Transcript Central incisor region: maxilla

In The Name of
GOD
Maxillary and Mandibular
Anatomic Radiographic
Landmarks
Intraoral Radiography
• Radiographs are
two-dimensional
representations of
objects that occupy
three dimensions.
• Facial, central and
lingual features are
superimposed.
• All landmarks are
NOT clearly
demonstrated on
radiographs from all
individuals.
Tooth and
supporting
structures
• Enamel

radiopaque
• Dentin and
Cementum

radiopaque
• Pulp space

radiolucent
• Lamina dura

radiopaque
• Periodontal ligament
space

radiolucent
• Alveolar bone

radiopaque
Image(s) courtesy © Dr. Allan G. Farman
Alveolar bone
Lamina dura
pdl space
Pulp space
Cementoenamel junction
Dentin-enamel
junction
Dentin
Enamel
ZYGOMATIC BONE
Anatomic
Landmarks
MAXILLA
© William C. Scarfe
Central incisor region: maxilla
• Premaxillary/median
palatal suture

radiolucent
• Incisive fossa /
foramen

radiolucent
• Incisive canal

Radiolucent with
radiopaque lines
• Nasal passages
(fossa or cavity)

radiolucent
• Nasal septum

radiopaque
• Anterior nasal spine

radiopaque
• Inferior concha

radiopaque
• Soft tissues of nose
and lips

radiopaque
Central incisor region: Features
Anterior Nasal Spine
© William C. Scarfe
Central incisor region: Features
Incisive Fossa / Foramen
© William C. Scarfe
Central incisor region: Features
Nasal Septum
© William C. Scarfe
Central incisor region: Features
Pre-maxillary / Median Palatine Suture
© William C. Scarfe
Central incisor region: Features
Inferior Concha / Turbinates
© William C. Scarfe
Central incisor region: Features
Nasal Fossa / Cavity / Meatus
© William C. Scarfe
Central incisor region: Features
Incisive / Nasopalatine Canal
© William C. Scarfe
Central incisor region: Features
Ala Cartilage
Nose & Lip Line
© William C. Scarfe
Central incisor region: Features
Incisive / Nasopalatine Canal
© William C. Scarfe
Maxillary Anterior
Image(s) courtesy © Dr. Allan G. Farman
Nasal septum
Nasal passage
Anterior nasal
spine
Premaxillary
suture
© William C. Scarfe
Image(s) courtesy © Dr. Allan G. Farman
Anterior Maxilla
Incisive fossa
Premaxillary
suture
© William C. Scarfe
Image(s) courtesy © Dr. Allan G. Farman
Anterior Maxilla
Anterior nasal spine
Incisive fossa
Lamina dura
Premaxillary suture
Periodontal ligament
space
Pulp
Nasal passage
Nasal passage
Nasal
septum
Anterior nasal
spine
Soft tissue
shadow of nose
Premaxillary
suture
Dental caries
Image(s) courtesy © Dr. Allan G. Farman
© William C. Scarfe
Lateral/Canine region: Maxilla
• Structures found on central incisor view
are displaced

lingual structures appearing more
posteriorly and facial structures more
anteriorly.
• Inverted “Y”

Lateral wall of nasal passage and anterior
medial wall of maxillary sinus.
Lateral/Canine region: Features
Canine Fossa
Lateral/Canine region: Features
Antral /
“Inverted”
Y
Lateral/Canine region: Features
Anterior Sinus
© William C. Scarfe
Nasal passage
Anterior nasal spine
Canine eminence
Canine ‘fossa’
Image(s) courtesy © Dr. Allan G. Farman
Anterior wall of
nasal passage
Canine ‘fossa’
Soft tissue shadow
of nose
Image(s) courtesy © Dr. Allan G. Farman
Inverted ‘Y’
Lateral wall of
nasal fossa
Maxillary sinus
Anterior wall of
maxillary sinus
Image(s) courtesy © Dr. Allan G. Farman
Inverted “Y”
Locule in maxillary
sinus: note tooth
periodontal ligament
space intact
Septum in maxillary
sinus
Bridge unit in porcelain
fused to metal
Image(s) courtesy © Dr. Allan G. Farman
Radiolucent anterior
filling material
Premolar region: maxilla
• Maxillary sinus

radiolucent
• Maxillary sinus floor
and septae

radiopaque
• Nutrient canals

radiolucent
• Occasionally: lateral
wall of nasal
passage

radiopaque
• Soft tissue shadow
of lips/cheeks.

Nasolabial fold
Premolar region: Features
Nasolabial Fold
Premolar region: Features
Maxillary Sinus
© William C. Scarfe
Premolar region: Features
Nutrient Canals
Premolar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman
Floor of maxillary sinus
Image(s) courtesy © Dr. Allan G. Farman
1st / 2nd molar region: maxilla
• Maxillary sinus floor
and septae

radiopaque
• Maxillary sinus

radiolucent
• Nutrient canals

radiolucent
• Zygomatic process
of the maxilla


“U”- shaped
radiopaque
• Zygomatic
arch/zygoma

radiopaque
• Less commonly:


Lateral wall of nasal
passage
radiopaque
Articular
eminence
Molar
region:
maxilla
Structures anterior
to green line seen
on intraoral
radiographs
Image(s) courtesy © Dr. Allan G. Farman
Zygomatic
bone
Zygomatic
Arch
Zygomatic
process of
maxilla
Zygomatic process (temporal bone)
Molar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman
Lateral
pterygoid
plate
Pterygoid
hamulus
(medial
Pterygoid)
Maxillary tuberosity
Molar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman
Pterygoid hamulus
Endodontically
treated tooth
Zygomatic process
of the maxilla
Zygomatic
arch
shadow
Floor of
maxillary
sinus
Maxillary
tuberosity
Image(s) courtesy © Dr. Allan G. Farman
2nd /3rd molar region: maxilla
• Coronoid process of
mandible\

radiopaque
• Maxillary tuberosity

radiopaque)
• Posterior wall of
maxillary sinus

radiopaque
• Maxillary sinus

radiolucent
• Pterygoid hamulus

radiopaque
• Pterygoid notch

radiolucent
• Lateral pterygoid
plate

radiopaque
3rd molar region: maxilla
Zygomatic
arch
Zygomatic
process
of maxilla
Coronoid
process of
mandible
Image(s) courtesy © Dr. Allan G. Farman
Image(s) courtesy © Dr. Allan G. Farman
Maxillary tuberosity
Maxillary sinus
Tuberosity
Dental
follicle
space
Image(s) courtesy © Dr. Allan G. Farman
Zygomatic process of the maxilla
Pterygoid
hamulus
Air space
Image(s) courtesy © Dr. Allan G. Farman
Posterior wall of maxillary sinus
Pterygoid
plate
Zygomatic process of maxilla
Zygomatic
arch
Pterygoid
hamulus
Coronoid
process of
mandible
Floor of maxillary sinus
Image(s) courtesy © Dr. Allan G. Farman
Shadow of zygomatic arch
Pterygoid
hamulus
Maxillary
tuberosity
Image(s) courtesy © Dr. Allan G. Farman
Coronoid process of mandible
Anatomic Landmarks
MANDIBLE
Incisor region: mandible
• Lingual foramen

radiolucent
• Genial tubercles

radiopaque
• Soft tissue shadow of lower lip

radiopaque
• Mental ridges

radiopaque
• Nutrient canals

radiolucent
Facial
Lingual
Mental
depression
Mental
ridge
Lingual
groove
Genial
tubercles
Image(s) courtesy © Dr. Allan G. Farman
© William C. Scarfe
Soft tissue
shadow of lower lip
Mental ridge
Cortex of
lower border of
mandible
Image(s) courtesy © Dr. Allan G. Farman
Image(s) courtesy © Dr. Allan G. Farman
Soft tissue shadow of
lower lip
Mental ridge
Lingual foramen
Cortical plate of
lower border of
mandible
Genial tubercles
Image(s) courtesy © Dr. Allan G. Farman
Mental ridge
Embossed
(locating) dot
Image(s) courtesy © Dr. Allan G. Farman
Periodontal ligament
space
Second shadow of
periodontal ligament
space due to shape
of root
Image(s) courtesy © Dr. Allan G. Farman
Nutrient canals
Image(s) courtesy © Dr. Allan G. Farman
Embossed dot
Lingual foramen
Image(s) courtesy © Dr. Allan G. Farman
Mandibular tori
Mental ridge
Genial tubercles
Canine/Premolar region: mandible
• Mental foramen

Radiolucent
 usually situated between and just beneath
roots of the premolars.
• Soft tissue shadow of reflected cheek

radiopaque
• Mandibular canal

radiolucent
Canine region: mandible
Image(s) courtesy © Dr. Allan G. Farman
© William C. Scarfe
Premolar region: mandible
Image(s) courtesy © Dr. Allan G. Farman
Mental
foramen
© William C. Scarfe
Mental
foramen
Mylohyoid ridge
Submandibular fossa
Image(s) courtesy © Dr. Allan G. Farman
Mandibular
canal
Mental
foramen
Periapical granuloma, abscess or cyst
(periodontal ligament space not intact)
Image(s) courtesy © Dr. Allan G. Farman
Image(s) courtesy © Dr. Allan G. Farman
Mylohyoid
ridge
Mental foramen Submandibular fossa
Molar region: mandible
• Mandibular canal

radiolucent
• External oblique
ridge

radiopaque
• Mylohyoid ridge
(internal oblique
ridge)

radiopaque
• Submandibular
fossa

radiolucent
• Cortex of lower
border

radiopaque
Image(s) courtesy © Dr. Allan G. Farman
Mandibular canal
External oblique ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman
External oblique ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman
External oblique ridge
Image(s) courtesy © Dr. Allan G. Farman
Mandibular canal
Internal oblique (mylohyoid) ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman
Internal oblique (mylohyoid) ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman
External
oblique
ridge
Internal
oblique
ridge
Submandibular fossa
Image(s) courtesy © Dr. Allan G. Farman
Lower
cortex of
mandible
Image(s) courtesy © Dr. Allan G. Farman
External
oblique
ridge
Internal
oblique
ridge
Lower cortex of mandible
Image(s) courtesy © Dr. Allan G. Farman
External
oblique
ridge
Internal
oblique
ridge
Lower cortex of mandible
Anatomical Variations
•
•
•
•
•
Mandibular torus.
Palatal torus.
High vs. low mandibular canal.
“Double” mandibular canals.*
Stafne’s bone cavity (static bone cyst).*
*usually seen only on extra-oral radiographs.
Mandibular torus Syn: lingual exostoses, torus mandibularis
Mandibular torus Syn: lingual exostoses, torus mandibularis
Image(s) courtesy © Dr. Allan G. Farman
Mandibular torus Syn: lingual exostoses, torus mandibularis
Image(s) courtesy © Dr. Allan G. Farman
Maxillary torus
Syn: torus palatinus
Maxillary torus
Image(s) courtesy © Dr. Allan G. Farman
Syn: torus palatinus
Maxillary torus
Image(s) courtesy © Dr. Allan G. Farman
Syn: torus palatinus
Maxillary torus
Syn: torus palatinus
Image(s) courtesy © Dr. Allan G. Farman