Xray advice on root abnormality

RE: Xray advice on root abnormality

Rob Davis — Sat, 13 Jul 2019 14:09:56 GMT

The comparison to last year is very interesting, I can't find a way to bring both radiographs up on my screen next to each other, but it looks as though there has been some resorption.

I agree with Evelyn that it doesn't appear to reach the pulp, and if the coronal portion of the tooth appears clinically normal I would leave it alone, ideally repeating the radiograph in 6-12 months.

If you do repeat the radiograph, please post it here as I'd love to see how it progresses!

RE: Xray advice on root abnormality

Evelyn Barbour-Hill — Fri, 12 Jul 2019 18:59:01 GMT

[quote user="Kate Richardson"]Fair enough have never been good at correct nomenclature. Mesial means towards the midline? so how does that work? Although I suppose it is more mesial than the 'caudal' root if you think about the mandible. So what do you call the distal tip of the root - the apex?[/quote]

It's partly because the teeth are not in a straight row in a line parallel to the long axis of the body. Indeed, when you get to the incisors they are in a shallow arch, the chord of which is actually perpendicular to the long axis of the body! And it's partly because they are all in the head, so none can be 'cranial' to another!

"Mesial" is not to be confused with "medial". Mesial means toward the middle of the dental arch (i.e.the space between the two central incisors) and "distal" is away from it. The tip of the root – the deep end – is the apex. So a point on the tooth is apical to another point on the tooth, if it is nearer to the apex, or coronal to it if it is in the other direction.

Having said that, while I would expect a scientific paper, or another veterinary dentist talking to me, to use the correct terms, I don't give a Frankly My Dear what descriptions you use as long as there's no confusion.

[quote user="Kate Richardson"]Do you think it could be some sort of weird resorption given it looked pretty normal last year?[/quote]

Oh, sorry, I misunderstood, I thought it had been unchanged for a year. Yes, I think probably there's been resorption involved.

RE: Xray advice on root abnormality

Kate Richardson — Fri, 12 Jul 2019 17:02:47 GMT

[quote user="Alexander Geddes"] When we describe teeth we used a slightly different nomenclature - so this is the distal aspect of the mesial root of the 309. [/quote]

Fair enough have never been good at correct nomenclature. Mesial means towards the midline? so how does that work? Although I suppose it is more mesial than the 'caudal' root if you think about the mandible. So what do you call the distal tip of the root - the apex?

RE: Xray advice on root abnormality

Kate Richardson — Fri, 12 Jul 2019 16:58:36 GMT

Do you think it could be some sort of weird resorption given it looked pretty normal last year?

RE: Xray advice on root abnormality

Evelyn Barbour-Hill — Thu, 11 Jul 2019 18:34:42 GMT

I think that pulp necrosis is wildly unlikely then.

RE: Xray advice on root abnormality

Kate Richardson — Thu, 11 Jul 2019 18:30:06 GMT

No. Had cat in as 107 had a resorptive lesion, but rexrayed whole mouth to check remaining teeth

RE: Xray advice on root abnormality

Evelyn Barbour-Hill — Thu, 11 Jul 2019 17:55:36 GMT

Has the 309 shown any signs or symptoms since then?

RE: Xray advice on root abnormality

Kate Richardson — Thu, 11 Jul 2019 16:33:22 GMT

The above xrays are from last August- 409 was fractured into 3 pieces, 2 of which were removed prior to xray, and 309 was xrayed then as well

RE: Xray advice on root abnormality

Kate Richardson — Thu, 11 Jul 2019 16:31:19 GMT

RE: Xray advice on root abnormality

Evelyn Barbour-Hill — Thu, 11 Jul 2019 16:26:33 GMT

Not quite sure, but I think there's a bit "missing" from the distal side of the most apical portion of the root. Possibly resorbed?

There's a wide gap between lamina dura and root, apically but not more coronad; but I think the gap has filled in with bone so the line representing the periodontal ligament is normal. I think.

If crown is normal colour and has no fracture or defect, and the periodontal state is only showing mild gingivitis, while pulp death is a possibility it must be a very small one.

I'd guess developmental abnormality.

RE: Xray advice on root abnormality

Simon Vogel — Thu, 11 Jul 2019 15:47:50 GMT

The dentist sitting next to me suggests indicates pulp death- possible perio origin, but assuming tooth structure is fine?

RE: Xray advice on root abnormality

Alexander Geddes — Thu, 11 Jul 2019 15:31:25 GMT

Hey Kate, thanks for posting this xray! When we describe teeth we used a slightly different nomenclature - so this is the distal aspect of the mesial root of the 309. do you have a view of the contralateral for comparison? Thanks Alex

RE: Xray advice on root abnormality

Kate Richardson — Thu, 11 Jul 2019 15:20:36 GMT

9yo FN DSH. Caudal aspect of cranial root 309, mild gingivitis, no mobility. Not seen this before- any thoughts?