Post on 07-Apr-2018
8/6/2019 Radio Graphic Landmarks (2)
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Maxillary and Mandibular
Anatomic Radiographic
Landmarks
Intraoral Radiography
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© William C. Scarfe
� Radiographs are
two-dimensionalrepresentations of
objects that occupy
three dimensions.
� Facial, central andlingual features are
superimposed.
� All landmarks are
NOT clearlydemonstrated on
radiographs from all
individuals.Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Tooth and
supporting
structures
� Enamel
" radiopaque
� Dentin andCementum
" radiopaque
� Pulp space
" radiolucent
� Lamina dura
" radiopaque
� Periodontal ligamentspace
" radiolucent
� Alveolar bone
" radiopaque
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© William C. Scarfe
Enamel
Dentin
Dentin-enamel
junction
Cemento-enamel junction
Pulp space
Lamina dura
pdl space
Alveolar boneImage(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Anatomic
Landmarks
MAXILLA
ZYGOMATIC BONE
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© William C. Scarfe
Central incisor region: maxilla
� Premaxillary/median
palatal suture
" radiolucent
� Incisive fossa /foramen
" radiolucent
� Incisive canal
" Radiolucent withradiopaque lines
� Nasal passages
(fossa or cavity)
" radiolucent
� Nasal septum
" radiopaque
� Anterior nasal spine
"
radiopaque� Inferior concha
" radiopaque
� Soft tissues of nose
and lips" radiopaque
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© William C. Scarfe
Central incisor region: Features Anterior Nasal Spine
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© William C. Scarfe
Central incisor region: FeaturesIncisive Fossa / Foramen
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© William C. Scarfe
Central incisor region: FeaturesNasal Septum
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© William C. Scarfe
Central incisor region: FeaturesPre-maxillary / Median Palatine Suture
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© William C. Scarfe
Central incisor region: FeaturesInferior Concha / Turbinates
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© William C. Scarfe
Central incisor region: FeaturesNasal Fossa / Cavity / Meatus
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© William C. Scarfe
Central incisor region: FeaturesIncisive / Nasopalatine Canal
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© William C. Scarfe
Central incisor region: Features Ala Cartilage Nose & Lip Line
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© William C. Scarfe
Anterior nasal
spine
Nasal septum
Premaxillary
suture
Nasal passage
Maxillary Anterior Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Incisive fossa
Premaxillary
suture
Anterior MaxillaImage(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Premaxillary suture
Incisive fossa
Anterior nasal spine
Pulp
Lamina dura
Periodontal ligament
space
Anterior MaxillaImage(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Dental caries
Premaxillarysuture
Soft tissue
shadow of nose
Anterior nasal
spine
Nasal passage
Nasal septum
Nasal passage
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Incisive fossa or periapical lesion?
� The periodontal
ligament spaces
" intact.
� SLOB Rule
" Same LingualOpposite Buccal
" The incisive fossa
being lingually
situated moves on
the resulting image
in the same direction
as the movement of
the tubehead.
Image(s) courtesy © Dr. Allan G. Farman
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© William C. ScarfeImage(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Lateral/Canine region: FeaturesCanine Fossa
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© William C. Scarfe
Lateral/Canine region: Features
Antral /³Inverted´
Y
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© William C. Scarfe
Lateral/Canine region: Features
Anterior Sinus
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© William C. Scarfe
Anterior wall of
nasal passage
Soft tissue shadow
of nose
Canine µfossa¶
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Maxillary sinus
Anterior wall of
maxillary sinus
Lateral wall of nasal fossa
Inverted µY¶
Image(s) courtesy©
Dr. Allan G. Farman
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© William C. Scarfe
Lateral wall of nasal fossa
Anterior wall of
maxillary sinus
(antrum)
Inverted µY¶
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Inverted ³Y´
Locule in maxillary
sinus: note tooth
periodontal ligament
space intact
Septum in maxillary
sinus
Bridge unit in porcelain
fused to metal
Radiolucent anterior
filling materialImage(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Premolar region: maxilla
� Maxillary sinus
" radiolucent
� Maxillary sinus floor and septae
" radiopaque
� Nutrient canals
" radiolucent
� Occasionally: lateral
wall of nasal
passage" radiopaque
� Soft tissue shadow
of lips/cheeks.
" Nasolabial fold
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© William C. Scarfe
Premolar region: FeaturesNasolabial Fold
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© William C. Scarfe
Premolar region: FeaturesMaxillary Sinus
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© William C. Scarfe
Premolar region: FeaturesNutrient Canals
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© William C. Scarfe
Premolar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Floor of maxillary sinus
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Maxillary molar region showing septum in sinus
Floor of maxillary sinus
Septum insinus
Zygomatic
process of
maxilla
Soft tissue
over
tuberosity
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
1st / 2nd molar region: maxilla
� Maxillary sinus floor and septae
" radiopaque
� Maxillary sinus
" radiolucent
� Nutrient canals
" radiolucent
� Zygomatic processof the maxilla
" ³U´- shaped
" radiopaque
� Zygomatic
arch/zygoma
" radiopaque
� Less commonly:" Lateral wall of nasal
passage
" radiopaque
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© William C. Scarfe
Zygomatic
bone
Zygomaticprocess of
maxilla
Zygomatic process (temporal bone)
Articular eminenceStructures anterior
to green line seen
on intraoralradiographs
Molar region: maxilla
Zygomatic
Arch
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Pterygoid
hamulus
(medialPterygoid)
Lateral
pterygoid
plate
Maxillary tuberosity
Molar region: maxillaImage(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Pterygoid hamulus
Molar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Zygomatic process
of the maxilla
Zygomatic
arch
shadow
Floor of
maxillary
sinus
Maxillary
tuberosity
Endodontically
treated tooth
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Zygomatic process
of the maxilla
Floor of maxillary
sinus
Shadow of
zygomatic arch
Coronoid
Process
(mandible)Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Zygomatic
arch
Zygomatic process
of maxilla
Floor of
maxillary
sinus
Nutrientcanal
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
2nd /3rd molar region: maxilla
� Coronoid process of mandible\
" radiopaque
� Maxillary tuberosity
" radiopaque)
� Posterior wall of
maxillary sinus
" radiopaque
� Maxillary sinus" radiolucent
� Pterygoid hamulus
" radiopaque
� Pterygoid notch
" radiolucent
� Lateral pterygoid
plate" radiopaque
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© William C. Scarfe
Coronoidprocess of
mandible
Zygomatic
processof maxilla
Zygomatic
arch
3rd molar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Maxillary tuberosity Maxillary sinus
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. ScarfeZygomatic process of the maxilla
Dentalfollicle
space
Tuberosity
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Pterygoid
hamulus
Air space
Posterior wall of maxillary sinus
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Coronoid
process of mandible
Zygomatic process of maxilla
Floor of maxillary sinus
Zygomatic
arch
Pterygoidhamulus
Pterygoid
plate
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Pterygoid
hamulus
Coronoid process of mandible
Maxillary
tuberosity
Shadow of zygomatic arch
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Anatomic Landmarks
MANDIBLE
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© William C. Scarfe
Incisor region: mandible
� Lingual foramen" radiolucent
� Genial tubercles
"
radiopaque� Soft tissue shadow of lower lip
" radiopaque
� Mental ridges" radiopaque
� Nutrient canals
" radiolucent
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© William C. Scarfe
Facial
Mental
depression
Mental
ridge
Lingual
groove
Genial
tubercles
Lingual
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Mental ridge
Soft tissue
shadow of lower lip
Cortex of
lower border of
mandible
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Lingual foramen
Mental ridge
Genial tubercles
Cortical plate of
lower border of mandible
Soft tissue shadow of
lower lip
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Second shadow of
periodontal ligament
space due to shape
of root
Periodontal ligament
space
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Nutrient canals
Image(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
Nutrient canals
Image(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
Nutrient canals inanterior mandible
Image(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
Lingual foramen
Embossed dot
Image(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
Mandibular tori
Genial tubercles
Mental ridge
Image(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
Canine/Premolar region: mandible
� Mental foramen" Radiolucent
" usually situated between and just beneath
roots of the premolars.� Soft tissue shadow of reflected cheek
" radiopaque
� Mandibular canal" radiolucent
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©William C. Scarfe
Canine region: mandibleImage(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
Mentalforamen
Premolar region: mandibleImage(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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©William C. Scarfe
Mental
foramenMandibular
canal
Submandibular fossa
Mylohyoid ridge
Image(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
Periapical granuloma, abscess or cyst
(periodontal ligament space not intact)
Mental
foramen
Image(s) courtesy©
Dr. Allan G. Farman
Image(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
Mental foramen
Mylohyoidridge
Submandibular fossa
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©William C. Scarfe
Molar region: mandible
� Mandibular canal" radiolucent
� External oblique
ridge
" radiopaque
� Mylohyoid ridge
(internal oblique
ridge)" radiopaque
� Submandibular fossa
" radiolucent
� Cortex of lower
border
" radiopaque
Image(s)courtesy © Dr Allan G Farman
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©William C. ScarfeMandibular canal
Image(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
External oblique ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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©William C. Scarfe
External oblique ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman
E t l bli id
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©William C. Scarfe
External oblique ridge
Mandibular canalImage(s) courtesy © Dr. Allan G. Farman
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©William C. Scarfe
Internal oblique (mylohyoid) ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman
I l bli ( l h id) id f dibl
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©
William C. Scarfe
Internal oblique (mylohyoid) ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman
8/6/2019 Radio Graphic Landmarks (2)
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© William C. Scarfe
Submandibular fossa
Lower
cortex of
mandible
External
obliqueridge
Internal
obliqueridge
Image(s) courtesy © Dr. Allan G. Farman
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Lower cortex of mandible
External
oblique
ridge
Internal
oblique
ridge
Image(s) courtesy © Dr. Allan G. Farman
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© William C. Scarfe
Lower cortex of mandible
External
oblique
ridge
Internal
oblique
ridge
A t i l V i ti
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© William C. Scarfe
Anatomical Variations
� Mandibular torus.� Palatal torus.
� High vs. low mandibular canal.
� ³Double´ mandibular canals.*
� Stafne¶s bone cavity (static bone cyst).*
*usually seen only on extra-oral radiographs.
Mandib lar tor s
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© William C. Scarfe
Mandibular torus Syn: lingual exostoses, torus mandibularis
Mandibular torus
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© William C. Scarfe
Mandibular torus Syn: lingual exostoses, torus mandibularis
Image(s) courtesy © Dr. Allan G. Farman
Mandibular torus
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© William C. Scarfe
Mandibular torus Syn: lingual exostoses, torus mandibularis
Image(s) courtesy©
Dr. Allan G. Farman
Maxillary torus
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© William C. Scarfe
Maxillary torus Syn: torus palatinus
Maxillary torus
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© William C. Scarfe
Maxillary torus Syn: torus palatinus
Image(s) courtesy©
Dr. Allan G. Farman
Maxillary torus
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© William C. Scarfe
Maxillary torus Syn: torus palatinus
Image(s) courtesy©
Dr. Allan G. Farman
Maxillary torus
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Maxillary torus Syn: torus palatinus