Veterinary Oral Diagnostic Imaging

Brenda L. Mulherin (Editor)

ISBN: 9781119780502 

October 2023 

Wiley-Blackwell 

448 Pages

DESCRIPTION

Veterinary Oral Diagnostic Imaging

Complete reference on using diagnostic imaging in veterinary dentistry and interpreting diagnostic images in dogs, cats, exotic pets, zoological animals, and horses

Veterinary Oral Diagnostic Imaging offers veterinary clinicians a complete guide to using diagnostic imaging for common dentistry and oral surgery procedures in a veterinary practice. It provides guidance on positioning, techniques, and interpreting diagnostic images in the oral cavity, with more than 600 high-quality dental diagnostic images showing both normal anatomy and pathology for comparison. Focusing on dental radiography in dogs, cats, exotic pets, zoological animals, and horses, the book also includes advanced modalities such as MRI, CT, and cone beam CT.

Veterinary Oral Diagnostic Imaging covers:

• History, physiology, and indications for diagnostic imaging of the oral cavity, with information on the history of diagnostic imaging and radiographic image creation

• Digital dental radiographic positioning and image labeling, covering the parallel technique, bisecting angle, radiographic positioning errors, and labial mounting

• Interpretation of anatomy, covering normal radiographic anatomy, dentition and tooth numbers, deciduous and permanent teeth of canine and feline patients, eruption patterns and common and uncommon radiographic pathology observed in these animals

• Standard imaging, radiographic anatomy, and interpretation of equine patients, as well as exotic pocket pets and zoological animals

Focusing on the fundamentals of dental radiographic imaging, interpretation, and applications to the oral cavity, Veterinary Oral Diagnostic Imaging is an essential resource for any veterinarian providing dental services as part of their practice, along with veterinary students and interns.

TABLE OF CONTENTS

List of Contributors

Preface

Acknowledgments

Chapter 1 History, Physiology, Modality Options, and Safety for Diagnostic Imaging of the Oral Cavity

 History of Diagnostic Imaging

 Discovery of X-rays

  Developing of Safety Measures

  Shortening of Exposure Time

  Glass Plates to Film

  Progression to Digital

 Philosophy of Diagnostic Imaging

  Choosing the Appropriate Modality

  Ability to Interpret Findings

 Radiographic Indications

  Documentation of Disease

  Value of Full Mouth Radiography

  American Animal Hospital Association Guidelines Regarding Dental Radiography

 Intraoral Dental Radiographic Equipment

  Generators

   Wall Mount units

   Handheld Units

   Mobile Units/Castor Mounted Units

  Film

   Standard Film

   Digital Image Acquisition

 Computed Radiography (CR) Photostimulable Phosphor (PSP) Plates (Indirect Plates)

  Digital Radiography Image Sensors (Direct Plates)

  Similarities of Indirect and Direct Plates

 Radiographic Imaging

  Basic Unit of an X-ray

  Milliamperes (mA), Kilovoltage peak (kVp), and Exposure Time

 Radiographic Densities

  Radiopaque

  Radiolucent

 Digital Image Creation

  Creation of a Digital Image

  Digital Imaging and Communications in Medicine Format (DICOM)

  Pixels

 Advanced Imaging Modalities

  Computed Tomography

  Cone Beam Tomography (CBCT)

  Magnetic Resonance Imaging

 Definitions Related to Imaging Modalities

  Sagittal Plane

  Transverse Plane

  Dorsal Plane

 Computed Tomography Window Width and Window Level

  Window Width

  Window Level

 Other Common Viewing Windows

  Bone Window

  Soft Tissue Window

 Radiation Safety

  Radiation Safety Apparel

  Collimation

  As Low As Reasonably Achievable (ALARA)

  Time, Distance, and Shielding

   Time

 Distance

 Shielding

 Radiation Safety Equipment Inspection

  Protective apparel

  Care of Radiation Safety Equipment

  Radiation Safety Inspection Protocol

Chapter 2 Digital Dental Radiographic Positioning and Image Labeling

 Benefits of Proper Positioning

  Practicing Techniques

 Use of Position Indicating Device (PID)

 Positioning Techniques

 Patient Positioning

  Sternal Recumbency

  Lateral Recumbency

  Dorsal Recumbency

 Sensor/Plate/Film Placement

  Basic Positioning of Sensor

 Eliminating Unused Film Space

  Visualization of the Crown and Space Apical to the Root

 Intra Oral Parallel Technique

  Ideal Radiographic Technique

  Placement of Sensor for Parallel Technique

 Size Matters

  Alternative Positioning

  Parallel Technique for Cats

 Intra Oral Bisecting Angle Technique

  Plane of the Tooth, Film, and the Angel that Bisects

  Shadow Game: Elongation, Foreshortening, and the Bisecting Angle

  Axis of the Sensor, the Tooth and the PID

  Positioning of the Patient Matters

 Anatomical Variations

 Uses of the Bisecting Angle Technique

 Occlusal Technique

  Localize Tooth Roots

  PID Perpendicular to the Target Area and Sensor

 Extra Oral Technique 

  Maxillary Premolars and Molar in Felines

  Eliminate Superimposition of Zygomatic Arch

  Extraoral Labeling

 “Almost Parallel” or “Near Parallel”

  Maxillary Premolars and Molar in Cats

  Decrease Superimposition of Zygomatic Arch

 Localization of Palatal Roots

  Clark’s Rule or “SLOB” Same Lingual Opposite Buccal

  Separation of Mesiobuccal and Mesiopalatal Roots

 Techniques for Small Patients and Caudal Teeth

  Combination of Techniques

  Radiographing from a Mesial or Distal Projection

 Technique Errors

 Foreshortening

  Underrepresentation of Disease

 Elongation

  Overrepresentation of Disease

 Correction of Error

  Position Bean Perpendicular to Bisecting Angle

 Cone Cutting

  Circular artifact

  Reposition the PID

  Reposition the Sensor

  Increase the distance of the PID from the Sensor

 Missing the Apex

  2-4 mm of Hard or Soft Tissue Apical to Root

  Reposition the Sensor

  Reposition the PID

  Flip Orientation of Sensor

 Over and Under Exposed

  Control of kVp, mA, or mAs

  Underexposure

   Increase kVp or mAs

  Overexposure

   Decrease kVp or mAs

 Radiographic Artifacts

  Direct Artifacts

   Chemically Developed Radiographs

   Contamination of Sensor

   Damage to Sensor

   Age of Equipment

  Indirect Artifacts

   Endotracheal Tubes

   Pumice/Prophy Paste

   Positioning Devices

 Repeated Radiographs

  Improper Positioning of PID

   Elongation

   Foreshortening

  Improper Generator Settings

   Overexposed

   Underexposed

  Improper Film Placement

   Too Far out of the Oral Cavity

   Too Far into the Oral Cavity

   Sensor Placed Backwards

Chapter 3 Interpretation of Normal Radiographic Anatomy

 Value of Intraoral Radiographic Imaging

  Value of Radiographs in dogs

  Value of Radiographs in Cats

 Quality of images

  Exposure Artifacts

  Positioning Techniques

  Positioning Artifacts

 Mounting of Standard Dental Radiographs

  Types of Mounting

   Labial Mounting

   Lingual Mounting

   Labial Mounting of Standard Dental Radiographic Film

   Lingual Mounting of Standard Film

   Digital Radiographic Mounting

  Labial Mounting- Positioning of Teeth

   Determining Maxilla from Mandible

   Determining Right from Left

   Viewing of Maxillary and Mandibular Canines, Premolars and Molars

   Viewing of Maxillary and Mandibular Incisors

 Modified Triadan Numbering System

 Deciduous vs Permanent Teeth

 Eruption Patterns

 Mixed Dentition

 Interpretation of Images

  Tooth Root Numbers

   Maxillary Teeth

   Mandibular Teeth

  Evaluation of the Structures

   Crown

    Enamel

    Pulp

    Dentin

   Root

    Root Formation

    Cementum

     Abnormalities associated with Cementum

    Periodontal Ligament

    Chevron

    Missing or Supernumerary Teeth

    Supernumerary Roots   

    Reduced Number of Roots and Root Malformations

     Developmental Root Abnormalities

     Fusion

 Concrescence

  Gemination

  Dilacerated Tooth Roots

  Bone

  Bone Loss

   Horizontal Bone Loss

   Vertical Bone Loss

   Furcation Bone Loss

  Interpretation of Radiographic Shadows

  Nomenclature

   Mesial

   Distal

   Lingual

   Palatal

   Coronal

   Apical 

   Facial

   Buccal

   Vestibular

   Labial

   Occlusal

 Diagrams of Normal Radiographic Anatomy of the Dog and Cat

Chapter 4 Interpretation of Common Oral Pathology in the Canine Patient

 Periodontal Disease

  Stages of Periodontal Disease

  Types of Bone Loss

   Horizontal Bone Loss

   Vertical Bone Loss

   Furcation Bone Loss

 Supernumerary Roots and Teeth

 Canine Tooth Resorption

 Types of Tooth Resorption

  External Surface Resorption

  External Replacement Resorption

  External Inflammatory Resorption

  External Cervical Root Surface Resorption

 Treatment of Tooth Resorption

 Odontogenic Cysts

  Dentigerous Cysts

 Tooth Fractures

  Root fractures

 Retained Tooth Roots

 Endodontic Disease

  Etiology

  Radiographic Signs of Endodontic Disease

   Widened Periodontal Ligament Space

   Loss of Lamina Dura

   Periapical Lucency

   External and Internal Root Resorption

   Widened Pulp Canal

   Pulp Canal Calcification

  Apical Periodontitis

   Acute Apical Abscess

  Endodontic Therapy

 Attrition and Abrasion

 Eruption Abnormalities

  Persistent Deciduous Teeth

  Abnormal Eruption

Chapter 5 Interpretation of Common Oral Pathology in the Feline Patient

 Periodontal Disease

 Stages of Periodontal Disease

 Types of Bone Loss

 Horizontal Bone Loss

 Vertical Bone Loss

 Furcation Bone Loss

 Buccal Alveolar Expansile Osteitis

 Tooth Resorption

  Stages of Tooth Resorption 

  Types of Tooth Resorption

  Criteria for Performing Crown Amputation/Intentional Root Retention

 Supraeruption/Extrusion

 Osteomyelitis and Osteitis

 Retained Tooth Roots

 Endodontic Disease

Chapter 6 Oral Surgery: Neoplasia and Cystic Conditions

 Radiographic indications of neoplasia (benign and malignant)

  Benign oral tumors

  Canine Acanthomatous Ameloblastoma (CAA)

  Peripheral Odontogenic Fibroma (POF)

  Feline Inductive Odontogenic Tumor (FIOT)

 Malignant oral tumors

  Nontonsillar Squamous Cell Carcinoma (SCC)

  Papillary Squamous Cell Carcinoma (PSCC)

  Oral Malignant Melanoma (MM)

  Fibrosarcoma (FSA)

  Osteosarcoma (OSA)

  Multilobular Osteochondrosarcoma (MLO)

 Radiographic indications of cystic conditions

  Dentigerous Cyst

  Radicular Cyst

  Canine Furcation Cyst

  Surgical Ciliated Cyst

  Lateral Periodontal Cyst

  Odontogenic Keratocyst/Canine Odontogenic Parakeratinized Cyst

 Compound and complex odontomas

 Limitations of dental radiography for neoplasia

Chapter 7 Interpretation of Unique Pathology in the Canine and Feline Patient

 Unique conditions with predilection for canine patients

 Craniomandibular Osteopathy (CMO)

 Idiopathic Calvarial Hyperostosis

 Periostitis Ossificans (PO) 

 Malformed Roots/Root Hypoplasia

 Dens invaginatus/Dens in Dente

 Unique conditions observed in both canine and feline patients

 Masticatory Myositis

 Pulp Stones and Denticles

 Osteosclerosis

 Renal Secondary Hyperparathyroidism

  Enamel Pearls

 Unique conditions with predilection for feline patients

  Dentition Abnormalities

 Fused Roots

 Supernumerary Roots

 Supernumerary Teeth

 Abnormal Eruption

 Unerupted Teeth

 Patellar Fracture and Dental Anomaly Syndrome (PADS) or Knees and Teeth Syndrome

Chapter 8 Diagnostic Imaging of Exotic Pet Mammals and Zoo Animals

 Dental Diagnostic Imaging for Non-Traditional (Exotic) Animals

 General considerations for Exotic Companion Mammals

  Restraint

  Knowledge of normal anatomy

 General Positioning and Projection Recommendations

  Standard Radiography

   Standard Radiographic Positions

    Lateral and dorsoventral

    Oblique Views

  Rostrocaudal

   Intraoral radiographs

   Intraoral films used extraorally

   Magnification techniques

  Anatomical variations

   Rabbits

 Guinea Pigs and Chinchillas

 Rats, Mice, Hamsters, Gerbils and other commonly kept rodent pets

 Ferrets

 African Pygmy Hedgehogs

 Sugar Gliders

 Prairie dogs

 Captive Non-domestic or “Wild” Mammals

  Small Zoologic species

 Non-human Primates

 Carnivores

  Radiographic Positioning and Techniques in Captive Animals

   Animal Training

  Dental Conditions in Zoologic Animals

   Trauma

   Attrition

   Macropod Progressive Periodontal Disease (MPPD)

   Molar Progression

  Advanced Diagnostic Imaging in Exotic Pet Mammals and Zoo Animals

   Standard Computed Tomography

   Cone Beam Computed Tomography

   Micro-Computed Tomography

   Considerations for Computed Tomography

Chapter 9 Diagnostic Imaging and Interpretation of the Equine Patient

 Introduction to Equine Dental Radiographs

 Radiation Safety

 Radiographic Systems

  Direct Digital Radiographic System

  Computed Tomography

  Standard Radiographic System

 Radiographic Technique

 Guidelines for Radiographic Views 

 Concepts to Understand

  Directing the Primary Beam Through the Interproximal Spaces

  Open Mouth Oblique Cheek Teeth Projections

 Radiographic Views

  Lateral View

  Dorsoventral View

  Dorsal Ventral Oblique Projection of the axillary cheek teeth

  Ventral Dorsal Oblique Projection of maxillary cheek teeth

  Ventral Dorsal Oblique Projection of the mandibular cheek teeth

  Dorsal Ventral Oblique Projection of the mandibular cheek teeth

  Occlusal Intraoral View of the maxillary incisors and canines

 Occlusal Intraoral View of the mandibular incisors and canines

 Evaluation of an Image

 Labial mounting

 Radiographic anatomy

 Radiographic changes in dental disease

 Equine Odontoclastic Tooth Resorption and Hypercementosis (EOTRH)

 Apical infections

 Periodontal disease

 Sinusitis

 Neoplasia

  Other Common abnormalities

Chapter 10 Advanced Imaging of the Veterinary Patient

 Introduction to the use of advanced imaging techniques in the maxillofacial region

  Choosing Advanced Imaging

  Determining Between MRI or CT

 Magnetic Resonance Imaging (MRI)

  Technical principles of MRI

  T1 and T2 Weighted Sequences

  Other MRI Sequences

 Indications for use of MRI over CT in the maxillofacial region

  Temporomandibular joint disease

  Salivary gland disease

 Abnormalities in the muscles of mastication and inability to open/close mouth

  Conclusions on the clinical indication for use of MRI

  Computed Tomography (CT)

   Technical principles of Multi-Detector CT (MDCT)

 Technical principles of Cone Beam CT (CBCT)

 Viewing CT images

 Differences in imaging characteristics between CBCT and MDCT

  Spatial resolution

  Soft tissue imaging

  Artifacts

 Other impactful differences in practical use between MDCT and CBCT

 Indications for use of either MDCT or CBCT in the maxillofacial region

  Maxillofacial trauma 

  Bony pathology

   Osteomyelitis/osteonecrosis

   Fibro-osseous disease

   Osseous neoplasia

  Clefts

 Indications for MDCT only (not CBCT) in the maxillofacial region

  Oral neoplasia with a soft tissue component

  Soft tissue pathology

 Indications for CBCT only (not MDCT) in the maxillofacial region

  Dentoalveolar trauma

  Periodontal disease

  Endodontic disease

  Tooth resorption

  Diagnosis and treatment of missing teeth 

 Conclusions on the clinical indication for use of CBCT versus MDCT

ABOUT THE AUTHOR

Brenda L. Mulherin, DVM, Diplomate AVDC, is a Clinical Professor with the Lloyd Veterinary Medical Center at Iowa State University College of Veterinary Medicine in Ames, Iowa, USA.