“Radiographic Assessment of the Pediatric Patient”
S.Lal, DDS

Special considerations
Risk assessment
Evidence of caries/hx
Trauma
Anomalies
Fluoride status
Diet

AAPD guidelines for radiographs
Based on Age and risk assessment

Child preparation and management
Euphemisms
Role models
Contour film
Gag reflex – distraction
Parental help
Bad taste

Film Sizes
Sizes 0,1,2, occlusal/lateral

Radiographic Tools
Snap-a-ray
Bite wings, periapicals

Radiographic techniques
Bite wings
Periapicals (not p.a.’s)
Max/mand occlusals
Extraoral/lateral film
Soft tissue x-ray
Panoramic radiographs

Bite Tabs

Bite wing x-ray
Mesial surface of canine to distal surface of 1st permanent molar

Bite wing x-ray
Incipient carious lesion.
Overlapping – common error

Occlusal Radiographs

Occlusal Radiographs
Posterior max. occlusal radiograph

Extra Oral film
Lateral Film

Trauma
Soft tissue Film
Indicated after trauma to locate missing piece(s) of fractured tooth.

Panaramic radiograph

Radiographic diagnosis of dental anomalies
Ankylosis

Anomalies
Gemination : unsuccessful attempt of an individual tooth bud to divide into two.

Anomalies
Dilaceration

Anomalies
Peg lateral
Supernumary primary lateral

Anomalies
Fusion: dentinal union of two teeth.
Supernumary tooth
Missing lateral

Anomalies
Concrescence: fusion with a cemental union.

Anomalies
Amelogenesis Imperfecta
Thin enamel
Increased dentin

Anomalies
Unfavorable resorptive pattern of roots.

Pathology
Retained primary root tips.

Pathology
Furcation involvement

Pathology
Furcation involvement with internal root resorption.

Pathology
Internal resorption with furcation involvement.

Artifacts/optical illusions
Cervical burnout
Mach band phenomenon
It may take 30%-70% demineralisation to occur before it can be evidenced radiographically.
Radiographs are 2D views of 3D objects.

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