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E5083. Dental Concepts in the Pediatric Population: A Primer for Pediatric Radiologists
Authors
  1. Kathryn Szymanski; Creighton School of Medicine
  2. Kathryn Preston; Phoenix Children's
  3. Cory Pfeifer; Phoenix Children's
Background
As cone beam CT has increased in prevalence among pediatric dental practices, pediatric radiologists are frequently called upon to evaluate targeted CT of the face as primary evaluators or as comparison images referenced when interpreting conventional CT. Radiologists unfamiliar with the pediatric dental lexicon may provide inadequate detail for ordering providers in issuing reports. This educational exhibit focuses on pediatric dental terminology as it pertains to targeted CT of the face, with emphasis on terms that are commonly misunderstood or misused by radiologists.

Educational Goals / Teaching Points
The conventional A-B-C primary (deciduous) tooth numbering system is compared to the adult 1-2-3 (universal) tooth numbering system, as well as the orthodontic quadrant-based labeling system (Palmer notation). The difference between overbite and overjet, as well as the malocclusion classes (I-III), are depicted. Retrognathia and prognathia are described in the context of common craniofacial anomalies and subsequent airway ramifications. Radiographic techniques used in pediatric orthodontic case planning are included with methods to assess skeletal maturity.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The terms buccal/facial and palatal/lingual are used to describe the inner and outer aspects of the alveolar ridges and teeth. In Palmer notation, orthodontic alphanumeric labeling begins in the midline with teeth numbered 1–8 (permanent) or A–E (primary), as opposed to the traditional universal numbering schema in which teeth are labeled 1–32. Overjet refers to the horizontal distance between the maxillary and mandibular incisors while overbite describes the vertical distance. Both can be exacerbated by habits, such as thumbsucking or pacifier use. Orthodontists assess bone age by evaluating cervical spine morphology on lateral cephalograms and in-office hand-wrist radiographs using skeletal maturation indicators (SMIs), which may differ from techniques used in pediatric radiology.

Conclusion
Dentistry and orthodontics involve a unique vocabulary. By better understanding its applications in diagnostic radiology, radiologists can improve the quality of care offered to patients.