1. “Radiographic Assessment of the Pediatric Patient” S.Lal, DDS

2. Special considerations 1. Risk assessment Evidence of caries/hx Evidence of caries/hx Trauma Trauma Anomalies Anomalies Fluoride status Fluoride status Diet Diet

3. AAPD guidelines for radiographs Based on Age and risk assessment Based on Age and risk assessment

4. Child preparation and management Euphemisms Euphemisms Role models Role models Contour film Contour film Gag reflex – distraction Gag reflex – distraction Parental help Parental help Bad taste Bad taste

5. Film Sizes Sizes 0,1,2, occlusal/lateral

6. Radiographic Tools Snap-a-ray Bite wings, periapicals

7. Radiographic techniques 1. Bite wings 2. Periapicals (not p.a.’s) 3. Max/mand occlusals 4. Extraoral/lateral film 5. Soft tissue x-ray 6. Panoramic radiographs

8. Bite Tabs

9. Bite wing x-ray Mesial surface of canine to distal surface of 1 st permanent molar

10. Bite wing x-ray Incipient carious lesion. Overlapping – common error

11. Occlusal Radiographs

12. Posterior max. occlusal radiograph

13. Extra Oral film Lateral Film

14. Trauma Soft tissue Film Indicated after trauma to locate missing piece(s) of fractured tooth.

15. Panaramic radiograph

16. Radiographic diagnosis of dental anomalies Ankylosis

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

18. Anomalies Dilaceration

19. Anomalies Peg lateral Supernumary primary lateral

20. Anomalies a) Fusion: dentinal union of two teeth. b) Supernumary tooth c) Missing lateral

21. Anomalies Concrescence: fusion with a cemental union.

22. Anomalies Amelogenesis Imperfecta a) Thin enamel b) Increased dentin

23. Anomalies Unfavorable resorptive pattern of roots.

24. Pathology Retained primary root tips.

25. Pathology Furcation involvement

26. Pathology Furcation involvement with internal root resorption.

27. Pathology Internal resorption with furcation involvement.

28. Artifacts/optical illusions 1. Cervical burnout 2. Mach band phenomenon  It may take 30%-70% demineralisation to occur before it can be evidenced radiographically.  Radiographs are 2D views of 3D objects.

29. THANK YOU! THANK YOU!