E4847. Essentials of Dental Imaging and Odontogenic Disease: Education for Residents
  1. Bret Kravis; Aurora St. Luke's Medical Center
The oral cavity is a frequently incidentally imaged part of the body and a very common site of disease, with the prevalence of carious disease estimated at 50% by age 12–15. This pathology is clinically significant for patients, both from a functional and visual standpoint, as well as in the relatively common event of odontogenic disease spread into adjacent tissues and structures, which can range from chronic indolent infections to life-threatening emergencies. Despite this ubiquity and inherent relevance, radiology training often devotes very little attention and resources to a comprehensive education of dental anatomy or the common routes of disease spread and the underlying pathophysiologic mechanisms.

Educational Goals / Teaching Points
This exhibit aims to provide the radiologist with foundational knowledge of dental anatomy and terminology to make identification of disease and reporting more consistent and efficient. It then outlines common periodontal and endodontal routes of spread for odontogenic disease, as well as the spaces that infection typically spreads to once it has extended beyond the maxilla or mandible.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Diagrams will be provided to help discuss dental nomenclature and numbering, as well as to help delineate between spaces in and near the floor of mouth. CT images will be shown to provide typical imaging appearance of dental caries, periodontal disease, periapical disease (via endodontal spread), odontogenic sinusitis, and several typical locations of odontogenic soft tissue infection spread, including subperiosteal and soft tissue abscesses, as well as abscess spread into the deep neck and Ludwig angina.

Radiologist training in recognizing and discussing odontogenic disease and infection is often limited, despite the ubiquity of disease and frequent relevance for patient care in both the long and short term. The basics of dental nomenclature, anatomy, and typical routes of spread for infection provided in this exhibit will help radiologists (particularly those still in training) to efficiently identify and describe odontogenic disease and ensuing infections of the head and neck.