Radiography chapter
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Interpretation

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Introduction

The interpretation of any radiograph requires time, appropriate equipment and a logical approach in order to avoid missing lesions.


Equipment Viewer

   
  • A magnifying glass or block is very useful, particularly for small lesion
  • A hot light within the viewer is helpful, as good contrast exists between hard tissues and air. Enamel, dentine and bone are the three hardest body tissues
  • Film quality depends on many variables - exposure, film speed, development quality, positioning etc. It may help to cut a "keyhole" in a card and view the radiograph through the keyhole with the room lights off.

 

Rinn Dentsply viewing box with magnifier
Rinn Dentsply viewing box with magnifier

 

Interpretation Process

 

1. Evaluate the image quality:

  • Is the image too light or dark?
  • Check the contrast
  • Has the image been processed properly?
  • Is the image distorted or superimposed?

2. Specifically identify the species, location and structures.

3. Examine the whole radiograph from left to right.

4. Teeth - check each tooth for:

  • Changes in contour and/or density of dentine
  • Changes in the bone level around roots (particularly furcation and interproximal)
  • Changes in the pulp chamber or periodontal space
  • Changes in bone density around the root and the integrity of lamina dura.

5. Jaw - examine the lesion in the jaw:

  • Site - location, extent, solitary, multi-focal or generalised
  • Size and shape - measure and describe. This may require one or more views
  • Symmetry - examine contralateral site. Bilateral symmetry is suggestive of a normal variant
  • Border - sclerosis, resorption, lack of continuity
  • Contents - lucent or opaque. Homogenous or varying density
  • Association with other structures. Teeth displaced or resorbing.

6. Attempt diagnosis or assess the need for further tests.

 

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