COLLEGE OF DENTISTRY
ORAL AND MAXILLOFACIAL RADIOLOGY [323 MDS]
DEPARTMENT OF MAXILLOFACIAL SURGERY AND
DIAGNOSTIC SCIENCES [MDS]
STUDY GUIDE
1
Message from the Dean
Assalamu alaikum wa rahamatullahi wa barakatahu
It is my pleasure to welcome you to the College of Dentistry - Zulfi at Majmaah University,
Kingdom of Saudi Arabia. College of Dentistry aims to improve the dental health of the
people in Kingdom of Saudi Arabia through providing the students with excellent clinical
training, supporting research and learning environment. Towards this goal the Department of
Maxillofacial Surgery & Diagnostic Sciences has prepared a study guide in Oral Radiology – 2
for the benefit of the students.
I have read this study guide and would like to assure you that the team has done an
excellent job in addressing all the questions a student will have at the start of the course. This
guide also contains all the schedule of lectures and practical classes. I would like to
congratulate the team for coming up with this guide.
I am happy to be the Dean of the College of Dentistry and I am sure that the assurance
from the dedication of our energetic and benevolent faculty and staff prompts you to be
skilled and knowledgeable in attaining high standard of education.
Best wishes
Dr. Abdur Rahman Al Atram
2
Message from the members of the committee
Dear Students,
We are delighted to welcome you to the course of Oral Radiology2. This
is a course which you will be studying in a span of two semesters; this study
guide will inform and update you about the various topics to be covered in 3rd
year first and second semester.
The topics covered in this module are highly relevant and have clinical
implications which will be of great help in your professional life. This course is
one of the very important and relatively continuous course which was taken in
last year with a name of oral radiology 1. It takes you further in radiology in
terms of identification of different lesions on the radiographs as well as recent
and relevant advancements in the field of dental radiology. Hence we the
committee suggest you to use this guide to prepare yourself during the course
and gain maximum benefit.
Best wishes & Good luck
Members of Committee
3
APPROVAL FOR THE COURSE
This course has been reviewed, revised and approved by:

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The Department of Maxillofacial Surgery and Diagnostic Sciences
College Curriculum Committee
College Council
4
TABLE OF CONTENTS
Page No
1
Message from the Dean
1
2
Message from the members of the committee
2
3
Approval of the course
3
4
General course information
5
5
Course description
6
6
General course objectives
7
7
Course contents
8
8
Detailed objectives of lectures
15
9
Detailed objectives of practicals
22
10
Student additional private study hours per week & student
support
28
11
Teaching & learning resources
29
12
Facilities required
31
13
Students Assessment
32
14
Course evaluation & Improvement process
34
5
GENERAL COURSE INFORMATION
Course Title
Course Code
Course
components
&
Credit Hours
Oral Radiology – II
323 MDS
Theory
First semester
Practical
Total
1
1
1
0
1
1
Second semester
Prerequisites
223MDS; 233MDS; 242MDS
Co-requisites
Anatomy of head and neck, different oral diseases and there clinical features
for the identification of radiographic findings
General Course Description
This course is a continuation of the previous oral radiology course 223MDS. It
deals with the advancement in dental radiology as well as the understanding of
different diseases and its appearance on the radiographs. It also helps in
identifying different diseases with similar radiographic features and
differentiating them based on their clinical symptoms. It is a continous course in
3rd year which runs for 1st and 2nd semester with an exception that the second
semester has only practical but no theory.
6
General Course objectives
At the end of the course, students should be able to –
1. Know the different types of radiographs that can be taken.
2. Understand the differential diagnosis of different oral diseases seen on radiographs.
3. Developing the students skills to obtain high quality dental radiographic images
4. Interpretation of these radiographic images
7
COURSE CONTENTS:
A - Lectures: 1st semester – 14 lectures
S.No
List of topic
1
Schedule
Detailed content
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2
3
4
5
6
Differential
Diagnosis of
Periapical
Radiolucenci
es
Differential
Diagnosis of
Pericoronal
Radiolucencies
Differential
Diagnosis of
Periapical
Radiopacities
Differential
Diagnosis of
Multilocular
Radiolucencues
Soft Tissue
Calcification
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No of
weeks
1
Contact
hours
1
1
1
Classification of
pericoronal radiolucencies
Radiographic features
Various modifications in
radiographic appearances
1
1
Classification of periapical
radiopacities
Radiographic features
Various modifications in
radiographic appearances
1
1
1
Classification of
Multilocular radiolucencies
There Radiographic
features
Various modifications in
radiographic appearances
Classification of soft tissue 1
calcifications
There Radiographic
features
Various modifications in
radiographic appearances
1
Self introduction to the
class
Introduction of the course
Schedule of the classes
Overview of the lectures
to be covered
Classification of periapical
radiolucencies
Radiographic features of
periapical radiolucencies
Various modifications in
radiographic appearances
1
8
7–8
Radiographic
Features of
diseases of
Bones and Joints
9
Computed
Tomography
10
Ultrasonography
11
MRI
12
Contrast
Medium
13
Salivary Gland
Imaging and its
disorders
14
Other
Specialized
Radiography
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Classification of
Fibrosseous
There Radiographic
features
Various modifications in
radiographic appearances
2
2
Introduction
Working principle
Dental Applications
Advantages
Limitations
Introduction
Working principle
Dental Applications
Advantages
Limitations
Introduction
Working principle
Dental Applications
Advantages
Limitations
Introduction
Working principle
Dental Applications
Advantages
Limitations
Introduction
Working principle
Dental Applications
Advantages
Limitations
Introduction
Working principle
Dental Applications
Advantages
Limitations
1
1
1
1
1
1
9
B - Practicals: 1st semester – 14 practicals
S.No
List of topic
1
Schedule
Detailed content


2
Panoramic
Radiographic
Procedure



3
Panoramic
Radiographic
Procedure



No of
weeks
1
Contact
hours
1
1
1
Supervision of Infection
control in Panoramic room
Supervision on Parts of
panoramic machine
Supervision of Technique of
taking radiograph
1
1
How the x ray machine
works
Different types of x ray
films
Demonstration of Infection
control in Panoramic room
Demonstration on Parts of
panoramic machine
Demonstration of
Technique of taking
radiograph
4
Principles of
Interpretation


Classification of principles
There applications
1
1
5
Principles of
Interpretation

Procedure for interpreting
radiograph
Report writing on
radiographic interpretation
Various points to be
considered while
interpreting the radiograph
Correct procedure for
report writing
Suggesting differential or
final diagnosis seeing the
radiograph
Various points to be
considered while
interpreting the radiograph
Correct procedure for
report writing
Suggesting differential or
final diagnosis seeing the
radiograph
1
1
1
1
1
1

6
Interpretation
of Periapical
Radiolucencies
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
7–8
Interpretation
of periapical
Radiopacities
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10
9 – 10
Interpretation
of Multilocular
Tadiolucencies
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11 –12
Interpretation
of Diseases of
Bones and
Joints
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13 –14
Interpretation

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
Various points to be
considered while
interpreting the radiograph
Correct procedure for
report writing
Suggesting differential or
final diagnosis seeing the
radiograph
Various points to be
considered while
interpreting the radiograph
Correct procedure for
report writing
Suggesting differential or
final diagnosis seeing the
radiograph
Various points to be
considered while
interpreting the radiograph
Correct procedure for
report writing
Suggesting differential or
final diagnosis seeing the
radiograph
1
1
1
1
1
1
11
D - Practicals: 2nd semester
S.No
List of topic
1
2
Introduction
Exercise on
IOPA
Radiographs


Practical schedule
Supervision while taking
radiograph and doing
interpretation
3
Occlusal
Radiography

Supervision while taking
radiograph and doing
interpretation
4
Exercise on
Panoramic
Radiogra[hy

Supervision while taking
radiograph and doing
interpretation
5
Exercise on
Lateral
Cephalogram

Supervision while taking
radiograph and doing
interpretation
6
7
Exercise on
Paranasal Sinus
View
Exercise on PA
Mandible
8
Exercise on
Reverse
Towne’s
9
Interpretation
of Lateral
Cephalogram
Interpretation
of Para Nasal
Sinus
10
11
Interpretation
of PA Mandible
12
Interpretation
of Reverse
Towne’s
Detailed content
No of
weeks
1
1
No of
weeks
1
1
1
1
1
1
1
1

Supervision while taking
radiograph and doing
interpretation
1
1
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Supervision while taking
radiograph and doing
interpretation
1
1
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Supervision while taking
radiograph and doing
interpretation
1
1

Taking of Radiograph
without supervision
1
1
1
1
1
1
1
1

Taking of Radiograph
without supervision
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Taking of Radiograph
without supervision
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Taking of Radiograph
without supervision
12
13
TMJ imaging
14
Specialized
radiography
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
Taking of Radiograph
without supervision
1
1
1
1
1
1
Different techniques that
can be followed using the
OPG machine –
demonstration
Final exam
Working principle of Intensifying Screen
13
Detailed Objectives of the Content
LECTURES
Semester 1
Lecture I – Schedule
At the end of the lecture students will be able to –
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Self introduction to the class
Understand the introduction of the course
Understand the Schedule of the classes
Understand the Overview of the lectures to be covered
Lecture 2 Differential Diagnosis of Periapical Radiolucencies
At the end of the lecture students will be able to –
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Classify periapical radiolucencies
Identify the Radiographic features of periapical radiolucencies
Identify various modifications in radiographic appearances
Lecture – 3 Differential Diagnosis of Pericoronal Radiolucencies
At the end of the lecture students will be able to
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
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Classify periapical radiopacities
Identify the Radiographic features of periapical radiopacities
Identify various modifications in radiographic appearances
Lecture – 4 – Differential Diagnosis Periapical Radiopacities
At the end of the lecture the students will be able to know –

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
Classify periapical radiopacities
Identify the Radiographic features of periapical radiopacities
Identify various modifications in radiographic appearances
Lecture – 5 – Differential Diagnosis of Multilocular Radiolucencies
At the end of the lecture students will be able to –
14
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Classify Multilocular radiolucencies
Identify the Radiographic features
Identify various modifications in radiographic appearances
Lecture -6 – Soft Tissue Calcification
At the end of the lecture students will be able to –
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Classify soft tissue calcifications
Identify the Radiographic features
Identify the various modifications in radiographic appearances
Lecture – 7 – 8 – Radiographic Features of Diseases of Bones & Joints
At the end of the lecture students will be able to –
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Classify the Fibrosseous lesions of bones and joints
Identify Their Radiographic features
Identify the various modifications in radiographic appearances
Lecture – 9 – Computed Tomography
At the end of the lecture students will be able to –
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Introduction
Working principle
Dental Applications
Advantages
Limitations
Lecture – 10 – Ultrasound
At the end of the lecture students will be able to –
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Introduction
Working principle
Dental Applications
Advantages
Limitations
15
Lecture – 11 – Magnetic Resonance Imaging (MRI)
At the end of the session students will be able to –
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Introduction
Working principle
Dental Applications
Advantages
Limitations
Lecture – 12 – Contrast Medium
At the end of the session students will be able to –
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Introduction
Working principle
Dental Applications
Advantages
Lecture – 13 – Salivary Gland Imaging
At the end of the session students will be able to –
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Introduction
Working principle
Dental Applications
Advantages
Limitations
Lecture – 14 – Other Specialized Radiography
At the end of the session students will be able to –
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Introduction
Working principle
Dental Applications
Advantages
Limitations
16
PROCESS OF MANUAL FILM DEVELOPING
PATIENT OF CLEIDO CRANIAL DYSPLASIA WITH MULTIPLE TEETH IMPACTION
17
Practical’s 1st Semester
Semester I
Practical 1 – Schedule –
At the end of the practical session students will be able to –
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Know the weekly schedule of the practical
What are the things that he should remember when he comes to the practical
The different equipments in the x ray department
Procedure to be followed –
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A course schedule will be discussed with the student to make them aware of the procedures
that they need to do in this semester
To make him aware of the dress code he should follow to enter in the clinics
He will be introduced to the extra oral radiographic machine to make him aware of the
equipment
Practical 2 – Panoramic Radiographic Procedure
At the end of the practical students will be able to know –
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Infection control in Panoramic room
Parts of panoramic machine
Technique of taking radiograph
Procedure to be followed –
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Demonstration of Infection control in Panoramic room
Demonstration on Parts of panoramic machine
Demonstration of Technique of taking radiograph
Practical 3 – Panoramic Radiographic Procedure
At the end of the practical students will be able to –
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Perform the Infection control in Panoramic room
Enumerate the of Parts of panoramic machine
Take the radiograph by themselves independently
Procedure to be followed –
 Every student will be individually supervised while he performs the infection control procedure
 He will be guided individually while he takes the panoramic radiograph
18
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He will be further guided to use the computer to make a proper entry before, during and after
procedure to make the radiograph available for further use
Practical 4 – Principles of Interpretation
At the end of practical students will be able to –
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Classify the principles of interpretation
Identify the application of principles of interpretation
Proceed with interpreting radiograph
To do adequate Report writing on radiographic interpretation
Procedure to be followed –
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Students will be given written proforma to guide them how to interpret a radiograph
Every student will be given a previously diagnosed and interpreted radiograph
The interpretation will be seen individually for each student and his relevant doubts will be
cleared
Emphasis will be given towards the procedure for writing the interpretation
Practical 5 and 6 – Interpretation of Periapical Radiolucencies
At the end of the practical students will be able to –
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

Understand the various points to be considered while interpreting the radiograph
Perform correct procedure for report writing
Suggest differential or final diagnosis seeing the radiograph
Procedure to be followed –
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Students will start taking relevant periapical and panoramic radiographs that report to the clinic
The patient radiographs will be interpreted by every student independently
Depending on the lesion each student will be guided towards proper understanding of the lesion
Old radiographs will be given as a guide to train him to understand the different appearances of
the same lesion where ever possible
19
Practical 7 and 8 – Interpretation of periapical Radiopacities –
At the end of the practical the students will be able to –
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
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Understand the various points to be considered while interpreting the radiograph
Perform correct procedure for report writing
Suggest differential or final diagnosis seeing the radiograph
Procedure to be followed –
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


Students will start taking relevant periapical and panoramic radiographs that report to the clinic
The patient radiographs will be interpreted by every student independently
Depending on the lesion each student will be guided towards proper understanding of the lesion
Old radiographs will be given as a guide to train him to understand the different appearances of
the same lesion where ever possible
Practical 9 and 10 – Interpretation of Diseases of Bones and Joints
At the end of the practical the students will be able to –
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

Understand the various points to be considered while interpreting the radiograph
Perform correct procedure for report writing
Suggest differential or final diagnosis seeing the radiograph
Procedure to be Followed –
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Students will be given pre typed case summaries related to the pre stored radiographs showing
diseases of bones and joints.
The pre stored radiographs will be shown to the students to train them to understand how
these complex lesions appear on the radiograph
They will be trained to co – relate the clinical features from the typed case proforma to the
radiographic appearance to understand the radiographs more clearly
Practical 11 and 12 – Interpretation of multi locular radiolucencies
At the end of the session students will be able to –



Understand the various points to be considered while interpreting the radiograph
Perform correct procedure for report writing
Suggest differential or final diagnosis seeing the radiograph
20
XCP – Extended Cone Positioning Paralleling Cone Technique
XCP – Cone Holder Positioning
Bisecting Angle Film Holder – Snap A Ray
Practical
Semester 2
Practical – 1 – schedule –
At the end of the lecture students should be able to –
 To enumerate the topics to be covered in the course
 To understand and explain the importance of the course
 To enlist the books used as learning resources in the course
Procedure to be followed –
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Students will be given a course syllabus which will be explained in detail to them to make them
aware towards what has to be done in this semester
Importance of different radiographic procedures will be explained to the students briefly
The radiographic machine to be used for advanced radiographs will also be shown
21
Practical – 2 – Exercise on IOPA Radiographs –
At the end of the practical’s the students will be able to know –

Understand the procedure of taking radiograph and doing interpretation
Procedure to be followed –


Students will be individually supervised to acknowledge how they take IOPA radiographs that
they have learnt throughout the course of radiology which is of one and half year
Every student will be supervised how he interpret this basic radiograph to make sure that they
are prefect with this basic radiographic diagnostic tool
Practical – 3 – Occlusal Radiography
At the end of the practical’s the students will be able to know –

Understand the procedure of taking radiograph and doing interpretation
Procedure to be followed –


Students will be individually supervised to acknowledge how they take occlusal radiographs that
they have learnt throughout the course of radiology which is of one and half year
Every student will be supervised how he interpret this basic radiograph to make sure that they
are prefect with this intra oral radiographic diagnostic tool
Practical – 4 and 5 – Exercise on Panoramic Radiography
At the end of the practical students will be able to –

Understand the procedure of taking radiograph and doing interpretation
Procedure to be followed –


Students will be individually supervised to acknowledge how they take panoramic radiographs
that they have learnt in the last semester
Every student will be supervised how he interpret this radiograph to make sure that they are
prefect in it
Practical – 6 and 7 Exercise on Lateral Cephalogram
At the end of the session students will be able to know –

Understand the procedure of taking radiograph and doing interpretation
22
Procedure to be followed –



Students will be given a demonstration as to how to perform the procedure
Every student will be individually supervised while he performs the procedure
Every student will be individually supervised while he interprets this radiograph
Practical 8 and 9 – Exercise on Paranasal Sinus View
At the end of the session students will be able to know –

Understand the procedure of taking radiograph and doing interpretation
Procedure to be followed –



Students will be given a demonstration as to how to perform the procedure
Every student will be individually supervised while he performs the procedure
Every student will be individually supervised while he interprets this radiograph
Practical – 10 and 11 – Exercise on PA Mandible
At the end of the session students will be able to know –

Understand the procedure of taking radiograph and doing interpretation
Procedure to be followed –



Students will be given a demonstration as to how to perform the procedure
Every student will be individually supervised while he performs the procedure
Every student will be individually supervised while he interprets this radiograph
Practical – 12 and 13 – Exercise on Reverse Towne’s
At the end of the session students will be able to know –

Understand the procedure of taking radiograph and doing interpretation
Procedure to be followed –



Students will be given a demonstration as to how to perform the procedure
Every student will be individually supervised while he performs the procedure
Every student will be individually supervised while he interprets this radiograph
23
Student additional private study hours per week & student support:
In Additional to the credit hours in the college hours the student is expected to put in 5 hours of private
study/learning hours per week. (This is an average for the semester not a specific requirement in each
week).
The students are encouraged to interact with the tutors of the course for any additional help required
during the course. The staff members are instructed to be in the office during the office hours so that
the students can approach the faculty for their help
After each class the faculty member allocates a few minutes to clear the doubts of the students if
needed
The power point presentation of each class is uploaded on the faculty member’s website from where
the students can easily retrieve it and come prepared for the lecture.
Group of three students are allotted to one faculty member, who is their mentor, the students can even
approach their respective mentors if they have any additional problems with the subject.
24
Teaching and learning resources:
Students will be shown power point presentations, quiz, and essay competition. During the practicals
students will be shown microscopic slides, models and casts to give them in depth knowledge and
understanding of the subject.
Use of more teaching aids during classes with special emphasis on the applied aspects of the structures,
impromptu questions asked during the class would also aid in developing cognitive skills. In addition we
would design quizzes and assignments in such a way that the students would have to correlate the various
topics and information given to them.
The students will be asked oral questions, debates, group discussions group tasks will be designed so that
the students learn to interact with their batch mates. In addition project work will be assigned to small
groups so that they learn to take up the responsibility and complete it.
Radiographic X Ray Tube which is the main component of any radiographic
machine
25
Recommended text books:
Textbook
Oral Radiology – Principles and Interpretation;
Author – White and Pharoah
Textbook
Principle’ s of Dental Imaging
Author – Langland and Langlais
Reference book
Recommended books
Shafer’s Text book of Oral Pathology
Oral Radiology – Principles and Interpretation;
Author – White and Pharoah
Website
www.oral radiology.com
26
Lab guide
Textbook of Dental Radiography
Author – Jansen and Harring
Facilities Required:
Theory: A class room with a seating capacity of at least 30 students, equipped with a projector and
smart board.
Practical: A well equipped radiology department with 3 IOPA machines, 2 panoramic machines,
automatic processor and clinics with individual computers which are connected to the radiographic
machine and can show the radiographic images
27
Student Assessment
Evaluation & assessment of students:
By Oral and Written examination, periodic assessment through assignments, evaluation of the projects
and group tasks.
Assessment of student communication skills will be through the seminars and term papers.
1st Semester
Assessment tools
Assessment
IN COURSE
ASSESSMENT – 60%
FINAL – 40%
Percentage
Behavior/Attitude
5%
Presentation
2%
Research
2%
Quiz
1%
Mid Term Theory
20%
Mid Term Practical
10%
Weekly Practical assessment
10%
Oral Exam
10%
Final Exam Theory
30%
Final Practical Exam
10%
THEORY – 50% AND PRACTICAL – 50%
2nd Semester
Assessment tools
Assessment
IN COURSE
ASSESSMENT – 60%
FINAL – 40%
Percentage
Behavior/Attitude
5%
Presentation
2%
Research
2%
Quiz
1%
Mid Term Practical
20%
Weekly Practical assessment
20%
Oral Exam
10%
Final Practical Exam
40%
PRACTICAL – 100%
The final marks obtained for the course will be decided by taking 70% marks from first semester and
30% from second semester.
28
SEMINARS
A. Guidelines for seminar sessions:
1. One seminar per student is scheduled during the semester.
2. Duration of each seminar will be of 15 minutes.
3. The students will be given the topics for seminar at least two weeks in advance. The topics
will be selected randomly by the students by a picking a slip (lottery method).
4. The student is expected to prepare a power point presentation for the seminar. They can
take the help of a staff member in preparing themselves for the presentation.
5. After each session group discussion will be allowed.
6. The tutor (faculty member in charge) will give his comments and feed back about the
presentation.
7. All the students are expected to be present during the seminars and also prepare
themselves by reading about the topic of presentation so as to have an active and
productive group discussion.
8. Seminars grading will be grouped under the theory assignment
B. Topics of Seminar
S.No
Topic Name
1.
Periapical Granuloma
2
Periodontal Abscess
3
Periapical Cyst
4
Dentigerous Cyst
5
Para Dental Cyst; Eruption Cyst; Gingival Cyst of Newborn
6
Ameloblastoma
7
Aneurysmal Bone Cyst
8
Principle of CT Scan
9
Magnetic Resonance Imaging
10
Radiation Therapy – Introduction, Working Principle
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11
History of X Ray
12
Digital Radiography
13
Apical Periodontitis
14
Dento – Alveolar Abscess
15
Periapical Scar
16
Multi Locular Cyst
17
Central Giant Cell Granuloma
18
Hyperparathyroidism
19
Soft Tissue Calcifications
20
Focal and Florid Cemento – Osseous Dysplsia
21
Digital Radiography
Seminar Topics in Second Semester
S.No
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
Name of Topic
Radiation Therapy – 1
Adverse Effects of Radiation Therapy on Oral Tissues– 2
Panoramic Radiography – 1
Patient Positioning in Panoramic Radiography – 2
Role of Nuclear Imaging in Head and Neck
Principles of Radiographic Interpretation
Cone Beam Computed Tomography
Digital Radiography
Posterio – Anterior View
Reverse Towne’s View
Faulty Intra Oral Radiographs
Sialography
Scintigraphy
Subtraction Radiography
Multi Locular Radiolucencies
Age Assessment Using Dental Radiographs
Forensic Odontology
Osteomyelitis
Radiology For Implants
Radiology In Trauma Imaging
Radiographic Differential Diagnosis of Dental Caries
Radiographic Differential Diagnosis of Periodontal Disease
Radiographic Features of Malignancies
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Course Evaluation & Improvement Process:
The students will be given a feedback form which can be submitted to the course director or to the dean
who will help in improvement of the subject teaching
Meetings will be conducted every week in the department to update the status of each student and the
difficulties felt by the colleague will be resolved accordingly.
Teachers will be subjected to go for up – gradation of knowledge by attending the relevant conferences
and will be encouraged to carry on a self improvement.
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