INTRAORAL

RADIOGRAPHIC
TECHNIQUES ǁ
By
Dr. Wajnaa
 Occlusal Technique Technique
The occlusal view is indicated when there is need to reveal
the skeletal or pathologic anatomy of either the floor of the
mouth or the palate.

The occlusal film, which is about three to four times the size
of periapical or bitewing film, is inserted into the mouth to
entirely separate the maxillary and mandibular teeth.

The film is exposed either from under the chin or angled

down from the top of the nose. Sometimes, it is placed in the
inside of the cheek to confirm the presence of a sialolith in
Stenson's duct, which carries saliva from the parotid gland.

The occlusal view is not included in the standard full mouth

series.
 Intraoral
Dental
Radiographs
Film Mount • A cardboard, plastic, or vinyl
holder used to support and
arrange dental radiographs in
anatomic order.
• The mounts come in various sizes
and templates.
 Film
Mounting or holder.

The placement of
radiographs in a
supporting structure or
holder.
 Full Mouth Survey (18 films)

Conventional Mounting Digital Mounting

Occlusal film projection
The occlusal film is used to:

1. Identify the extent of lesions in buccolingual direction

2. Identify the buccolingual location of impacted teeth or other abnormalities

3. Show the location of developing teeth in children using #2 size film

4. Image patients with trismus that have limited mouth opening

 • Maxillary occlusal projections
• Mandiular occlusal projections

Occlusal film Maxillary occlusal projections include:-

projection A- Upper standard occlusal
B- Upper oblique occlusal
C- Vertex occlusal
A- Upper standard
occlusal:-
• This projection shows the anterior part
of maxilla and upper anterior teeth.
• The technique involve:-
• 1. Patient position where the occlusal
plane horizontal and parallel to the floor.
• 2. Film placed on to the occlusal surfaces
of lower teeth and patient asked to bite
together gently the film place centrally in
the mouth (the long axis crossways).
• 3. X-ray tube positioned above the
patient in the midline directed downward
through the bridge of the nose at 65° - 70°
to the film packet.
 Upper
standard
occlusal
B- Upper oblique occlusal :-
• This projection shows the posterior
part of maxilla and the upper
posterior teeth.
• The technique involve:-
• 1. Patients position where the occlusal
plane horizontal and parallel to the floor.
• 2. Film placed on the occlusal surfaces
of lower teeth with long axis
anteroposteriorly placed to the side of
the mouth under examination and
patient asked to bite gently.
• 3. X-ray tube positioned at the side of
patient's face directed downwards
through the cheek at 65 - 70° to the film.
 Upper
oblique
occlusal
C- Vertex occlusal:-

• This projection shows a plan view of

teeth bearing area of maxilla from
above to assess the bucco - palatal
position of unerupted canines.
• The technique involve:-
• 1. The patient is seated with occlusal
plane horizontal and parallel to the floor.
• 2. The film placed on the occlusal
surfaces of lower teeth with its long axis
anteroposteriorly and patient asked to
bite on to it.
• 3. X-ray tube is positioned above the
patient in the midline directed
downwards through the vertex of the
skull.
 Vertex
occlusalsal
Mandibular occlusal projection:-
• a/ Lower 90° occlusal (true occlusal).
• b/ Lower standard occlusal.
• c/ Lower oblique occlusal.
a/ Lower 90° occlusal (true occlusal):-
• This projection used to show a plan
view of the tooth bearing area of
mandible and the floor of the mouth.
• The technique:-
• 1. Patient tips his head backward as
far as comfortable, where it is supported.
• 2. The film placed centrally into the
mouth on the occlusal surfaces of lower
teeth with long axis crossways and
patient bite gently on the film.
• 3. X-ray tube placed below the
patients chin in midline centering on
imaginary line joining the first molar at
90° to the film.
Mandibular occlusal projection

True Occlusal Lower standard occlusal

b/ Lower standard occlusal :-
• This projection is taken to show lower
anterior teeth and anterior part of
mandible.
• Technique :-
• 1. Patient is seated with the head supported
and occlusal plane horizontal and parallel to
the floor.
• 2. Film placed centrally into the mouth and
the long axis anteroposterior then ask him to
bite on the film gently.
• 3. X-ray tube positioned in midline centering
through the chin point at 45° to the film.
C / Lower oblique
occlusal:-
• This projection shows the submandibular
salivary gland on the side of interest.
• The technique:-
• 1. Patients head is supported and rotated
away from the side under investigation and
the chin is raised.
• 2. The film placed on occlusal surfaces of
lower teeth over to the side under
investigation with long axis anterior
posteriorly then he bite on the film gently.
• 3. X-ray tube directed upwards and
forwards toward the film from below and
behind the angle of mandible and parallel to
the lingual surface of the mandible.
Lower oblique occlusal
 LOCALIZATION TECHNIQUES

Definition
Is a method used to locate the position of a tooth or object in the jaw.

Objective
• The radiograph presents as two dimensional image of a three-
dimensional object.
Indication for using of localization techniques:
• 1- Foreign bodies • 6- Root position
• 2- Impacted teeth • 7- Jaw fracture
• 3- Unerupted teeth • 8- Broken needles or instrument
• 4- Retained root • 9- filling materials
• 5- Salivary stone
The techniques are:
• Right angle technique
• Tube shift technique
• Use of radio-opaque media
• Stereoradiography (it is not widly used, it is time consuming and
needs a special viewing device).
Right angle technique

• It involve the use of at least 2 films were taken perpendicular to each

others.
• Intraoral e.g.: periapical radiograph and occlusal radiograph
• Extraoral e.g.: lateral skull projection for anteroposterior area
posteroanterior(PA) projection for mediolateral area
 Right angle technique
Impacted tooth
Right angle technique
Right angle technique

Fractured mandible
Tube shift technique ( Clark’s rule)
• The area in question is anesthetized, a small hypodermic needle is
inserted in vertical position in mucobuccal fold near the object in
question, a radiograph is taken, then insert another film and second
radiograph is taken with mesial shifted tube. The two films are
processed and compared.
• If the object in the second radiograph appears more mesialy, that
means the object is located far lingualy or palataly, while if it is more
distally(in relation to the needle) it means it is buccaly positioned, and
if it is not move it means that it is close to the needle.
• When the object in question is close to a tooth or surface of a crown
so that there is no need for insertion of a needle
• ** To remember the tube shift technique. KEEP IN YOUR MIND THE
WORD:
• (SLOB) Same = Lingual
Opposite = Buccal
Tube shift technique
Radio-opaque media
• Barium sulfate, lipiodol and dionosil can be used to demonstrate
cavernous areas with hard and soft structures. After the injection of
the radio-opaque media (mostly lipiodol) in cyst for example, film
exposed, processed and viewed to see the extension of the cyst.
Radio-opaque media also used in sialogram to demonstrate the
salivary glands and their duct.
Sialography