abscessed versus sinus

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demonicr

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how do you tell from an x-ray if a tooth is abscessed, by looking at a tooth that is superimposed on the sinuses? everything just looks dark.
 
demonicr said:
how do you tell from an x-ray if a tooth is abscessed, by looking at a tooth that is superimposed on the sinuses? everything just looks dark.

If the tooth is superimposed on the sinus the x-ray angulation was incorrect. Once you start looking at radiographs I don't think you'll have any problem identifying a PARL (periapical radiolucency). But here are some ways you can tell it is a normal anatomical structure:

1) Reposition x-ray cone and take another film
2) Patient history
3) Look at a radiograph taken several years ago and see if it's different
4) Follow the pneumotization around the root of tooth. You should see cortical bone. Plus, an abscess just doesn't look like a sinus.
5) An abscess involving all posterior teeth is very unusual.
6) Does the tooth have caries or restorations?
 
An abscess technically would most likely be seen clinically. Maybe you are referring to rareifying osteitis...you should be able to see the floor of the sinus or maybe be able to follow the pdl of the infected tooth to differentiate? Maybe some budding radiology nerds can come help.
 
I usually just pull it so I can see first-hand.
 
toofache32 said:
I usually just pull it so I can see first-hand.
You can always reimplant it if you're wrong...what's the harm in looking?
 
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