1. Principles of radiographic
interpretation
Islam Kassem
Consultant oral & maxillofacial surgeon
ikassem@dr.com
2. Definition
Interpretation of radiographs can be regarded as
an unraveling process — uncovering all the
information contained within the black, white
and grey radiographic images.
ikassem@dr.com
3. Interpretation of radiographs can be regarded as
an unraveling process — uncovering all the
information contained within the black, white
and grey radiographic images.
ikassem@dr.com
4. II-Essential requirements for
interpretation
1- Optimum viewing conditions
2- Understanding the nature and limitations of the black,
white and grey radiographic image
3- Knowledge of what the radiographs used in dentistry
should look like, so a critical assessment of individual film
quality can be made
4-Detailed knowledge of the range of radiographic
appearances of normal anatomical structures
5- Detailed knowledge of the radiographic appearances of the
pathological conditions affecting the head and neck
6- A systematic approach to viewing the entire radiograph and
to viewing and describing specific lesions
7- Access to previous films for comparison.
ikassem@dr.com
5. 1- Optimum viewing conditions
• An even, uniform, bright light viewing screen
(preferably of variable intensity to allow viewing
of films of different densities)
• A quiet, darkened viewing room
• The area around the radiograph should be
masked by a dark surround so that light passes
only through the film
• Use of a magnifying glass to allow fine detail to be
seen more clearly on intraoral films
• The radiographs should be dry.
ikassem@dr.com
6. The nature and limitations of the
radiographic image
ikassem@dr.com
7. 2- Understanding the nature and limitations of
the black, white and grey radiographic image
ikassem@dr.com
8. 3- Knowledge of what the radiographs used in dentistry should
look like, so a critical assessment of individual film quality can be
made
ikassem@dr.com
9. 4-Detailed knowledge of the range of
radiographic appearances of normal
anatomical structures
ikassem@dr.com
10. 5- Detailed knowledge of the
radiographic appearances of the
pathological conditions affecting the
head and neck
ikassem@dr.com
11. 6- A systematic approach to viewing
the entire radiograph and to viewing
and describing specific lesions
ikassem@dr.com
12. 7- Access to previous films for comparison.
ikassem@dr.com
14. Imaging as an Examination Tool
Clinical examination
Signs
Symptoms
Ordering the right type of imaging examination
Ordering the right number of imaging examination
Necessary vs. unnecessary examinations
Benefit to the patient
15. Viewing condition
View box
Monitor
Prints
Ambient light reduced
Quiet room
Intraoral films mounted on a opaque holder
Equal intensity of light on the view box
Monitors: calibration
Magnification
Software limitations
16. Systematic Approach
Intraoral images
Teeth, periodontium, bone, adjacent structures
Tooth #1 to #16, and then #17 to #32
Extraoral images;
Panoramic, other extraoral plain radiographs
Cross sectional images
CT, MRI
17. Localize the abnormality
How many lesions?
Where is the lesion?
Localized vs generalized
Single arch or both the arches
Inside the bone or outside
Relation to the crown
Relation to the root
Superior to the mandibular canal
18. Periphery
Well defined or ill defined?
Sharp margins
Corticated margins
Sclerotic margins
Radiolucent band
Blends into adjacent area
Irregular margins
25. When not to order imaging
You have not clinically / radiographically
evaluated the patient
No benefit to the patient
Additional images may not provide extra
information
No ‘routine’ radiograph
26. What goes on the report
Patient, doctor, clinic identification
Date, type and number of examination
Reasons for the examination
Clinical information
Relevant observation
Radiographic Impressions
Any further tests, examinations
