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Skull – teeth

image of Skull – teeth
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Abstract

Dental radiography is essential for the practice of good veterinary dentistry. A thorough work-up of the oral cavity and even the nasal passages should always have some component of dental radiography associated with it. Ideally, all patients presenting for initial dental care should have a full-month radiographic examination in order to diagnose early lesions that are not apparent on intra-oral examination. This chapter explains indications; radiography; alternative imaging procedures and abnormal imaging findings.

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Figures

Image of 19.2
19.2 An occlusal dental radiographic film lead backing, showing the convex dot that should always point towards the X-ray beam.
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19.5 Hand-held dental X-ray machines are becoming more commonplace because of their mobility and versatility.
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19.6 Developing box and its three components.
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19.7 Stainless steel dental film clip for use in processing films.
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19.8 A CR reader and a size 2 CR plate as well as a size 2 dental film (left) for comparison.
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19.9 A DR size 2 sensor that is much thicker than both the CR plate and dental film.
Image of 19.10
19.10 An intra-oral parallel radiograph can only be made of the mandibular premolars and molars, excluding the first premolar. (a) Placement of the dental film or sensor. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. (b) Parallel radiograph of the mandibular first molar area showing the following normal anatomical structures: 1 = enamel; 2 = dentine; 3 = pulp horn; 4 = pulp chamber; 5 = root canal; 6 = alveolar bone; 7 = lamina dura (radiopaque); 8 = periodontal ligament space (radiolucent); 9 = mandibular canal; 10 = alveolar bone height; F = furcation area.
Image of 19.11
19.11 (a) Incident beam perpendicular to tooth: elongation of image. (b) Incident beam perpendicular to film: foreshortening of image. (c) Incident beam perpendicular to the bisecting line: life-size image. (© David Crossley and reproduced with permission)
Image of 19.12
19.12 A Pattol device that helps the radiographer determine the bisecting angle. The incident beam should always be perpendicular to the bisecting line (B) formed by this angle.
Image of 19.13
19.13 Superimposition of the zygomatic arch over the roots of maxillary fourth premolar 208 in a cat.
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19.14 Near lateral technique in a cat. (a) Principle behind the technique; note that the roots are separated from the zygomatic arch. (b) Extra-oral dental radiograph of maxillary fourth premolar 208.
Image of 19.15
19.15 Intra-oral 45-degree oblique maxilla overview radiograph. (a) Placement of the dental film. The bisecting line (dashed) is shown. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. (b) Radiograph clearly showing all the teeth except the incisors.
Image of 19.16
19.16 Intra-oral 30-degree oblique mandible overview radiograph. (a) Placement of the dental film. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. (b) Radiograph clearly showing all the teeth except the incisors.
Image of 19.17
19.17 Bisecting angle technique for the maxillary incisors and canines. The bisecting line (dashed) is drawn through the bisecting angle between the film cassette and the third incisor or the canine tooth in a rostrocaudal orientation. The beam should be centred on the tooth used (i.e. incisor or canine). (a) Placement of the dental film. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. (b) Digital radiograph of maxillary incisors and canine teeth. This is a DR image and therefore the sensor is too small to fit both incisors and canines into one image.
Image of 19.18
19.18 Lateral bisecting angle technique for the maxillary canine tooth. The bisecting line (dashed) is drawn through the bisecting angle between the film cassette and the canine tooth in a lateromedial orientation. The beam should be centred on the middle of the canine tooth and directed perpendicular to the bisecting line. (a) Placement of the dental film. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. (b) Dental radiograph of the maxillary canine tooth.
Image of 19.19
19.19 Bisecting angle technique for the maxillary premolars and molars. (a) Placement of the dental film. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. (b) Digital radiograph of the maxillary fourth premolar tooth. Note the superimposition of the mesiobuccal and mesiopalatal roots.
Image of 19.20
19.20 In order to separate the two mesial roots of the maxillary fourth premolar for evaluation, one of two accessory bisecting angle views should be taken. (a) A rostral oblique dental radiograph. (b) A caudal oblique dental radiograph. Both these views were taken of a dried skull. Note the separation of the mesial roots when compared with Figure 19.19 .
Image of 19.21
19.21 Bisecting angle technique for the mandibular incisors and canines. (a) Placement of the dental film. (b) Digital radiograph of the mandibular incisors and canines. This is a DR image and therefore the sensor is too small to fit both incisors and canines into one image. (a, © David Crossley and reproduced with permission)
Image of 19.22
19.22 Lateral bisecting angle technique for the mandibular first premolar and canine. (a) Placement of the dental film. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. (b) Digital radiograph of the rostral mandible, showing the first two premolars completely as well as incomplete views of the canine and 3 premolar teeth. This is a DR image and therefore the sensor is too small to fit both premolars and canine teeth into one image.
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19.24 Modified Triadan numbering system as used in (a) the cat and (b) the dog. (© David Crossley and reproduced with permission)
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19.25 Periodontitis of a maxillary molar. (a) Dental radiograph showing 209 with mobility (clinically) but very little radiographic evidence of periodontitis. (b) Transverse CT image in a bone window of the same tooth as in (a), showing widened periodontal ligament space (arrowed) and sclerotic bone surrounding 209, as seen in teeth with periodontitis.
Image of 19.26
19.26 Root fractures of 302 and 404 in a dog that suffered rostral mandibular trauma.
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19.27 Increased periodontal ligament space (arrowed) after reimplantation of a luxated 204.
Image of 19.28
19.28 Mandibular fracture extending through the alveoli of both 408 and 409.
Image of 19.29
19.29 A persistent deciduous maxillary first incisor in a dog. No permanent successor is seen in the rostral maxilla. Note the crown and root size differences compared with the adjacent teeth.
Image of 19.30
19.30 Unerupted canine of a German Shepherd Dog, due to a bony obstruction (possibly a retained deciduous tooth root).
Image of 19.31
19.31 Unerupted canine tooth, presenting as a dentigerous cyst (arrowed).
Image of 19.32
19.32 A dog presenting with nine incisor teeth. The three extra teeth are of similar size to the other incisors, therefore they are not persistent deciduous teeth. Note the emulsion artefacts confirming that this radiograph was made on dental film.
Image of 19.33
19.33 Gemination of 308 in a cat. Note that in this case there is also a supernumerary root.
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19.34 A supernumerary 105 in a dog.
Image of 19.35
19.35 The 409 of a toy-breed dog with periodontal disease evidenced by the wide periodontal ligament space (arrowed). The mesial (rostral) root of the molar is dilacerated (red *) and the distal (caudal) root has a bulbous apex (yellow *).
Image of 19.36
19.36 Periodontal disease is affecting both teeth in this view. There is marked vertical bone loss present at the distal root of 408 and the mesial root of 409, visible as an enlarged periodontal ligament space around the root (black arrows; normal periodontal ligament space is indicated with a red arrow). Bone loss at the furcation area (between the two roots) of 408 is present, indicating further bone loss (white arrow). The start of a resorptive lesion is present in the distal root–crown interface of 408 (yellow arrow).
Image of 19.37
19.37 A pathological jaw fracture in a toy-breed dog due to periodontitis of 309.
Image of 19.38
19.38 A complicated crown fracture of 309. There are periapical radiolucencies present on both roots, which may be a result of inflammation or indeed infection around the apex (arrowed).
Image of 19.39
19.39 Resorptive lesions affecting 408 and 409 in the mandible of a dog. Note the disappearance of the lamina dura and periodontal ligament space where ankylosis has occurred (*). Resorptive areas of 409 are arrowed.
Image of 19.40
19.40 Resorptive lesions of both canine teeth in the rostral mandible of a cat. Ankylosis is also evident, as there is no lamina dura or periodontal ligament space visible around both canine teeth.
Image of 19.41
19.41 Carious lesion of 209. The area between the three roots (*) has been destroyed. Periapical radiolucencies confirm inflammation or infection.
Image of 19.42
19.42 Acanthomatous epulis of the left mandible, associated with 304. There is invasion, represented by the moth-eaten appearance around 302, 303, 304 and 305, and the periodontal ligament around these teeth has been destroyed. Metaplastic bone (arrowed) within the soft tissue of the tumour is also visible.
Image of 19.43
19.43 Complex odontoma of the rostral right mandible of a small cross-breed dog.
Image of 19.44
19.44 Right mandibular mass in a cat. This dental radiograph shows the lytic and expansile lesion clearly.
Image of 19.45
19.45 Deformed canine of an 8-month-old mixed-breed dog. The tooth developed in the nasal passages, causing a purulent unilateral nasal discharge. A dentigerous cyst is also visible where the root of 101 is expected.
Image of 19.46
19.46 A large periapical lesion around the distal root of a 208 that presented with an extra-oral swelling ventral to the eye. There is a complicated crown fracture of this tooth.

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