Maxillary and Mandibular Anatomic Radiographic Landmarks

Intraoral Radiography

Image(s) courtesy Dr. Allan G. Farman

Radiographs are two-dimensional representations of objects that occupy three dimensions. Facial, central and lingual features are superimposed. All landmarks are NOT clearly demonstrated on radiographs from all individuals.
William C. Scarfe

Tooth and supporting structures

Enamel
"

Lamina dura
"

radiopaque

radiopaque

Dentin and Cementum

"

Periodontal ligament space

"

radiopaque radiolucent

radiolucent radiopaque
William C. Scarfe

Pulp space
"

Alveolar bone
"

Image(s) courtesy Dr. Allan G. Farman

Alveolar bone Lamina dura pdl space Pulp space Cementoenamel junction Dentin-enamel junction Dentin Enamel
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ZYGOMATIC BONE

Anatomic Landmarks

MAXILLA

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Central incisor region: maxilla

Premaxillary/median palatal suture
"

Nasal septum
"

radiopaque radiopaque radiopaque

radiolucent

Anterior nasal spine

"

Incisive fossa / foramen

"

Inferior concha
"

radiolucent Radiolucent with radiopaque lines

Incisive canal
"

Soft tissues of nose and lips

"

radiopaque

Nasal passages (fossa or cavity)

"

radiolucent

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Central incisor region: Features

Anterior Nasal Spine

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Central incisor region: Features

Incisive Fossa / Foramen

William C. Scarfe

Central incisor region: Features

Nasal Septum

William C. Scarfe

Central incisor region: Features

Pre-maxillary / Median Palatine Suture

William C. Scarfe

Central incisor region: Features

Inferior Concha / Turbinates

William C. Scarfe

Central incisor region: Features

Nasal Fossa / Cavity / Meatus

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Central incisor region: Features

Incisive / Nasopalatine Canal

William C. Scarfe

Central incisor region: Features

Ala Cartilage Nose & Lip Line

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Maxillary Anterior
Nasal septum Nasal passage Anterior nasal spine Premaxillary suture

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Anterior Maxilla
Incisive fossa

Premaxillary suture

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Anterior Maxilla
Anterior nasal spine Incisive fossa Lamina dura Premaxillary suture Periodontal ligament space Pulp
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Nasal passage Nasal septum Anterior nasal spine Soft tissue shadow of nose Premaxillary suture Dental caries
Image(s) courtesy Dr. Allan G. Farman

Nasal passage

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Incisive fossa or periapical lesion?

The periodontal ligament spaces
"

intact. Same Lingual Opposite Buccal The incisive fossa being lingually situated moves on the resulting image in the same direction as the movement of the tubehead.
Image(s) courtesy Dr. Allan G. Farman

SLOB Rule
"

"

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

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Lateral/Canine region: Features

Canine Fossa

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Lateral/Canine region: Features

Antral / Inverted Y

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Lateral/Canine region: Features

Anterior Sinus

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Nasal passage Anterior nasal spine Canine eminence

Canine fossa

Image(s) courtesy Dr. Allan G. Farman

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Anterior wall of nasal passage

Canine fossa Soft tissue shadow of nose

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Inverted Y
Lateral wall of nasal fossa Maxillary sinus Anterior wall of maxillary sinus

Image(s) courtesy Dr. Allan G. Farman

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Inverted Y
Lateral wall of nasal fossa

Anterior wall of maxillary sinus (antrum)

William C. Scarfe Image(s) courtesy Dr. Allan G. Farman

Inverted Y Locule in maxillary sinus: note tooth periodontal ligament space intact Septum in maxillary sinus Bridge unit in porcelain fused to metal Radiolucent anterior filling material William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Premolar region: maxilla

Maxillary sinus
"

radiolucent

Maxillary sinus floor and septae

"

Occasionally: lateral wall of nasal passage

"

radiopaque

radiopaque radiolucent

Nutrient canals
"

Soft tissue shadow of lips/cheeks.

"

Nasolabial fold

William C. Scarfe

Premolar region: Features

Nasolabial Fold

William C. Scarfe

Premolar region: Features

Maxillary Sinus

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Premolar region: Features

Nutrient Canals

William C. Scarfe

Premolar region: maxilla

Image(s) courtesy Dr. Allan G. Farman

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Floor of maxillary sinus

Image(s) courtesy Dr. Allan G. Farman

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Maxillary molar region showing septum in sinus Zygomatic process of maxilla Soft tissue over tuberosity Septum in sinus

Image(s) courtesy Dr. Allan G. Farman

Floor of maxillary sinus

William C. Scarfe

st 1

nd 2

molar region: maxilla

Zygomatic process of the maxilla
" "

Maxillary sinus floor and septae

"

radiopaque radiolucent radiolucent

Maxillary sinus
"

U- shaped radiopaque

Nutrient canals
"

Zygomatic arch/zygoma
"

radiopaque Lateral wall of nasal passage radiopaque

William C. Scarfe

Less commonly:
"

"

Articular eminence Molar region: maxilla

Structures anterior to green line seen on intraoral radiographs

Image(s) courtesy Dr. Allan G. Farman

Zygomatic bone Zygomatic Arch Zygomatic process of maxilla Zygomatic process (temporal bone)
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Molar region: maxilla

Image(s) courtesy Dr. Allan G. Farman

Lateral pterygoid plate Pterygoid hamulus (medial Pterygoid) Maxillary tuberosity

William C. Scarfe

Molar region: maxilla

Image(s) courtesy Dr. Allan G. Farman

Pterygoid hamulus
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Endodontically treated tooth

Zygomatic process of the maxilla Zygomatic arch shadow Floor of maxillary sinus Maxillary tuberosity
Image(s) courtesy Dr. Allan G. Farman

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Zygomatic process of the maxilla

Shadow of zygomatic arch

Floor of maxillary sinus Coronoid Process (mandible)

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Nutrient canal

Floor of maxillary sinus Zygomatic arch Zygomatic process of maxilla

William C. Scarfe

nd 2

rd /3

molar region: maxilla

Maxillary sinus
"

Coronoid process of mandible\

"

radiolucent radiopaque radiolucent

radiopaque radiopaque)

Pterygoid hamulus
"

Maxillary tuberosity
"

Pterygoid notch
"

Posterior wall of maxillary sinus

"

radiopaque

Lateral pterygoid plate

"

radiopaque

William C. Scarfe

rd 3

molar region: maxilla

Zygomatic arch Zygomatic process of maxilla Coronoid process of mandible

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Maxillary tuberosity

Maxillary sinus

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Tuberosity

Dental follicle space

Image(s) courtesy Dr. Allan G. Farman

Zygomatic process of the maxilla

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Pterygoid hamulus

Air space
Image(s) courtesy Dr. Allan G. Farman

Posterior wall of maxillary sinus

William C. Scarfe

Pterygoid plate Zygomatic arch Pterygoid hamulus Coronoid process of mandible

Zygomatic process of maxilla

Image(s) courtesy Dr. Allan G. Farman

Floor of maxillary sinus

William C. Scarfe

Shadow of zygomatic arch

Pterygoid hamulus Maxillary tuberosity

Image(s) courtesy Dr. Allan G. Farman

Coronoid process of mandible

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Anatomic Landmarks MANDIBLE

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Incisor region: mandible

Lingual foramen
"

radiolucent radiopaque radiopaque radiopaque radiolucent

Genial tubercles
"

Soft tissue shadow of lower lip

"

Mental ridges
"

Nutrient canals
"
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Facial

Lingual

Mental depression Mental ridge Lingual groove Genial tubercles

Image(s) courtesy Dr. Allan G. Farman

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Soft tissue shadow of lower lip

Mental ridge Cortex of lower border of mandible

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Soft tissue shadow of lower lip Mental ridge Lingual foramen Cortical plate of lower border of mandible Genial tubercles
William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Periodontal ligament space

Second shadow of periodontal ligament space due to shape of root

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Nutrient canals

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Nutrient canals

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Nutrient canals in anterior mandible

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Embossed dot

Lingual foramen

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Image(s) courtesy Dr. Allan G. Farman

Mandibular tori

Mental ridge Genial tubercles

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Canine/Premolar region: mandible

Mental foramen
Radiolucent " usually situated between and just beneath roots of the premolars.
"

Soft tissue shadow of reflected cheek

"

radiopaque radiolucent

Mandibular canal
"

William C. Scarfe

Canine region: mandible

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Premolar region: mandible

Image(s) courtesy Dr. Allan G. Farman

Mental foramen

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Mental foramen

Mandibular canal

Mylohyoid ridge Submandibular fossa

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Mental foramen

Periapical granuloma, abscess or cyst (periodontal ligament space not intact)

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Mylohyoid ridge

Mental foramen Submandibular fossa

William C. Scarfe

Molar region: mandible

Mandibular canal
"

radiolucent

Submandibular fossa
"

External oblique ridge

"

radiolucent

radiopaque

Cortex of lower border

"

Mylohyoid ridge (internal oblique ridge)

"

radiopaque

radiopaque

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

Mandibular canal

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External oblique ridge of mandible

Image(s) courtesy Dr. Allan G. Farman

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External oblique ridge of mandible

Image(s) courtesy Dr. Allan G. Farman

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External oblique ridge

Image(s) courtesy Dr. Allan G. Farman

Mandibular canal

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Internal oblique (mylohyoid) ridge of mandible

Image(s) courtesy Dr. Allan G. Farman

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Internal oblique (mylohyoid) ridge of mandible

Image(s) courtesy Dr. Allan G. Farman

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External oblique ridge Internal oblique ridge Lower cortex of mandible

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Submandibular fossa
Image(s) courtesy Dr. Allan G. Farman

Image(s) courtesy Dr. Allan G. Farman

External oblique ridge Internal oblique ridge

Lower cortex of mandible

William C. Scarfe

Image(s) courtesy Dr. Allan G. Farman

External oblique ridge Internal oblique ridge

Lower cortex of mandible

William C. Scarfe

Anatomical Variations
Mandibular torus. Palatal torus. High vs. low mandibular canal. Double mandibular canals.* Stafnes bone cavity (static bone cyst).*

*usually seen only on extra-oral radiographs.

William C. Scarfe

Mandibular torus Syn: lingual exostoses, torus mandibularis

William C. Scarfe

Mandibular torus Syn: lingual exostoses, torus mandibularis

Image(s) courtesy Dr. Allan G. Farman

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Mandibular torus Syn: lingual exostoses, torus mandibularis

Image(s) courtesy Dr. Allan G. Farman

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Maxillary torus

Syn: torus palatinus

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Maxillary torus

Syn: torus palatinus

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Maxillary torus

Syn: torus palatinus

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe

Maxillary torus

Syn: torus palatinus

Image(s) courtesy Dr. Allan G. Farman

William C. Scarfe