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Oral Radiology PRINCIPLES and INTERPRETATION To access your Student Resources, visit: http://evolve.elsevier.com/White/oralradiology/ Evolve ® Student Resources for White/Pharoah: Oral Radiology: Principles and Interpretation, 6th Edition, offer the following features: • Web Resources • Suggested Reading Lists http://evolve.elsevier.com/White/oralradiology/ Oral Radiology PRINCIPLES and INTERPRETATION Sixth Edition STUART C WHITE, DDS, PhD Distinguished Professor Section of Oral and Maxillofacial Radiology School of Dentistry University of California, Los Angeles Los Angeles, California MICHAEL J PHAROAH, DDS, MSc, FRCD(C) Professor, Department of Radiology Faculty of Dentistry University of Toronto Toronto, Ontario Canada 11830 Westline Industrial Drive St Louis, Missouri 63146 ORAL RADIOLOGY: PRINCIPLES AND INTERPRETATION ISBN: 978-0-323-04983-2 Copyright © 2009, 2004, 2000, 1994, 1987, 1982 by Mosby, Inc., an affiliate of Elsevier Inc All rights reserved No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Permissions may be sought directly from Elsevier’s Rights Department: phone: (+1) 215 239 3804 (US) or (+44) 1865 843830 (UK); fax: (+44) 1865 853333; e-mail: healthpermissions@elsevier.com You may also complete your request on-line via the Elsevier website at http://www.elsevier.com/permissions Notice Neither the Publisher nor the Authors assume any responsibility for any loss or injury and/or damage to persons or property arising out of or related to any use of the material contained in this book It is the responsibility of the treating practitioner, relying on independent expertise and knowledge of the patient, to determine the best treatment and method of application for the patient The Publisher Library of Congress Cataloging-in-Publication Data Oral radiology : principles and interpretation / [edited by] Stuart C White, Michael J Pharoah.—6th ed p ; cm Includes bibliographical references and index ISBN 978-0-323-04983-2 (pbk : alk paper) Teeth—Radiography Jaws—Radiography Mouth—Radiography I White, Stuart C II Pharoah, M J [DNLM: Radiography, Dental WN 230 O63 2009] RK309.O7 2009 617.6′07572—dc22 2008016461 Vice President and Publisher: Linda Duncan Senior Editor: John Dolan Managing Editor: Jaime Pendill Publishing Services Manager: Patricia Tannian Project Manager: Claire Kramer Design Direction: Kimberly Denando Working together to grow libraries in developing countries www.elsevier.com | www.bookaid.org | www.sabre.org Printed in China Last digit is the print number: TO OUR FAMILIES Liza Heather, Kelly, Ingrid, Xander, and Zeke Linda Jayson, Edward, and Lian This page intentionally left blank CONTRIBUTORS Byron W Benson, DDS, MS Professor and Vice Chair Department of Diagnostic Sciences Texas A&M Health Science Center Baylor College of Dentistry Dallas, Texas Alan G Lurie, DDS, PhD Professor and Chair Oral and Maxillofacial Radiology University of Connecticut School of Dentistry Farmington, Connecticut Sharon L Brooks, DDS, MS Professor Department of Periodontics and Oral Medicine University of Michigan School of Dentistry Ann Arbor, Michigan André Mol, DDS, MS, PhD Assistant Professor Department of Diagnostic Sciences and General Dentistry University of North Carolina at Chapel Hill School of Dentistry Chapel Hill, North Carolina Laurie C Carter, DDS, PhD Professor and Director Oral and Maxillofacial Radiology Director of Advanced Dental Education Virginia Commonwealth University School of Dentistry Richmond, Virginia Carol Anne Murdoch-Kinch, DDS, PhD Associate Professor Department of Oral and Maxillofacial Surgery/Hospital Dentistry University of Michigan Ann Arbor, Michigan Allan G Farman, BDS, PhD (odont), DSc (odont) Professor, Division of Radiology and Imaging Science Department of Surgical and Hospital Dentistry Clinical Professor, Department of Diagnostic Radiology School of Medicine Adjunct Professor, Department of Anatomical Sciences and Neurobiology University of Louisville Louisville, Kentucky Mel L Kantor, DDS, MPH, PhD Professor Division of Oral and Maxillofacial Radiology Department of Diagnostic Sciences UMDNJ New Jersey Dental School Newark, New Jersey Ernest W.N Lam, DMD, PhD, FRCD(C) Associate Professor Oral and Maxillofacial Radiology University of Toronto Toronto, Ontario, Canada Linda Lee, DDS, MSc, Dipl ABOP, FRCD(C) Dental Oncology Princess Margaret Hospital University Health Network University of Toronto Toronto, Ontario, Canada Susanne Perschbacher, DDS, MSc, FRCD(C) Assistant Professor Oral and Maxillofacial Radiology University of Toronto Toronto, Ontario, Canada C Grace Petrikowski, DDS, MSc, FRCD(C) Associate Professor Faculty of Dentistry, University of Toronto Toronto, Ontario, Canada Axel Ruprecht, DDS, MScD, FRCD(C) Gilbert E Lilly Professor of Diagnostic Sciences Professor and Director of Oral and Maxillofacial Radiology Professor of Radiology Professor of Anatomy and Cell Biology The University of Iowa Iowa City, Iowa William C Scarfe, BDS, MS, FRACDS Professor Radiology and Imaging Sciences University of Louisville School of Dentistry Louisville, Kentucky Vivek Shetty, DDS, Dr Med Dent Professor Section of Oral and Maxillofacial Surgery UCLA School of Dentistry Los Angeles, California John B Ludlow, DDS, MS, FDS, RCSEd Professor of Oral and Maxillofacial Radiology University of North Carolina at Chapel Hill School of Dentistry Chapel Hill, North Carolina vii viii CONTRIBUTORS Sotirios Tetradis, DDS, PhD Professor Section of Oral and Maxillofacial Radiology UCLA School of Dentistry Los Angeles, California Ann Wenzel, PhD, Dr Odont Professor and Head Department of Oral Radiology School of Dentistry University of Aarhus Aarhus, Denmark Robert E Wood, DDS, PhD, FRCD(C), DABFO Head, Department of Dental Oncology Princess Margaret Hospital Associate Professor, University of Toronto Toronto, Ontario, Canada PREFACE Each new edition of this textbook provides the opportunity to include recent progress in our rapidly changing field of diagnostic imaging Every chapter has been revised in light of new knowledge, technology, and techniques It is the continuing goal of our textbook to present the underlying science of diagnostic imaging, including the core principles of image production and interpretation for the dental student For the first time, we are able to offer supplemental resources to both instructors and students We will have a companion Evolve website (http://evolve.elsevier.com/White/oralradiology) for the sixth edition For instructors, a test bank and image collection will save time in preparing for lectures and examinations For students, it provides added practice with case studies and links to more resources We are sincerely appreciative of the contributions of all authors for sharing their expertise with the reader and acknowledge the superb contributions of previous contributors, Kathryn Atchison and Neil Frederiksen This edition welcomes three new authors Dr William C Scarfe and Dr Allan G Farman, colleagues at the University of Louisville, prepared an excellent new chapter on cone-beam imaging This imaging modality is rapidly evolving and making substantive superb contributions to diagnostic challenges involving placement of dental implants, detection and interpretation of dental and osseous disease, and cephalometric analysis Their chapter describes the underlying principles and clinical applications of this technology Dr Susanne Perschbacher at the University of Toronto rewrote the chapter on periodontal diseases, a critical subject in oral health that dentists manage daily The chapters on radiographic manifestations of disease in the orofacial region have been updated with an effort to keep a balance between the amount of detailed information and the depth of knowledge required for the dental student The additions include the latest information on etiology and diagnosis and more examples of advanced imaging, including cone-beam computed tomography images New concepts on the classification of oral and maxillofacial diseases published by the World Health Organization have been introduced Also, the clinical and radiologic aspects of new entities have been included, such as bisphosphonate-related osteonecrosis in the chapter on inflammatory lesions of the jaws The chapter on orofacial implants has been expanded and updated to include the application of new imaging modalities and new software programs to keep students and instructors abreast of this rapidly changing field Stuart C White Michael J Pharoah ix .. .Oral Radiology PRINCIPLES and INTERPRETATION To access your Student Resources, visit: http://evolve.elsevier.com/White/oralradiology/ Evolve ® Student Resources for White/Pharoah: Oral Radiology: ... Principles and Interpretation, 6th Edition, offer the following features: • Web Resources • Suggested Reading Lists http://evolve.elsevier.com/White/oralradiology/ Oral Radiology PRINCIPLES and. .. Department of Radiology Faculty of Dentistry University of Toronto Toronto, Ontario Canada 11830 Westline Industrial Drive St Louis, Missouri 63146 ORAL RADIOLOGY: PRINCIPLES AND INTERPRETATION