Al-Najm:38-39 1

Occlusal Radiograph
& Radiology
Hamza Mohib
19-09 (3 Year BDS)

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Occlusal Radiograph
Called so beacuse the Teeth are held in occlusion when the radiograph is taken

Occlusal radiography is defined as those intraoral radiographic

techniques taken using a dental X-ray set where the image
receptor (film packet or digital phosphor plate — 5.7 × 7.6 cm) is
placed in the occlusal plane.

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4-5 Times the
size of intra-
oral
periapical
radiogrpah

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Occlusal Radiographic
Projections

Maxillary Occlusal Mandibular Occlusal

Projections Projections

Upper standard (or 
Lower 90° occlusal (true occlusal)
anterior)occlusal(standard occlusal)

Lower 45° (or anterior) occlusal

Upper oblique occlusal (oblique (standard Occlusal)
occlusal)

Lower oblique occlusal (oblique

Vertex occlusal (vertex occlusal) occlusal)

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MAXILLARY OCCLUSAL PROJECTIONS ►
Upper standard (or anterior) occlusal
INDICATIONS
• Periapical assessment of the upper anterior teeth, especially in children but also in adults unable to tolerate
periapical holders
• Detecting the presence of unerupted canines, supernumeraries and odontomes
• As the midline view, when using the parallax method for determining the bucco/palatal
position of unerupted canines
• Evaluation of the size and extent of lesions such as cysts or tumours in the anterior
maxilla
• Assessment of fractures of the anterior teeth and alveolar bone. It is especially useful in children following
trauma because image receptor placement is straightforward.

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MAXILLARY OCCLUSAL PROJECTIONS ►
Upper standard (or anterior) occlusal
TECHNIQUE AND POSITIONING
• The technique can be summarized as follows:
1. The patient is seated with the head supported and with the occlusal plane horizontal and parallel to the floor and
is asked to support a protective thyroid shield.
2. The image receptor, suitably barrier wrapped, is placed flat into the mouth on to the occlusal surfaces of the
lower teeth. The patient is asked to bite together gently. The image receptor is placed centrally in the mouth with
its long axis crossways in adults and anteroposteriorly in children.
3. The X-ray tubehead is positioned above the patient in the midline, aiming downwards through the bridge of the
nose at an angle of 65∞–70∞ to the image receptor

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MAXILLARY OCCLUSAL PROJECTIONS ►
Upper oblique occlusal
INDICATIONS
Periapical assessment of the upper posterior teeth, especially in adults unable to tolerate
periapical image receptors
• Evaluation of the size and extent of lesions such as cysts, tumours or osteodystrophies
affecting the posterior maxilla
• Assessment of the condition of the antral floor As an aid to determining the position of roots
displaced inadvertently into the antrum during attempted extraction of upper posterior teeth
• Assessment of fractures of the posterior teeth and associated alveolar bone including the
tuberosity.

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MAXILLARY OCCLUSAL PROJECTIONS ►
Upper oblique occlusal
TECHNIQUE AND POSITIONING
1. The patient is seated with the head supported and with the occlusal plane horizontal and parallel to the floor.
2. The image receptor, suitably barrier wrapped, is inserted into the mouth onto the occlusal surfaces of the lower
teeth, with its long axis anteroposteriorly. It is placed to the side of the mouth under investigation, and the patient
is asked to bite together gently.
3. The X-ray tubehead is positioned to the side of the patient’s face, aiming downwards through the cheek at an
angle of 65°–70° to the image receptor, centring on the region of interest

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MANDIBULAR OCCLUSAL PROJECTIONS ►
Lower 90° occlusal
INDICATIONS
• Detection of the presence and position of radiopaque calculi in the submandibular
salivary ducts
• Assessment of the buccolingual position of unerupted mandibular teeth
• Evaluation of the buccolingual expansion
of the body of the mandible by cysts, tumours or osteodystrophies
• Assessment of displacement fractures of the anterior body of the mandible in the
horizontal plane

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MAXILLARY OCCLUSAL PROJECTIONS ►
Lower 90° occlusal
TECHNIQUE AND POSITIONING
1. The image receptor, suitably barrier wrapped and facing downwards, is placed centrally into the mouth, on to the
occlusal surfaces of the lower teeth, with its long axis crossways. The patient is asked to bite together gently.
2. The patient then leans forwards and then tips the head backwards as far as is comfortable, where it is supported.
3. The X-ray tubehead, with circular collimator fitted, is placed below the patient’s chin, in
the midline, centring on an imaginary line joining the first molars, at an angle of 90° to the
image receptor

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MANDIBULAR OCCLUSAL PROJECTIONS ►
Lower 45° occlusal
INDICATIONS
• Periapical assessment of the lower incisorteeth, especially useful in adults and children
unable to tolerate periapical image receptors
• Evaluation of the size and extent of lesions such as cysts or tumours affecting the anteriorpart of the mandible
• Assessment of displacement fractures of the anterior mandible in the vertical plane.

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MAXILLARY OCCLUSAL PROJECTIONS ►
Lower 45° occlusal
TECHNIQUE AND POSITIONING
1. The patient is seated with the head supported and with the occlusal plane horizontal and
parallel to the floor.
2. The image receptor, suitably barrier wrapped and facing downwards, is placed centrally into the mouth, on to the
occlusal surfaces of the lower teeth, with its long axis anteroposteriorly, and the patient is asked to bite gently
together.
3. The X-ray tubehead is positioned in the midline, centring through the chin point, at an
angle of 45° to the image receptor

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MANDIBULAR OCCLUSAL PROJECTIONS ►
Lower oblique occlusal
INDICATIONS
• Detection of radiopaque calculi in a submandibular salivary gland
• Assessment of the buccolingual position of unerupted lower wisdom teeth
• Evaluation of the extent and expansion of cysts, tumours or osteodystrophies in the posterior part of the body and
angle of the mandible

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MAXILLARY OCCLUSAL PROJECTIONS ►
Lower oblique occlusal
TECHNIQUE AND POSITIONING
1. The image receptor, suitably barrier wrapped and facing downwards, is inserted into the mouth, onto the
occlusal surfaces of the lower teeth, over to the side under investigation, with its long axis anteroposteriorly. The
patient is asked to bite together gently.
2. The patient’s head is supported, then rotated away from the side under investigation and the chin is raised. This
rotated positioning allows the subsequent positioning of the X-ray tubehead.
3. The X-ray tubehead with circular collimator is aimed upwards and forwards towards the image receptor, from
below and behind the angle of the mandible and parallel to the lingual surface of the mandible

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Thanks
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