slightly above (approximately 1/8 inch) the incisal edges of the lateral incisor and cuspid teeth.

The film's anterior border should be located lingual to the distal surface of the opposite central incisor. Adjust the tube to an average angulation of -20º. Direct the central ray straight through the bisecting plane. Follow the manufacturer's instructions for exposure times. MANDIBULAR INCISORS Adjust the head as described for radiographs of mandibular teeth. Place the film packet in the mouth with the long axis vertical. Both the long borders of the packet should be placed under the tongue with the center of the film opposite the midline of the arch and the upper border parallel to and slightly above (approximately 1/8 inch) the incisal edges of the incisor teeth. Adjust the tube to an average angulation of -15º. Direct the central ray straight through the interproximal spaces at the center of the film and perpendicular to the bisecting plane. Follow the manufacturer’s instructions for exposure times. Bitewing Radiographic Technique: Radiographs are an important part of dental diagnosis and treatment planning. Patients may be prescribed radiographs that will be used along with a clinical examination. Bitewing radiography is a commonly used dental x-ray technique and may be a component of the radiologic examination. Bitewing radiographs provide vital information to aid in the diagnosis of the most common dental diseases; specifically tooth decay and periodontal bone loss or gum disease. Additional important findings may be detected on bitewings, including the condition of fillings and the presence of calculus or tartar. Background Bitewing radiographs provide an image of the crowns of the top and bottom teeth on a single film.The type of film used for this examination provides a high resolution image that is able to detect the subtle changes that occur with dental diseases. Bitewings are usually prescribed in a series of 4 films, positioned on both sides of the mouth, examining the structures from the eye teeth, or canines, back. Bitewing Procedure 1)The patient is seated in an upright position in the dental chair. 2)The patient is covered with a lead apron and thyroid collar. Accepted standards for infection control will be followed, with the operator wearing gloves and some of the surfaces covered in a protective barrier. 3)A film is placed into the patient’s mouth using a cardboard film holding device. This device holds the film in position while the patient bites his or her teeth together onto a portion of the cardboard tab.It is important that the patient closes his or her

4)Once the film is in position. and kVp settings.Prepare theinter-proximalparallelingdevice. necessitating a re-take of that film. Have the patient close gently but firmly on the bite-block to hold the film in position. 3.Sometimes a plastic film holder with an attached ring may also be used. The patient exposure dose of radiation is kept as low as possible in order to maximize diagnostic value while minimizing risk. Look through the locator ring to see if thebite-block is centered in the ring. mA settings. while waiting for the films to be processed. You are now ready to take the radiograph on the opposite side of the patient's mouth. 5. BISECTING-ANGLE TECHNIQUE The following procedures describe this technique: 1. 2. Position the film packet in the patient's mouth. to expose the film. mA settings. align the tube head using the same technique as previously described for the paralleling device. 6)The operator re-enters the operatory and removes the film from the patient’s mouth. and kVp settings. After making the exposure. 3. Paralleling TECHNIQUE The following procedures describe this technique: 1. The operator leaves the room where he or she will press a button. 4.Program the X-ray machine forhe discussed time.Make the exposure. 8)Following film processing.Slide the locator ring onto the indicator rod.teeth completely in their natural bite. Place the lower edge of the packet between the . rather. which produces an audible beep. the paralleling device is ready for positioning in the patient's mouth. Hold the wing of the packet between your thumb and index finger. 5)The patient is instructed to hold still while maintaining the correct position. If it is.Anatomical variations. the operator will remove the thyroid collar and lead apron and ensure that the patient is comfortable. put the exposed film in a lead lined container or behind a protective screen.Radiation doses from dental radiography are considered comparable to the levels of radiation that we are exposed to every day from natural sources. Insert the end of the indicator rod into the holes in the bite-block. the operator directs the cone of the x-ray unit toward the film. as well as local restorations may obscure the image so that all the required areas cannot be clearly seen.andthe midsagittal plane is perpendicular to the floor. the films are assessed to determine whether all areas can be visualized adequately. Position the paralleling device with film in the patient’smouthsothatthe anterioredgeofthefilm touches the distal surface of the mandibular cuspid. 2. such as the earth and space. Fold the bitewing tab against the film packet and insert the packet into the bite-block so that the printed side facesthe backing support. Program the X-ray machine for the discussed time. Then. the films are examined. This procedure may be repeated for different areas of the mouth as required. This initial assessment does not examine the films for disease. 7)Once the series of bitewing radiographs has been completed. Bitewing radiographs provide the dental professional with important information that is vital in the diagnosis and treatment planning for patients.Position the patient so that the ala-tragus line is parallelwiththefloor. Slide the locator ring down the indicator rod until the ring almost touches the surface of the patient's face.

). 3. Occlusal films are normally very comfortable.set the X-ray machine at 10 mA. Instruct the patient to close slowly. Make the exposure. Place the film in the patient's mouth.— Projection of central ray (CR) for maxillary posterior occlusal radiographs. and the midsagittal plane is perpendicular to the floor. The film packet is nowpositioned. This allows different developing times to be used for these films. Occlusal radiographs are exposed using the bisected angle technique. As the patient's maxillary teeth contact your index finger. 5. MANDIBULAR OCCLUSAL RADIOGRAPHS Mandibular occlusal radiographs are taken by using the following procedures: 1. rollyour fingeroutfacially.andthemid-sagittalplaneis perpendicular to the floor. position the patient so that the ala-tragus line is at a 45° angle with the floor. and 60 impulses (1 second). To place the packet. and the narrow side of the packet toward the patient’scheeks. 4. Use 70 kVp if the patient is a child. a.For maxillary anterior occlusal radiographs. retract one corner of the patient’s mouth until the packetcan be inserted. Center the tube head cylinder onthebridgeofthe. position the patient so that the . set the vertical angulation of the tube head at +75°. 90 kVp. b. 90 kVp.Formandibularposteriorocclusal radiographs. Position the packet far enough in the mouth so that it covers all theteeth. 2. Position the patient. set the vertical angulation of the tube head at +5° to +l0°. Have the patient closegently but firmly on the packet to hold it in place. MAXILLARY OCCLUSAL RADIOGRAPHS Maxillary occlusal radiographs are taken by using the following procedures: 1. Position the patient so that the ala-tragus line is parallelwiththefloor. The occlusal packet contains two X-ray films. The pebbled surface of the packet should be towardtheocclusalsurfacesof the maxillary teeth. Have the patient relax the muscles of the mouth and cheek as much aspossible.permittingthepatient's teeth to close on the wing. Center the tube head at the top of the patient's nose so that the central X-ray beam will be projected as shown in. patient's nose so that the central X-ray beam will be projected as shown inFormaxillaryposteriorocclusal radiographs. Rest the wing of the packet on the occlusal surfaces of the mandibular teeth.tongue and the lingual surfaces of the mandibular teeth.Program the X-ray machine for 10 mA. The finished radiographs can then be compared for diagnostic purposes.— Projection of central ray (CR) for maxillary anterior occlusal radiographs.)2. (Reducethe kilovoltage 5 kVp if the arch is edentulous. (Reduce the kVp setting for edentulous patients and children as discussed earlier. 4.Formandibularanteriorocclusal radiographs.Positionthepacketsothat itsanterioredge touches the distal surface of the mandibular cuspid. set thevertical angulation of the tube head at +65°. a. Special care must be taken to avoid gagging the patient. and 60 impulses (1 second). Position the tube head.

set the vertical angulation of the tube head at 0°. Prepare the anterior paralleling device. 3. Make theexposure. follow the given guidelines for the specific area listed:NOTE: After each exposure.graphs. 5. 4. It is not as specific as the other X-rays because its purpose is to show the general condition of all the teeth. 3. Have the patient close gentlybut firmly.Formandibularposteriorocclusal radiographs. 1. 3. sinuses and jaw joint. b. and the short sides of the packet are toward thepatient'scheeks.Place the film packet in the patient's mouth with the pebbled surface toward the occlusal surfaces of the mandibular teeth. Maxillary Cuspid Area Set the exposure time selector to manufacturer's suggested . 5. Place a cotton roll under the bite-block. For mandibular anterior occlusal radio. Position the tube head. Center the film on the midline so that it is parallel with the longaxis of the incisors (fig. Adjust the locator ring and align the tubehead cylinder as previously described. 4.10°. set the vertical angulation ofthe tube head at .ala-tragus line and mid-sagittal plane are perpendicular to the floor. a. put the exposed film inacleanpapercupor disposable container.It is used to help viewWhen taking a full mouth series or an individual periapical radiograph. 2. Maxillary Incisor Area Settheexposuretimeselectortomanufacturer's suggestedimpulses. Then place the cup or disposable container in a lead container or behind aprotective screen. 2. Position the parallelingdevice with film in the patient's mouth. Extraoral radiographs example: Panoramic X-ray: Is one X-ray that provides a full picture of your whole mouth. 4. Make the exposures. 1. 1-14).complete upper and lower jaw. Center the tube head cylinder on the tip of the patient’schin so that the central X-ray beam will be projected as shown in.Havethepatientclose gently on the packet to hold it in place. 6. Center the tube head cylinder beneath the patient's chin so that the central X-ray beam will be projected as shown in.

Prepare the anterior paralleling device.This X-ray is to be taken every 5-7 years . jaw joint pain. wisdom teeth and certain abnormalities. Position the paralleling device with film in the patient's mouth. It will give a broad view but does not provide the fine detail that Bite-Wings or P.impulses.A. 115). trauma. Place a cotton roll under the bite-block and have general tooth development.s provide. Center the film on the cuspid and parallel with the tooth's long axis (fig.

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