Amalgam, gold, stainless steel, porcelain,
composite, and acrylic.
Metallic restorations
Absorb x-rays and as a result very little (if
any) radiation comes in contact with the
film and appears radiopaque. Examples
are amalgam and gold.
Nonmetallic restorations
May vary in radiographic appearance from radiolucent to slightly opaque depending upon the density of the material. Examples are porcelain, composite, and acrylic. Prcelain is the most dense and least radiolucent and acrylic is the least dense and most radiolucent.
Amalgam restorations
Most common restorative material. It absorbs x-ray beam and prevents x-rays from reaching the film and appears completely radiopaque. Can be seen in a variety of shapes, sizes, and locations.
One-surface amalgam restorations
Pit amalgams. Appear as distinct, small, round, or ovoid radiopacities. May be seen on buccal, lingual, or occlusal surfaces.
Two-surface and multisurface amalgam
Appear radiopaque and are characterized by their irregular outlines or borders. May involve any tooth surface.
Amalgam overhangs
Extensions of amalgam seen beyond the crown portion of a tooth in the interproximal region. Results from improper band placement arounda tooth before the condensing of the amalgam restoration. They appear radiopaque and easily visualized. It disrupts the natural cleansing countours, traps food and plaque, and contributes to bone loss. They must be removed to prevent destruction of interproximal bone.
Amalgam fragments
Also known as amalgam scraps. Inadvertently embedded in adjacent soft tissue during the restoration of a tooth. They vary in size and shape and appear as dense radiopacities with irregular borders. May be seen in any location where soft tissue is present.
Gold restorations
Usually has smoother borders and appear completely radiopaque but can be difficult to differentiate from amalgam. If patient is present, examine the patient for verification.
Gold crowns and bridges
Radiopaque restorations with smooth contours and regular borders. Gold inlays and onlays exhibit marginal outlines that appear smooth and regular.
Gold foil restorations
Appear as small, round radiopacities and are indistinguishable from the one-surface restorations. A two-surface gold foil restoration may appear similar to the gold inlay with smooth regular marginal outlines, or may exhibit slightly irregular margins and resemble the two-surface amalgam.
Stainless steel and chrome crowns
Prefabricated restorations that are usually used as interim or temporary restorations. They are thin and do not absorb dental x-rays and appear radiopaque but not as densely radiopaque as amalgam or gold. Their outlines and margins appear very smooth and regular. They appear see-through on radiographs.
Post and core restorations
Seen in endodontically treated teeth. It is cast metal and appears radiodense as amalgam or gold. Appear radiopaque. The core portion resembles the prepared portion of a tooth crown and the post portion extends into the pulp canal.
Porcelain restoration
Appear slightly radiopaque and resemble the radiodensity of dentin.
All-porcelain crowns
Appear slightly radiopaque. A thin radipaque line outlining the prepared tooth may be evident. This thin line represents cement. The radiodensity appears identical to an all-porcelain bridge.
Porcelain-fused-to-metal crown
Has two radiographic components. The metal component appears completely radiopaque and the porcelain component appears slightly radiopaque. The radiodensity appears identical to porcelain-fused-to-metal bridge.
Composite restorations
Varies in radiographic appearance from radiolucent to slightly radiopaque, depending upon the composition of the composite material. Some manufacturers add radiopaque particles to help differentiate composite restoration from dental caries. Careful visualization and digital examination of the tooth in question will confirm which it is.
Acrylic restorations
Often used as an interim or temporary crown or filling. It is the least dense and appears radiolucent or barely visible.
Materials used in restorative dentistry
Base material, metallic pins
Base materials
Zinc phosphate cement and zinc oxide-eugenol paste, used as cavity liners to protect pulp of tooth. They are placed on the floor of cavity preparation. They appear radiopaque, and less radiodense to amalgam.
Metallic pins
Used to enhance the retention of amalgam or composite. Appear cylindrical or screw-shaped radiopacities on radiographs.
Materials used in endodontics
Gutta percha, silver points.
Gutta percha
Used in endodontics. Claylike material to fill pulp canals. Appears radiopaque. Appears less radiodense when compared to metallic restorations.
Silver points
Used in endodontics to fill pulp canals. They appear very radiopaque. They appear more radiodense than gutta percha.
Materials used in prosthodontics
Complete dentures and removable partial dentures. Radiographic appearance varies depending on the base material and type of denture teeth used. Patients are instructed to remove partial dentures before radiographs are taken. If not removed can give the illusion of rootless or floating teeth.
Complete dentures
Consists of two component parts: a base material and denture teeth. The base material is acrylic and appears as a very faint radiopacity or in some cases may not been seen at all. Denture teeth may be porcelain or acrylic and vary in their radiographic appearance. Anterior porcelain include one or two metal retention pins (diatorics) that appear as tiny,desne radiopacities superimposed over the radiopaque porcelain. Posterior porcelain appear radiopaque. Acrylic (plastic) dentures lack density and appear faintly radiopaque or radiolucent.
Removable partial dentures
Can be constructed from a variety of base materials, including cast metal, combination of cast metal and acrylic, and all acrylic. Cast material appears densely radiopaque Metal with acrylic appears densely radiopaque where metal is present and slightly radiopaque in the areas of acrylic. Acrylic appears slightly radiopaque or aradiolucent and the metal clasps appear radiopaque and are seen resting on abutment teeth. The teeth can be acrylic or porcelain. Porcelain appear radiopaque and acrylic appear faintly radiopaque or radiolucent.
Materials used in orthodontics
Orthodontic bands, brackets, and wires. They have a radiopaque appearance. Fixed orthodontic retainers have the same appearance.
Materials used in oral surgery
Implants. The endosteal implant is made of metallic material and appears radiopaque. Suture wires appear as thin radiopaque lines. Metallic splints and plates, bone screws, and stabilizing arches appear radiopaque.
Identification of miscellaneous objects
Jewelry appears as dense radiopacities and cause an artifact known as ghost image which can obscure important information. Eyeglasses can have metal components in the frames that appear as radiopacities. Patient napkin chains show up as radiopacities.
