Dr MUMENA C.H

*One of the most common disease seen in radiographs*Rec pathogenesis*Radiographs are used to detect lesions that are

not easily observed in the clinical examination*Carious lesion appears radiolucent in the

radiographs*Carious lesions are usually larger than their

radiographic appearance*Reason: For density changes to be observed

radiographically, 30-50% demineralization must have occurred

*Proximal caries:

*Occur on proximal surfaces

*Detection: Bitewing radiographs

*Radiographic appearance:*Notching of the enamel usually in area of 1-2 mm

apical to the contact point.

* Forms a traingular pattern to the dentinoenamel junction (rec pathogenesis) into dentin

* Spread out in dentin, undermining enamel

*Becomes more diffuse in radiographic appearance as they advance into dentin

*Occlusal caries:

*Occur on occlusal surface of premolars and molars

*Detection: Clinical examination more reliable

*Reason: radiographic superimposition of normal structures, hard to detect early lesions

*Use of radiographs: when occlusal caries have extended into dentin

*Occlusal caries cont…

*Radiographic appearance:

*First thin radiolucent line between the enamel and dentin

*More diffuse radiographically when in dentin

*Thin radiopaque band of secondary dentin between dentin and pulp chamber in advanced lesions

*Buccal and lingual caries:

*Detection is best with clinical examination

*Reasons: superimposition of structures

*Radiographic presentation:

*Difficulty to distinguish buccal, lingual and occlusal caries radiographically

*Buccal and lingual caries have a well defined radiopaque band that can not be found in occlusal caries

*Root surface caries:

*Occur on surface where attachment has migrated apically (Gingival recession)

*Detection: Careful clinical examination, radiographs

*Radiographic appearance:

*No particular pattern

*Diffuse scooping out of the tooth structure

*N.B root surface caries cannot occur where there is gingival attachment: evaluate bone level

*Recurrent caries:

*Occur at the margin of the existing restorations

*Detection: radiographic for occlusal and proximal restorations, large restorations may obscure early recurrent lesions

*Radiographic presentation:

*Radiolucency at the margin of existing restorations

*Similar in appearance to primary carious lesions

*Appreciate radiographic appearance of restorations such as:

*Amalgam

*Gold and other metals

*Pins

*Calcium hydroxide base

*Gutta percha

*Composite e.t.c

*N.B: Distinguish them from the discussed appearences

*After completion of this part: Follow radiographic presentation of periodontal diseases in part 3