ROENTGENOLOGY

Caries and
Periodontal
Diseases

GROUP 7
Baranquil, Mary Cris
Samuela, Shamane
Tabayag, Grithchen
Vales, Rizza Mabelle

Caries
-breakdown of tooth structure caused by
acid-producing bacteria in the mouth.
-the diagnosis of caries is made through a
combination of the clinical examination and
radiographs
-unless fairly large, interproximal caries in
the posterior region usually requires
radiographs to make diagnosis.

Radiographs

-the bitewing film is primarily used for caries

identification, but the periapical film is also
helpful. The different in angulation between
the two films gives two different
perspectives and can be especially helpful
in diagnosing recurrent caries around
existing restorations

Approximately 40-50% demineralization is required for radiographic detection

of a lesion.
As seen in the occlusal view, above right, the thickness of the tooth
buccolingually masks the carious lesion when it is small.
The actual depth of penetration of a carious lesion is actually deeper than it
appears on the radiograph.

Occlusal Caries

-must have penetrated into dentin

-diagnosed from clinical exam
-may be seen as thin radiolucent line or cupshaped zone underlying occlusal enamel,
but difficult to see on radiographs unless
lesion is large.

-some feel that a sharp explorer used too

forcefully may contribute to spread of caries
by opening up pit or fissure.

Buccal/Lingual Caries

-should be identified from clinical exam

-sometimes seen as well-defined circular
area in middle of tooth, although it is not
very radiolucent.
-Depth can not be determined
radiographically.

Root Caries

-saucer-like cratering on the roots of the

teeth, involving the cementum.
-usually found on older individuals with
prominent recession and/or periodontitis
-may have xerostomia due to medications.
May be confused with cervical burnout

Cervical Burnout

-is an apparent radiolucency found just

below the CE junction on the root due to
anatomical variation (concave root formation
posteriorly) or gap between the enamel and
bone covering the root (anteriorly). Mimica
root caries. Posteriorly, this radiolucency
usually disappears when another film of the
region is examined. Caries does not occur
on the root of the tooth unless there is a loss
of alveolar bone and gingival tissue due to
recession or periodontitis.

Posterior cervical burnout. The invagination

of the proximal root surfaces allow more xrays to pass through this area, resulting in a
more radiolucent appearance on the
radiograph. X-rays directed at a different
angle usually pass through more tooth
structure and the radiolucency disappears.

Anterior cervical burnout. The space

between the enamel and the bone overlying
the tooth will appear more radiolucent than
either the enamel or the bone-tooth
combination.

Recurrent Caries

Found around the margins of existing

restorations. May be due to unusual
susceptibility to caries, poor oral hygiene,
failure to remove all caries during cavity
preparation, a defective restoration or a
combination of the above.

Rampant Caries
Extensive and rapidly progressing caries
usually found in children and teens with poor
diet and inadequate oral hygiene.