Jaw X-ray is a method of visualization of the bone base of the upper and lower jaw using X-rays. The images show the bone structure, teeth and temporomandibular joint. The examination allows you to detect areas of rarefaction or increased density in the bone, foci of infectious and inflammatory processes and necrosis. X-ray is used in the diagnosis of neoplasms, cracks and fractures, as well as joint pathologies and anomalies in the development of jaw bones. The area is studied in direct, lateral and axial projections, depending on the purpose of the study.
Indication
To tell the patient exactly whether it is necessary and possible for him to do jaw x-ray, his attending physician should. General indications for such a diagnostic procedure are:
- suspected malformations of the jaws (in childhood or adulthood). These may be congenital cleft of the hard / soft palate, impaired growth and proper development, malocclusion.
- suspicion of infectious-inflammatory and specific pathologies. These include osteomyelitis, periostitis, syphilis, actinomycosis, tuberculosis or necrosis of the jaw bone.
- to identify various acquired defects resulting from injury or removal of oncological formations.
- suspicion of the presence of a false joint.
- suspected benign or malignant neoplasm.
What shows
On the X-ray images of the upper and lower jaws, you can see the following:
- defects – cracks, fractures, presence or absence of bone fragments;
- pathological changes in bone tissue – foci of tissue rarefaction, compaction, thickening or thinning of the cortical plate;
- areas of necrosis – sequestration;
- sclerotic process;
- various periosteal layers, osteophytes (bone growths);
- tumor-like neoplasms.
Preparation
Jaw X-ray is a procedure that does not require special training. You will only need to take off all the jewelry, a denture (if possible and if it is available).
Method of conducting
An X-ray of the jaw of an adult or a child is a simple procedure to perform. It can be done in different projections in order to better examine the structure of bone tissue and accurately diagnose.
Lower jaw X-ray
To get general information about the condition of the lower jaw, an X-ray image is performed in a direct projection. It allows for the primary diagnosis of inflammatory, oncological and traumatic diseases. The patient is laid as follows: lying on his stomach, face down, resting the tip of his nose and forehead on the cassette. The sensor of the X-ray machine is installed at the occipital protuberance.
A picture of the lower jaw in a lateral projection is performed to assess the condition of the body, branches and teeth of the desired side. The patient lies on his side, with his cheek on the cassette, located at a slight angle.
For the diagnosis of diseases of the mandible, pictures are also taken in axial projection. The patient takes a lying position on his stomach, pulling his head forward with his chin as much as possible. At the same time, it is pressed against the cassette by the front surface of the neck and the lower jaw.
Upper jaw X-ray
To assess the condition of the bone tissue of the upper jaw and the chin region of the lower jaw, nasal-chin laying is performed. To do this, the patient lies on his stomach, face down, resting the tip of his nose and chin on the cassette. The sensor is installed perpendicular to the cassette, 2 pictures are taken – with the mouth open and closed.
A panoramic X-ray, or orthopantomogram, displays the entire upper and lower jaws in a direct projection. In such a picture, you can see almost all the anatomical features of the patient’s dental system, all kinds of neoplasms, defects, fractures of the roots of teeth and so on. Orthopantomogram allows you to identify the following pathologies:
- tooth root caries lesion;
- hidden carious cavities;
- cysts, granulomas, tumors;
- pathological changes in the roots and near-root space.
Interpretation
Deciphers the X-ray images of an adult’s jaw usually by a radiologist. Other specialists may also be involved in this work: a dentist, a facial surgeon, an otolaryngologist. Specific pathologies of the upper and lower jaws have certain radiological features:
- Chronic osteomyelitis. Depending on the type of disease, the images may show foci of resorption of different shapes with a shadow of necrotic masses inside. In more severe cases, sequestration communication with the oral cavity is visualized.
- Acute osteomyelitis. When examining the image, you can see foci of bone resorption that do not have clear boundaries.
- Fractures or cracks of the jaw bones. Such pathology gives itself away by the fact that thin, elongated darkening is quite clearly visible in the pictures. In such cases, it is important not only to identify the fracture, but also to see the bone fragments, if any, and understand how they are displaced.
- Chronic periostitis. In the picture with such pathology, periosteal thickenings will be visible. If the disease has turned into a severe form, areas of ossification of the periosteum and new bone tissue along the edge of the jaw are visualized.
Contraindications
Upper and lower jaw x-ray is contraindicated:
- for women during pregnancy. Certain types of X-rays, for example digital, are allowed to be done by pregnant women only in the second trimester.
- patients who have open bleeding, for example, from the gums.
- patients in serious condition.
