Anatomic Radiopacities of the Jawbones 口腔診斷學 Anatomic Radiopacities of the Jawbones 顎骨之X光不透過解剖影像 陳玉昆助理教授: 高雄醫學大學 口腔病理科 07-3121101~2755 yukkwa@kmu.edu.tw 1

學 習 目 標 Understanding: 1. 顎骨之X光不透過解剖影像

參考資料 References: Wood, Goaz. Differential diagnosis of oral lesions. Mosby, 3rd ed., Chapter 24, p. 555-562 Eric Whaites. Essentials of dental radiography and radiology, 4th edition, 2007, pp.6, 135, 257, 278, 309, 311-21, 355 Tantanapornkul W et al. Correlation of darkening of impacted mandibular third molar root on digital panoramic images with cone beam computed tomography findings Dentomaxillofac 2009;38:11-6 http//www.conebeam.com

Anatomic Radiopacities of the Jaws Possible causes include: Normal anatomical structures Radiopacity A dental anomaly A bony lesion A soft tissue calcification A foreign body Artifactual Pathological Ref. 2

Anatomic Radiopacities of the Jaws (1) Enamel Dentine Cementum Lamina dura Periodontal ligament space Cervical burn out Ref. 1

Anatomic Radiopacities of the Jaws (1-1) Ref. 2

Anatomic Radiopacities of the Jaws (1-2) Normal distance from CEJ to crestal margin : 2-3mm Ref. 2

Anatomic Radiopacities of the Jaws (1-3) Cervical burnout Side view Plan view Ref. 2

Anatomic Radiopacities of the Jaws (2) Tooth crypt Mandibular canal Ref. 1

Anatomic Radiopacities of the Jaws (2-1-1) Mesioangular Vertical Distoangular Horizontal Inverted Transverse Ref. 2

Anatomic Radiopacities of the Jaws (2-1-2) Ref. 2

Anatomic Radiopacities of the Jaws (2-2) Ref. 2

Anatomic Radiopacities of the Jaws (2-3) Pericoronal infection Ref. 2

Anatomic Radiopacities of the Jaws (2-4) Indentation of upper margin of inferior canal Pericoronal infection Ref. 2

Anatomic Radiopacities of the Jaws (2-5) Radiolucent band across the root: narrowed canal Radiolucent band across the root: a change in direction Ref. 2

Anatomic Radiopacities of the Jaws (2-6) Pericoronal infection Buccal aspect Distal aspect Radiolucent across root apex Ref. 2

Anatomic Radiopacities of the Jaws (2-6-1) Panorex: unerupted left upper canine Spiral CT (cross section): buccal unerupted left upper canine (2mm slices) Ref. 2

Anatomic Radiopacities of the Jaws (2-6-2) CBCT: mesiodens Ref. 2

Anatomic Radiopacities of the Jaws (2-6-3) Panorex: mesial root darkening; no root grooving CBCT: thinning lingual cortex by root & ID Ref. 3

Anatomic Radiopacities of the Jaws (2-6-4) Panorex: root darkening; no root grooving CBCT: perforation of lingual cortex by root & ID Ref. 3

Anatomic Radiopacities of the Jaws (2-6-5) Panorex: without root darkening CBCT: root grooving Ref. 3

Anatomic Radiopacities of the Jaws (2-6-6) Panorex: root seems to approximate ID CBCT: lingual cortex perforation without root approximates ID Ref. 3

Anatomic Radiopacities of the Jaws (2-6-7) CBCT: lower 3rd molar with root approximates ID Ref. 2

Anatomic Radiopacities of the Jaws (2-6-8) CBCT: lower 3rd molar with root approximates ID Ref. 2

Anatomic Radiopacities of the Jaws (2-6-9) Impacted 3rd molar Ref. 5

Anatomic Radiopacities of the Jaws (2-6-10) Impacted 3rd molar Ref. 5

Anatomic Radiopacities of the Jaws (2-6-11) Impacted molar Ref. 5

Anatomic Radiopacities of the Jaws (2-6-12) Impacted molar Ref. 5

Anatomic Radiopacities of the Jaws (2-6-13) Impacted maxillary cuspid Ref. 5

Anatomic Radiopacities of the Jaws (2-6-14) Impacted maxillary cuspid Ref. 5

Anatomic Radiopacities of the Jaws (2-6-15) Impacted #22 Impacted #22 simulated extraction Ref. 5

Anatomic Radiopacities of the Jaws (2-6-16) Impacted #22 Ref. 5

Anatomic Radiopacities of the Jaws (2-6-17) Impacted left canine Ref. 5

Anatomic Radiopacities of the Jaws (2-6-18) Impacted left canine Ref. 5

Anatomic Radiopacities of the Jaws (2-6-19) Mandibular impacted tooth and nerve localization Ref. 5

Anatomic Radiopacities of the Jaws (2-6-20) Mandibular impacted tooth and nerve localization Ref. 5

Anatomic Radiopacities of the Jaws (2-7) Object moves in same direction Front Right Left Principle of parallax: the apparent displacement of an object due to different positions of the observer Same Lingual Opposite Buccal SLOB (遠方) (近方) Ref. 2

Anatomic Radiopacities of the Jaws (2-8) Position 1 Position 2 Position 2 Position 1 Same Lingual (遠方-palatal side) Ref. 2

Anatomic Radiopacities of the Jaws (2-9) Panorex Upper occlusal Unerupted mesiodens Crown portion (遠方-palatal side) Apex portion (近方-labial side) SLOB Same Lingual Opposite Buccal Ref. 2

Anatomic Radiopacities of the Jaws (2-10) Not recommended due to high radiation dose Vertex occlusal Ref. 2

Anatomic Radiopacities of the Jaws (3) Nasal fossa Anterior nasal spine Incisive canal Incisive canal cyst Ref. 1

Anatomic Radiopacities of the Jaws (4) Nasal fossa Anterior nasal spine Soft tissue shadow of nose Ref. 1

Anatomic Radiopacities of the Jaws (5) Anterior nasal spine Inferior turbinates Ref. 1

Anatomic Radiopacities of the Jaws (6) Maxillary sinus Y Medial wall of sinus meets the lateral wall of nasal chamber Ref. 1

Anatomic Radiopacities of the Jaws (7) Zygoma Maxillary sinus floor- flat Ref. 1

Anatomic Radiopacities of the Jaws (8) Maxillary sinus floor- scalloped Ref. 1

Anatomic Radiopacities of the Jaws (9) Zygomatic bone Zygomatic process Tuberosity- soft tissue shadow Ref. 1

Anatomic Radiopacities of the Jaws (10) Lateral pterygoid plate Hamular process Ref. 1

Anatomic Radiopacities of the Jaws (11) Coronoid porcess Ref. 1

Anatomic Radiopacities of the Jaws (12) External oblique ridge Mylohyoid ridge (internal oblique ridge) Ref. 1

Anatomic Radiopacities of the Jaws (13) Mental ridge Ref. 1

Anatomic Radiopacities of the Jaws (14) Lingual foramen- radiopque ring Genital tubercle- occlusal view Ref. 1

Anatomic Radiopacities of the Jaws (15) Ala of nose Ala of nose- edentulous jaw Ref. 1

Anatomic Radiopacities of the Jaws (16) Nasal labial fold Ref. 1

Summaries 明白顎骨之X光不透過解剖影像。