Which periodontal pockets can be seen on periapical radiographs?

The presence of periodontal pockets on periapical radiographs is closely associated with the location of the roots of the teeth and their surrounding structures. Periapical radiographs primarily capture the area surrounding the apex of the teeth, which can include the bone level and any pathological changes in that region.

Mesial and distal pockets refer to the pockets located on the sides of the teeth where they are adjacent to neighboring teeth. These pockets can indeed be visualized on periapical radiographs because the radiographs show the alveolar bone level and any bone loss that occurs due to periodontal disease, which typically affects these areas.

In contrast, while buccal and lingual pockets are also possible, their visualization on periapical films is less direct. Buccal pockets, for instance, are situated on the outward-facing surface of the teeth, and while they can influence the overall bone health seen in a periapical radiograph, they may not always be as clearly defined in this imaging. Lingual pockets similarly can pose visibility issues depending on the angulation of the radiograph.

Thus, the mesial and distal pockets are the most reliably seen and assessed on periapical radiographs due to their positioning relative to the imaging area and bone anatomy captured