University of California, Irvine
Dental imaging is commonly obtained in radiological studies. It has been estimated that over 90% of the adult population has dental disease. Given its widespread prevalence, recognition of incidental or etiological dental lesions has the potential to improve the patient’s morbidity and pain.
Educational Goals / Teaching Points
To familiarize the viewer with dental pathology through demonstration of specific imaging features and patterns.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Ubiquitously known cavities are extremely prevalent within the majority of the adult population. Cavities are demineralization of the teeth from oral bacterial acid production. Initial cavities involve the enamel. When the infection proceeds into the dentin, it can spread more easily. Treatment for these lesions are typically through improved dental hygiene, fluoride treatment, or amalgam fillings.
Periodontal disease is caused when bacterial plaque builds up along the gums and teeth. When this infectious debris extends under the gum line, there is involvement of the periodontal ligament causing teeth loosening and uncovering of the roots.
Periapical disease is when the infection reaches the tooth apex. When the pulp of the teeth becomes affected, the patient starts to experience pain due to pressure within the pulp chamber. Eventually with continued pressures in the pulp, the tooth will die. Pericoronitis occurs when the gum inflammation is around the crown of the incompletely erupted tooth. Pericoronitis and periapical disease can extend beyond the bone margin and spread to the soft tissues.
Treatment of periapical disease varies depending on the level of involvement. A root canal is indicated for small periapical lesions with a devitalized tooth. If a root canal is insufficient, various tooth saving surgeries may be attempted, such as a mucoperiosteal flap creation. If these measures are unsuccessful, tooth extraction is necessary. When the tooth is removed, there will be soft tissue within the tooth socket that will eventually fill with bone, given proper healing.
Evaluation of dental imaging can add additional value to radiological reports. Prompt dental diagnoses allow for earlier evaluation and treatment.