Radiographic interpretation
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RADIOGRAPHIC INTERPRETATION. CDS 824. PERIAPICAL RADIOGRAPHS PANORAMIC RADIOGRAPHS BITEWING RADIOGRAPHS. Approach radiographic interpretation as you do all other aspects of evaluation – systematic and repetitive. NORMAL VS. ABNORMAL. Anatomy (hard tissue, soft tissue)

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CDS 824




Approach radiographic interpretation as you do all other aspects of evaluation – systematic and repetitive


  • Anatomy (hard tissue, soft tissue)

  • Variants (torus, root shape)

  • Pathology ( decay, bone loss, disease)

Set Yourself Up for Success

View radiographs in a darkened area with a lighted viewbox

Periapical Radiographs

Full Mouth Series

Develop a routine for intrepretation

My Routine

  • Start above the apices of the teeth on the upper right

  • Proceed around the arch to the left, bottom left, and bottom right

  • Look for normal or abnormal anatomy

Routine continued

  • Examine the bone, root formation, and all structures supporting the teeth

  • Again, look for normal or abnormal appearances such as dilacerated roots, root canals, bone loss, etc.

Final Exam of a FMX

  • Look for decay last on the BWX and anterior periapicals

Common Anatomical Landmarks on Periapical Films


  • Malar Shadow

Coronoid Process

  • This can sometimes be viewed on a second molar shot

Maxillary Sinus

  • This frequently seen on molar films

Nasolabial Fold

  • The soft tissue shadow cast by the cheek at its junction with the lip


  • The inverted y appearance is comprised of the floor of the maxillary sinus and the floor of the nasal fossa

Intermaxillary Suture

  • Appearance of the two processes of the maxilla joining

Lateral Fossa

  • Appearance of thinner bone in the area of a smaller rooted tooth

Incisive Foramen

  • Exit point for the nasopalatine nerve

Anterior Nasal Spine

  • Will appear apical to the roots of the maxillary central incisors

External Oblique Ridge

  • Anterior border of the mandibular ramus

Internal Oblique Ridge

Also known as the mylohyoid ridge – serves as attachment for the mylohyoid muscle

Mandibular Canal

  • Appearance of the housing for the inferior alveolar nerve

Mental Foramen

  • Anterior exit of the mandibular nerve

Genial Tubercle

  • Attachment for the genioglossus and the geniohyoid muscles

Lingual Foramen

  • Exit for the incisive branch of the mandibular nerve

Mental Ridge

  • Appear apical to the mandibular incisors

Border of the Mandible

Mandibular Tori

  • Will appear as diffuse radiopaque area superimposed on roots of teeth

Root Dilaceration

  • Carefully observe all apices of roots for curves – especially if doing endo or extract!

Root Canal Treatment

  • Examine root canal therapy for type of fill, adequacy of fill, lesions, etc.

Composites and Other Resins

  • Resins will appear radiolucent – so must check clinically to verify the status of the tooth

Metal Castings

Appearance will be very regular – not anatomical like an amalgam

Amalgam Restoration

  • Outline will be irregular following the disease process that was removed

Bitewing Radiographs

Decay at the Contact Point

Decay Proximity to Pulp

  • BWX are very helpful in helping visualize decay proximity to pulp

BWX and Restorability

  • BWX are the most helpful in determining restorability of a tooth

Panoramic Films

Helpful for viewing impacted teeth, bone lesions, and anatomical structures not captured on periapical films.


Pterygomaxillary Fissure

Hard Palate

Soft Palate

Styloid Process – Stylohyoid Ligament

Tongue – Air Space

Turbinates- Concha

Orbit of the Eye

Border of the Mandible

Mandibular Canal

Hyoid Bone



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