2d) General Radiology Report

Date report generated

Date data acquired

Requesting provider

Patient file number / identifier

Use a non-identifying chart/file number only; do not enter names, DOBs, or other identifying info.

Include admin details in human-readable copy

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Acquired Imaging

Number and type of radiographs

TMJ

TMJ appearance

Maxillary Sinuses

Maxillary sinus proximity and condition

Bone

Generalized bone trabecular pattern

Crestal Bone loss

Horizontal Bone Loss

Vertical Bone Loss

Comment

Roots

Generalized crown to root ratio

Evidence of external root resorption

Evidence of internal root resorption

Suspicion of root fracture

Dilaceration of root

Apical findings

Are there any teeth with apical findings?

Teeth

Patient edentulous? Y/N

General condition

(M) = missing adult/deciduous teeth

(PE) = Partially Erupted teeth

(UE) = Unerupted teeth

(RF) = Retained Root Fragments

(FR) = Fractured teeth

Comment

Tooth conditions

Tipping and Drifting, Calculus, Wear and defects

Caries

Will be assessed separately

(I) = Incipient

(D) = Dentine

(G) = Gross

(R) = Recurrent

Tooth restorations

Will be assessed separately

Open margins, Overhangs, Open contacts

Impressions and Summarized pertinent findings

Comments

Further radiographic investigation indicated?

Consult with Radiologist or CBCT required?

Further clinical investigation indicated?

Appendix

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2d) General Radiology Report Date report generated: 2026-04-22 Acquired Imaging Date data acquired: 2026-04-22 Teeth Apical findings Caries Roots Bone Tooth conditions Tooth restorations Maxillary Sinuses TMJ TMJ appearance: WNL Impressions and Summarized pertinent findings Appendix Comments: Radiological findings should be corroborated clinically.