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2 Objectives Define the key words. 3 Objectives Describe and identify the radiographic appearance of all structures of the teeth. Name significant anatomical landmarks of the maxilla
and mandible. Identify significant anatomical landmarks normally seen on intraoral radiographs of the maxilla and mandible. 4 Key Words Alveolar bone Alveolar process Alveolus Angle of
mandible 5 Key Words Cementum Condyle Coronoid process of the mandible 6 Key Words Exfoliation External auditory meatus (foramen) Frontal bone 7 Key Words Incisive (anterior palatine) foramen
8 Key Words Mandible Mandibular canal Mandibular foramen Mastoid process
9 Key Words Maxillary tuberosity Median palatine suture Mental foramen
10 Key Words Mylohyoid ridge Nasal bones Nasal conchae
11 Key Words Oblique ridge Occipital bone Periodontal ligament (PDL)
12 Key Words Pulp chamber Ramus Septum Sphenoid bone Styloid process
13 Key Words Supernumerary teeth Suture Symphysis Temporal bone
14 Key Words Tuberosity (maxillary) Zygoma Zygomatic arch
15 Introduction The importance of learning to identify normal radiographic anatomy may be summarized as follows: To evaluate the image receptor
for correct positioning so that the areas of interest and anatomical structures are clearly visible, enhancing the diagnostic value of the radiograph 16
Introduction The importance of learning to identify normal radiographic anatomy may be summarized as follows: To assist with determining into which frame of the x-ray mount each radiograph is to be mounted To assist in interpreting radiographs and recognizing a deviation from the normal that would require referral to the dentist for evaluation
17 Figure 22-1 Frontal view of the skull. 18 Figure 22-2 Lateral view of the skull.
19 Figure 22-3 Frontal view of the nose. 20 Figure 22-4 Palatal view of
maxilla. 21 Figure 22-5 Lateral view of detached mandible.
22 Figure 22-6 Lingual view of detached mandible. 23
Radiographic Appearance of the Alveolar Bone and Tooth Area 24 Figure 22-7 Drawing of
mandibular premolar–molar area. 25 Figure Radiograph of mandibular premolar area showing (1) dentin, (2) enamel, (3) pulp chamber, (4) periodontal ligament space, (5) lamina dura, (6) pulp (root) canal, and (7) cancellous (trabecular) bone. Note that because only a very thin layer of cementum covers the root, it is radiographically indistinguishable from the underlying dentin.
26 Figure Radiograph of mixed dentition in mandibular canine area showing (1) primary canine, (2) primary first molar with partially resorbed roots, (3) permanent canine, and (4) permanent first premolar with incomplete root formation.
27 Figure 22-10 Facial bones recorded on radiographs 28 TABLE 22-1 Radiopaque and Radiolucent Features 29
Figure 22-11 Sequence for interpreting normal radiographic anatomy. 30 Anatomy Basics, Intraoral Radiographs
31 Figure Drawing of maxillary midline area illustrating (1) outline of nose, (2) incisive foramen (anterior palatine foramen), (3) lateral fossa, (4) nasal fossa, (5) nasal septum, (6) border
of nasal fossa, (7) anterior nasal spine, and (8) median palatine suture.
32 Figure Radiograph of maxillary midline area showing (1) incisive (anterior palatine) foramen, indicated by an
irregularly shaped, rounded radiolucent area, (2) outline of the nose, (3) lateral fossa, (4) nasal fossa (radiolucent), (5) nasal septum, (6) border of nasal fossa, (7) anterior nasal spine, and (8) median palatine suture. 33 Figure 22-14 Drawing of maxillary canine
area
34 Figure Radiograph of maxillary canine area showing (1) lateral fossa, (2) nasal fossa, (3) inverted Y (intersection of the borders of the nasal fossa and maxillary sinus), (4) maxillary sinus, and (5)
dense radiopaque area caused by overlapping of the mesial surface of the first premolar over the distal surface of the canine. This overlapping is common in this region of the oral cavity because of the curvature of the arch. 35 Figure 22-16
Soft tissue of the nose in the path of the x-ray beam
36 Figure 22-17 Soft tissue image of the nose 37 Anatomy Basics, Intraoral Radiographs
38 Figure Drawing of maxillary premolar area illustrating (1) border (floor) of maxillary sinus, (2) maxillary sinus, (3) septum in maxillary sinus dividing the sinus into two compartments, (4) zygomatic process of maxilla, (5) zygoma, and (6) lower border of
zygomatic arch. 39 Figure Radiograph of maxillary premolar area showing (1) border (floor) of maxillary sinus, (2) maxillary sinus, (3) zygomatic process of maxilla, (4) septum in maxillary sinus dividing the sinus into two compartments, (5) zygoma, and (6) inferior
border of the zygomatic arch.
40 Figure Drawing of maxillary molar area illustrating (1) border (floor) of maxillary sinus, (2) maxillary sinus, (3) zygomatic process of maxilla, (4) zygoma, (5) septum in maxillary
sinus, (6) lower border of zygomatic arch, (7) hamulus (hamular process), (8) maxillary tuberosity, and (9) coronoid process (mandible).
41 Figure Radiograph of maxillary molar area showing (1) border (floor) of maxillary sinus, (2) maxillary sinus, (3) zygomatic process of maxilla, (4) zygoma, (5) lateral pterygoid plate, (6) lower border of zygomatic arch, (7) maxillary tuberosity, and (8)
coronoid process of the mandible.
42 Figure Radiograph of maxillary molar area showing (1) hamulus (hamular process), a downward projection of the medial pterygoid plate, (2) lateral pterygoid plate, (3) coronoid process of the mandible, (4) maxillary tuberosity, and (5) maxillary sinus.
43 Figure Coronoid process of the mandible may be recorded on intraoral radiographs of the maxillary posterior region. Note the position of the image receptor
holder when exposing a maxillary posterior periapical radiograph. The coronoid process of the mandible will most likely be recorded on this radiograph. 44 Anatomy Basics, Intraoral Radiographs 45 Figure Drawing of mandibular midline area illustrating (1) mental ridge, (2) nutrient canal, (3) nutrient foramen, (4) genial tubercles surrounding the (5) lingual foramen, and (6) inferior border of mandible.
46 Figure Radiograph of the mandibular midline area showing (1) mental ridge, (2) nutrient canal, (3) nutrient foramen, (4) genial tubercles surrounding the (5) lingual foramen, and (6) inferior
border of the mandible (radiopaque band of dense cortical bone). 47 Figure Drawing of mandibular canine area
illustrating (1) nutrient canal, and (2) torus mandibularis (lingual torus). 48 Figure Radiograph of mandibular canine area
showing (1) nutrient canal, (2) torus mandibularis (lingual torus). 49 Anatomy Basics, Intraoral Radiographs
50 Figure Drawing of mandibular premolar area illustrating (1) torus mandibularis, (2) oblique ridge, (3) mylohyoid ridge, (4) submandibular fossa, (5) mandibular canal, and (6) mental foramen.
51 Figure Radiograph of mandibular premolar area showing (1) submandibular fossa, (2) thin radiolucent line indicating the periodontal ligament space, (3) thin radiopaque line representing the lamina dura, and (4) the mental
foramen. 52 Figure Radiograph of mandibular premolar area showing (1) small torus mandibularis (lingual torus).
53 Figure Drawing of mandibular molar area illustrating (1) oblique ridge, (2)
mylohyoid ridge, (3) submandibular fossa, and (4) mandibular canal.
54 Figure Radiograph of mandibular molar area showing (1) oblique ridge, (2) mylohyoid ridge, (3) mandibular canal (note the thin, parallel radiopaque lines representing the canal walls), and (4) submandibular fossa.
55 Review: Chapter Summary 56 Review: Chapter Summary
57 Recall: Study Questions 58 Reflect: Case Study Your colleague is viewing a full mouth series
of radiographs that he just finished mounting. As he is describing the following features, see if you can tell him the name of the anatomic landmark.
59 Reflect: Case Study A dense, vertical radiopacity separating two paired oval radiolucencies observed
in the maxillary anterior region. Large, paired oval radiolucencies separated by a dense, vertical radiopacity observed in the maxillary anterior region. A thin radiolucent line resembling a fracture observed between the maxillary central incisors.
60 Reflect: Case Study A round or pear-shaped radiolucency observed between the maxillary central incisors. A broad, U-shaped radiopacity observed
superimposed over the maxillary posterior teeth roots 61 Reflect:
Case Study A radiopaque downward projection of bone that appears pointed or hook-like observed in the far posterior region of the maxilla. A large triangular shaped radiopacity observed superimposed over the maxillary tuberosity region. 62 Reflect: Case Study A large radiolucency
outlined by a thin radiopaque border that is observed in almost all the periapical radiographs of the maxilla, from the canine posteriorly. A very small, round radiolucency observed in the midline apical (below) the mandibular incisors.
63 Reflect: Case Study A horizontal radiopaque line extending from the premolar region to the symphysis. A round radiolucency that resembles an abscess
observed near the apex of the mandibular second premolar. A horizontal radiopaque line observed in the mandibular posterior region, superimposed across the molar roots. 64 Reflect: Case Study Another horizontal radiopaque line observed in the mandibular posterior region, but inferior to (below)
the line described in #12 above. This line is observed inferior to the molar roots. A large, irregularly shaped radiolucency observed below the line described in #13 above. 65 Relate: Laboratory Application What is the thin radiopaque band between the maxillary incisors called?Tooth germ **Normal landmarks in maxilla:** Median palatine suture or intermaxillary suture: A thin radiolucent line in the midline between central incisors. It extends superiorly to the anterior nasal spine and posteriorly to the end of the hard palate.
What is the name of the diagonal radiopaque line visible at the lower part of the roots of the mandibular molars?External oblique ridge – The external oblique ridge or line is the bony anterior border of the ramus located on the outer aspect of the mandible. This ridge has a downward diagonal course and is seen on most mandibular molar periapicals and molar bitewings.
What is the radiolucent line that extends through the area near the lower molars?The mylohyoid ridge appears as a thick radiopaque line frequently seen near the roots/apices of the posterior teeth. The submandibular salivary gland fossa appears as an area of more radiolucent bone inferior to the mylohyoid ridge.
Is the maxillary sinus septa radiopaque or radiolucent?Maxillary sinus – The maxillary sinus is one of the paired paranasal sinuses. This prominent radiolucent air-filled cavity is located above the posterior teeth on the right and left sides of the maxilla.
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