Which imaging is recommended for PSR codes 3+?

• A. Panoramic Only
• B. 4 BWX's
• C. No Radiographs
• D. FMX, Panoramic and 4 BWX's

Answer: (D)

When a patient has PSR codes 3 or higher, you need a comprehensive radiographic assessment to accurately gauge the extent of bone loss and involvement around all teeth. This level of probing depth or clinical finding signals possible significant periodontal disease, so you don’t rely on a single image type—you use a combination to map the full picture.

The best imaging set for this scenario includes a full mouth radiographic series (FMX) to obtain detailed periapical views of every tooth, a panoramic radiograph to give a broad overview of the jaws and any generalized bone loss, and four bitewing radiographs to accurately assess the crestal bone levels and interproximal surfaces, especially in the posterior regions. Together, they provide both high-resolution local detail and a complete overview, which is essential for accurate diagnosis and planning.

Panoramic imaging alone may miss subtle or localized bone loss and periapical details. Relying only on bitewings could overlook vertical bone changes or furcation involvement. No radiographs at all would leave crucial information unknown, making treatment planning unreliable. The combination of FMX, panoramic, and bitewings ensures you have the necessary data to evaluate progression and determine appropriate therapy.