chapter 31

Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc.

Chapter 31Chapter 31

Descriptive TerminologyDescriptive Terminology

Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. 2

Dental RadiographyDental Radiography

QuestionsQuestions What is the difference between a radiograph and What is the difference between a radiograph and

an x-ray?an x-ray? What is the difference between radiolucent and What is the difference between radiolucent and

radiopaque?radiopaque? What terms may be used to describe radiolucent What terms may be used to describe radiolucent

and radiopaque lesions?and radiopaque lesions?



Chapter 31 Reading Chapter 31 Reading Iannucci & HowertonIannucci & Howerton (pp. 372-382)(pp. 372-382)



Chapter 31 OutlineChapter 31 Outline Descriptive TerminologyDescriptive Terminology

Definition and usesDefinition and uses Review of basic termsReview of basic terms


What is Descriptive Terminology?What is Descriptive Terminology?

Descriptive terminology is terms used to Descriptive terminology is terms used to describe the appearance, location, and size describe the appearance, location, and size of a lesion.of a lesion. This information should be documented for all This information should be documented for all

lesions viewed on dental images.lesions viewed on dental images.


Why Use Descriptive Terminology?Why Use Descriptive Terminology?

Descriptive terminology allows dental Descriptive terminology allows dental professionals to describe and discuss what is professionals to describe and discuss what is seen on a dental image intelligently and to seen on a dental image intelligently and to communicate using a common language.communicate using a common language. It eliminates the chance for miscommunication.It eliminates the chance for miscommunication. It allows for documentation that images were It allows for documentation that images were

reviewed.reviewed.


Descriptive Terminology Descriptive Terminology versus Diagnosisversus Diagnosis

Descriptive terminology allows the dental Descriptive terminology allows the dental hygienist to describe what is seen on an hygienist to describe what is seen on an image image without without implying a diagnosis.implying a diagnosis. The patient’s medical and dental history, clinical The patient’s medical and dental history, clinical

findings, signs and symptoms, laboratory tests, findings, signs and symptoms, laboratory tests, and biopsy results are necessary for the dentist to and biopsy results are necessary for the dentist to make a definitive diagnosis.make a definitive diagnosis.


Review of Basic TermsReview of Basic Terms

Radiograph/dental image versus x-rayRadiograph/dental image versus x-ray Radiolucent versus radiopaqueRadiolucent versus radiopaque Terms used to describe radiolucent lesionsTerms used to describe radiolucent lesions Terms used to describe radiopaque lesionsTerms used to describe radiopaque lesions


Radiograph/Dental Image versus Radiograph/Dental Image versus X-rayX-ray

RadiographRadiograph An image that is produced on photosensitive film An image that is produced on photosensitive film

by exposing the film to x-rays and then processing by exposing the film to x-rays and then processing the film so that a negative is producedthe film so that a negative is produced

Not applicable with digital radiography, in which Not applicable with digital radiography, in which term digital image used insteadterm digital image used instead

X-rayX-ray A beam of energy that has the power to penetrate A beam of energy that has the power to penetrate

substances and to record shadow images on substances and to record shadow images on photographic filmphotographic film


Radiolucent versus RadiopaqueRadiolucent versus Radiopaque

Iannucci & HowertonIannucci & Howerton (pp. 373-374) (Figs. 31-1, (pp. 373-374) (Figs. 31-1, 31-2,31-2, 31-331-3))

RadiolucentRadiolucent This that portion of a processed image that is dark or This that portion of a processed image that is dark or

black.black.• Caries appears radiolucent because the area of tooth with Caries appears radiolucent because the area of tooth with

caries is less dense than surrounding structures.caries is less dense than surrounding structures.

RadiopaqueRadiopaque This is that portion of a processed image that This is that portion of a processed image that

appears light or white.appears light or white.• A metallic restoration appears radiopaque because it is very A metallic restoration appears radiopaque because it is very

dense and absorbs the radiation.dense and absorbs the radiation.


Terms Used to Describe Terms Used to Describe Radiolucent LesionsRadiolucent Lesions

Appearance Appearance LocationLocation SizeSize


AppearanceAppearance

Iannucci & HowertonIannucci & Howerton (pp. 374-375) (Box 31-(pp. 374-375) (Box 31-1)1)

Unilocular radiolucent lesionsUnilocular radiolucent lesions One compartmentOne compartment Tend to be small and nonexpansileTend to be small and nonexpansile Have borders that may appear corticated or Have borders that may appear corticated or

noncorticated on imagenoncorticated on image


AppearanceAppearance Iannucci & HowertonIannucci & Howerton (pp. 374-375) (Figs. 31-4, (pp. 374-375) (Figs. 31-4,

31-5)31-5) Unilocular lesion, corticated bordersUnilocular lesion, corticated borders

The lesion exhibits a thin, well-demarcated The lesion exhibits a thin, well-demarcated radiopaque rim of bone at the periphery.radiopaque rim of bone at the periphery.

Usually indicative of a benign, slow-growing process.Usually indicative of a benign, slow-growing process. Unilocular lesion, noncorticated bordersUnilocular lesion, noncorticated borders

The lesion does not exhibit a thin radiopaque rim of The lesion does not exhibit a thin radiopaque rim of bone at the periphery.bone at the periphery.

The periphery appears fuzzy or poorly defined.The periphery appears fuzzy or poorly defined. May represent either a benign or a malignant process.May represent either a benign or a malignant process.



Iannucci & HowertonIannucci & Howerton (pp. 374-375) (Fig. 31-(pp. 374-375) (Fig. 31-6)6)

Multilocular radiolucent lesionsMultilocular radiolucent lesions A lesion that exhibits multiple radiolucent A lesion that exhibits multiple radiolucent

compartmentscompartments Frequently expansileFrequently expansile Typically benign lesions with aggressive growth Typically benign lesions with aggressive growth

potentialpotential


LocationLocation


May appear in a periapical, inter-radicular, May appear in a periapical, inter-radicular, edentulous, or pericoronal location.edentulous, or pericoronal location. May appear as alveolar bone loss.May appear as alveolar bone loss.


Periapical LocationPeriapical Location


A lesion located around the apex of a toothA lesion located around the apex of a tooth ExampleExample

Periapical cyst secondary to pulpal necrosis Periapical cyst secondary to pulpal necrosis


Inter-radicular LocationInter-radicular Location

Iannucci & HowertonIannucci & Howerton (p. 376) (Fig. 31-8)(p. 376) (Fig. 31-8) A lesion located between the roots of A lesion located between the roots of

adjacent teethadjacent teeth ExampleExample

Lateral periodontal cystLateral periodontal cyst


Edentulous ZoneEdentulous Zone


A lesion located in an area without teethA lesion located in an area without teeth


Pericoronal LocationPericoronal Location

Iannucci & HowertonIannucci & Howerton (p. 377) (Fig. 31-10)(p. 377) (Fig. 31-10) A radiolucent lesion located around the crown A radiolucent lesion located around the crown

of an impacted toothof an impacted tooth ExampleExample

Dentigerous cyst Dentigerous cyst


Alveolar Bone LossAlveolar Bone Loss

Iannucci & HowertonIannucci & Howerton (p. 377) (Fig. 31-11)(p. 377) (Fig. 31-11) Loss of bone in the maxilla or mandible that Loss of bone in the maxilla or mandible that

surrounds and supports the teethsurrounds and supports the teeth Appears radiolucentAppears radiolucent


SizeSize

Iannucci & HowertonIannucci & Howerton (p. 377) (Fig. 31-12)(p. 377) (Fig. 31-12) Can vary in size from several millimeters in Can vary in size from several millimeters in

diameter to several centimeters in diameterdiameter to several centimeters in diameter Can be measured on an image with a millimeter Can be measured on an image with a millimeter

rulerruler


Terms Used to Describe Terms Used to Describe Radiopaque LesionsRadiopaque Lesions

AppearanceAppearance Location Location SizeSize




Can be described as focal opacity, target Can be described as focal opacity, target lesion, multifocal confluent, irregular, ground lesion, multifocal confluent, irregular, ground glass, or mixed lucent-opaque.glass, or mixed lucent-opaque. Radiopaque lesions occur not only in bone but in Radiopaque lesions occur not only in bone but in

soft tissue as well.soft tissue as well.


Focal OpacityFocal Opacity

Iannucci & HowertonIannucci & Howerton (pp. 377-378) (Fig. 31-(pp. 377-378) (Fig. 31-13) 13)

A well-defined, localized radiopaque lesion on A well-defined, localized radiopaque lesion on an imagean image

ExampleExample Condensing osteitisCondensing osteitis


Target LesionTarget Lesion

Iannucci & HowertonIannucci & Howerton (p. 378) (Fig. 31-14)(p. 378) (Fig. 31-14) A well-defined, localized radiopaque area A well-defined, localized radiopaque area

surrounded by a uniform radiolucent halo surrounded by a uniform radiolucent halo ExampleExample

Benign cementoblastomaBenign cementoblastoma


Multifocal ConfluentMultifocal Confluent

Iannucci & HowertonIannucci & Howerton (p. 378) (Fig. 31-15)(p. 378) (Fig. 31-15) Multiple radiopacities that appear to overlap Multiple radiopacities that appear to overlap

or flow togetheror flow together ExampleExample

Osteitis deformans, florid osseous dysplasiaOsteitis deformans, florid osseous dysplasia Multifocal confluent radiopacities involving multiple Multifocal confluent radiopacities involving multiple

quadrants of the jaws usually represent benign quadrants of the jaws usually represent benign fibro-osseous disorders.fibro-osseous disorders.


Irregular Ill-DefinedIrregular Ill-Defined


A radiopacity may exhibit an irregular, poorly A radiopacity may exhibit an irregular, poorly defined pattern.defined pattern. It may represent a malignant condition.It may represent a malignant condition.

ExamplesExamples Osteosarcoma and chondrosarcoma Osteosarcoma and chondrosarcoma


Ground GlassGround Glass

Iannucci & HowertonIannucci & Howerton (p. 379) (Fig. 31-17)(p. 379) (Fig. 31-17) A granular or pebbled radiopacity that A granular or pebbled radiopacity that

resembles pulverized glassresembles pulverized glass Often said to resemble the appearance or texture Often said to resemble the appearance or texture

of an orange peelof an orange peel ExamplesExamples

Fibrous dysplasia, osteitis deformans, and Fibrous dysplasia, osteitis deformans, and osteopetrosisosteopetrosis


Mixed Lucent-OpaqueMixed Lucent-Opaque

Iannucci & HowertonIannucci & Howerton (p. 379) (Fig. 31-18) (p. 379) (Fig. 31-18) Exhibits both a radiopaque and a radiolucent Exhibits both a radiopaque and a radiolucent

componentcomponent Often represent calcifying tumorsOften represent calcifying tumors

ExampleExample Compound odontomaCompound odontoma


Soft Tissue OpacitySoft Tissue Opacity

Iannucci & HowertonIannucci & Howerton (p. 379) (Fig. 31-19)(p. 379) (Fig. 31-19) Appears as a well-defined, radiopaque area Appears as a well-defined, radiopaque area

located in soft tissuelocated in soft tissue ExamplesExamples

SialolithSialolith Calcified lymph nodeCalcified lymph node


LocationLocation


Radiopaque lesions may appear in the same Radiopaque lesions may appear in the same places as radiolucent lesions: in a periapical, places as radiolucent lesions: in a periapical, inter-radicular, edentulous, or pericoronal inter-radicular, edentulous, or pericoronal location.location.


Periapical LocationPeriapical Location

Iannucci & HowertonIannucci & Howerton (p. 380) (Fig. 31-20)(p. 380) (Fig. 31-20) Periapical refers to a radiopaque lesion Periapical refers to a radiopaque lesion

located around the apex of a tooth.located around the apex of a tooth. ExampleExample

Benign cementoblastomaBenign cementoblastoma


Inter-radicular LocationInter-radicular Location

Iannucci & HowertonIannucci & Howerton (p. 380) (Fig. 31-21)(p. 380) (Fig. 31-21) A radiopaque lesion located between the A radiopaque lesion located between the

roots of adjacent teethroots of adjacent teeth ExampleExample

Sclerotic boneSclerotic bone


Edentulous ZoneEdentulous Zone

Iannucci & HowertonIannucci & Howerton (p. 380) (Fig. 31-22)(p. 380) (Fig. 31-22) A radiopaque lesion located in an area A radiopaque lesion located in an area

without teethwithout teeth ExampleExample

Complex odontomaComplex odontoma


Pericoronal LocationPericoronal Location

Iannucci & HowertonIannucci & Howerton (p. 380) (Fig. 31-23)(p. 380) (Fig. 31-23) A radiopaque lesion located around the A radiopaque lesion located around the

crown of an impacted toothcrown of an impacted tooth ExampleExample

Adenomatoid odontogenic tumor is a mixed Adenomatoid odontogenic tumor is a mixed lucent-opaque lesion. lucent-opaque lesion.


SizeSize

Radiopaque lesions can vary from several Radiopaque lesions can vary from several millimeters to several centimeters in diameter.millimeters to several centimeters in diameter. They can be measured on an image with a ruler.They can be measured on an image with a ruler.

chapter 31

Documents