ACJ Quiz – Panoramic X-rays 03

the wire on the upper jaw is a fix retainer that prevent movement of the teeth after orthodontic treatment, the rest are not seen in thisX ray, in the pulp chamber of tooth # 1.6 pulpal sclerosis is evident but not pulp stone, it has o be vividly round and sharp

caries on distal tooth # 4.7 which is root caries as well, dilaceration on tooth # 4.8, acceptable composite restoration on tooth # 3.6, CBO on distal 4.4 evident, pulpal sclerosis in 4.6 and 3.6 pulp chamber, space loss is due to extraction (or missing ) of lower premolars and closing the space with first molars

sinus pneumatization on both sides, both upper lateral incisors are missing and upper canines are mesially shifted and replaced them so space loss is correct as well, caries on mesial of 4.4 and caries on distal of 4.3

implants are platform switching but BL not TL, attrition can be detected in lower incisors, CBO can be detected in lower canine/ premolar area, crowns over implants are connected and are PFM.

on both distal surfaces of upper second molars overhang is detectable, post in tooth # 1.5 is custom cast post, there is no periodontal bone loss and root caries,

the root canal on tooth # 4.6 is acceptable, the radiolucency in the mesial surface of the tooth # 3.6 is CBO, and there is no caries

root canal of tooth # 2.5 is acceptable, sinus pneumatization is seen in both sides, no RO can be seen, recurrent caries on distal tooth # 1.3

tooth # 4.5 shows a tooth with ERR and underfilled RCT and prefabricated metal post and zirconia/metal crown, teeth # 3.7, 4.6 and 4.7 show acceptable amalgam restoration, tooth # 4.7 shows liner/base

socket of 1.6 and 3.6 show healed socket, post in 3.7 is prefabricated metal post and acceptable, dilaceration in 2.7, and there is generalized periodontal bone loss

) implant in 1.6 area is a BL implant with platform switching and no bone loss, RO can be seen in 1.4 area, sinus pneumatization both sides, PFM crown on 2.6 and 2.7

all implants are BL, and restorations on them are PFM crowns, on implant 4.6, crown and the abutment and the screw all are dislodged, if there was a healing abutment or a cover screw on it, dislodged restoration was not a correct option, but here it is obvious that there were a crown and it came off. RCT on 4.5 and 3.5 are acceptable, composite restoration on 4.5 is acceptable

implant is BL, no evidence of sinus elevation, the bridge in second quadrant is zirconia/metal bridge, there is no occlusal caries, no open margin, there is peri implant bone loss but no peri implantitis can be detected merely by X ray evaluation.

the implant over the tooth # 1.6 is not dislodged as we can see the cover screw over it. The implants are BL, and crowns are PFM, caries on mesial and sital of tooth # 2.6, RCT on tooth # 1.7 is acceptable

tooth # 4.6 shows RO with apical perforation and gutta going through the apex, which is considered foreign body, caries on distal tooth # 4.5

Periodontal bone loss is general, Ridge atrophy can be seen in both lower first molar region, space loss can be detected by mesialy tilted second molars, attrition can be detected in lower anteriors.

There is silver point in the root canal of tooth # 2.7, PFM bridge on both sides, on the first quadrant it is cantilever as there is no metal connection between 1.5 and 1.4, crowns on tooth # 2.7 and 2.6 are connected,

crown on tooth # 3.7 is PFM, on teeth # 3.6 and 4.6 are zirconia/full metal, abrasion is obvious on tooth # 3.3, pulpal sclerosis can be seen on impacted tooth # 4.8, teeth 3.8 and 4.8 are impacted and root canal of tooth # 4.5 is acceptable. No RO.

the post on 2.1, 1.4 and 4.7 are casting posts, post on 1.1 and 2.1 are fiber posts, no prefabricated metal posts, dislodged restoration on tooth # 4.3, vertical root fracture on tooth # 4.7

the restoration on tooth # 2.6 is Composite, if yo pay attention on the occlusal edges of the restoration, it is clear that the opacity reduces, remember that newer composites has opacities close to amalgam, CBO can be detected in lower premolar canine region, on mesial of tooth # 4.7 enostosis can be seen

the restoration on tooth # 2.7 is buccal/Lingual composite restoration. The stylohoid process is considered elongated if it is lower than half of the ramus length, no radicular cyst (basically based on a RO we cannot define a radicular cyst), around the tooth # 4.8 it is not dentigerous cyst but normal follicule, there is no root caries, in mesial tooth # 3.7 CBO can be detected, as it is not accompanied with periodontal bone loss, the bone angulation between teeth # 2.5 and 2.7 cannot be considered vertical as it is from CEJ to CEJ

post in tooth # 1.6 is casting post, in tooth # 2.7 broken files can be detected that are foreign bodies, no fiber post can be detected, recurrent caries can be detected in mesial tooth # 1.2 and mesial tooth # 2.2, Sinus pneumatization can be detected in both sides

on tooth # 4.4 dislodged restoration is evident, as there is remnant of gutta inside the canal, a crown with filling and a post was dislodged, Crowns are PFM, root canal on tooth # 3.5 is acceptable, foreign body is the amalgam debris distal to tooth # 4.7, no periodontal bone loss is evident

Occlusal caries on teeth # 3.7, 1.6, caries on mesial crown tooth # 3.4, 3.7, caries on distal teeth # 1.4, 2.2, 4.4, 3.5, RO and CO on tooth # 4.6, multiple space loss, open margin for crown 1.2