traction e%%ect) ca&sed 'y thes&'mandi'&lar %oea

< ypical tra'ec&lar str&ct&re o% the 'ody o% themandi'le

= "ental %oramen > a&rodont ? "andi'&lar canal

7 Internal o'li*&e line (contin&ation o% the temporalcrest o% the right mandi'le)

@ External o'li*&e line (anterior margin o% the rightmandi'le)

B "ylohyoid line 6D Retromolar triangle, $ith medial and lateral cr&ra 66 Island o% 'one marro$ %ollo$ing tooth extraction 6; asal compact 'one o% the mandi'le 6< Interdental calc&l&s



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Prelegere Metode Stomat ENG