**8. Trauma from occlusion**

Trauma from occlusion can produce visible changes radiographically in the thickness of the lamina dura, morphology of the alveolar bone crest, width of the PDL space, and density of the surrounding cancellous bone [31].

**55**

*Role of Radiographic Evolution: An Aid to Diagnose Periodontal Disease*

pocket depth, and analysis of occlusal contacts and habits [32].

space, which may be generalized or localized [33].

interest through the process of motion "unsharpness."

**9. Advanced procedures**

**9.1 Tomography**

**Figure 4.**

*9.1.1 Main indications*

implants.

Traumatic lesions manifest more clearly in faciolingual aspects because mesiodistally, the tooth has the added stability provided by the contact areas with adjacent teeth. Therefore slight variations in the proximal surfaces may indicate greater changes in the facial and lingual aspects. The radiographic changes listed next are not pathognomonic of trauma from occlusion and must be interpreted in combination with clinical findings, particularly tooth mobility, presence of wear facets,

*Early furcation involvement suggested by fuzziness in the bifurcation of the mandibular first molar,* 

The injury phase of trauma from occlusion produces a loss of the lamina dura that may be noted in apices, furcations, and marginal areas. This loss of lamina dura results in widening of the PDL space. The repair phase of trauma from occlusion results in an attempt to strengthen the periodontal structures to better support the increased loads. Radiographically, this is manifested by a widening of the PDL

Tomography is a generic term formed by the Greek words "Tomo" (slice) and "Graph" (picture). So tomography refers to imaging by sections or sectioning, through the use of any kind of penetrating wave. A device used in tomography is called a tomography, while the image produced is a tomogram. Conventional film-based tomography, also called body section radiography is, a radiographic technique designed to image more clearly objects lying within a plane of interest. This is accomplished by blurring the images of structures lying outside the plane of

In conventional medical X-ray tomography, sectional image is taken through a body

• When a pathology is strongly suspected clinically, but plain films are negative.

• Preoperative assessment of jaw height, thickness and texture before inserting

by moving an X-ray source and the film in opposite directions during the exposure.

The main clinical indicated to examine various facial structures:

*DOI: http://dx.doi.org/10.5772/intechopen.88035*

*particularly when associated with bone loss on the roots.*

*Role of Radiographic Evolution: An Aid to Diagnose Periodontal Disease DOI: http://dx.doi.org/10.5772/intechopen.88035*

**Figure 4.**

*Periodontal Disease - Diagnostic and Adjunctive Non-surgical Considerations*

may be an indicator of periodontal health (**Figure 3**).

apex of the area is pointed in the direction of the root.

of inflammation and the resorption of bone.

reduce the risk of missing furcation involvement [31].

especially if there is bone loss on adjacent roots.

are visible suggests furcation involvement of the teeth.

PDL space, and density of the surrounding cancellous bone [31].

diagnostic criteria are suggested [32]:

**8. Trauma from occlusion**

ing bone-supported portion [30–32].

**7. Furcation involvement**

lamina dura in radiographs and the presence or absence of clinical inflammation, bleeding on probing, periodontal pockets, or clinical attachment loss. Therefore it can be concluded that the presence of an intact crestal lamina dura

2.Continued periodontal bone loss and widening of the periodontal space results in a wedge-shaped radiolucency at the mesial or distal aspect of the crest. The

3.Subsequently, the destructive process extends across the alveolar crest, thus reducing the height of the interdental bone. As increased osteoclastic activity results in increased bone resorption along the endosteal margins of the medullary spaces, the remaining interdental bone can appear partially eroded.

4.The height of the interdental septum is progressively reduced by the extension

5.Frequently a radiopaque horizontal line can be observed across the roots of a tooth. This opaque line demarcates the portion of the root where the labial or lingual bony plate has been partially or completely destroyed from the remain-

Definitive diagnosis of furcation involvement is made by clinical examination, which includes careful probing with a specially designed probe (e.g., Nabers). Radiographs are helpful, but root superimposition, caused by anatomic variations and/or improper technique, can obscure radiographic representation of furcation involvement. As a general rule, bone loss is greater than it appears in the radiograph. A tooth may present marked bifurcation involvement in one film but appear to be uninvolved in another. Radiographs should be taken at different angles to

The recognition of a large, clearly defined radiolucency in the furcation area is easy to identify but less clearly defined radiographic changes are often overlooked. To assist in the radiographic detection of furcation involvement, the following

1.The radiographic change in the furcation area can be determined clinically,

2.Reduced radiodensity in the furcation area in which bony trabeculae outlines

3.Whenever there is marked bone resorption in relation to a single molar root, it

Trauma from occlusion can produce visible changes radiographically in the thickness of the lamina dura, morphology of the alveolar bone crest, width of the

can be assumed that the furcation of it is also involved (**Figure 4**).

**54**

*Early furcation involvement suggested by fuzziness in the bifurcation of the mandibular first molar, particularly when associated with bone loss on the roots.*

Traumatic lesions manifest more clearly in faciolingual aspects because mesiodistally, the tooth has the added stability provided by the contact areas with adjacent teeth. Therefore slight variations in the proximal surfaces may indicate greater changes in the facial and lingual aspects. The radiographic changes listed next are not pathognomonic of trauma from occlusion and must be interpreted in combination with clinical findings, particularly tooth mobility, presence of wear facets, pocket depth, and analysis of occlusal contacts and habits [32].

The injury phase of trauma from occlusion produces a loss of the lamina dura that may be noted in apices, furcations, and marginal areas. This loss of lamina dura results in widening of the PDL space. The repair phase of trauma from occlusion results in an attempt to strengthen the periodontal structures to better support the increased loads. Radiographically, this is manifested by a widening of the PDL space, which may be generalized or localized [33].
