1. By Mohamed B. Hassanin, BDS, MSc , PhD Associate Professor
Oral Radiology II :MDS 314 “
By Mohamed B. Hassanin, BDS, MSc , PhD Associate Professor

2. Principles of Radiographic Interpretation

4. Imaging as an Examination Tool
Clinical examination
Signs
Symptoms
Ordering the right type of imaging examination
Ordering the right number of imaging examination
Necessary vs unnecessary examinations
Benefit to the patient

5. Viewing condition Viewbox Monitor Prints Ambient light reduced
Quiet room
Intraoral films mounted on a opaque holder
Equal intensity of light on the view box
Monitors: calibration
Magnification
Software limitations

6. Systematic Approach Intraoral images Extraoral images;
Teeth, periodontium, bone, adjacent structures
Tooth #1 to #16, and then #17 to #32
Extraoral images;
Panoramic, other extraoral plain radiographs
Cross sectional images
CT, MRI

7. Localize the abnormality
How many lesions?
Where is the lesion?
Localized vs generalized
Single arch or both the arches
Inside the bone or outside
Relation to the crown
Relation to the root
Superior to the mandibular canal

8. Periphery Well defined or ill defined? Sharp margins
Corticated margins
Sclerotic margins
Radiolucent band
Blends into adjacent area
Irregular margins

9. Shape
Circular
Oval
Scalloped
Multilocular

10. Internal structures Radiolucent Mixed Radiopaque Trabeculation Septa
Calcifications
Tooth or similar entities

11. Adjacent structures Teeth Lamina dura Crestal bone Periodontal spaces
Alveolar bone
Nerve canals
Maxillary sinuses
Cortical bones

12. Description, description, description
Speak out loudly
List it down
Compare findings in different images
Clinical information

13. Radiographic findings
Abnormal
Developmental
Acquired
Cysts
Tumors
(benign/malig)
Inflammatory
Bone dysplasia
Vascular
Metabolic
Trauma
Normal

14. Characterize your lesion and state your D/D
Vascular
Infection
Neoplasm
Drugs
Idiopathic/inflammatory
Congenital
Autoimmune
Trauma
Endocrine/metabolic

15. In the Land of 10,000 lakes,…

16. …we see the fish!

18. Liar, Liar!! Do Our Eyes Lie?

19. Dirty words! Sun-ray appearance Ground glass Cotton wool Onion skin
Driven snow
Etc, etc

20. When not to order imaging
You have not clinically / radiographically evaluated the patient
No benefit to the patient
Additional images may not provide extra information
No ‘routine’ radiograph

21. What goes on the report Patient, doctor, clinic identification
Date, type and number of examination
Reasons for the examination
Clinical information
Relevant observation
Radiographic Impressions
Any further tests, examinations