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X-ray of the jaw for adults and children
Last reviewed: 23.04.2024
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X-ray in medicine is a method of studying the anatomical structures of the body to obtain their projection using x-rays on paper or film, which does not require penetration. Without it, it is difficult to imagine modern diagnostics. X-ray of the jaw allows you to make the correct diagnosis and control the treatment of dentists, maxillofacial, plastic surgeons.
Digital radiography was introduced in the mid-1980s [1], and with its ever-increasing popularity, it now competes with traditional film-screen radiography (SFR) in all radiographic applications. [2]
Indications for the procedure
Examination of the patient allows the doctor to make assumptions regarding the diagnosis, but only an x-ray will give an accurate picture and the choice of the treatment algorithm.
Indications for its implementation are:
- in dentistry - problems of teeth, bone tissue, gums (caries, inflammation, abscess, periodontal disease, cysts and tumor processes, osteomyelitis, etc.), the result of filling, the installation of implants, jaw prostheses, bracket systems;
- in maxillofacial, plastic surgery - determining the degree and nature of damage in various injuries, improving the appearance.
X-ray of adult jaw
What is revealed by an x-ray of the jaw in an adult? In addition to the listed dental diagnoses, these can be various defects (fractures, cracks, fragments), sclerotic processes, areas of dead tissue, bone growths and other pathological changes.
The need for an x-ray during pregnancy (teeth suffer from a lack of calcium during this period) often causes concerns for expectant mothers who care about the health of their baby.
Modern equipment allows you to safely do an x-ray examination. The radiovisiograph equipped with the X-ray machine acts purposefully on a specific tooth, has low radiation, and displays a clear picture on the monitor. And yet, in the first trimester of pregnancy, it is best to refrain from this procedure.
X-ray of the jaw of a child
Despite the small doses of radiation, young children are very sensitive to x-rays, they have closer internal organs, therefore it is better to protect them and not carry out the procedure until 3-4 years. An orthopantogram or panoramic picture of the teeth is recommended to be done no earlier than 5 years.
When is the need to take a picture for kids? In addition to cases of injury, with its help they control the growth of teeth, teething of constants, carry out their alignment, prevent the development of bone tissue diseases, give an assessment of the state of the oral cavity.
Technique of the x-ray of the jaw
For a complete picture of the state of the jaw, several projections are required. So, an x-ray of the lower jaw is performed in the straight and lateral. The first gives general information, the second - the state of the right side. The technique of the procedure does not cause difficulties.
A direct projection is obtained in a horizontal position. A person is laid face down on the stomach, while the tip of the nose and forehead should rest against the cassette, and the x-ray sensor should be located on the side of the occipital protuberance.
Lateral is done lying on its side, the cartridge is placed under the cheek with a slight slope. Sometimes you need a picture also in axial (transverse) section. In this case, the patient lies on his stomach, the head is stretched forward as far as possible, and the cassette is held by the neck and lower jaw.
The x-ray of the upper jaw consists of two images: with a closed and open mouth. The body on the stomach, the chin and the tip of the nose touch the cassette; the sensor is perpendicular to it.
3d jaw x-ray
Since digital radiography found its application in dentistry, many new applications for medical imaging have been proposed, including registration of dental images, damage detection, bone healing analysis, diagnosis of osteoporosis and forensic dental examination. [3]
Computed tomography or 3d x-ray allows you to make a high-quality three-dimensional image of the jaw in any projection, to make a 3d model of the jaw. Without traumatic procedures, this method makes it possible to obtain a virtual cut of tissues and look into any layer of them.
This procedure cannot be dispensed with when planning bone grafting, implantation, or enlarging the bottom of the maxillary sinus.
Panoramic x-ray of the jaw
Currently, panoramic radiography is the most common extraoral technique in modern dentistry due to its low cost, simplicity, informational content and reduced impact on the patient. Since this method of radiography gives the dentist a general idea of the alveolar ridge, condyles, sinuses and teeth, it plays a major role in the diagnosis of caries, jaw fractures, systemic bone diseases, loose teeth and intraosseous lesions.
This type of examination is called an orthopantomogram and is a circular x-ray of the jaw. The information obtained in this way is called a tooth passport. For the dentist, she opens up data on the presence and location of carious cavities, evaluates bone tissue for suitability for implantation, detects abnormalities, inflammations, and poor-quality fillings.
You can see the image on the screen, enlarge it, and also save it on the storage medium or get a snapshot. Successful panoramic radiography requires careful patient positioning and the right technique. [4] An appropriate technical procedure requires the upright position of the patient with an elongated neck, shoulders down, straight back and feet together. [5]
X-ray of the jaw with milk teeth
In pediatric dentistry, x-rays are an integral part of diagnosis. Although baby teeth are temporary, in order for healthy constants to form, they must be treated.
On the eve of therapy, they make an x-ray of the jaw with milk teeth. The X-ray diffraction pattern allows us to determine the maxillary anomalies, the discrepancy between the state of the root system of temporary teeth, monitor the process of replacing them with root teeth, and make a diagnosis of occlusion, abscesses, and carious lesions.
When examining children, they resort to targeted radiographs (a picture of 1-2 teeth and nearby soft tissues), panoramic and 3d x-rays. There are certain time limits for the procedure. So, children with milk teeth can be X-rayed every 2 years, adolescents with permanent - once every 1% - 3 years.
The use of jaw x-ray in forensic medical determination of age is justified, since there is no other reliable age indicator for determining age in adults. [6], [7]
X-ray signs of jaw osteomyelitis
Osteomyelitis is an infectious process involving bone tissue. In most cases, chronic focal infection in periodontal tissues in the form of periodontitis and periodontitis, less often injury, leads to jaw osteomyelitis.
An infectious-inflammatory focus can spread to several teeth (limited), capture another anatomical region of the jaw (focal), or the entire jaw (diffuse).
Currently, the diagnosis of osteomyelitis is mainly carried out using panoramic radiography, photographing the oral cavity and clinical diagnostic examination.
Radiological signs usually appear on the 8-12th day from the onset of the disease and allow to differentiate them by distribution, as well as to determine the nature of destruction of bone tissue. [8]However, at an early stage, 4-8 days after the onset of osteomyelitis, signs such as an increase in the thickness of the alveolar dura mater, sclerogenic changes around the mandibular canal, sclerogenic changes in the upper jaw, and confirmation of osteoclasia and bone structure may not be detected on diagnostic radiographs. [9]
X-ray of the jaw with a fracture
Traumatic damage to the jaw (violation of its integrity) is a fairly common type of pathology of the maxillofacial zone. Only x-ray diagnostics can determine their presence, classified by location (upper or lower jaw, only its body or with a tooth), the nature of the damage (single, double, multiple, unilateral, bilateral) and other important signs.
To visualize the damage, radiographs are used in direct and lateral projection, intraoral smack, if necessary, tomograms (linear or panoramic).
Fracture of the lower jaw with a face injury usually occurs in young men aged 16 to 30 years. [10], [11] Compared with other large bones of the viscerocranium, such as the cheekbone and upper jaw, it is noted that the lower jaw is prone to fractures much more often, accounting for up to 70% of all face fractures. [12]
X-ray signs are the fracture line and the displacement of the fragments. The first examination is carried out for the purpose of diagnosis, the second for control after matching bone fragments, then after a week, two, 1.5 months, 2-3 months.
The anatomical classification is best described by Dingman and Natvig, who determine fractures of the lower jaw in the symphysis, parasymphysis, body, angle, branch, condyle, coronoid process and alveolar process. [13]
X-ray of periostitis of the jaw
Periostitis or inflammation of the periosteum is most often localized in the lower jaw. It can occur due to injuries, tooth disease, the spread of infection through the bloodstream, lymphatic tract due to infections (sore throat, flu, SARS, otitis media). Pathology is acute and chronic. [14]
When identifying characteristic clinical signs, an x-ray of the jaw is prescribed. X-ray in acute course does not detect changes in the bone, but only foci of abscess, cysts, granulation tissue, indicating periodontitis.
In the case of chronic periostitis, the x-ray shows newly formed bone tissue.
Complications after the procedure
The procedure will not have any undesirable consequences and complications if the established standards are observed, based on which the number of possible X-ray sessions per year is calculated.
The maximum value of x-ray radiation should not exceed 1000 microsievert. Translated into specific procedures, this means 80 pictures taken digitally, 40 orthopantograms, 100 pictures by a radiovisiograph.
For children and pregnant women, the figures are halved.
Reviews
According to patient reviews, the jaw x-ray does not deliver much complexity and discomfort. According to doctors, this is the most informative diagnostic method.