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Skull – teeth
/content/chapter/10.22233/9781910443293.chap19
Skull – teeth
- Author: Gerhard Steenkamp
- From: BSAVA Manual of Canine and Feline Musculoskeletal Imaging
- Item: Chapter 19, pp 316 - 332
- DOI: 10.22233/9781910443293.19
- Copyright: © 2016 British Small Animal Veterinary Association
- Publication Date: January 2016
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
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19.2
An occlusal dental radiographic film lead backing, showing the convex dot that should always point towards the X-ray beam. © 2016 British Small Animal Veterinary Association
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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. © 2016 British Small Animal Veterinary Association
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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. © 2016 British Small Animal Veterinary Association
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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. © 2016 British Small Animal Veterinary Association
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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. © 2016 British Small Animal Veterinary Association
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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. © 2016 British Small Animal Veterinary Association
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19.9
A DR size 2 sensor that is much thicker than both the CR plate and dental film.
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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. © 2016 British Small Animal Veterinary Association
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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.
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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) © 2016 British Small Animal Veterinary Association
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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)
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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. © 2016 British Small Animal Veterinary Association
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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.
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19.13
Superimposition of the zygomatic arch over the roots of maxillary fourth premolar 208 in a cat. © 2016 British Small Animal Veterinary Association
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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. © 2016 British Small Animal Veterinary Association
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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.
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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. © 2016 British Small Animal Veterinary Association
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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.
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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. © 2016 British Small Animal Veterinary Association
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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.
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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. © 2016 British Small Animal Veterinary Association
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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.
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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. © 2016 British Small Animal Veterinary Association
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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.
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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. © 2016 British Small Animal Veterinary Association
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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.
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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
. © 2016 British Small Animal Veterinary Association
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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
.
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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) © 2016 British Small Animal Veterinary Association
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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)
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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 3rd premolar teeth. This is a DR image and therefore the sensor is too small to fit both premolars and canine teeth into one image. © 2016 British Small Animal Veterinary Association
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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 3rd 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) © 2016 British Small Animal Veterinary Association
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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. © 2016 British Small Animal Veterinary Association
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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.
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19.26
Root fractures of 302 and 404 in a dog that suffered rostral mandibular trauma. © 2016 British Small Animal Veterinary Association
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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. © 2016 British Small Animal Veterinary Association
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19.27
Increased periodontal ligament space (arrowed) after reimplantation of a luxated 204.
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19.28
Mandibular fracture extending through the alveoli of both 408 and 409. © 2016 British Small Animal Veterinary Association
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19.28
Mandibular fracture extending through the alveoli of both 408 and 409.
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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. © 2016 British Small Animal Veterinary Association
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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.
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19.30
Unerupted canine of a German Shepherd Dog, due to a bony obstruction (possibly a retained deciduous tooth root). © 2016 British Small Animal Veterinary Association
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19.30
Unerupted canine of a German Shepherd Dog, due to a bony obstruction (possibly a retained deciduous tooth root).
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19.31
Unerupted canine tooth, presenting as a dentigerous cyst (arrowed). © 2016 British Small Animal Veterinary Association
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19.31
Unerupted canine tooth, presenting as a dentigerous cyst (arrowed).
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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. © 2016 British Small Animal Veterinary Association
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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.
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19.33
Gemination of 308 in a cat. Note that in this case there is also a supernumerary root. © 2016 British Small Animal Veterinary Association
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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. © 2016 British Small Animal Veterinary Association
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19.34
A supernumerary 105 in a dog.
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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 *). © 2016 British Small Animal Veterinary Association
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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 *).
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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). © 2016 British Small Animal Veterinary Association
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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).
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19.37
A pathological jaw fracture in a toy-breed dog due to periodontitis of 309. © 2016 British Small Animal Veterinary Association
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19.37
A pathological jaw fracture in a toy-breed dog due to periodontitis of 309.
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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). © 2016 British Small Animal Veterinary Association
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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).
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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. © 2016 British Small Animal Veterinary Association
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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.
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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. © 2016 British Small Animal Veterinary Association
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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.
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19.41
Carious lesion of 209. The area between the three roots (*) has been destroyed. Periapical radiolucencies confirm inflammation or infection. © 2016 British Small Animal Veterinary Association
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19.41
Carious lesion of 209. The area between the three roots (*) has been destroyed. Periapical radiolucencies confirm inflammation or infection.
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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. © 2016 British Small Animal Veterinary Association
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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.
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19.43
Complex odontoma of the rostral right mandible of a small cross-breed dog. © 2016 British Small Animal Veterinary Association
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19.43
Complex odontoma of the rostral right mandible of a small cross-breed dog.
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19.44
Right mandibular mass in a cat. This dental radiograph shows the lytic and expansile lesion clearly. © 2016 British Small Animal Veterinary Association
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19.44
Right mandibular mass in a cat. This dental radiograph shows the lytic and expansile lesion clearly.
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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. © 2016 British Small Animal Veterinary Association
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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.
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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. © 2016 British Small Animal Veterinary Association
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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.