Case of the Month

An intriguing dental scan and how to interpret it

OPG requested for Dental Evaluation in a Patient, male, 50 years old, with a previous history of treatment (fixed prostheses and bridges). Bone morphology and future implantological evaluation.

 

0.934 mGycm3
16.37 s
66.00 kV
9.00 mA

Image source

Radiology Report

Cortical bone appears to be reduced within physiological limits; no abnormalities detected. No alterations of the medullary trabecular architecture are noted.  Condyloid and coronoid processes of normal radio-morphology.

Signs of periodontal disease with relative perialveolar bone resorption.

Image of coronal root discontinuity of 48. Multisegmented finding in the right subparotid region, calcified lymph node? Other? Further investigation with ultrasound examination of the neck is recommended

Learn more about: Periodontal disease

Most common gum disease is a serious gum infection that damages the soft tissue and, without treatment, can destroy the bone that supports your teeth.

Periodontitis is often improperly called “pyorrhea” and can cause teeth to loosen or lead to tooth loss. Periodontitis is common but largely preventable.

Causes

Periodontal diseases can derive from poor oral hygiene, smoking, genetic predisposition, stress, systemic diseases (e.g. decompensated diabetes, high blood sugar levels, some forms of rheumatoid arthritis, congenital or acquired immune deficiencies). The most common form of the disease, especially in young people, is gingivitis.

In rare cases, forms of periodontitis may occur in pediatric patients: aggressive periodontitis (localized or generalized) or periodontitis as a manifestation of systemic diseases (associated with hematological diseases, genetic diseases or other).

Symptoms

Gingivitis, of which main symptoms are:

  • Inflammation: the inflamed gum appears red and swollen;
  • Bleeding: the gum bleeds easily, with simple tooth brushing or even spontaneously;

Periodontitis may present:

  • Periodontal pockets: necklines between tooth and gum that increase the depth of the gum grooves
  • Periodontal abscesses: presence of pus that can leak through the gums
  • Migration of the teeth: teeth displacements with the opening of spaces between the dental elements
  • Mobility of the teeth: the loss of the supporting tissues of the tooth determines a progressive mobility of the teeth up to their loss

Treatment

The first step in treating the disease is the removal of plaque and tartar and the restoration of proper oral hygiene. In cases of gingivitis, these therapeutic precautions may be sufficient for restoring correct periodontal health. In cases of periodontitis, in addition to professional and personal hygiene maneuvers, the administration of antibiotics under the prescription of the dental specialist may be indicated In some cases, minor gingival surgery may be necessary to eliminate the causative factors that are present deeper.

Periodic dental check-ups are of fundamental importance to avoid the progression of the disease.

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Source: Bambino Gesù Hospital (Rome)