ROENTGENOLOGY

MIDTERMS LECTURE

RADIOGRAPHIC TECHNIQUE: B. INTRAORAL RADIOGRAPHIC & EXAMINATIONS

CATEGORIES GENERAL STEPS FOR MAKING AN EXPOSURE

● Periapical Projections 1. Prepare Unit for Exposure
● Bitewing Projections 2. Greet and seat the patient
3. Adjust the x-ray unit setting

CRITERIA OF QUALITY
1. Record complete area of interest.
● In intraoral, full length of roots and at
least 2mm of periapical bone
● In bitewing, should demonstrate each
posterior proximal surface at least once
2. Least possible amount of distortions
● Pay close attention to proper positioning
of receptor and x-ray tube
3. Optimal density and contrast 4. Wash hands thoroughly
● Crucial parameters: milliamperage (mA), 5. Examine the oral cavity
peak kilovoltage (kVp), exposure time 6. Position the tube head
7. Position the receptor
PERIAPICAL IMAGING 8. Position the x-ray tube
● Paralleling Technique 9. Make the exposure
○ Less distorted view of dentition
● Bisecting-Angle Technique PARALLELING TECHNIQUE
● The x-ray receptor is supported parallel to the
● Image Receptor: Medium that can capture an long axis of the teeth, and the central ray of the
image, including film, charge-coupled device x-ray beam is directed at right angles to the
(CCD) or complementary metal oxide teeth and receptor.
semiconductor. (CMOS) sensors or storage ● Receptor-holding instruments
phosphor plates ○ Use the instruments to allow precise
positions of the receptor in the patient’s
mouth

● Receptor placements
○ For the best images, the receptor should
be positioned parallel to the teeth and
deep in the patient’s mouth
● Angulation of the tube head
○ Orient the aiming cylinder of the x-ray
machine in the vertical and horizontal
planes to align with the aiming ring.
BISECTING-ANGLE TECHNIQUE
● This method may be useful when the operator is
unable to apply the paralleling technique
because of large rigid sensors or the anatomy of
the patient.
the ring, the central ray is
directed through the contacts in
the region being examined.
○ Vertical angulation
■ In practice, the clinician’s goal is
to aim the central ray of the
x-ray beam at right angles to a
plane bisecting the angle
between the receptor and the
long axis of the tooth.
■ works well with flat,
two-dimensional structures, but
teeth that have depth or are
multirooted show evidence of
distortion
PARALLELING TECHNIQUE – MAXILLARY CENTRAL
INCISOR PROJECTION

● Receptor-holding instruments
○ The preferred method is to use a
receptor-holding, bisecting-angle
instrument that provides an external
device for localizing the x-ray beam.
● Positioning of the Patient
○ For images of the maxillary arch, the
patient’s head should be positioned
upright with the sagittal plane vertical
and the occlusal plane horizontal.
○ When the mandibular teeth are to be
radio- graphed, the head is tilted back
slightly to compensate for the changed
occlusal plane when the mouth is
opened
● Receptor Placement
○ The receptor is positioned behind the
area of interest, with the apical end
against the mucosa on the lingual or
palatal surface.
● Angulation of the Tube Head
○ Horizontal angulation.
■ When a receptor-holding device
with a beam-localizing ring is
used, the instrument is
positioned horizon- tally so that
when the tube is aligned with
PARALLELING TECHNIQUE – MAXILLARY LATERAL
INCISOR PROJECTION
PARALLELING TECHNIQUE – MAXILLARY CANINE PARALLELING TECHNIQUE – MAXILLARY
PROJECTION PREMOLAR PROJECTION
PARALLELING TECHNIQUE – MAXILLARY MOLAR PARALLELING TECHNIQUE – MANDIBULAR
PROJECTION CENTROLATERAL PROJECTION
PARALLELING TECHNIQUE – MANDIBULAR CANINE PARALLELING TECHNIQUE – MANDIBULAR
PROJECTION PREMOLAR PROJECTION
PARALLELING TECHNIQUE – MANDIBULAR MOLAR
PROJECTION BITEWING EXAMINATION
● Bitewing (also called interproximal) images
include the crowns of the maxillary and
mandibular teeth and the alveolar crest on the
same receptor.
● Horizontal bitewing receptor
○ The beam is carefully aligned between
the teeth and parallel with the occlusal
plane.

Receptor-holding device for bitewing images

Bitewing loop

● Vertical bitewing receptor

○ Orienting the length of the receptor
vertically increases the likelihood that
the residual alveolar crests in the
maxilla and the mandible will be
recorded on the radiograph
PREMOLAR BITEWING PROJECTION MOLAR BITEWING PROJECTION