DR.

AZRA HAFEEZ
LECTURER & FCPS TRAINEE
DOW UNIVERSITY OF HEALTH SCIENCES

R A D IO LO G Y
R A D IO LO G IC A L
EX A M IN ATIO N
1. PLAIN FILMS/DIGITAL XRAYS:
a. Intraoral radiograph:
i. Periapical films
ii. Occlusal view radiographs
iii. Bitewing radiographs
b. Extraoral radiograph:
i. Orthopantogram (OPG)
ii. Lateral view skull/Lateral
cephalogram
iii. PA view skull/ PA cephalogram
iv. Occipitomental view
v. Waters view or paranasal sinus
view (PNS)
vi. Submentovertex view (SMV) or jug
handle view
vii. Reverse Townes view

viii.Oblique lateral view mandibular

body
2. TOMOGRAPHY:
a. Computed tomography (CT)
b. Cone beam CT (CBCT)
c. Positron emission tomogram (PET)
3. Magnetic resonance imaging (MRI)
4. Radionuucleoide imaging
a. Scintigraphy or bone scan
b. Single photon emission computed
tomography (SPECT)
5. CONTRAST ENHANCED
RADIOLOGICAL
INVESTIGATIONS:
a. Sialography
b. Angiography
6. Ultrasonography
PLAIN XRAYS

Most commonly employed diagnostic tool.

Available at dental chair side or hospital itself.
Faster, easy to aquire and much cheaper than
the other diagnostic tool.
Xray machines are focussed at specific
angulations at the patient.
Xrays are then captured in a film or a sensor.
By processing the film or the sensor, a two
dimensional image of the structures through
 which x-rays passedrogh can be
obtained as a radiographic film or a
digital image in a computer which
can be later printed out in any media
as per requirement.
RAD IO D EN SITY O F IM AG E:

The amount of x-ray beam

attenuated (stopped) by the
structure determines the
radiodensity of the image.
Radiopaque or white parts It shows
the dense structures which have
totally stopped the x-ray beam.
Examples:bone, metallic objects
like implants, plates, embeded
foreign particles, bullet etc.
 Radiolucent or black parts It
shows the areas where the x-ray
beam has passed through the object
and has not been hindered at all.
Examples: air-filled maxillary sinus.
Grey parts It shows areas where
the x-ray beam has been stopped to
a varying degree.
Examples: Soft tissue s like fat,
muscle,glands have varying
dadiodensities. Cartilage is more
radiodense than fat but less than
FACTO RS AFFECTIN G O N
RAD IO D EN SITY O F IM AG E:
1. Intensity of the x-ray.

2. Possibility of superimposition.

3. Distance from the x-ray source and

sensitivity of the film.
PLAIN X-RAYS:

1. INTRAORAL RADIOGRAPHS

2. EXTRAORAL RADIOGRAPHS
AD VAN TAG ES O F IN TRAO RAL
RAD IO G RAPH S:
Best spatial resolution.
Minimal distortion
Midline structures can be best
visualized without superimposition
Chair side availability need not
shift the patient.
D ISAD VAN TAG ES O F
IN TRAO RAL RAD IO G RAPH S:
Cant be used in patients with
restricted mouth opening.

Not useful for viewing large lesions.

PERIAPICAL RAD IO G RAPH S:
PERIAPICAL RAD IO G RAPH S:

Film is held in relation to to the long

axis of the tooth. Best image can be
obtained if the film is placed parallel
to the long axis of the tooth, in close
proximity and the rays are perfectly
perpendicular to the tooth and the
film.
TECH N IQ U ES:

1. Parallel cone technique

2. Bisecting cone technique
STRU CTU RES VIEW ED :

Teeth
Periapical areas
Lamina dura
Periodontal ligament space
Alveolar bone
Floor of maxillary sinus adjacent to
the root of maxillary teeth.
IN D ICATIO N S:
For the detection and assessment of
dental caries
Periodontal lesions
Perapical lesions
Periodontal ligament space
For the evaluation of root apex formation
Detecting fractured teeth
Endodontic treatment
Study of crown and root length and their
morphology.
AD VAN TAG ES:

Better visiability of periapical region

and their pathology

Evaluation of integrity of lamina dura

and periodontal ligamental space
D ISAD VAN TAG ES:
Not used in patients with limited
mouth opening
Difficult to detect any large pathology
involving the jaw beyound the
eriapical region
Multiple radiographs for the
evaluation of dental arch
Cant be used in patients with
exaggerated gag reflex
Increased risk of radiation exposure.
AN ATO M Y
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LIN E