|







| |
| RADIOGRAPHIC ANALYSIS |
|
|
|
|
|
| BW |
PA: |
FMX |
|
PANOREX |
OTHER |
|
|
|
|
07/02/97 |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| GENERAL TOOTH SURVEY |
|
|
|
|
|
|
| MISSING TEETH: |
|
1, 5, 12, 16, 17, 21, 28, 32 |
|
Length of Time Missing |
removed at age 29,34,29,29,29,34,34,34 |
| IMPACTIONS: |
|
None |
| ROOT TIPS: |
|
None |
| PEG: |
|
None |
| IMPLANT: |
|
None |
| PONTIC: |
|
None |
| CORONAL TOOTH STRUCTURE |
|
|
|
|
|
|
| CARIES |
|
UNACCEPTABLE |
|
|
QUESTIONABLE |
|
M: |
|
M: |
|
|
O: |
|
O: |
|
|
D: |
|
D: |
|
|
F: |
|
F: |
|
|
L: |
|
L: |
|
|
I: |
|
I: |
|
|
MO: |
|
MO: |
|
| FRACTURE |
|
None |
| PREVIOUS RESTORATIONS |
2, 3, 4, 13, 14, 15, 18, 19, 20, 22, 29, 30, 31 |
| PIN PLACEMENT |
|
|
|
|
|
|
|
|
|
Tooth |
None |
|
|
Location |
Acceptable |
|
|
|
|
Unacceptable |
Furcation |
None |
|
|
|
|
Pulp Chamber |
None |
|
|
|
|
Fluting |
None |
|
|
Surface: |
M: |
None |
|
|
|
D: |
None |
|
|
|
F: |
None |
|
|
|
L: |
None |
|
|
|
M & D: |
None |
|
|
|
|
|
|
|
|
| RADICULAR TOOTH STRUCTURE |
|
|
|
|
|
|
|
Replacement Resorption |
None |
|
Internal: |
|
None |
|
External: |
|
None |
|
|
Surface M: |
None |
|
|
D: |
None |
|
|
F: |
None |
|
|
L: |
None |
|
Severity |
Minimal |
None |
|
|
Moderate |
None |
|
|
Severe |
None |
|
Proximity |
|
|
|
|
|
|
|
|
Tooth Number |
None |
|
|
|
|
|
|
|
|
|
Root Canal System |
Normal |
2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 15, 18, 19, 20, 22, 23, 24, 25, 26, 27,
29, 30, 31 |
|
|
|
|
|
|
|
|
|
|
Calcification |
Minimal |
None |
|
|
|
Moderate |
None |
|
|
|
Obliterated |
None |
|
|
Blunderbuss |
|
None |
|
Root Configuration |
Normal |
2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 15, 18, 19, 20, 22, 23, 24, 25, 26, 27,
29, 30, 31 |
|
|
|
|
|
|
|
|
|
|
Excessively Short |
None |
|
|
Excessively Curved |
None |
|
|
Additional Concerns: |
None |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
| RADIOGRAPHIC ANALYSIS |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Root Canal Treatment |
|
|
|
|
|
|
|
Acceptable |
|
18 |
|
|
Questionable |
Short Fill |
None |
|
|
|
Inadequate Fill |
None |
|
|
|
Perforation |
None |
|
|
Unacceptable: |
Short Fill |
None |
|
|
|
Inadequate Fill |
None |
|
|
|
Perforation |
None |
|
|
Root Canal Material |
|
|
|
|
|
|
|
Gutta Percha |
18 |
|
|
|
Silver Point |
None |
|
|
|
Paste |
None |
|
|
Post Placement |
NONE |
|
|
|
Acceptable |
None |
|
|
|
Questionable |
|
|
|
|
|
|
|
Length |
None |
|
|
|
Diameter |
None |
|
|
|
Perforation |
None |
|
|
|
Fracture |
None |
|
|
|
Unacceptable: |
|
|
|
|
|
|
|
Length |
None |
|
|
|
Diameter |
None |
|
|
|
Perforation |
None |
|
|
|
Fracture |
None |
|
|
Post Material |
Metal |
None |
|
|
|
Carbon-Fiber |
None |
|
|
|
Ceramic |
None |
|
|
|
Other: |
None |
| REMAINING TOOTH STRUCTURE |
|
|
|
|
|
|
|
Acceptable |
2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 15, 18, 19, 20, 22, 23, 24, 25, 26, 27,
29, 30, 31 |
|
Questionable |
None |
|
Unacceptable Treatable |
None |
|
Unacceptable Non-Treatable |
None |
| SUPPORTING STRUCTURE |
|
|
|
|
|
|
| HORIZONTAL BONE POSITION |
|
|
|
|
|
|
|
WNL |
None |
|
< 2 mm |
None |
|
< 4 mm |
2, 3, 4, 6, 7, 8, 9, 10, 11, 13, 14, 15, 18, 19, 20, 22, 27, 29, 30, 31 |
|
> 4 mm |
23, 24, 25, 26 |
| VERTICAL DEFECTS / INFRABONY: |
Negative |
|
Mild |
|
|
Moderate |
|
|
Severe |
|
| FURCATION INVOLVEMENT(RADIOGRAPHIC): |
18 |
|
Class II Tooth #: |
18 |
|
Class III Tooth #: |
None |
| PERIAPICAL RADIOLUCENCY |
|
|
|
|
|
|
|
Location |
10 |
|
Size (in mm): |
2 |
|
|
|
|
|
|
|
|
| PERIAPICAL OPACITY |
|
|
|
|
|
|
|
|
Location |
None |
|
Size (in mm): |
|
| APICAL ROOT RESORPTION |
|
|
|
|
|
|
|
Mild |
7, 8, 9, 10, 23, 24, 25, 26 |
|
Moderate |
None |
|
Severe |
None |
|
|
|
|
|
|
|
|
| OTHER |
|
None |
|
|
|
|
|
|
|
|
| RADIOGRAPHIC TEMPOROMANDIBULAR JOINT |
|
LEFT |
|
RIGHT |
|
|
Joint Films Obtained? |
|
|
No |
No |
|
Joint Films Required? |
|
|
No |
No |
|
WNL |
|
|
|
|
|
|
|
|
|
|
|
|
| TMJ RADIOGRAPH REQUIRED |
|
|
|
|
|
|
|
TMJ Radiograph Evaluated |
|
LEFT |
|
RIGHT |
|
|
Panorex |
|
|
|
|
|
Transcranial |
|
|
|
|
|
Tomography |
|
|
|
|
|
CT Scan |
|
|
|
|
|
MRI |
|
|
|
|
|
TMJ Radiograph Findings |
|
LEFT |
|
RIGHT |
|
|
Asymmetry |
|
|
|
|
|
Degenerative Changes |
|
|
|
|
|
Condylar Fracture |
|
|
|
|
|
Pathologic Lesion |
|
|
|
|
|
|
Location: |
|
|
|
|
|
Description: |
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
[ Home ] [ Up ]
|