NORMALRADIOGRAPHIC

ANATOMICAL LANDMARKS
 Tooth anatomy

Supporting structures

Anatomical landmarks
 Tooth Anatomy
• Teeth are composed primarily of dentin, with
an enamel cap over the coronal portion and
a thin layer of cementum over the root
surface.

Radiographic Appearance of Enamel

ENAMEL appears more radio-opaque than

other tissues.

It is 90% mineral causes greator

attenuation of X-ray photons.
RADIOGRAPHIC APPEARANCE OF DENTIN

75% mineral content less

radiopaque than enamel.
Radiopacity similar to bone.
ENAMELODENTINAL JUNCTION
appears as a distinct interface
separating these two structures.
Radiographic appearance of CEMENTUM
 50%mineral content and it appears as a
very thin layer on the root surface.
 It is usually not so apparent radiographically.

CERVICAL BURNOUT

• Radiographs sometimes show diffuse

radiolucent areas with ill defined
borders present on the mesial or distal
aspects of the teeth in the cervical
region.

• These regions appear between the

edge of the enamel cap and the crest
of the alveolar ridge.
REASON FOR CERVICAL BURNOUT
• Normal configuration of the
affected teeth, results in
decreased X-ray absorption in
the areas in question.

• Perception of these areas is due to

contrast with the adjacent
,relatively radiopaque enamel and
alveolar –bone.

• It should not be confused with root

caries which has similar appearance.
Radiographic Appearance of the Pulp
• It is composed of soft tissues so it appears
radiolucent.

• Pulp chambers and root canals extend from

the interiors of the chamber till the root
apices.

• It is seen radiographically also as apical

foramen.

• In some cases, it may exit on the side of the

canal.

• Lateral canals may end at the apex as a

discernible foramen or may exit at the side of
the root.
ENAMEL

PULP

DENTIN
• The pulp canals of a developing tooth root diverge
and walls of the root taper to a knife edge.

• A radiolucent area is seen surrounding it in the

trabecular bone. It is surrounded by the
hyperostotic bone.

• IT IS THE DENTAL PAPILLAWITH ITS

BONY CRYPT.

• Its radiographic evaluation helps in determining

the stage of maturation of the developing tooth.
Supporting Structures

Periodontal ligament
space

Lamina dura

Alveolar crest

Trabecular bone
 RADIOGRAPHIC FEATURES OF THE
PERIODONTAL LIGAMENT SPACE
• It is composed of collagen so appears as a
radiolucent space between the root and lamina
dura.

• It is thinner in the middle of the root and slightly

wider near the alveolar crest and the apex
,suggesting that the fulcrum of the physiologic
movements is in the region where PDL is thinnest.
RADIOGRAPHIC FEATURES OF LAMINA DURA
• It is a thin radiopaque layer of dense bone
surrounding the tooth socket.

• Its radiographic appearance is due to

attenuation of the X-ray beam as it passes
tangentially through the thickness of the bone.

• It is thicker than the surrounding

trabecular bone and thickness increases
with increase in amount of occlusal
stress.
RADIOGRAPHIC FEATURES OF ALVEOLAR CREST
• It is the radiopaque gingival margin of the
alveolar process which surrounds the teeth.

• It is considered normal if it is 1.5mm or less

from the CEJ.

• It shows apical recession with the age or

periodontal disease.
RADIOGRAPHIC FEATURES OF THE CANCELLOUS BONE
• Also called as the trabecular bone or the spongiosa.

• Lies between the cortical plates in both the jaws.

• It is composed of thin radiopaque plates and rods

surrounding many small radiolucent pockets of
marrow.

• In posterior maxilla, it is similar to anterior maxilla

but marrow spaces are larger.
Cancellous bone
The cancellous bone (also called trabecular
bone or spongiosa) in both jaws.
To evaluate the trabecular pattern in a specific area,
the
practitioner should examine the trabecular
distribution, size, and density and compare them
throughout both jaws. This frequently demonstrates
that a particularly suspect region is characteristic for
the individual. The trabeculaein the anterior maxilla
are typically thin and numerous, forming a fine,
granular, dense pattern, and the marrow spaces are
consequently small and relatively numerous. In the
posterior maxilla the trabecular pattern is usually quite
similar to that in the anterior maxilla, although the
marrow spaces may be slightly larger.
In the anterior mandible the trabeculae are
somewhat thicker than in the maxilla, resulting
in a coarser pattern, with trabecular plates that
are oriented more horizontally. The trabecular
plates are also fewer than in the maxilla, and
the marrow spaces are correspondingly larger.
In the posterior mandible the periradicular
trabeculae and marrow spaces may be
comparable to those in the anterior mandible
but are usually somewhat larger.
Note…Occasionally the trabecular spaces in
this region are very irregular, with some so
large that they mimic pathologic lesions.
ANATOMIC LANDMARKS OF MAXILLA

 Intermaxillary suture

 Anterior nasal spine

 Nasal fossa and Nasal septum

 Incisive foramen

 Superior foramina of nasopalatine canal

 Lateral fossa

 Nose

 Nasolacrimal canal

 Maxillary sinus

 Zygoma & zygomatic process of maxilla

 Nasolabial fold

 Pterygoid plates
RADIOGRAPHIC FEATURES INTERMAXILLARY SUTURE
• Also called as median suture.

• In IOPA, it appears as a thin radiolucent

line in the midline between the two
portions of premaxilla.

• It extends from the alveolar crest

between the central incisors superiorly
through the anterior nasal spine and
continues posteriorly between the
maxillary palatine process to the
posterior aspect of the hard palate.
 RADIOGRAPHIC FEATURE
Anterior Nasal Spine

• Mostly seen on IOPA of maxillary central incisors.

• Located in midline1.5-2cm above the alveolar crest.
• It is radiopaque and usually V-shaped.
 RADIOGRAPHIC FEATURES NASAL
FOSSA & NASAL SEPTUM
The nasal cavity shows the hazy shadow of the
inferior nasal conchae extending from the right
and left lateral walls

Floor of Nasal
Nasal Fossa Septum
 RADIOGRAPHIC FEATURES INCISIVE FORAMEN
• Also called as NASOPALATINE or ANTERIOR PALATINE
FORAMEN.
• It is the oral terminatus of the nasopalatine canal.
• It transmits the nasopalatine vessels and nerves.
• Lies in the midline of palate behind the central incisors at the
junction of the median palatine and incisive sutures.
• Radiographic image variability is due to:
1.Different angles of the X-ray beam.
2.Variability in its anatomic size.
IT IS FREQUENTLY THE POTENTIAL SITE
OF CYST FORMATION.
Radiographic features of Superior Foramina of
the Nasopalatine canal
• The nasopalatine canal originates at two
foramina in floor of the nasal cavity.

• Radiographically, it can be recognized as two

radiolucent areas above the apices of the
central incisors in floor of the nasal cavity near
its anterior border and both the sides of the
septum.

Lateral wall of
nasopalatine
Superior canal
foramina
RADIOGRAPHIC FEATURES OF THE
LATERAL FOSSA
• Also called as INCISIVE FOSSA.
• Appears as depression in the maxilla near
the apex of the lateral incisor .
• Appears diffusely radiolucent in the IOPA.
RADIOGRAPHIC FEATURES OF THE
NASOLACRIMAL CANAL
• The nasal and maxillary bones form the
nasolacrimal canal.

• It runs from the medial aspect of the antero

inferior border of the orbit inferiorly, to drain
under the inferior conchae into the nasal cavity.
RADIOGRAPHIC FEATURES OF NOSE
• The soft tissue of the nose is frequently
seen in the projections of the maxillary
central and lateral incisors
,superimposed over the roots of these
teeth.
• Image appears uniformly opaque with a
sharp border.
 RADIOGRAPHIC FEATURES
NASOLABIAL FOLD

An oblique line demarcating a region that

appears to be covered by a slight radio opacity
frequently traverses periapical radiographs of
the premolar region.
RADIOGRAPHIC FEATURES OF
MAXILLARY SINUS
• MAXILLARY SINUS is an air containing cavity
lined by mucous membrane.
• Appears as the three sided pyramid .
Base -formed by mesial wall adjacent to
nasal cavity.
Apex –extending laterally into the
zygomatic process of maxilla.
MAXILLARY SINUS

On the IOPA, maxillary sinus appears as a thin ,delicate •

radiopaque line.

It extends from the distal aspect of the canine to the •

posterior wall of the maxilla above the tuberosity.

Around the age of puberty, its floor coincides with the floor •
of the nasal cavity.
 MAXILLARY SINUS
• In response to the loss of function (associated with
loss of posterior teeth) the sinus may expand
further into the alveolar bone , occasionally
extending to the alveolar ridge.

• Thin radiolucent lines of the uniform width are

found within the image of the maxillary sinus.

• These are shadows of the neuro -vascular canals

that accommodate the posterior superior
vessels and nerves.
RADIOGRAPHIC FEATURES
ZYGOMATIC PROCESS AND ZYGOMATIC BONE
• The zygomatic process of the maxilla is an
extension of the lateral maxillary surface that
arises in the region of the apices of the first and
the second molars and serves as the articulation for
the zygomatic bone.

• Appears as a U-shaped radiopaque line with

rounded ends projected in the apical region of
the first and second molars.
RADIOGRAPHIC FEATURES
PTERYGOID PLATES
• The medial and lateral pterygoid plates lie
immediately posterior to the tuberosity of
maxilla.

• They cast a single radiopaque shadow

without any evidence of trabeculation.

• Extending inferiorly from the medial pterygoid

plate, the hamular process may be seen.
-Maxillary tuberosity
-Hamular process
Anatomic Landmarks of Mandible
 Symphysis
 Genial tubercles
 Lingual foramen
 Mental ridge
 Mental fossa
 Mental foramen
 Mandibular canal
 Nutrient canals
 Mylohyoid ridge
 Submandibular gland fossa
 External oblique ridge
 Inferior border of mandible
 Coronoid process
RADIOGRAPHIC FEATURES SYMPHYSIS

• The region of mandibular symphysis in

infants demonstrate a radiolucent line
through the midline of the jaw between
the images of the forming deciduous
central incisors.

• The suture usually fuses by the end of 1st

year of life and is no longer radiographically
apparent.
 RADIOGRAPHIC FEATURE
GENIAL TUBERCLES
• These are tiny bumps of bone that serve
as attachment for the genioglossus and
geniohyoid muscles.

• Present on lingual side.

• On IOPA, appears as ring shaped

radiopacity below the apices of
mandibular incisors.
RADIOGRAPHIC FEATURE LINGUAL
FORAMEN
• It is a hole or tiny opening located on the
internal surface of mandible and
surrounded by the genial tubercles.
• Radiographically, appears as a
radiolucent dot inferior to the apices of
the mandibular incisors.
RADIOGRAPHIC FEATURES MENTAL RIDGE
• It is a linear prominence of cortical bone
located on the external surface extending
from the premolar region to the midline
and slopes upward.

• Radiographically, appears as a
radiopaque band that extends from the
premolar region to the incisor region.
RADIOGRAPHIC FEATURE MENTAL FOSSA

• Located above the mental ridge.

• On peri apical radiograph, appears as a

radiolucent area above the mental
ridge.
RADIOGRAPHIC FEATURE MENTAL FORAMEN
• Located on the external surface of the
mandible as an opening in the region of
the mandibular premolars.

• Mental nerves and blood vessels exit

through it.

• Radiogarphically, it appears as a small ovoid

radiolucent area located below the apices of
the premolars.
RADIOGRAPHIC FEATURES MANDIBULAR CANAL

• Tube like passage extending from the

mandibular foramen to the mental
foramen and contains inf.alv. Nerves
and blood vessels.
• Appears as a radiolucent band
outlined by two radiopaque lines of
cortical plate.
RADIOGRAPHIC FEATURES NUTRIENT CANALS
• Nutrient canals are tube like
passage-ways through bone
that contains nerves and blood
vessels that supply the teeth.

• Radiographically seen as vertical

radiolucent lines.

• More prominent in anterior

mandible where bone is thin.
RADIOGRAPHIC FEATURES MYLOHYOID RIDGE
• Linear prominence of bone located on
the internal surface of mandible.

• Extends from the molar region

downward and forward towards the
lower border of mandibular symphysis.

• On IOPA, appears as radiopaque

band extending downward from
molars.
RADIOGRAPHIC FEATURES EXTERNAL OBLIQUE RIDGE
• Linear prominence of bone located on
external surface of mandible
extending downwards and is a
continuation of anterior border of
ramus.

• It appears as a radiopaque band

extending downwards and forwards
from ant. border of mandible & ends in
3rd molar region.
RADIOGRAPHIC FEATURES SUBMANDIBULAR GLAND FOSSA
• Depressed area of bone
located on the internal
surface of mandible.

• Submandibular salivary gland

lies in this fossa.

• It appears as a radiolucent
area in the molar region
below the mylohyoid ridge.
RADIOGRAPHIC FEATURES INTERNAL OBLIQUE RIDGE

• Linear prominence of bone located

on internal surface of mandible
extending downwards and
forwards from ramus.

• It appears as a radiopaque band

extending downwards from ramus.
 RADIGRAPHIC FEATURES
INFERIOR BORDER OF THE MANDIBLE

Occasionally, seen as a dense

broad radiopaque band of
bone.
 RADIOGRAPHIC FEATURES CORONOID PROCESS

• It is a marked prominence of bone on the ant.

ramus of the mandible.

• Not seen on a mandibular IOPA but appears

on a maxillary molars IOPA.

• It is seen as a triangular radiopacity

superimposed over or inferior to maxillary
tuberosity.
RESTORATIVE MATERIALS
• Vary in their radiographic
appearance.
• Depend primarily on their
thickness, density and atomic
number.
• A variety of restorative materials
may be recognized on intra oral
radiographs.