{"id":30723,"date":"2022-04-12T13:08:06","date_gmt":"2022-04-12T13:08:06","guid":{"rendered":"https:\/\/todaysveterinarypractice.com\/?p=30723"},"modified":"2022-04-29T14:04:37","modified_gmt":"2022-04-29T14:04:37","slug":"intraoral-radiographs-identifying-normal-anatomy","status":"publish","type":"post","link":"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/dentistry\/intraoral-radiographs-identifying-normal-anatomy\/","title":{"rendered":"Intraoral Radiographs: Identifying Normal Anatomy"},"content":{"rendered":"<p class=\"p1\"><span class=\"s1\">Full-mouth intraoral radiographs are an essential part of the evaluation of oral health. Combined with extraoral and intraoral examinations of an anesthetized patient, intraoral radiographs provide information needed to diagnose and treat oral disease. As with any skill in veterinary medicine, interpreting intraoral radiographs improves with time and experience. To appreciate abnormal, you first need to understand normal. This article explains why full-mouth radiographs should be taken for every dentistry patient and later reviews:<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<ul>\n<li class=\"p2\">normal radiographic dental anatomy<span class=\"Apple-converted-space\">\u00a0<\/span><\/li>\n<li class=\"p2\">criteria for diagnostic radiographs<\/li>\n<li class=\"p2\">steps for reading an intraoral radiograph<span class=\"Apple-converted-space\">\u00a0<\/span><\/li>\n<li class=\"p2\">radiographic tooth development in pediatric patients<\/li>\n<li class=\"p3\">normal anatomic structures that may be misinterpreted as pathology<\/li>\n<\/ul>\n<p class=\"p4\"><span class=\"s1\">By the end of this article, general practitioners should be able to appreciate the benefits of full-mouth radiographs and know how to recognize normal anatomic structures on intraoral radiographs of dogs and cats.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<h2 class=\"p5\">Why Take Full-Mouth Radiographs?<\/h2>\n<p class=\"p4\"><span class=\"s1\">To determine the full extent of oral disease and develop a treatment plan for your patients, an oral examination and full-mouth radiography performed with the patient under general anesthesia are required. Not including full-mouth radiographs as the standard of care for every dentistry patient could result in sending patients out the door with undiagnosed, untreated, painful oral disease. Research confirms that the diagnostic yield of full-mouth radiographs is high and that routine use of full-mouth radiographs is justifiable (<\/span><strong><span class=\"s2\">BOX 1<\/span><\/strong><span class=\"s1\">).<sup>1,2<\/sup><span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p><div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 1 Research Findings on the Diagnostic Yield of Full-Mouth Radiographs<sup>1,2<\/sup><\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\"><strong>Radiographs of teeth without clinically visible lesions <\/strong><\/p>\n<ul>\n<li>Clinically important findings were identified in 27.8% of dogs and 41.7% of cats.<\/li>\n<li>Tooth resorption lesions missed on clinical examination were diagnosed for 8.7% of cats.<\/li>\n<\/ul>\n<p><strong>Radiographs of teeth with clinically visible lesions<\/strong><\/p>\n<ul>\n<li>Clinically essential information was identified in 32.2% of cats, and additional information was identified in 53.9% of cats.<\/li>\n<li>Clinically essential information was identified in 22.6% of dogs, and additional information was identified in 50% of dogs.<\/div><\/div><\/li>\n<\/ul>\n<p class=\"p4\"><span class=\"s1\">Use of intraoral radiographs is supported by the American Veterinary Medical Association (AVMA) and the American Animal Hospital Association (AAHA). After a 2015 review of cases of jaw fractures and retained tooth roots, the AVMA professional liability newsletter stated that it would be difficult to defend complications resulting from dentistry procedures if the veterinarian did not have access to dental radiographs.<sup>3<\/sup> The AAHA Guidelines Task Force strongly recommends obtaining full-mouth intraoral dental radiographs for all dentistry patients.<sup>4<\/sup><span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<h2 class=\"p5\">Tooth Anatomy<\/h2>\n<p class=\"p4\"><span class=\"s1\">For proper evaluation of intraoral radiographs, knowledge of normal anatomy of the tooth, the mandible, and the maxilla is essential. Recognizing pathology requires familiarity with normal dental anatomy (<\/span><strong><span class=\"s2\">FIGURE 1<\/span><\/strong><span class=\"s1\">). The radiographic components of the tooth and its supporting structures are provided in <\/span><strong><span class=\"s2\">TABLE 1<\/span><\/strong><span class=\"s1\">.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<div id=\"attachment_30599\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig1.png\"><img fetchpriority=\"high\" decoding=\"async\" aria-describedby=\"caption-attachment-30599\" class=\" wp-image-30599\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig1.png\" alt=\"\" width=\"450\" height=\"340\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig1.png 855w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig1-300x227.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig1-768x580.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30599\" class=\"wp-caption-text\">Figure 1. Radiograph of the right mandibular first molar (409) in a dog. Cementoenamel junction (orange arrows); dentin (black asterisk); pulp cavity (blue arrow); periodontal ligament space (yellow arrow); lamina dura (white arrow); mandibular canal (yellow asterisk); ventral cortex of the mandible (orange asterisk); interradicular bone (blue asterisk); interproximal bone (white asterisk).<\/p><\/div>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table1.png\"><img decoding=\"async\" class=\"aligncenter size-full wp-image-30632\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table1.png\" alt=\"\" width=\"1987\" height=\"1160\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table1.png 1987w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table1-300x175.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table1-1024x598.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table1-768x448.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table1-1536x897.png 1536w\" sizes=\"(max-width: 1987px) 100vw, 1987px\" \/><\/a><\/p>\n<h2 class=\"p5\">Criteria For Diagnostic Radiographs<\/h2>\n<h3 class=\"p6\">Criteria<span class=\"Apple-converted-space\">\u00a0<\/span><\/h3>\n<p class=\"p1\"><span class=\"s1\">A diagnostic radiograph must include the following anatomic landmarks (<\/span><strong><span class=\"s2\">FIGURES 2\u20134<\/span><\/strong><span class=\"s1\">):<\/span><\/p>\n<ul>\n<li class=\"p2\">The level of alveolar bone (alveolar margin)\n<div id=\"attachment_30600\" style=\"width: 410px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2A.png\"><img decoding=\"async\" aria-describedby=\"caption-attachment-30600\" class=\" wp-image-30600\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2A.png\" alt=\"\" width=\"400\" height=\"297\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2A.png 852w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2A-300x223.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2A-768x570.png 768w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/a><p id=\"caption-attachment-30600\" class=\"wp-caption-text\">Figure 2. Diagnostic dental radiograph in a dog and cat. Alveolar bone margin (orange arrows), periodontal ligament space (yellow arrows), 2\u20133 mm around the apex (white arrows). (A) Right maxillary canine tooth (104) in a young dog. Note the wide pulp cavity and open apex consistent with a developing tooth in a young dog.<\/p><\/div>\n<p><div id=\"attachment_30601\" style=\"width: 410px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30601\" class=\" wp-image-30601\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2B.png\" alt=\"\" width=\"400\" height=\"297\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2B.png 848w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2B-300x223.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig2B-768x571.png 768w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/a><p id=\"caption-attachment-30601\" class=\"wp-caption-text\">Figure 2. (B) Right mandibular third and fourth premolars and first molar (407, 408, 409) in a cat. Note tooth resorption at the furcation of 407 (white asterisk).<\/p><\/div><\/li>\n<li class=\"p2\">The periodontal ligament space\n<p><div id=\"attachment_30602\" style=\"width: 410px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig3.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30602\" class=\" wp-image-30602\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig3.png\" alt=\"\" width=\"400\" height=\"283\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig3.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig3-300x213.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig3-768x544.png 768w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/a><p id=\"caption-attachment-30602\" class=\"wp-caption-text\">Figure 3. Diagnostic radiograph of the left mandibular first molar (309) in a dog. The alveolar bone margin, periodontal ligament space, and 2\u20133 mm around the apex of each tooth root are visible. The entire crown is not visible.<\/p><\/div><\/li>\n<li class=\"p2\">The entire tooth root, including 2 to 3 mm around the apex of each root<\/li>\n<li class=\"p3\">As much of the crown as possible<\/li>\n<\/ul>\n<div class=\"mceTemp\"><\/div>\n<div id=\"attachment_30603\" style=\"width: 410px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig4.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30603\" class=\" wp-image-30603\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig4.png\" alt=\"\" width=\"400\" height=\"524\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig4.png 858w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig4-229x300.png 229w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig4-782x1024.png 782w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig4-768x1006.png 768w\" sizes=\"(max-width: 400px) 100vw, 400px\" \/><\/a><p id=\"caption-attachment-30603\" class=\"wp-caption-text\">Figure 4. Diagnostic radiograph of the right and left maxillary first and second incisors (101, 102, 201, 202) in a dog. Nondiagnostic radiograph for the right and left maxillary third incisors (103 and 203) (white asterisks).<\/p><\/div>\n<p class=\"p4\"><span class=\"s1\">Both roots of the same tooth do not need to appear on the same radiograph, nor do the entire crown and root(s). Obtaining a diagnostic image of 1 tooth may require 2 radiographs (e.g., the mandibular first molar in a larger dog [<\/span><strong><span class=\"s2\">FIGURE 5<\/span><\/strong><span class=\"s1\">]). Similarly, 2 radiographic images of a canine tooth in a dog may be required: 1\u00a0image of the coronal portion of the root showing the level of alveolar bone to evaluate presence\/absence of periodontal disease and 1 image of the most apical portion of the tooth root and the periapical area to evaluate presence\/absence of endodontic disease (<\/span><strong><span class=\"s2\">FIGURE 6<\/span><\/strong><span class=\"s1\">).<\/span><\/p>\n<div id=\"attachment_30604\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30604\" class=\" wp-image-30604\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5A.png\" alt=\"\" width=\"450\" height=\"324\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5A.png 861w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5A-300x216.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5A-768x553.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30604\" class=\"wp-caption-text\">FIGURE 5. Diagnostic radiographs of mandibular molars in a dog; 2 images of the mandibular first molar are often needed for larger dogs. (A) Right mandibular first molar distal root (409), mandibular second molar (410), and third molar (411). Note: 411 has been removed (white asterisk).<\/p><\/div>\n<div id=\"attachment_30605\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30605\" class=\" wp-image-30605\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5B.png\" alt=\"\" width=\"450\" height=\"503\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5B.png 862w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5B-269x300.png 269w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig5B-768x858.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30605\" class=\"wp-caption-text\">FIGURE 5. (B) Right mandibular fourth premolar distal root (408) and right mandibular first molar mesial root (409).<\/p><\/div>\n<div id=\"attachment_30606\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30606\" class=\" wp-image-30606\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6A.png\" alt=\"\" width=\"450\" height=\"320\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6A.png 853w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6A-300x213.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6A-768x546.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30606\" class=\"wp-caption-text\">Figure 6. Two views of the canine tooth in a young dog. (A) Left maxillary canine tooth (204), showing the crown and most coronal portion of the root. Note the persistent deciduous left maxillary canine tooth (604) (white asterisk).<\/p><\/div>\n<div id=\"attachment_30607\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30607\" class=\" wp-image-30607\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6B.png\" alt=\"\" width=\"450\" height=\"320\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6B.png 853w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6B-300x213.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig6B-768x547.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30607\" class=\"wp-caption-text\">Figure 6. (B) Additional view showing the apical portion of the root and the periapical area. Note the wide pulp cavity and open apex consistent with an immature tooth in a young dog.<\/p><\/div>\n<p class=\"p4\"><span class=\"s1\">Two radiographic views are also needed for complete evaluation of the maxillary canine teeth in dogs and cats (<\/span><strong><span class=\"s2\">FIGURE 7<\/span><\/strong><span class=\"s1\">). The occlusal view is useful for comparing the pulp cavity sizes of the maxillary canine teeth and examining the buccal aspects of the teeth for signs of periodontitis. Lateral views of the right and left maxillary canine teeth are required for accurately <\/span>evaluating the periapical region without superimposition<span class=\"s1\"> on the maxillary premolar teeth and for evaluating periodontal status at the mesial and distal aspects of the canine teeth.<sup>5<\/sup> The palatal side of maxillary canine teeth cannot be fully evaluated with radiographs; evaluating the maxillary canine tooth for periodontal disease on the palatal side requires use of a periodontal probe.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<div id=\"attachment_30608\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30608\" class=\" wp-image-30608\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7A.png\" alt=\"\" width=\"450\" height=\"461\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7A.png 871w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7A-293x300.png 293w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7A-768x787.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30608\" class=\"wp-caption-text\">FIGURE 7. Radiographs of maxillary canine teeth in a cat. (A) The occlusal view of the maxillary canine teeth is useful for evaluating the pulp cavity size (yellow asterisks) and buccal bone (orange asterisks). The apical portion of the maxillary canine teeth is superimposed on the maxillary premolars and cannot be evaluated.<\/p><\/div>\n<div id=\"attachment_30609\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30609\" class=\" wp-image-30609\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7B.png\" alt=\"\" width=\"450\" height=\"286\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7B.png 852w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7B-300x191.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig7B-768x489.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30609\" class=\"wp-caption-text\">FIGURE 7. (B) Lateral view of the left maxillary canine tooth (204) is required for evaluating the mesial and distal alveolar bone margins (white asterisks) and periapical area (orange arrow).<\/p><\/div>\n<h3 class=\"p6\">Viewing<span class=\"Apple-converted-space\">\u00a0<\/span><\/h3>\n<p class=\"p4\"><span class=\"s1\">Some veterinary software programs will label the image with the tooth number(s) as they are exposed and will orient them correctly on the computer screen. If images are not labeled and correctly oriented by the software, certain clues will help determine whether the image is of the maxillary or mandibular arcade (<\/span><strong><span class=\"s2\">TABLE 2<\/span><\/strong><span class=\"s1\">).<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table2.png\"><img loading=\"lazy\" decoding=\"async\" class=\"aligncenter size-full wp-image-30633\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table2.png\" alt=\"\" width=\"1974\" height=\"355\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table2.png 1974w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table2-300x54.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table2-1024x184.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table2-768x138.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Table2-1536x276.png 1536w\" sizes=\"(max-width: 1974px) 100vw, 1974px\" \/><\/a><\/p>\n<p class=\"p4\"><span class=\"s1\">When viewing intraoral radiographs, orient the image the same way each time (just as you would do with thoracic or abdominal radiographs). If the tooth on the image is a maxillary tooth, then the radiograph should be rotated so the crowns of the teeth point downward (in their natural position) on the computer screen. If the tooth on the image is a mandibular tooth, then the radiograph should be rotated so the crowns of the teeth point upward. After determining if the tooth is in the maxilla or the mandible and orienting the radiograph accordingly, ask yourself whether the radiograph is of the right or left side of the mouth. If the rostral mandibular or maxillary premolars or molars are toward the right side of the radiograph, then you are looking at the right maxillary or mandibular premolars and molars. If the rostral teeth are located toward the left side of the radiograph, then you are looking at the left mandibular or maxillary premolars and molars (<\/span><strong><span class=\"s2\">FIGURE 8<\/span><\/strong><span class=\"s1\">). When viewing incisors, the right maxillary or mandibular incisors are on the left side of the image and the left maxillary or mandibular incisors are on the right side of the image (similar to a ventrodorsal abdominal or thoracic radiograph) (<\/span><strong><span class=\"s2\">FIGURE 9<\/span><\/strong><span class=\"s1\">).<\/span><\/p>\n<div id=\"attachment_30610\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig8.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30610\" class=\" wp-image-30610\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig8.png\" alt=\"\" width=\"450\" height=\"322\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig8.png 864w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig8-300x215.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig8-768x549.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30610\" class=\"wp-caption-text\">Figure 8. Radiograph of mandibular premolars and molar in a cat. The rostral teeth are toward the left. This radiograph shows the left mandibular third and fourth premolars and first molar (307, 308, 309).<\/p><\/div>\n<div id=\"attachment_30611\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30611\" class=\" wp-image-30611\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9A.png\" alt=\"\" width=\"450\" height=\"533\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9A.png 856w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9A-253x300.png 253w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9A-768x910.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30611\" class=\"wp-caption-text\">Figure 9. Radiographs of incisors in a cat and dog. (A) Maxillary incisors in a cat. The right maxillary incisors (101, 102, 103) are on the left side of the radiograph (orange asterisks), and the left maxillary incisors (201, 202, 203) are on the right (white asterisks). The palatine fissures are the symmetrical radiolucent structures (orange arrows) distal to the maxillary incisors.<\/p><\/div>\n<div id=\"attachment_30612\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30612\" class=\" wp-image-30612\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9B.png\" alt=\"\" width=\"450\" height=\"440\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9B.png 858w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9B-300x293.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig9B-768x751.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30612\" class=\"wp-caption-text\">FIGURE 9. (B) Mandibular incisors in a dog. The right mandibular incisors (401, 402, 403) are on the left (orange asterisks), and the left mandibular incisors (301, 302, 303) are on the right (white asterisks). The fibrocartilaginous mandibular symphysis joins the 2\u00a0mandibles and appears as a radiolucent line between the central incisors (blue arrows).<\/p><\/div>\n<p class=\"p4\"><span class=\"s1\">The number of full-mouth radiographs needed to see all the teeth, including the level of alveolar bone and the periapical area around each tooth root, can vary with patient size (the larger the patient, the more images usually needed). Mount full-mouth radiographs so that the patient\u2019s right maxilla and right mandible are on the viewer\u2019s left side and the patient\u2019s left maxilla <\/span>and left mandible are on the right side <span class=\"s1\">(<\/span><strong><span class=\"s2\">FIGURE\u00a010<\/span><\/strong><span class=\"s1\">).<\/span><\/p>\n<div id=\"attachment_30613\" style=\"width: 1948px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig10.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30613\" class=\"size-full wp-image-30613\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig10.png\" alt=\"\" width=\"1938\" height=\"701\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig10.png 1938w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig10-300x109.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig10-1024x370.png 1024w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig10-768x278.png 768w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig10-1536x556.png 1536w\" sizes=\"(max-width: 1938px) 100vw, 1938px\" \/><\/a><p id=\"caption-attachment-30613\" class=\"wp-caption-text\">Figure 10. Full mouth radiographs of a cat.<\/p><\/div>\n<h2 class=\"p5\">Steps For Reading An Intraoral Radiograph<\/h2>\n<p><span class=\"s1\">Every time you read an intraoral radiograph, follow the same steps in the same order, just as you do for thoracic or abdominal radiographs.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<ol>\n<li class=\"p2\">Evaluate the level of alveolar bone around each tooth; alveolar bone should be 1 to 2 mm apical to the cementoenamel junction.<\/li>\n<li class=\"p2\">Follow the periodontal ligament space around each root, pausing at the apex to evaluate the periapical area. The periodontal ligament space should be of uniform width around the entire tooth root.<\/li>\n<li class=\"p2\">Evaluate the size of the pulp cavity of each tooth. The pulp cavity size should be consistent with the age of the patient and with the contralateral tooth.<\/li>\n<li class=\"p3\">Look at all the bone and soft tissue visible on the radiograph; additional pathology may be present in these tissues.<\/li>\n<\/ol>\n<p><span class=\"s1\">If you are not sure of the significance of a radiographic finding, take another view or look at the radiograph of the contralateral tooth. Remember that normal anatomy can sometimes mimic pathology.<\/span><\/p>\n<h2 class=\"p5\">Radiographs Of Pediatric Patients<\/h2>\n<h3 class=\"p6\">Deciduous Dentition<\/h3>\n<p class=\"p4\"><span class=\"s1\">Interpreting intraoral radiographs of pediatric patients can be challenging because of the presence of deciduous teeth and permanent tooth buds. The permanent maxillary canine teeth erupt mesial to the deciduous maxillary canine teeth. All other permanent teeth erupt lingual or palatal to their deciduous tooth counterparts. There are no deciduous precursors for the permanent first premolar or molars. In dogs, the maxilla and mandible have 3 deciduous premolars: the second, third, and fourth premolars, named for the teeth that succeed them in the jaw rather than their function or anatomy. The deciduous maxillary third premolar is anatomically similar to the permanent maxillary fourth premolar. The deciduous maxillary fourth premolar is anatomically similar to the permanent maxillary first molar (3 roots and a large occlusal surface). The deciduous mandibular fourth premolar has the function and morphology of a molar but is replaced by the permanent fourth premolar (<\/span><strong><span class=\"s2\">FIGURE 11<\/span><\/strong><span class=\"s1\">).<sup>6<\/sup><span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<div id=\"attachment_30614\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30614\" class=\" wp-image-30614\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11A.png\" alt=\"\" width=\"450\" height=\"309\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11A.png 931w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11A-300x206.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11A-768x527.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30614\" class=\"wp-caption-text\">Figure 11. Deciduous and permanent teeth in a young dog. Note: There are no deciduous precursors for the first premolar or molar teeth. (A) Left maxilla. Permanent tooth buds (asterisks): left maxillary canine (204) (red); first premolar (205) (black); second premolar (206) (yellow); third premolar (207) (blue); and fourth premolar (208) (orange). Note: the permanent left maxillary first and second molar teeth (209, 210) are not visible in this radiograph. Deciduous teeth (arrowheads): left maxillary canine (604) (red); second premolar (606) (yellow); third premolar (607) (blue); and fourth premolar (608) (orange).<\/p><\/div>\n<div id=\"attachment_30615\" style=\"width: 461px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30615\" class=\" wp-image-30615\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11B.png\" alt=\"\" width=\"451\" height=\"310\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11B.png 932w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11B-300x206.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig11B-768x528.png 768w\" sizes=\"(max-width: 451px) 100vw, 451px\" \/><\/a><p id=\"caption-attachment-30615\" class=\"wp-caption-text\">Figure 11. (B) Left mandible. Permanent teeth (asterisks): left mandibular second premolar (306) (yellow); third premolar (307) (blue); fourth molar (308) (orange); first molar (309) (green); and second molar (310) (white). Note: the permanent mandibular first premolar and third molar teeth are not visible in this radiograph. Deciduous teeth (arrowheads): second premolar (706) (yellow); third premolar (707) (blue); fourth premolar (708) (orange).<\/p><\/div>\n<h3 class=\"p6\">Permanent Tooth Development<span class=\"Apple-converted-space\">\u00a0<\/span><\/h3>\n<p class=\"p4\"><span class=\"s1\">At the time of permanent tooth eruption, the apex is incomplete, the pulp cavity is wide, and the primary dentin layer is thin. As the tooth develops, the apex <\/span>closes and secondary dentin is produced by odontoblasts<span class=\"s1\"> within the pulp cavity. Apical closure occurs by 7 to 9.5\u00a0months of age in dogs<sup>7<\/sup> and 7 to 11\u00a0months in cats.<sup>8<\/sup> As the dog or cat continues to mature, the pulp cavity continues to get smaller as the thickness of the secondary dentin layer increases (<\/span><strong><span class=\"s2\">FIGURE 12<\/span><\/strong><span class=\"s1\">).<\/span><\/p>\n<div id=\"attachment_30616\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30616\" class=\" wp-image-30616\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12A.png\" alt=\"\" width=\"450\" height=\"459\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12A.png 607w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12A-294x300.png 294w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30616\" class=\"wp-caption-text\">Figure 12. Development of left maxillary canine tooth (204) in the cat. (A) Immature tooth with wide pulp cavity, thin dentin layer, and open apex.<\/p><\/div>\n<div id=\"attachment_30617\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30617\" class=\" wp-image-30617\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12B.png\" alt=\"\" width=\"450\" height=\"458\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12B.png 611w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12B-295x300.png 295w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30617\" class=\"wp-caption-text\">Figure 12. (B) Maturing tooth, smaller pulp cavity, thicker dentin layer, and closed apex.<\/p><\/div>\n<div id=\"attachment_30618\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12C.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30618\" class=\" wp-image-30618\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12C.png\" alt=\"\" width=\"450\" height=\"457\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12C.png 611w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig12C-296x300.png 296w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30618\" class=\"wp-caption-text\">Figure 12. (C) Mature tooth, small pulp cavity, thick dentin layer, and closed apex.<\/p><\/div>\n<p class=\"p4\"><span class=\"s1\">Why is the tooth development process important? Radiographs of a tooth in a mature dog or cat should show a small pulp cavity and a thick layer of dentin. In a mature dog or cat, if the radiograph of a tooth shows a large pulp cavity and a narrow layer of dentin, development of that tooth has arrested and the tooth is nonvital. When the tooth dies, the pulp cavity of that tooth stays the same size for the rest of the animal\u2019s life.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<h2 class=\"p5\">Normal Anatomy That May Mimic Pathology<\/h2>\n<h3 class=\"p6\">Two \u201cWhite Lines\u201d in the Maxilla<\/h3>\n<p class=\"p1\"><span class=\"s1\">For dogs, 2 radiopaque lines appear on radiographs of the maxillary canine and premolar teeth: the junction of the vertical body of the maxilla and its palatine process and the maxillary conchal crest. These normal anatomic structures can mimic the lamina dura and interfere with interpretation of apical structures.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<ul>\n<li class=\"p2\">The junction of the vertical body of the maxilla and its palatine process is visualized as a radiopaque line that crosses the midroot of the maxillary canine tooth and continues caudally and is apical to the roots of the maxillary premolars.<span class=\"Apple-converted-space\">\u00a0<\/span><\/li>\n<li class=\"p3\">The maxillary conchal crest is seen as a radiopaque line that begins just mesial to the root of the canine tooth and continues caudally to reach the level of the third premolar. Because of its location close to the apex of the maxillary canine tooth<i>,<\/i> it is difficult to change its location by changing angulation of the x-ray beam (<strong><span class=\"s3\">FIGURE 13A<\/span><\/strong>).<sup>9<\/sup><\/li>\n<\/ul>\n<div id=\"attachment_30619\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30619\" class=\" wp-image-30619\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13A.png\" alt=\"\" width=\"450\" height=\"296\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13A.png 934w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13A-300x198.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13A-768x506.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30619\" class=\"wp-caption-text\">Figure 13. Radiographs of maxillary canine teeth in a dog and cat, showing linear opacities (white lines). (A) Left maxillary canine tooth (204) in a dog. Conchal crest (white arrow), junction of the vertical body of the maxilla and its palatine process (yellow arrow).<\/p><\/div>\n<p class=\"p1\"><span class=\"s1\">For cats, the 2 lines are also formed by the junction of the vertical body of the maxilla and its palatine process and the conchal crest.<\/span><\/p>\n<ul>\n<li class=\"p2\">The vertical body of the maxilla and its palatine process is visualized as a radiopaque line that crosses the middle third of the maxillary canine tooth root.<span class=\"Apple-converted-space\">\u00a0<\/span><\/li>\n<li class=\"p3\">The conchal crest appears as a radiopaque line that begins just mesial to the root apex and ends at the third premolar. Because of the anatomic location of these 2 structures close to the apex of the maxillary canine tooth, the linear opacities always appear close to the tooth root (<strong><span class=\"s3\">FIGURE 13B<\/span><\/strong>).<sup>10<\/sup><\/li>\n<\/ul>\n<div id=\"attachment_30620\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30620\" class=\" wp-image-30620\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13B.png\" alt=\"\" width=\"450\" height=\"295\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13B.png 931w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13B-300x197.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig13B-768x504.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30620\" class=\"wp-caption-text\">Figure 13. (B) Left maxillary tooth (204) in a cat. Conchal crest (white arrow), junction of the vertical body of the maxilla and its palatine process (yellow arrow). Note: the teeth are slightly elongated, and the left maxillary third premolar (207) has a supernumerary (additional) root. The zygomatic arch is the radiopaque structure superimposed on the roots of 207, 208, and 209.<\/p><\/div>\n<h3 class=\"p6\">Chevron<\/h3>\n<p class=\"p4\"><span class=\"s1\">A chevron artifact is a very regular chevron-shaped radiolucency commonly associated with the maxillary incisors and canine teeth in dogs (<\/span><strong><span class=\"s2\">FIGURE\u00a014<\/span><\/strong><span class=\"s1\">); radiographically, it looks similar to lesions of endodontic origin. This effect is created by trabecular bone and vascular channels around the apices, contrasted with the dense compact bone of the alveolar walls and incisive bone.<sup>11<\/sup><\/span><\/p>\n<div id=\"attachment_30621\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig14.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30621\" class=\" wp-image-30621\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig14.png\" alt=\"\" width=\"450\" height=\"613\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig14.png 853w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig14-220x300.png 220w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig14-752x1024.png 752w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig14-768x1046.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30621\" class=\"wp-caption-text\">Figure 14. Chevron lucencies associated with right maxillary incisors (101, 102, 103). Note the regular shape of the lucency and the intact lamina dura around the apex of the tooth (arrows). Courtesy Chanda Miles, DVM, DAVDC.<\/p><\/div>\n<p class=\"p4\"><span class=\"s1\">In general, periapical lesions associated with endodontic disease will be more circular or irregularly shaped lucencies and the periodontal ligament space will not be visible around the root tip. The root tip of an endodontically diseased tooth may exhibit signs of apical root resorption.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<h3 class=\"p6\">Summation<\/h3>\n<p class=\"p4\"><span class=\"s1\">Other lucencies and opacities are created by the summation effect of superimposed structures, projecting overlying anatomy in a way that makes the structure appear to be associated with a tooth root or its supporting bone.<sup>11<\/sup> Summation of the mandibular first molar apices superimposed over the mandibular canal can be confused as an endodontic lesion (<\/span><strong><span class=\"s2\">FIGURE\u00a015<\/span><\/strong><span class=\"s1\">). <\/span><strong><span class=\"s2\">BOX 2<\/span><\/strong><span class=\"s1\"> lists clues for differentiating summation of normal structures from pathology.\u00a0<\/span><\/p>\n<div id=\"attachment_30622\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30622\" class=\" wp-image-30622\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15A.png\" alt=\"\" width=\"450\" height=\"312\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15A.png 865w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15A-300x208.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15A-768x533.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30622\" class=\"wp-caption-text\">FIGURE 15. Radiographs showing periapical lucencies in a dog. (A) Right mandibular first molar (409) showing the summation effect resulting from superimposition of the apex of the tooth roots over the mandibular canal (arrows).<\/p><\/div>\n<div id=\"attachment_30623\" style=\"width: 461px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30623\" class=\" wp-image-30623\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15B.png\" alt=\"\" width=\"451\" height=\"301\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15B.png 861w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15B-300x200.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15B-768x513.png 768w\" sizes=\"(max-width: 451px) 100vw, 451px\" \/><\/a><p id=\"caption-attachment-30623\" class=\"wp-caption-text\">FIGURE 15. (B) Black dashed line indicates the dorsal border of the mandibular canal. Orange dashed lines indicate the periodontal ligament extension lines. The lucency is contained within the extension lines and therefore is probably the result of superimposition of the apices over the mandibular canal.<\/p><\/div>\n<div id=\"attachment_30624\" style=\"width: 461px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15C.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30624\" class=\" wp-image-30624\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15C.png\" alt=\"\" width=\"451\" height=\"303\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15C.png 859w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15C-300x202.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig15C-768x516.png 768w\" sizes=\"(max-width: 451px) 100vw, 451px\" \/><\/a><p id=\"caption-attachment-30624\" class=\"wp-caption-text\">FIGURE 15. (C) Left mandibular first molar (309). The periapical lucency is irregular in shape, wider than the root tip, and extends beyond the extension lines of the periodontal ligament space. There is evidence of apical root resorption. These findings are consistent with endodontic disease and are not the result of superimposition of the apices of 309 on the mandibular canal.<\/p><\/div>\n<p><span class=\"s1\">When in doubt, consult with a board-certified veterinary dentist or take follow-up radiographs in 3 to 6 months to evaluate changes in the appearance of the periapical lucency. <\/span><\/p>\n<div class=\"su-box su-box-style-default\" id=\"\" style=\"border-color:#606060;border-radius:3px;\"><div class=\"su-box-title\" style=\"background-color:#939393;color:#FFFFFF;border-top-left-radius:1px;border-top-right-radius:1px\">BOX 2 Clues for Determining Whether a Periapical Lucency Is Normal Anatomy or Pathology <\/div><div class=\"su-box-content su-u-clearfix su-u-trim\" style=\"border-bottom-left-radius:1px;border-bottom-right-radius:1px\">\n<ul>\n<li>Look at the clinical appearance of the tooth.<\/li>\n<li>Compare the radiograph with one of the contralateral tooth.<\/li>\n<li>Move the x-ray tube head. If the lucency is periapical pathology, it will remain adjacent to the apex of the tooth regardless of the tube head position. If the lucency results from summation, it will appear to move away from the apex of the tooth with a tube head shift.<\/li>\n<li>Draw imaginary lines that extend the periodontal ligament space apically. If the lucency is within the extension lines, it is probably normal anatomy. If it is irregularly shaped and extends beyond the extension lines, it probably represents periapical pathology.<\/div><\/div><\/li>\n<\/ul>\n<h3 class=\"p6\">Foramina<\/h3>\n<p>The caudal and middle mental foramina may be mistaken for periapical pathology associated with the rostral mandibular premolars.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<p>In the dog, the middle mental foramen is ventral to the mesial root of the second premolar and the caudal mental foramen is ventral to the mandibular third premolar (<strong><span class=\"s3\">FIGURE 16<\/span><\/strong>).<\/p>\n<div id=\"attachment_30625\" style=\"width: 459px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30625\" class=\" wp-image-30625\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16A.png\" alt=\"\" width=\"449\" height=\"327\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16A.png 856w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16A-300x218.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16A-768x559.png 768w\" sizes=\"(max-width: 449px) 100vw, 449px\" \/><\/a><p id=\"caption-attachment-30625\" class=\"wp-caption-text\">Figure 16. Mental foramina of the dog. (A) Rostral mandible of a dog skull, showing the location of the rostral (white asterisk), middle (black asterisk), and caudal (orange asterisk) mental foramina. The mandibular first premolar is missing. Courtesy Chanda Miles, DVM, DAVDC.<\/p><\/div>\n<div id=\"attachment_30626\" style=\"width: 459px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30626\" class=\" wp-image-30626\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16B.png\" alt=\"\" width=\"449\" height=\"316\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16B.png 865w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16B-300x211.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig16B-768x541.png 768w\" sizes=\"(max-width: 449px) 100vw, 449px\" \/><\/a><p id=\"caption-attachment-30626\" class=\"wp-caption-text\">Figure 16. (B) Radiograph of right mandibular premolars, showing the middle mental foramen ventral to the mesial root of the mandibular second premolar (406) (black arrow) and caudal mental foramen ventral to the mandibular third premolar (407) (orange arrow). Courtesy Chanda Miles, DVM, DAVDC.<\/p><\/div>\n<p>In the cat, the middle mental foramen is in the interdental space between the mandibular canine tooth and third premolar and the caudal mental foramen is ventral to the mandibular third premolar (<strong><span class=\"s3\">FIGURE 17<\/span><\/strong>). To distinguish between a foramen and a periapical radiolucency, change the angle of the tube head when obtaining the radiograph. The foramen will move relative to the root as the angle of the tube head is changed. If the lucency remains associated with the apex of the tooth, then it is periapical pathology.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<div id=\"attachment_30627\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30627\" class=\" wp-image-30627\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17A.png\" alt=\"\" width=\"450\" height=\"299\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17A.png 855w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17A-300x199.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17A-768x510.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30627\" class=\"wp-caption-text\">Figure 17. Mental foramina of the cat. (A) Rostral mandible of cat skull, showing the location of the middle (black asterisk) and caudal (orange asterisk) mental foramina. Courtesy Chanda Miles, DVM, DAVDC.<\/p><\/div>\n<div id=\"attachment_30628\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30628\" class=\" wp-image-30628\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17B.png\" alt=\"\" width=\"450\" height=\"322\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17B.png 850w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17B-300x215.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig17B-768x549.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30628\" class=\"wp-caption-text\">Figure 17. (B) Radiograph of left mandibular premolars showing the middle mental foramen in the interdental space between the left mandibular canine (304) and third premolar teeth (307) (black arrow) and the caudal mental foramen ventral to the mandibular third premolar (307) (orange arrow). Courtesy Chanda Miles, DVM, DAVDC.<\/p><\/div>\n<h3 class=\"p6\">Radicular Groove of Mandibular First Molar<\/h3>\n<p class=\"p3\">The periodontal ligament space on the distal aspect of the mesial root of the mandibular first molar in a dog may appear as a double line or shadow. This double line represents the radicular groove (<strong><span class=\"s3\">FIGURE 18<\/span><\/strong>).<sup>6<\/sup> Incorrectly interpreting this normal anatomic structure may lead you to believe that there are 2 mesial roots in the first molar.<span class=\"Apple-converted-space\">\u00a0<\/span><\/p>\n<div id=\"attachment_30629\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18A.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30629\" class=\" wp-image-30629\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18A.png\" alt=\"\" width=\"450\" height=\"364\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18A.png 855w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18A-300x243.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18A-768x622.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30629\" class=\"wp-caption-text\">Figure 18. Radicular groove in a dog. (A) Radiograph showing double line resulting from the radicular groove on the distal side of the mesial root of the right mandibular first molar (409) (orange arrows).<\/p><\/div>\n<div id=\"attachment_30630\" style=\"width: 460px\" class=\"wp-caption aligncenter\"><a href=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18B.png\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-30630\" class=\" wp-image-30630\" src=\"https:\/\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18B.png\" alt=\"\" width=\"450\" height=\"366\" srcset=\"https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18B.png 855w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18B-300x244.png 300w, https:\/\/navc.sitepreview.app\/todaysveterinarypractice.com\/wp-content\/uploads\/sites\/4\/2022\/04\/TVP_MayJune22_Charlier_NormalDentalRadiographs_Fig18B-768x624.png 768w\" sizes=\"(max-width: 450px) 100vw, 450px\" \/><\/a><p id=\"caption-attachment-30630\" class=\"wp-caption-text\">Figure 18. (B) Extracted mesial root of the right mandibular first molar, with the radicular groove visible on the distal side of the mesial root. Black arrows point to the edges of the radicular groove that cause the double line seen in (A).<\/p><\/div>\n<h2 class=\"p5\">Conclusions<\/h2>\n<p class=\"p4\"><span class=\"s1\">To obtain essential information for determining appropriate treatment for each tooth in each patient, full-mouth radiographs are required.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n<p class=\"p4\"><span class=\"s1\">As with most things in veterinary medicine, the first step in learning how to interpret intraoral radiographs is becoming familiar with normal dental anatomy. Radiographs are 2-dimensional, and superimposed structures may cause misinterpretation of normal anatomy as pathology. The second step in learning how to interpret intraoral radiographs is understanding radiographic findings associated with oral diseases. To read about pathology seen on intraoral radiographs, see \u201cIntraoral Radiographs: Identifying Common Pathology\u201d in the July\/August 2022 issue of <i>Today\u2019s\u00a0Veterinary Practice<\/i>. The more intraoral radiographs you read, the more disease you will find and the more you will believe in the value of full-mouth intraoral radiographs for every dentistry patient.<\/span><\/p>\n<p class=\"p4\"><span class=\"s1\">Author\u2019s note: Special thanks to the veterinary nurses who obtained these radiographs and are an integral part of the oral healthcare team.<span class=\"Apple-converted-space\">\u00a0<\/span><\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Full-mouth radiographs can identify important pathology that can not be seen during clinical examination.<\/p>\n","protected":false},"author":236,"featured_media":30631,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"iawp_total_views":4227,"footnotes":""},"categories":[401],"tags":[13],"class_list":["post-30723","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-may-june-2022","tag-peer-reviewed","column-insights-in-dentistry","clinical_topics-dentistry","clinical_topics-radiology-imaging"],"acf":{"hide_sidebar":false,"hide_sidebar_ad":false,"hide_all_ads":false},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v24.7 (Yoast SEO v27.3) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>Intraoral Radiographs: Identifying Normal Anatomy | Today&#039;s Veterinary Practice<\/title>\n<meta name=\"description\" content=\"Full-mouth intraoral radiographs are an essential part of the evaluation of oral health and can 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