EVALUATION OF DIAGNOSTIC VALUES OF DENTAL RADIOGRAPHY IN THE MANAGEMENT OF DENTAL PATHOLOGIES (CASE STUDY OF FEDERAL MEDICAL CENTRE ASABA)

LIST OF TABLES

Table 1:      Age distribution of patients for dental clinical and radiographic exams in Federal Medical Centre Asaba.

Table 2:      Sex distribution of patients for dental clinical and radiographic exams     –

Table 3       Carious Lesions

Table 4:      DentoalveolarAbscess

Table 5:      Chronic periodontitis

Table 6:      Acute Apical periodontitis

Table 7:      Acute Apical pulpitis (reversible pulpitis)

Table 8:      Chronic pulpitis (irreversible pulpitis)

Table 9:      Pericoronitis         –

Table 10:    Retained Root

Table 11     Chronic Gingivitis

Table 12:    Fracture

TABLE OF CONTENTS

Title Page

Approval page

Certification

Dedication

Acknowledgement

List of tables

Table of contents

Abstract

Chapter One

1.0    Introduction

• Background of Study
• Statement of Problem
• Objectives of Study –
• Significance of Study

1.5     Scope of the Study

1.6   Literature Review

Chapter Two

2.0 Theoretical Background

2.1   Anatomy of the Teeth

2.1.1Development and Eruption Teeth

2.1.2Primary Dentition

2.1.3Permanent Dentition

2.2Dental numbering system and notation

2.2.1 Palmer Notation Method

2.2.2FDI World Dental Federation Notation

2.2.3 Universal numbering System (dental)

2.3  Dental pathologies and intra-oral infections

2.3.1 Dental Caries

2.3.2 Periodontitis         –

2.3.3 Pulpitis

2.3.4 Tooth Abscess

2.3.5  Furcation Defect

2.3.6 Pericoronitis

2.3.7 Retained Tooth – Root

2.3.8 Cracked Tooth Syndrome

• Gingivitis

2.3.10 Calculus

• Dental Radiographic Views

2.4.1 Intra-oral radiographic views

2.4.2  Extra– oral radiographic view

Chapter Three:

3.0 Research  Methodology

3.1 Research Design

3.2 Target Population

3.3 Area of Study

3.4 Inclusion Criteria

3.5 Instruments of Data Collection

3.6 Methods of Data Analysis

Chapter Four:

4.0 Results

• Presentation of tables

Chapter  Five:

5.0     Discussion, Summary, conclusion, and recommendation

5.1     Discussion

5.2 Summary of Findings

5.3Conclusion

5.4     Recommendation

5.5 Limitations of the Study

5.6  Areasfor further Studies

References

ABSTRACT

This non-experimental restrospective study was aimed to obtain information on the diagnostic value of dental radiography in the assessment of dental pathologies. And also the findings when dental radiography is compared with clinical examinations. It was conducted at Federal Medical centre Asaba. A total of 130 dental cases were reviewed.The results of this research showed that dental radiography had more diagnostic yield than clinical evalution. It was found that clinical examination had more negative findings compared with negative radiographic findings in all the pathologies assessed. However, the agreement between radiographic and clinical findings was very high. This was contrasted in chronic pulpitis where the agreement between clinical and radiographic findings, and only clinically detected had equal rate of 22.2% compared to 55.5% of only radiographically detected (negative clinical findings).Also in pericoronitis, radiography alone detected highest 62.5%.When the dental cases were distributed according to sex, more females (51.5%) than males (48.5%) had dental pathologies. It also showed that the prevalence of dental pathologies was higher in age range of 21-30 years (23.1%) compared to others.In conclusion, dental radiography was found highly invaluable in the diagnosis of dental pathologies and should be recommended for accurate diagnosis.

CHAPTER ONE

• INTRODUCTION

• BACKGROUND OF STUDY

Dental radiography is the x-ray examination of the teeth and associated structures.  It is the most common radiographic procedure done in cases of dental and maxillofacial disorders.  Dental radiographs on the other hand are the x-ray images of the teeth, bones, and surrounding soft tissues to screen for and help identify pathologies in the teeth, mouth and jaw.  X-ray images can show cavities, cancerous or benign masses, hidden dental structures (such as wisdom teeth), and bone loss.

Dental radiography provides diagnostic information  on caries, plaque retention factor, furcation defects, subgingival calculus and other pathologies.  In diagnosing periodontal diseases, radiographs, play an important role since critical information such as alveolar bone level, widening of periodontal ligament, crestal bone height and irregularity and crown root ratio cannot be found in clinical examination¹

Clinical and radiographic examinations play an integral role in the diagnosis of periodontal disorders as well as in the choice of treatment and in follow-up examination². Features visualized are dependent on the radiographic view.  Bitewing and periapical radiography are both useful tools for this purpose³.  In addition to intra-oral radiography, panoramic radiography has been used as adjunct to the examination of marginal bone tissue⁴.  Panoramic radiography compares favourably with intra-oral radiography in the assessment of marginal bone level⁵.

Very few radiographic studies⁵ have elucidated the diagnostic yield on alveolar vertical bone defects and furcation involvements.

Caries epidemiological studies have traditionally been based on clinical examination alone⁶.  Several studies have confirmed that the prevalence of proximal carries is significantly under estimated when clinical data are compared with the radiographic information.  Dental radiography are claimed to be of great importance, particular for the detection of proximal caries in contacting posterior surfaces⁷.

Plague – induced periodontal diseases are mixed infections associated with relatively specific groups of indigeneous oral bacteria⁸.  Susceptibility to these diseases is highly variable and depends on host responses to periodontal pathogens⁹.  Although bacteria cause plague – induced inflammatory periodontal diseases, progression and clinical characteristics of these disease are influenced by both acquired and genetic factors that can modify susceptibility to infection¹⁰.

To arrive at a periodontal diagnosis, the dentist must rely upon such factors as:

1. Presence or absence of clinical signs of inflammation (eg bleeding upon probing).
2. Probing depts.;

• Extent and pattern of loss of clinical attachment and bone.

1. Patent’s medical and dental histories, and
2. Presence or absence of miscellaneous signs and symptoms, including pain, ulceration and amount of observable plague and calculus

Plague – induced periodontal diseases have traditionally been divided into two general categories based on whether attachment loss has occurred: gingivitis and periodontitis.  Gingivitis is the presence of gingival inflammation without loss of connective tissue attachment.  Periodontitis can be defined as the presence of gingival inflammation at sites where there has been a pathological detachment of collagen fibers from cementum and the junctional epithelium has migrated apically.  In addition, inflammatory events associated with connective tissue attachment loss also lead to the resorption of coronal portions of tooth – supporting alveolar bone¹¹.

This research is aimed at gathering information about the additional value of radiographic examination compared to clinical examination in assessing caries and other dental pathologies.  This will give information about the precise extent of underestimated pathologies when only clinical criteria is used.

• STATEMENT OF PROBLEM

1. There is sparse literature support on the diagnostic value of dental radiography in the assessment of dental pathologies.
2. The impressions based on clinical examination and radiological outcomes in the diagnosis and management of dental pathologies have not been evaluated in the area under study.
   • OBJECTIVES OF STUDY
3. To obtain information on the diagnostic value of dental radiography in the assessment of dental pathologies.
4. To compare the impressions based on clinical examination with radiological outcomes in the diagnosis and management of dental pathologies in federal medical centre Asaba.

• To determine the age and sex distribution of patients for dental clinical and radiographic exams in FMC Asaba
  • SIGNIFICANCE OF STUDY

1. This will help dental surgeons in planning initial, corrective and supportive phases of therapy.
2. The result of this study will help in the definitive management of patient with dental and maxillofacial disease.
   • SCOPE OF THE STUDY

The study surveyed dental radiography examinations in federal medical centre Asaba, Delta state.  It covers all patient’s dental records from 1^st January 2011 – 1^st March 2012.

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