CENTURY INTERNATIONAL INSTITUTE OF DENTAL SCIENCE & RESEARCH CENTER

Department Of Oral Medicine & Radiology

2010-2011

OBJECT LOCALIZATION TECHNIQUES

Submitted
by
Shabhana . B
IV th BDS, Part 1.
 Contents

1. Introduction

2. Indications

3. Localization Technique

4. Tube Shift Technique

5. Right Angle Technique

6. Stereoscopy

7. Radiographic Technique for Localization of Impacted Teeth & Foreign Bodies

8. Conclusion

9. Bibliography

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Introduction
 These are methods to locate the position of a tooth or an
object in the jaws.
 The dental radiograph is a two dimensional picture of a
three dimensional object, it depicts the object in the
superior – inferior and antero posterior relationship.
 It fails to depict buccolingual relation or depth of the
object.
 Localization is used to overcome this lacune.

Indications
 Foreign bodies
 Impacted Teeth
 Unerupted Teeth
 Retained Roots
 Salivary Stones
 Jaw Fractures
 Broken needles and instruments
 Root positions
 Filling Materials

Localization Techniques
1. Tube shift technique [Buccal object rule or clarks rule]
2. Right angle technique
3. Stereoscopy

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Tube shift technique
 Buccal object rule or clarks rule
 The basic principle is that relative position of the
radiographic images of two separate objects changes
when the projection angle at which the project was
made is changed.
 Different horizontal angle used when trying to locate
vertically aligned images. Example: Root Canals.
 Different vertical angle is used trying to locate a
horizontally aligned images. Example: Mandibular
Canal.

Method
 Two radiographs of the object taken.
 First radiograph with proper technique and angulation
as prescribed.
 Second radiograph is with changing the direction of the
central ray either with a different horizontal or vertical
angulation and keeping all other parameter equivalent
to the first radiograph.

Interpretation
 If the dental structure seen in the second radiograph
appears to have moved in same direction as the shift of
PID, the object in question is said to be positioned
lingually.

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  If the object appears to have moved in a direction
opposite to the shift of PID, then object in question is
said to be positioned buccally.
 SLOB rule – SAME SIDE LINGUAL OPPOSITE
SIDE BUCCAL.

Right Angle Technique

 Here two projections are taken at right angles to each

other which helps to localize an object in the maxilla or
mandible.

Method
 A periapical radiograph is taken to show the position of
the object superior-inferiorly and anterio posteriorly.
 Next occlusal radiograph is taken, which will show the
object’s buccolingual and anterio posterior relationship.
 Two radiographs when studied together, helps to
localize the objects in all three dimension.

Stereoscopy
 It is used to determine the location of small intracranial
calcification and multiple foreign bodies in dense or thick
section.
 Also used in cases in which the interpretation of images
produced at right angle might be difficult.
 Evaluate the relationship of margins of bony fractures.

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  Stereoscopic imaging requires the exposure of two films,
one for each eye and thus deliver twice amount of radiation
to patient.
 Between exposure, patient is maintained in position, film is
changed, the tube is shifted from right eye to left eye
position.
 After processing, the film are viewed with a stereoscope
that uses either mirrors or prisms to coordinate the
accommodation and convergence of the viewers eye, so
that brain can fuse the two images.
 This technique is popular for the evaluation of bony
pockets in patient with periodontal diseases.
 For morphology of temperomandibular joint area.
 Determination of root configuration of the teeth that
require endodontic therapy.
 Assessment of the relationship of the mandibular canal to
the root of the unerupted mandibular third molars.
 Assessment of bone shape when the placement of dental
implant is considered.

Radiographic Techniques For Localization Of Impacted Teeth & Foreign

Bodies

Maxillary Area

1. Incisor Zone
 Stereoscopic
 Lateral profile
 Occlusal

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 2. Cuspid Zone
 Stereoscopic
 Lateral profile
 Occlusal
3. Bicuspid & Molar Zone
 Periapical
 Occlusal

Mandibular Area

1. Incisor Zone
 Periapical
 Lateral profile
 Occlusal
2. Posterior Zone
 Occlusal
 Periapical
3. Third Molar Zone
 Periapical
 Lateral Oblique
 Oblique Occlusal

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Conclusion
 In clinical practice, the dentist must often derive from a
radiograph three dimensional information concerning
patients.
 This two methods, right angle technique and tooth shift
technique are frequently used to obtain such three
dimensional information.
 The dentist may wish to use radiograph to determine
the location of a foreign object or an impacted tooth
within jaw.

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Bibliography

 Dental & Maxillo Facial Radiology (2nd

Edition)
Chapter Number, Page Number.
By Freny R Karjodkar
 Oral Radiology Principles & Intrepretation (6th
Edition)
Chapter Number, Page Number
By Stuart C White, Michael J Pharoah

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