Use of Radiographs for Periodontal Evaluation
1. Methods of good quality Radiographic
And Long-Cone Parallelization Method. Long cone parallelization technique provides a radiograph, more anatomically accurate compared to other intraoral methods such as cuts the corner.
B. Long-Grayscale-Low-Contrast Images. Large-scale contrast radiographic images seen many shades of gray that make it easier to see subtle changes such as the loss of bone tissue diseases of parodont. These images can be obtained using high KVP exhibitions (70-100 Lam), or using digital image processing adjustments to maximize the gray scale, as a rule, exposed images.
2. Limitations of Radiographs of periodontal evaluation. There are restrictions in
the use of x-ray in the diagnosis of diseases of parodont.
A. Two-Dimensional Image. On the x-ray provides a two-dimensional image of complex three-dimensional structure. The fact that the two-dimensional x-ray images can mislead the viewer. For example, buccal alveolar bone can hide bone loss on the language aspect of the tooth, and palatal root makes it difficult to identify the crotch part of the jaw molar.
B. information is limited Noncalcified structures. In addition, x-rays do not provide any information about noncalcified components of the periodontium.
C. limited information on parodontium. X-rays do not disclose the following: the presence or absence of periodontal pockets, early loss of bone mass, fine morphology of the destruction of the bone, tooth mobility, sooner fork of belonging, status of the alveolar bone tissue and lingual surfaces, or the level of the epithelial attachment.
1. Periodontal Pockets
a. The only reliable way to detect the periodontal pocket and assess its extent by careful periodontal probing.
B. Periodontal pocket consists of soft tissues, so it will not be visible in the photo.
2. Early Bone Loss
a. The earliest signs of periodontitis, which should be detected clinically, not x-ray. By the time of bone loss of periodontal becomes detectable on the x-ray, is usually beyond the very early stages of the disease.
1) Interseptal bone defects less than 3 mm, usually not visible on x-rays.
2) the height of the bones of the face and language aspects it is difficult to assess radiographically, because teeth are laid on top of bones.
B. On the radiograph may not accurately show the form of the deformation of the bones, because it's not three.
c. On the radiograph with poor technique and excessive vertical angles can hide bone loss (see Fig. 20-7).
1) for this reason, bitewing x-ray should be the primary x-rays are used to assess the axial bone height, not periapical x-ray.
2) proper long cone parallelization method can prevent the distortion of the axial bone height periapical x-rays and increase their usefulness.