Sunday, May 28, 2023

Radiographic evaluation in extraction EXCEPT.. Root configuration and surrounding bone condition



Radiographic evaluation in extraction EXCEPT?

  • A- Relationship of associated withal structure
  • B- Root configuration and surrounding bone condition
  • C- Access to the tooth , crown condition and tooth mobility
  • D- All
  • E- A + B***

typical radiographic images:

The typical radiographic images that are obtained to define scoliosis include the upright images of the whole spine taken from the back as well as from the side. These radiographs are often done with lead shields to less irradiate the patient while allowing a complete view of the spine. Your doctor will be able to measure X-rays to determine the amount of curvature, which is measured in degrees according to the Cobb method. A right spine has a curvature of 0 °, any curvature of more than 10 ° to be considered scoliosis. Between 0 ° and 10 °, we speak of "postural asymmetry" which is not a true scoliosis. The way the patient stands on the X-ray and many other factors can result in moderate curvature. Profile radiography is performed to evaluate thoracic kyphosis (or round back) and lumbar lordosis (arch).

determine the flexibilityof the curvature:

Other radiographs can be performed to determine the flexibility of the curvature (or how it is recovering). These reducibility pictures can be made in different ways. These pictures can be made on patients lying on a table and inclined to the right and to the left. Clich├ęs in traction are made with traction on the arms and legs to stretch the spine. A tilt shot with fulcrum is taken with a cushion placed at the top of the curvature to increase its correction. These pictures are rather made as part of a preoperative assessment.

Magnetic resonance imaging:

Magnetic resonance imaging (MRI) of the spine is often performed in patients with SIA. MRI is specifically used to evaluate structures other than vertebrae, for example to explore the spinal cord and eliminate any abnormalities. An MRI is usually requested if your doctor finds some minimal neurological abnormalities during the clinical examination, if there is any clear pain associated with scoliosis or if the x-rays show atypical scoliosis. The likelihood of finding something abnormal on MRI is low, but if abnormalities are recognized, contact a neurosurgeon.

 risk of aggravation of the curvature:

Treatment of adolescent idiopathic scoliosis includes three methods: observation, corset and surgery. The proposed treatment is based on the risk of aggravation of the curvature. In general, the curvature of the SIA progresses during the patient's rapid growth period. While most curvatures slow their progression significantly to skeletal maturity, a few, specifically curvatures greater than 60 °, continue to progress into adulthood.

growth potential assessed:

As scoliosis worsens during rapid growth, growth potential is assessed by taking into account the age of the patient, the age of first menses, and radiological parameters. Young girls grow up very quickly until their first period and then their growth usually slows down. Female patients continue to grow until approximately two years after their first menstruation.

maturity of the spine:

X-rays of the spine, pelvis, hand and wrist are often used to assess growth. The sign of Risser is often used to determine the skeletal maturity of the pelvis of the child, correlated with the maturity of the spine. This test Risser can classify the skeletal maturity on a scale of 0 to 5. Patients who have a Risser 0 and 1 test are growing rapidly, while those who have a test of 4 and 5 have finished growing. Generally patients who are treated for scoliosis should have their height measured at each visit to determine their growth potential.