ACJ Quiz – Panoramic X-rays 02

calculus is evident in mesial and distal of tooth # 1.7 and mesial of 1.2, root caries is evident in mesial of the tooth # 1.7 which is accompanied with periodontal bone loss. There are multiple acceptable amalgam restorations but none of them has liner/base with it

for the missing tooth # 2.6  there is no evidence that it is congenital. Tooth # 2.8 is impacted, PFM bridge has a PFM crown and and a pontic, post in the tooth # 2.7 is prefabricated metal post

under the PFM crown on tooth # 3.6 is an amalgam filling, post if prefabricated metal post, the bridge in the anterior is a maryland bridge which does not include PFM crowns but two porous plates in the lingual surfaces of the abutment teeth.

) tooth # 4.6 shows supraeruption and RO, calculus is evident in anterior region, there are two prefabricated metal posts in teeth # 4.6 and 4.7.

there are recurrent caries and open margin in distal tooth # 1.7, overhang is mesial tooth # 1.8, pontic is the place of the tooth # 1.6, sinus peumatization can be selected when sinus floor touches the tip of the root of posterior teeth

there seem to be periodontal bone loss in posterior region, but when supraeruption happens we have increase the distance between bone level and the CEJ and should not be mistaken with bone loss. Root canal in tooth # 3.7 is acceptable. RO is for tooth #3.6

RO and CO can be seen in the tooth # 4.7 region, abrasion is seen on the occlusal surface of the posterior teeth, here these are considered abrasion not attrition as there are PFM crowns causing them but not original teeth, composite restoration is on the tooth # 4.1, tooth # 4.3 and 4.4 on distal CBO can be seen.

the crowns are PFM and acceptable with acceptable RCT, for pulp stone we need a round radioopacity in the pulp chamber, here they are considered pulpal sclerosis but not pulp stone

RO is for 4.5 and 3.6, teeth # 4.6, 4.5 show acceptable composite filling, distal 3.4 shows overhang, there is no space loss

the crown on tooth # 1.4 is PFM with open margin on mesial, recurrent caries can be seen in mesial 1.3, root caries can be detected on distal tooth # 1.8, over eruption can be seen on tooth # 1.7 which is accompanied with space loss in mesial

both posts are casting posts, in premolars in many cases casting posts and cores has two posts. Overhang is distal 2.6, amalgam restoration is on 2.7, tooth # 2.6 also shows furcation involvement

for the bridge the options of bridge and PFM crowns can be selected, but connected crowns are selected when there is no pontic. RO can be seen in tooth # 3.4 , recurrent caries can be detected in 3.3 and 3.4

RCT on tooth # 4.7 is acceptable, there is sealer puff that is considered as foreign body, also space loss is due to loss of tooth # 4.6, CBO can be seen in distal tooth # 4.4 and caries on distal tooth # 4.5 can be detected.

have it in mind that an acceptable crown can be placed over unacceptable root canal, you have to evaluate them separately, the crown over 2.1 is acceptable but post placement is not as there is no gutta in the canal, in the tip of 2.1 also external resorption is evident. Dentinal pin can be seen in 1.7

tooth # 4.5 has a zirconia/full metal crown, tooth # 4.6 shows healing socket and 4.7 shows healed socket, open margin is distal toth # 3.6, attrition/abrasion ca be detected on tooth # 3.2, but on dentinal pin until it is inside the tooth we cannot comment on it as unacceptable even if we feel it is inside the pulp as it can be superimposed.

castin post is in tooth # 2.3, zirconia/full metal can be seen in 1.8, 1.7and 2.6, RO on tooth # 1.5, ridge atrophy on 1.6 area, there is no full porcelain crown

zirconia crown/full metall crown on 3.6 or 4.3, implant on 3.6 is bone level, there is prefabricated fiber post on tooth # 4.3, missed canal in mesial of 4.7, attrition/abrasion in anteriors, recurrent caries on 4.4 distal. There is no vertical bone loss, bone appearance in mesial of implant is normal.

sinus pneumatization can be seen on both sides, PFM crowns on teeth # 1.1, 2.1, 1.6, tooth # 1.7 shows amalgam with liner/base and amalgam with overhang, attrition and abrasion can be seen on tooth # 2.2, 2.3 and 1.2, no bone loss can be detected near in 1.1 implant

remember when there is attrition it most of the times accompanies with passive eruption that can be misinterpreted with periodontal bone loss in anterior region. Over eruption can be seen in tooth # 3.8, attrition in anteriors,

implant crown on 1.6 is not seated perfectly on the abutment. Implants are all bone level, all restorations are composite, peri implantitis is a clinical term and cannot be selected merely based on X ray.

RO is on tooth # 3.6 , periodontal bone loss can be detected in posterior regions, caries on mesial of tooth # 4.5, no pulpal obliteration

) RB5 caries on mesial tooth # 1.7, PFM crowns on teeth # 1.6 and 2.6, tooth # 2.4 is missing, sinus pneumatization can be seen when root tip is touching the sinus

two lower premolars are missing but there is no reason that they can be considered congenitally missing teeth, all crowns are PFM, RC6 caries in tooth # 3.4, furcation involvement is a periodontal term and can be detected in tooth # 4.6,

the post in tooth # 2.5 is custom cast post, ridge atrophy can be seen in tooth # 1.5 region, sinus pneumatization in both sides, PFM bridge in upper right region, periodontal bone loss is evident between 2.6 and 2.7. Root canal of teeth # 1.7, 1.3, 2.4, 2.5 are acceptable

foreign body and RO can be detected in tooth # 4.7 region, amalgam restoration in tooth # 3.7 under crown, prefabricated fiber post in tooth # 4.5 which opacity resemble dentin, attrition can be detected in anterior region