““Radiographic Radiographic Assessment of Assessment of the Pediatric the Pediatric Patient”Patient”

S.Lal, S.Lal, DDSDDS

Special considerationsSpecial considerations

1.1. Risk assessmentRisk assessment Evidence of caries/hxEvidence of caries/hx TraumaTrauma AnomaliesAnomalies Fluoride statusFluoride status DietDiet

AAPD guidelines for AAPD guidelines for radiographsradiographs

Based on Age and risk assessmentBased on Age and risk assessment

Child preparation and Child preparation and managementmanagement

EuphemismsEuphemisms Role modelsRole models Contour filmContour film Gag reflex – distractionGag reflex – distraction Parental helpParental help Bad tasteBad taste

Film SizesFilm Sizes

Sizes 0,1,2, Sizes 0,1,2, occlusal/lateralocclusal/lateral

Radiographic ToolsRadiographic Tools

Snap-a-raySnap-a-ray Bite wings, Bite wings,

periapicalsperiapicals

Radiographic techniquesRadiographic techniques

1.1. Bite wingsBite wings

2.2. Periapicals (not p.a.’s)Periapicals (not p.a.’s)

3.3. Max/mand occlusalsMax/mand occlusals

4.4. Extraoral/lateral filmExtraoral/lateral film

5.5. Soft tissue x-raySoft tissue x-ray

6.6. Panoramic radiographsPanoramic radiographs

Bite TabsBite Tabs

Bite wing x-rayBite wing x-ray

Mesial surface of Mesial surface of canine to distal canine to distal surface of 1surface of 1stst permanent molarpermanent molar

Bite wing x-rayBite wing x-ray

Incipient carious Incipient carious lesion.lesion.

Overlapping – Overlapping – common errorcommon error

Occlusal RadiographsOcclusal Radiographs

Occlusal RadiographsOcclusal Radiographs

Posterior max. Posterior max. occlusal occlusal radiographradiograph

Extra Oral filmExtra Oral film

Lateral FilmLateral Film

TraumaTrauma

Soft tissue FilmSoft tissue Film Indicated after Indicated after

trauma to locate trauma to locate missing piece(s) missing piece(s) of fractured tooth.of fractured tooth.

Panaramic radiographPanaramic radiograph

Radiographic diagnosis of Radiographic diagnosis of dental anomaliesdental anomalies

AnkylosisAnkylosis

AnomaliesAnomalies

Gemination : Gemination : unsuccessful unsuccessful attempt of an attempt of an individual tooth individual tooth bud to divide into bud to divide into two.two.

AnomaliesAnomalies

DilacerationDilaceration

AnomaliesAnomalies

Peg lateralPeg lateral Supernumary Supernumary

primary lateralprimary lateral

AnomaliesAnomalies

a)a) Fusion: dentinal Fusion: dentinal union of two union of two teeth.teeth.

b)b) Supernumary Supernumary toothtooth

c)c) Missing lateralMissing lateral

AnomaliesAnomalies

Concrescence: Concrescence: fusion with a fusion with a cemental union.cemental union.

AnomaliesAnomalies

Amelogenesis Amelogenesis ImperfectaImperfecta

a)a) Thin enamelThin enamel

b)b) Increased dentinIncreased dentin

AnomaliesAnomalies

Unfavorable Unfavorable resorptive pattern resorptive pattern of roots.of roots.

PathologyPathology

Retained primary Retained primary root tips.root tips.

PathologyPathology

Furcation Furcation involvementinvolvement

PathologyPathology

Furcation Furcation involvement with involvement with internal root internal root resorption.resorption.

PathologyPathology

Internal Internal resorption with resorption with furcation furcation involvement.involvement.

Artifacts/optical illusionsArtifacts/optical illusions

1.1. Cervical burnoutCervical burnout2.2. Mach band phenomenonMach band phenomenon

It may take 30%-70% It may take 30%-70% demineralisation to occur before it demineralisation to occur before it can be evidenced radiographically.can be evidenced radiographically.

Radiographs are 2D views of 3D Radiographs are 2D views of 3D objects.objects.

THANK YOU!THANK YOU!