Dental Maxillary and Mandibular Anatomic Radiographic Landmarks.ppt

Dental Maxillary and Mandibular Anatomic Radiographic Landmarks

OPG, CBCT, Dental X-rays

1. © William C. Scarfe
Maxillary and Mandibular
Anatomic Radiographic
Landmarks
Intraoral Radiography

2. © William C. Scarfe
•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.
Image(s) courtesy © Dr. Allan G. Farman

3. © William C. Scarfe
Tooth and
supporting
structures
•Enamel
radiopaque
•Dentin and
Cementum
radiopaque
•Pulp space
radiolucent
•Lamina dura
radiopaque
•Periodontal ligament
space
radiolucent
•Alveolar bone
radiopaque

4. © William C. Scarfe
Enamel
Dentin
Dentin-enamel
junction
Cemento-
enamel junction
Pulp space
Lamina dura
pdl space
Alveolar bone
Image(s) courtesy © Dr. Allan G. Farman

5. © William C. Scarfe
Anatomic
Landmarks
MAXILLA
ZYGOMATIC BONE

6. © 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

7. © William C. Scarfe
Central incisor region: Features
Anterior Nasal Spine

8. © William C. Scarfe
Central incisor region: Features
Incisive Fossa / Foramen

9. © William C. Scarfe
Central incisor region: Features
Nasal Septum

10. © William C. Scarfe
Central incisor region: Features
Pre-maxillary / Median Palatine Suture

11. © William C. Scarfe
Central incisor region: Features
Inferior Concha / Turbinates

12. © William C. Scarfe
Central incisor region: Features
Nasal Fossa / Cavity / Meatus

13. © William C. Scarfe
Central incisor region: Features
Incisive / Nasopalatine Canal

14. © William C. Scarfe
Central incisor region: Features
Ala Cartilage Nose & Lip Line

15. © William C. Scarfe
Central incisor region: Features
Incisive / Nasopalatine Canal

16. © William C. Scarfe
Anterior nasal
spine
Nasal septum
Premaxillary
suture
Nasal passage
Maxillary Anterior
Image(s) courtesy © Dr. Allan G. Farman

17. © William C. Scarfe
Incisive fossa
Premaxillary
suture
Anterior Maxilla
Image(s) courtesy © Dr. Allan G. Farman

18. © William C. Scarfe
Premaxillary suture
Incisive fossa
Anterior nasal spine
Pulp
Lamina dura
Periodontal ligament
space
Anterior Maxilla
Image(s) courtesy © Dr. Allan G. Farman

19. © William C. Scarfe
Dental caries
Premaxillary
suture
Soft tissue
shadow of nose
Anterior nasal
spine
Nasal passage
Nasal septum
Nasal passage
Image(s) courtesy © Dr. Allan G. Farman

20. © 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.

21. © William C. Scarfe
Lateral/Canine region: Features
Canine Fossa

22. © William C. Scarfe
Lateral/Canine region: Features
Antral /
“Inverted”
Y

23. © William C. Scarfe
Lateral/Canine region: Features
Anterior Sinus

24. © William C. Scarfe
Nasal passage
Anterior nasal spine
Canine ‘fossa’
Canine eminence
Image(s) courtesy © Dr. Allan G. Farman

25. © William C. Scarfe
Anterior wall of
nasal passage
Soft tissue shadow
of nose
Canine ‘fossa’
Image(s) courtesy © Dr. Allan G. Farman

26. © William C. Scarfe
Maxillary sinus
Anterior wall of
maxillary sinus
Lateral wall of
nasal fossa
Inverted ‘Y’
Image(s) courtesy © Dr. Allan G. Farman

27. © William C. Scarfe
Inverted “Y”
Locule in maxillary
sinus: note tooth
periodontal ligament
space intact
Septum in maxillary
sinus
Bridge unit in porcelain
fused to metal
Radiolucent anterior
filling material
Image(s) courtesy © Dr. Allan G. Farman

28. © William C. Scarfe
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

29. © William C. Scarfe
Premolar region: Features
Nasolabial Fold

30. © William C. Scarfe
Premolar region: Features
Maxillary Sinus

31. © William C. Scarfe
Premolar region: Features
Nutrient Canals

32. © William C. Scarfe
Premolar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman

33. © William C. Scarfe
Floor of maxillary sinus
Image(s) courtesy © Dr. Allan G. Farman

34. © William C. Scarfe
1
st
/ 2
nd
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

35. © William C. Scarfe
Zygomatic
bone
Zygomatic
process of
maxilla
Zygomatic process (temporal bone)
Articular eminence
Structures anterior
to green line seen
on intraoral
radiographs
Molar region: maxilla
Zygomatic
Arch
Image(s) courtesy © Dr. Allan G. Farman

36. © William C. Scarfe
Pterygoid
hamulus
(medial
Pterygoid)
Lateral
pterygoid
plate
Maxillary tuberosity
Molar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman

37. © William C. Scarfe
Pterygoid hamulus
Molar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman

38. © William C. Scarfe
Zygomatic process
of the maxilla
Zygomatic
arch
shadow
Floor of
maxillary
sinus
Maxillary
tuberosity
Endodontically
treated tooth
Image(s) courtesy © Dr. Allan G. Farman

39. © William C. Scarfe
2
nd
/3
rd
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

40. © William C. Scarfe
Coronoid
process of
mandible
Zygomatic
process
of maxilla
Zygomatic
arch
3
rd
molar region: maxilla
Image(s) courtesy © Dr. Allan G. Farman

41. © William C. Scarfe
Maxillary tuberosityMaxillary sinus
Image(s) courtesy © Dr. Allan G. Farman

42. © William C. ScarfeZygomatic process of the maxilla
Dental
follicle
space
Tuberosity
Image(s) courtesy © Dr. Allan G. Farman

43. © William C. Scarfe
Pterygoid
hamulus
Air space
Posterior wall of maxillary sinus
Image(s) courtesy © Dr. Allan G. Farman

44. © William C. Scarfe
Coronoid
process of
mandible
Zygomatic process of maxilla
Floor of maxillary sinus
Zygomatic
arch
Pterygoid
hamulus
Pterygoid
plate
Image(s) courtesy © Dr. Allan G. Farman

45. © William C. Scarfe
Pterygoid
hamulus
Coronoid process of mandible
Maxillary
tuberosity
Shadow of zygomatic arch
Image(s) courtesy © Dr. Allan G. Farman

46. © William C. Scarfe
Anatomic Landmarks
MANDIBLE

47. © William C. Scarfe
Incisor region: mandible
•Lingual foramen
radiolucent
•Genial tubercles
radiopaque
•Soft tissue shadow of lower lip
radiopaque
•Mental ridges
radiopaque
•Nutrient canals
radiolucent

48. © William C. Scarfe
Facial
Mental
depression
Mental
ridge
Lingual
groove
Genial
tubercles
Lingual
Image(s) courtesy © Dr. Allan G. Farman

49. © William C. Scarfe
Mental ridge
Soft tissue
shadow of lower lip
Cortex of
lower border of
mandible
Image(s) courtesy © Dr. Allan G. Farman

50. © William C. Scarfe
Lingual foramen
Mental ridge
Genial tubercles
Cortical plate of
lower border of
mandible
Soft tissue shadow of
lower lip
Image(s) courtesy © Dr. Allan G. Farman

51. © William C. Scarfe
Mental ridge
Embossed
(locating) dot
Image(s) courtesy © Dr. Allan G. Farman

52. © William C. Scarfe
Second shadow of
periodontal ligament
space due to shape
of root
Periodontal ligament
space
Image(s) courtesy © Dr. Allan G. Farman

53. © William C. Scarfe
Nutrient canals
Image(s) courtesy © Dr. Allan G. Farman

54. © William C. Scarfe
Lingual foramen
Embossed dot
Image(s) courtesy © Dr. Allan G. Farman

55. © William C. Scarfe
Mandibular tori
Genial tubercles
Mental ridge
Image(s) courtesy © Dr. Allan G. Farman

56. © William C. Scarfe
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

57. © William C. Scarfe
Canine region: mandible
Image(s) courtesy © Dr. Allan G. Farman

58. © William C. Scarfe
Mental
foramen
Premolar region: mandible
Image(s) courtesy © Dr. Allan G. Farman

59. © William C. Scarfe
Mental
foramen
Mandibular
canal
Submandibular fossa
Mylohyoid ridge
Image(s) courtesy © Dr. Allan G. Farman

60. © William C. Scarfe
Periapical granuloma, abscess or cyst
(periodontal ligament space not intact)
Mental
foramen
Image(s) courtesy © Dr. Allan G. Farman

61. © William C. Scarfe
Mental foramen
Mylohyoid
ridge
Submandibular fossa
Image(s) courtesy © Dr. Allan G. Farman

62. © William C. Scarfe
Molar region: mandible
•Mandibular canal
radiolucent
•External oblique
ridge
radiopaque
•Mylohyoid ridge
(internal oblique
ridge)
radiopaque
•Submandibular
fossa
radiolucent
•Cortex of lower
border
radiopaque

63. © William C. ScarfeMandibular canal
Image(s) courtesy © Dr. Allan G. Farman

64. © William C. Scarfe
External oblique ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman

65. © William C. Scarfe
External oblique ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman

66. © William C. Scarfe
External oblique ridge
Mandibular canalImage(s) courtesy © Dr. Allan G. Farman

67. © William C. Scarfe
Internal oblique (mylohyoid) ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman

68. © William C. Scarfe
Internal oblique (mylohyoid) ridge of mandible
Image(s) courtesy © Dr. Allan G. Farman

69. © William C. Scarfe
Submandibular fossa
Lower
cortex of
mandible
External
oblique
ridge
Internal
oblique
ridge
Image(s) courtesy © Dr. Allan G. Farman

70. © William C. ScarfeLower cortex of mandible
External
oblique
ridge
Internal
oblique
ridge
Image(s) courtesy © Dr. Allan G. Farman

71. © William C. ScarfeLower cortex of mandible
External
oblique
ridge
Internal
oblique
ridge
Image(s) courtesy © Dr. Allan G. Farman

72. © William C. Scarfe
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.

73. © William C. Scarfe
Mandibular torusSyn: lingual exostoses, torus mandibularis

74. © William C. Scarfe
Mandibular torusSyn: lingual exostoses, torus mandibularis
Image(s) courtesy © Dr. Allan G. Farman

75. © William C. Scarfe
Mandibular torusSyn: lingual exostoses, torus mandibularis
Image(s) courtesy © Dr. Allan G. Farman

76. © William C. Scarfe
Maxillary torusSyn: torus palatinus

77. © William C. Scarfe
Maxillary torusSyn: torus palatinus
Image(s) courtesy © Dr. Allan G. Farman

78. © William C. Scarfe
Maxillary torusSyn: torus palatinus
Image(s) courtesy © Dr. Allan G. Farman

79. © William C. Scarfe
Maxillary torusSyn: torus palatinus
Image(s) courtesy © Dr. Allan G. Farman