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Radiographic Anatomy First lecture The upper jaw (maxillae)

Leif Kullman
Assoc. Prof. OMF Radiology

As you know is x-rays an important tool to diagnose different diseases

The radiographic recognition of disease requires a sound knowledge of the radiographic appearance of normal structures Thats why we will start already now with anatomy

First some definitions



=White or gray areas Metal enamel dentin - bone =Black areas Less grey than neighboring area


Findings in radiographs

Hard tissues, such as bones and teeth

=radiopaque view

Anatomic landmarks

foramens, cavities are radiolucent and bone ridges radiopaque bone lesion visible as cavity = radiolucency



amalgam as white areas composites as grey areas, less radio-opaque than teeth root canal filling as grey, more radio-opaque than tooth crowns =radiopaque

Prosthodontic appliances

Facial bones and some landmarks visible in dental radiographs of the upper jaw. We will concentrate on the upper jaw today

Upper jaw region----some basic structures to start with


Maxilla Zygomatic bone Nasal cavity Maxillary Sinus Orbit

Different dental radiographs


Periapical x-ray Bite wing All these intraoral x-rays

small x-ray showing crowns of teeth showing teeth from above, along the axis of teeth OPG showing all teeth, jaws and surroundings

Occlusal x-ray

Panoramic view

Lateral view All these extraoral x-rays..whats that?  Posterior-anterior view  Tomographic methods especially

CT= computed tomography, based on radiation MRI= magnetic resonance imaging, based on
magnetic fields

Extra-oral Radiography
Include all views made of the orofacial region with the film positioned extra-orally.  Used to visualize the skull and facial structures, for detection of disease or injury or to evaluate skeletal growth.  All extra oral radiograph require screen film and intensifying screen, thats why they will only give us a low radiation dose even if they are quite big

(the screen will enhance the small radiation coming)

Occlusal view but nor normal anatomy!

Periapical x-ray (intraoral ones)

A FMS or CMS can be taken

9 in the upper and 7 in the lower jaw and 4 bitewings

Normal findings in x-rays


dentin and enamel have different shades

due to variation in mineralization


radiopacity: enamel dentin pulp cemento-enamel junction should be recognized lamina dura


thin layer of dense bone surrounding the root thin radiolucent area between root and lamina dura bone that extens between the teeth normal level no more than 1,5 mm from cemento-enamel junction

periodontal ligament space

alveolar crest

Normal bone findings in x-rays


cortical bone  superficial layer of all bones  better visible in mandible than in maxilla  dense and hard bone cancellous bone  s.c. trabecular bone  trabeculation varies  net-like appearance

Today the upper jaw!!

Normal findings in x-rays, upper jaw

Intermaxillary suture  visible in occlusal radiographs Anterior nasal spine  visible in periapical radiograph Incisive foramen  visible in periapical or occlusal radiograph Maxillary sinus  in OPG and periapical x-rays Zygomatic process  in opg and periapical x-rays


Name the following structures j

a enamel b dentin c enamel-dentin junction d pulp horn e pulp chamber f root canal g furcation area h cancellous bone between the roots i furcation area..enamel pearl? j lamina dura k PDL space l lamina dura (approximal)

i L k

c d e g h

a b

b c

Identify the teeth: 21, 22, 23 (24, 25) Locate the radiographic apices of these teeth Name the structures: a floor of nasal fossa b inverted Y (crossing sinus max-nasal cavity) c floor of sinus max d soft tissue of the nose

The lateral fossa between the lateral and the canine

Upper anterior

Identify the teeth and name the structures

12, 11; 21 22 a nasal septum b nasal mucosa c nasal fossa d floor of the nasal fossa e anterior nasal spine f intermaxillary suture g incisive foramen h soft tissue of the nose

g f h

a Identify the teeth and name the structures b f

Identify the teeth: 14, 13, 12 a floor nasal cavity b floor sinus max c filling, plastic d filling in plastic e PDL of the second root f Lateral fossa

d c

Canine view/x-ray

Identify the teeth: and name the structures

a b

d Identify the teeth: 21, 22, 23, 24, 25, 63, 64, 65 c Estimate the age: 8-9 y a floor nasal fossa b bony crypt (developing tooth) c follicular space d not fully formed root .

Premolar and molar view


c d

Locate the radiographic apexes of these teeth. Name the structures

a zygomatic arch bZygomatic bone inferior border c tooth bud d follicular space


a c d

Locate the radiographic apexes of these teeth. Name the following structures
a lateral part of floor of nasal fossa b sinus max inferior border c septum in sinus max d posterior wall of SM

Identify the teeth and name the strucures

d c a b

Identify the teeth: 17 to 27 (55 to 53, 63 to 65) Name the following structures a Nasal septum, intermaxillary suture b superior foramina of the nasopalatine canal c sinus max d nasolacrimal duct

c b a


a Proc. Coronoideus

b tuberosity
c pterygoid plates d proc. Zygomaticus Locate the radiographic apices of these teeth Name the following structures

Identify the area and name structures

a b f c

Identify the area:upper anterior (midline), edentulous patient Name the following structures a nasal fossa b mucosa of nasal fossa c floor of nasal cavity d nose e nose opening f anterior nasal spine

Thanks for answer this question!!