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Case Approach (22 (Assess the periphery and corners of the image (This…
Case Approach
- Assess the periphery and corners of the image
This includes:
- orbits
- articular processes of the temporal bone
- cerivical spine
- styloid processes
- pharynx
- hyoid bone
- Examine the outer cortices of the mandible
Trace in a circle:
- anteior/posterior rami
- coronoid processes
- condyles/condylar necks
- inferior border
- continiyuity of cortices
- Examine the cortices of the maxilla
- Posterior/Medial walls
- Floor of Max sinuses
- Zygomatic processes/ pterygomaxillary fissure
- Examine the zygomatic bones and arches
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- Assess the internal density of the maxillary sinuses
- Compare LHS to RHS
- Opacification (inflammatio or diease)
- Assess the structures of the nasal cavity and the palates
- nasal floor/hard palate and conchae extending horizontally along both sides
- nasal septum
- Examine bone the pattern of the maxilla and mandible
- assess the density and pattern of the trabeculae for abnormalities
- assess size, position, cortication and symmetry of the: IAN canal, mandb foramina, mental foramen
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- surrounding bone (assoc. structures, densiity ect..)
- perio (bone levels)
- caries (P lesions)
- Tooth wear (hard tissue loss)
- Oral Cancer/Path (radioopacities/lucencies)
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"This is a periapical radiograph of teeth in quadrant 4. We can see tooth 45 to 48. 48 is not completely visible in this radiograph. The bone is of normal density. Generalised horizontal bone loss present, Suggestive of hx of but there is veritcal bone loss associated with the interproximal of 47 suggestive of active/progressive periodontal disease.
The crown and apicies of 45-47 are clearly visible.
Unable to comment on the tooth wear.
The crowns are heavily restored with very radio-opaque materials possibly amalgam. 47 has two roots and two visible canals. There appears to be blunting of the pulpal horns and wideing of the PDL space and possibly a PARL at the apicies.
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"Image is bordered on the RHS by the tounge and LHS by the lip/buccal sulcus, there appears to be adequate salivary flow present"
"Periodontal health is in !? health, gingival biotype is !?"
" The extent of tooth wear is!? "
" Tooth 48 to 44 are present - all restored... 44/45 have MOD composite resin restorations that appear to have some occl staining, 46 a full coverage white restoration, and 47/48 occl amalgam restorations that appear to have developed some creep or coronal leakage
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Conservative, 'reversible management' intially
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