PATTERN OF FINDINGS IN DENTAL RADIOGRAPHS: A CASE STUDY UNIVERSITY OF NIGERIA TEACHING HOSPITAL ITUKU/OZALLA, ENUGU

ABSTRACT

The study was undertaken to identify the pattern of findings in dental radiographs in university of Nigeria teaching Hospital Ituku-Ozalla, Enugu. It is a retrospective study where information was obtained from patient’s folders at the record department in dental unit in the institution understudy.
 The study was carried out from 31st January 2012 to 31st January 2013. The study is divided into chapters with each chapter subdivided into units as listed below.
 Introduction which is chapter one covers background of study, statement of problem, specific objectives, significance of study, scope of study, operational definition of terms and literature review. 
In chapter two, I have theoretical background which comprises anatomy of the human teeth, deciduous dentition, permanent dentition, development and eruption of teeth, dental formula, dental pathologies and dental radiography.
Others include chapter 3, 4 and 5 treating research methodology, data presentation, discussion, summary of findings, limitations of the study, recommendation, areas of further studies and conclusion.  
The results showed that there is increase of dental pathologies in the institution understudy were female had the highest frequency (n=128).
   
LIST OF TABLES:

Table 1: Age and Sex distribution of the patients------41
Table 2: Distribution of dental radiography findings according to gender of the patients41
Table 3: Location of dental radiography findings-----42
Table 4: Types of dental radiographic procedure used-------43
Table 5: Dental radiography findings and their radiographic features--44
 
LIST OF FIGURES:

Figure 1: Anatomy of the human teeth------16
Figure 2: Palmer Notation for the deciduous dentition. -----22
Figure 3: Palmer Notation for the permanent deciduous.----23
Figure 4: FDI Notation for the deciduous dentition------24
Figure 5: FDI Notation for the permanent dentition------25
 
TABLE OF CONTENTS

Title page----------i
Certification----------ii
Approval page----------iii
Dedication----------iv
Acknowledgment---------v
Abstract----------vi
List of tables----------vii
List of figures----------viii
Table of contents---------ix
CHAPTER ONE: INTRODUCTION
1.1 Background of Study--------1
1.2 Statement of Problem--------3
1.3 Specific Objectives--------3
1.4 Significance of study--------3
1.5 Scope of study---------4
1.6 Operational Definition of Terms-------4
1.7 Literature Review---------5
1.7.1 Radiography in the Assessment of   Dental Caries-----5
1.7.2 Radiography in the Assessment of Periapical Status-----6
1.7.3 Radiography in Endodontic Procedures-----9
1.7.4 Rate of Incidental Findings of Pathology and dental Anomalies in Pediatrics Patients----10
1.7.5 Bifid Mandibular Canals in Panoramic Radiographs----12
CHAPTER TWO
2.1 Theoretical Background -------16
2.1.1 Anatomy of the Human Teeth-------16
2.1.2 Deciduous Dentition --------18
2.1.3 Permanent Dentition:--------18
2.1.4 Development and Eruption of Teeth------19
2.1.5 Dental Formulae --------21
2.1.5.1 Palmer Notation--------21
2.1.5.2 Federation Dentaire International  Notation -----23
2.1.6 Dental Pathologies --------23
2.1.7 Dental Radiography --------32
2.1.7.1Intra –Oral Radiography -------32
2.1.7.2Extra-Oral Radiography -------35
CHAPTER THREE: RESEARCH METHODOLOGY:
3.1 Research Design--------39
3.2 Target Population--------39
3.3 Area of Study---------39
3.4 Inclusion and Exclusion criteria------39
3.5 Sampling Technique--------39
3.6 Instrument of data collection-------40
3.7 Method of data analysis-------40
CHAPTER FOUR: RESULTS
4.1 Data Presentation ---------41
CHAPTER FIVE: DISCUSSION, SUMMARY, CONCLUSION, AND RECOMMENDATION
5.1 Discussion---------45
5.2 Summary of Findings--------46
5.3 Limitations of the Study-------47
5.4 Areas for Further Studies-------47
5.5 Conclusion---------48
5.6 Recommendation--------48
References---------

INTRODUCTION

Dental radiography is the x-ray examination of the teeth and associated structures. It is the most common radiographic procedure done in cases of dental and maxillofacial disorders. Dental radiographs on the other hand are the x-ray images of the teeth, bones, and surrounding soft tissues. They are among the most valuable tools a dentist has for keeping mouth and teeth healthy1. By understanding what the structures of the mouth look like normally on an x-ray film, dentists can diagnose problems in the teeth2 and jaws. For adults, radiographs can: show areas of decay that may not be visible with an oral examination, especially small areas of decay between teeth, identify decay occurring beneath an existing filling, reveal bone loss that accompanies gum disease, reveal changes in the bone or in the root canal resulting from infection, assist in the preparation of tooth implants, braces, dentures, or other dental procedures, reveal an abscess (an infection at the root of a tooth or between the gum and a tooth ) and reveal other developmental abnormalities such as cysts and some types of tumors.
For children, radiographs can be used to: identify decay, determine if there is enough space in the mouth to fit all incoming teeth, determine if primary teeth are being lost quickly enough to allow permanent teeth to come in properly, check for the development of wisdom teeth and identify if the teeth are impacted (unable to merge through the gums).
      In addition, dental radiographs help the dentist to find and treat dental problems early in their development, which can potentially save you money, unnecessary discomfort, and maybe even your life3. 
      Dental radiographs are divided into two main categories: intra-oral, which means that the x-ray film is inside the mouth and they are the most common radiographs made4, and extra-oral, which means that the x-ray film is outside the mouth. The most frequently requested intra-oral radiography are bitewing radiography, periapical radiography and occlusal radiography, while the most frequently requested extra-oral radiography are dental panoramic radiography, oblique lateral radiography and cephalometry.
Teeth, the hardest substances in the body are the organs of chewing, which is also known as mastication5. The teeth are embedded in the alveoli or sockets of the alveolar ridges of the mandible and the maxilla. A tooth is identified and described on the basis of whether is it deciduous (primary) or permanent (secondary), the type of tooth and its proximity to the midline or front of the mouth. Babies are born with two sets, or dentitions, the temporary or deciduous teeth and the permanent or secondary teeth, so we are”diphyodonts”5. At birth the teeth of both dentitions are present, in immature form, in the mandible and maxilla6. The primary or temporary or deciduous dentition which is a child’s first set of teeth comprises 20 teeth, ten in each jaw. They begin to erupt when the child is about 6 months old, and should all be present by 24 months. The permanent teeth on the other hand begin to replace the deciduous teeth in the 6th year of age and this dentition, consisting of 32 teeth, is usually complete by the 21st year. With eruption of all 32 permanent teeth, there will be sixteen in each jaw, most commonly the wisdom tooth fails to erupt or develop. In the permanent dentition posterior to the canine, are the first and second premolar (bicuspid) followed by the first second and sometimes third permanent molar teeth. Each tooth consists of a variety of hard mineralized tissue with central area, the pulp chamber and canal, consisting of blood vessels and nerve supported by loose connective tissue. The part of the tooth that projects above the gingival (gum) is the crown, while the part embedded in the jaw is the root. Enamel is limited to the crown of the tooth whereas dentine encircles the pulp chamber in the crown of the tooth and extends into the root of the tooth, enveloping the pulp canal.
     This research work will enable us to know the pattern of findings in dental radiographs in the hospital understudy.