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SKILLS LAB RADIOLOGI ANATOMI GIGI NORMAL

Jul 07, 2018

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    EVALUASI PERUBAHAN

    JARINGAN PERIODONSIUM

    SECARA RADIOGRAFIS

     Hanna H. Bachtiar Iskandar 

     RKG-FKG UI 

     Klarifikasi sk 2, 4 dan 5

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     Reminders ***

     Prior knowledge (RDs dan RKG skenariosee!"#n$a%

    Fisika Radiasi&

    e'ek io!ois radiasi ionisasi&

     )ro*eksi radiasi ionisasi& )era*"ran )er"ndan+"ndanan kese!a#a*an radiasi,

    Radio+ana*o#i )ada eraai )ro$eksi radiora'i

    Radio+ )a*o!oi di idan kedok*eran ii

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     Normal Alveolar Crest 

    • -,.+-,/ ## a)i0a! *o

    0e#en*o+ena#e! 1"n0*ion

    • Para!!e! *o !ine 1oinin *2e

    CEJ o' ad1oinin *ee*2• S#oo*2

    • Con*in"a*ion o' 0or*i0a!

     )ar*3!a#ina d"ra& 2as *2e

    sa#e 4id*2 andradio)a0i*$

    • 5rae0"!a*ion 2as nor#a!

    densi*$ and )a**ern

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    Prinsi) In*er)re*asi radiora'ik6

    -, E7a!"asi #"*" radiora' / kri*eria #"*" $an aik 

    8, E7a!"asi s)esi'ik (  specific viewing):use loop

       rin0i& konsis*en& DD3 radiora'is

    9, E7a!"asi se0ara "#"# ( general  viewing) :from a distance

     8 ko#)onen& 8 as)ek& kesi#)"!an

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    M"*" 6 S"d"* 7er*ika! *idak *e)a*

    sa!a2 in*er)re*asi

    Specific view detil 

     

    eneral view  men!eluru"

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    E7a!"asi #"*" radiora'

     / kri*eria #"*" $an aik 

    • O$ek *er0ak") dan *er!e*ak di *ena2

    radiora' 

    • Kon*ras& de*i! dan ke*a1a#an 2ar"s aik • 5idak *er1adi dis*orsi 7er*ika!• 5idak *er1adi dis*orsi 2ori:on*a!

    • Dis*orsi #ini#a!

     radiora' da)a*diin*er)re*asi

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     Evaluasi mutu radiora! "anoramik 

    • Obyek tercakup tujuan pembuatan radiograf

    • Kontras,detil, ketajaman•#$%  s/d tepi mandibula

    •Simetris, sudut mandibula kiri kanan sama jelas

    •Septum nasal dan palatum durum jelas

    •Gigi anterior dan posterior proporsional dan sama jelas

    •Tidak ada host imae

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      o$ek HARUS

    *er0ak")

    dan sea!ikn$a

    Kon*ras& de*i!&

    ke*a1a#anHARUS aik 

    Dis*orsi s"d"* HARUS

    di2indari

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    “Not only ori!ontally distorted

     due to film placement image formation"

    aux pearl

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    E7a!"asi se0ara "#"# ( general  viewing)

     8 ko#)onen& 8 as)ek&

    kesi#)"!an

    • 8 ko#)onen

     ii& 1ar )erio& *! ra2an

    • 8 as)ek keadaan& )er"a2an& 2""nan

    • Kesi#)"!an asa! ke!ainan ; "n*"k ren0ana

     )era4a*an

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    8, E7a!"asi s)esi'ik (  specific viewing)

       rin0i& konsis*en& DD3 radiora'is

    •  rin0i 6 se*ia) aian ana*o#is ke*ia ko#)onen& er"r"*an (ii6dari #a2ko*a s3d a)ika!< 1ar )erio #"!ai

    #esia! dari kres kor*ika! s3d -38 a)ika!& dis*a!& i'"rkasi < *!

    ra2an k"a!i*as ; )o!a dan densi*as%

    •  konsis*en 6 se!a!" !ak"kan in*er)re*asi denan )o!a dan"r"*an $an sa#a & aar *idak ada in'or#asi dianos*ik $an

    *er!e4a*

    •  Denan se#"a in'or#asi dianos*ik $an *e!a2

    dik"#)"!kan& "a* DD3radiora'is denan "r"*an

     )riori*as

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    s"eci!ic vie&in 

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    simpulkan

    DD3 Radiora'is

    Dari enera! 7ie4

    In'or#asi dianos*ik 

    dari

    ke*ia *a2a)an

    in*er)re*asi

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     Radiora"hic assessment o! "eriodontal

    condition'alteration'disease

    -, A#o"n* o' one )resen*

    9, Condi*ion o' a!7eo!ar 0res*

    8, In7o!7e#en* o' '"r0a*ion areas

    =, >id*2 o' )eriodon*a! !ia#en*/, Lo0a! 'a0*ors

    ?, Cro4n *o roo* ra*io

    @, Ana*o#i0 0onsidera*ions

    , Pa*2o!oi0 0onsidera*ions, Marina! 0on*a0*

    -., O00!"sa! !ine

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    Interpretasi radiografik jaringan periodontal

    Lihat Pharoah tentang periodontal disease

    Keadaan tulang yang ada  kuantitas (tinggi/lebar) dan kualitas (pola/densitas)

    gambaran keseluruhan 

    luas kerusakan (lokal/menyeluruh)

    bentuk kerusakan (horizontal &/ vertikal)densitas (rarefied/condensed )

    pola trabekulasi (normal/berubah)

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    Sisa *"!an $an ada ke2i!anan *"!an ren0ana )era4a*an

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    kondisi alveolar crest : bagian

    penting  dalam melakukan evaluasiradiografik keadaan jar. periodonsium

    kres kortikal melanjut ke lamina dura

      ada/tidak, kesinambungan, outline,densitas, lebar, tinggi, bentuk

    kanselus

    pola dan densitasnya

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    #ini tulan (ukal-"alatal'linual 

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     Keterlibatan furkasiPerhatikan adanya

    kerusakan/kehilangan tulang

    daerah furkasi

    periodontal/marginal, atau akibat

    perluasan karies

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    Se*e!a2 kor*ika! kres& )er"a2an r"an

     )eriodon*a! *er"*a#a di daera2 #arina!&

    #er")akan aian )en*in da!a# e7a!"asi

     )er"a2an3ke!ainan3)en$aki* )eriodon*a!

      ebar !uang "eriodontal

     *ea!3!ear& ke)ada*an s*r"k*"r ana*o#i

    indi7id" ereda Di)er!"kan reference site

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     Yang dapat dievaluasi secara radiogras :Kalkukus, tambalan yang tidak sempurna,perawatan orto

     #aktor okal

     "erbandingan mahkota$akar!%&'!%#'* 

    sisa tulang yang adamenentukan perbandingan

    mahkotaakar radiogras

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     Karang gigi#calculus

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    $am%alan mengemper#&ver"anging

     Restoration

    Pera4a*anor*odon*i

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    5"#)an *indi2 denan s*r"k*"r ana*o#i ra2an&

    Ben*"k ana*o#i #a2ko*a dan akar $an

    'unfavoura%le for t"e periodontal condition

    ( #a2ko*a $an se)er*i *a"n& akar $an r"n0in%

     "ertimbangan %natomis

     "ertimbangan patologis lain Adan$a karies $an #e!ia*kan #arina!

    dan a*a" di#ensi ke*ia

    ("ka!3!in"a!3)a!a*a!%

    Kondisi3ke!ainan sis*e#ik 

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    #ertimbangan anatomis

     dan patologis

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    • 5i*ik kon*ak6 ada3*idak& aik3*idak 

     )en$ea3'ak*or $an #e#)erera* ke!ainan

    Kontak marginal

     aris klusal

    •  ari radiograf dapat diprakirakankemungkinan +#  Konfirmasi jejasnya di radiograf 

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    Garis ok!"si

    Kon*ak #arina!3*i*ik kon*ak 

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     periodontal diseases

    ---Periodontal condition

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    -,Gini7a! diseases (G%

    9, C2roni0 )eriodon*i*is (CP%

    8, Aressi7e )eriodon*i*is (AP%

    =, Periodon*i*is as a #ani'es*a*ion o' s$s*e#i0

      diseases (PS%

    /, Ne0ro*i:in )eriodon*a! diseases (NP%

    ?, Periodon*a! as0esses (PA%

    @, Periodon*i*is 4i*2 endodon*i0 !esion (PEnd%

    , De7e!o)ed and a0"ired (DAC%de'or#a*ions and 0ondi*ions

    classifcation operiodontal diseases

    Abbreviated version o the 1999

    Trauma $rom Occlusion

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    !" #ingival $iseases

    •. A. Dental plaque-induced gingival diseases

    •. B. Non-plaque-induced gingival lesions

    S"!i*32a#)ir *idak da)a* die7a!"asi dari

    radiora' kon7ensiona!&

     ke0"a!i denan #en"a2 kondisi sinar

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    !!" %hronic Periodontitis

    • &light/mild: crest irregularity/erosion ' lost

    of up to ( mm )*+ %-&.

    • moderate: lost of more than ( mm )*+

    %-&. up to half of the root length triangular appearance

    • severe: lost of 012- more than half of the

    root length ,3oating appearance

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    )" *ocali4ed0" #enerali4ed 56 789 of

    sites are involved

     E)#EN#I*N *F #HE +I,EA,E 

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    ( eneralized/localized)

    %&'( cronic adultmarginal periodontitis

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    MODERA5E

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    SEVERE

    i i d i i

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    Pa*ien*s 8. $ears

    Eaera*ed rea0*ion *o #ini#a! )!a"e

    a00"#"!a*ion

    A!#os* a!! are 2ori:on*a! one !oss #a$ res"!* in

    ear!$ *oo*2 !oss

     Lo0a!i:ed 'or# is a!so 0a!!ed Lo0a!i:ed

    J"7eni!e Periodon*i*is (LJP%

    III. Aggressive PeriodontitisLo0a!i:ed or enera!i:ed

    ' li d ) i # i d titi

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    'ocali!ed )ggressie #eriodontitis

    Seen in se0ond de0ade

    Pri#ari!$ in7o!7es 'irs* #o!ars and 0en*ra!

    in0isors (*ee*2 *2a* er")* 'irs*% Ra)id one !oss

    Mini#a! a#o"n*s o' )!a"e

    O7er *i#e& o*2er *ee*2 are in7o!7ed

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    &+ Periodontitis a Maniestationo Systemic Diseases

    • ) )ssociated -it ematological disorders• . )ssociated -it genetic disorders

    • Not oter-ise specified 0 malignancies

    etc1

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     *eukemia

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     eukemia ; punc"ed out appearance

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    #halasemia

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     anerhans Cell Histioctosis

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    Fi(rous ds"lasia

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    EVALUASI PERUBAHANJARINGAN PERIODONSIUM

    SECARA RADIOGRAFIS

     Hanna H. Bachtiar Iskandar 

     RKG-FKG UI 

    Klarifkasi sk 6 dan 7

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    +" 2ecroti4ing Periodontal $iseases

    • A, Ne0ro*i:in "!0era*i7e ini7i*is

    • B, Ne0ro*i:in "!0era*i7e )eriodon*i*is

    +& )bscesses of te #eriodontium

    • A, Gini7a! as0ess

    • B, Periodon*a! as0ess ride o' one

    • C, Peri0orona! as0ess er")*ion3i#)a0*ion

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    Endo-/erio

    • Radiora)2i0a!!$&

    4idenin o' PDL

    or 7aria!e si:e o'

     )eria)i0a!

    radio!"0en0$ #a$

     e )resen*

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      E7a!"a*ion and Fo!!o4+")

    o' 5rea*#en*

    Re#ission o' )eriodon*a! disease 0an e

    radiora)2i0a!!$ de#ons*ra*ed $ *2e

    re'or#a*ion o' 2ea!*2$ ar02i*e0*"re a* *2e 0res*, Di''i0"!* in 0on7en*iona! radiora)2 #ake a

    re)rod"0i!e radiora)2

      Cres*a! !a#ina d"ra and s2ar) an!es

      e*4een *2e 0res*a! !a#ina d"ra and *2e

      !a#ina d"ra o' *2e ad1a0en* *ee*2 4i!! re'or#

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    22 3 non macroscopic caity 4

    5 67 isually 8

    967 conentional rad 8

    up to :67 digital rad 8

    $&  digital subtraction radiography

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    Medicolegal 

    oncerns have been raised the ability to manip!late the images ora!lt p!rposes. Man!act!rers o sot"areprogrammes have installed #a!dit trails$%

    "hich can trac& do"n and recover the originalimage.

    • ;any insurance companies in the

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    In dealing "ith radiographicinterpretation :

    '(A) )(* +,AI- D*S -)

    /-'0..

    )(* **S A- -) S**.

     Sir William

    Osler-

    ;emember

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    Thank You foryour kind attention

    Thank You for

    your kind attention