Object Localization
by
Radiographic
Techniques
Why localization?
INDICATIONS
Foreign bodies
Impacted, unerupted teeth
Supernumerary teeth
Broken needles
Retained roots
Fractures of maxillofacial structures
Soft tissue calcifications
Intra-osseous tumors
Calculi in gland/duct of gland
Filling materials in alveolar process
Techniques
Miller Technique/ Right angle Technique
Clark Technique/ Tube-shift Technique
MILLER TECHNIQUE
Usually indicated for impacted tooth
anf foreign body
Two radiographs made are positioned
at right angles to each other
LOCALIZES in 3 Dimensions
DISADVANTAGES
Can be used in maxilla but not
that useful like in mandible -
LOCALIZATION OF FOREIGN BODIES
Crosscut
Fissure
Bur
Foreign
Body
Waters View Lateral View
Cross-section occlusal
film PA view
Lateral view
INTRA OSSEOUS TUMOURS
Occlusal
Lateral view
view
Lateral Occlusal view
oblique
Views at right angle to each other will show
actual bone separation and displacement
Eg:
Condyle # - Reverse Towne + Transpharyngeal
Clark’s rule
Tube shift technique
C.A. Clark
PRINCIPLE
Relative positions of radiographic
images of two separate objects changes ,when
projection angle at which images were made,is
changed
Tube shift may be carried in:
Horizontal direction
Vertical direction
HORIZONTAL TUBE SHIFT(HTS)
Shifts in Horizontal Angulation of x-
ray beam moves position of objects
on x-ray film in a mesial or distal
Image of tooth that is farther away from X-ray
tube
(lingual) moves in same direction as tube
and image of tooth that is closer to X-ray tube
(buccal) moves in opposite direction
SLOB
again appears
Image of object appears at rootatapex
root apex
When object is present lingually
When object is present buccally
X-ray made using normal horizontal angulation
MESIAL SHIFT
TECHNIQUE
Image of object moves mesial
distal totoroot
rootapex
apex
(SAME LINGUAL)
(OPPOSITE BUCCAL)
When object is present lingually
When object is present buccally
If X-ray is made angulated from the mesial
MESIAL SHIFT
TECHNIQUE
Image of object appears at rootatapex
again appears root apex
When object is present
in same vertical plane as reference
If
X-ray
X-ray
made
is made
using
angulated
normal horizontal
from the mesial
angulation
Localization of broken needles
Recovery of broken needle is a difficult
operation because of needle’s small size.
Exact localization is extremely important
Lateral Periapical
view film
PA view
Lateral view
with syringe
RECENT ADVANCES (3D)
Computed Tomography
• Highly accurate
• High radiation exposure
• Expensive
Magnetic Resonance Imaging
• Very expensive
• Not used often
CBCT
Cone Beam CT (CBCT)
Nerve canal
Impaction
Root canals
Thank You!
Any questions?
