Intraoral Radiographic Techniques Flashcards
Periapical
Whatever is present around the apex of the tooth
Bitewing
Looking for interdental bone levels
Open up contacts to focus on interproximal areas
Crown
Above bone
Root
Part of tooth below bone
Apex
Terminal part of root
How much space is needed above the root apex in the radiograph?
2-3mm of periapical space
Radiopaque
- White areas on image
- Objects that absorb X-rays and do not allow free passage
What types of areas are radiopaque?
Bone, enamel, dentin
Radiolucent
- Black area on an image
- Objects permit the passage of all or some X-rays
What types of areas are radiolucent?
Tissue, gingiva, infection
How many radiographs are in a standard FMX at VCU?
20 images
What does an FMX consist of?
14-16 PAs
4 bitewings
Position Indicating Device
Guide where you should place the X-ray tube
Suspension arm
Holds X-ray tube on the wall
Control panel
Has exposure parameters
Image receptor
VCU uses digital sensors
Soon as you do the exposure you’ll be the image on the screen in real time
Which periodical radiograph technique is used by VCU?
Paralleling technique
How does the paralleling technique work?
Long axis of tooth and image receptor is parallel while X-rays are perpendicular to both
Horizontal angulation in paralleling technique
Center of X-ray beam must be directed towards the interproximal contact areas
Vertical angulation in paralleling technique
Central ray is directed perpendicular to receptor and long axis of the tooth
Bisecting technique
- Place sensor close to the teeth, not parallel
- Forms angle, x-rays are then perpendicular to to the imaginary bisector rather than the long axis
Vertical angulation in bisecting technique
Results in an image identical to the tooth in dimension
When would you use the bisecting technique?
- Difficulty in positing receptor parallel to teeth
- Difficult anatomy, pt is unable to tolerate the holders
- Edentulous patients (missing a bunch of teeth)
- Pediatric pt
- Severe gag reflex
- No digital sensors available
Blue
Anterior
Red
Bitewing
Yellow
Posterior
Green
Endo
Error A: Missing areas due to incorrect sensor position
Missing apex, periapical bone, part of the tooth and root, bone level
Error B: Beam Angulation
- Incorrect horizontal beam leads to overlap of the interproximal contacts
- Incorrect vertical angulation leads to elongation or foreshortening and missing anatomy
Error C: Cone cut
Incorrect horizontal and vertical angulation, PID is not aligned with the XCP ring
What does a periapical radiograph focus on?
Tooth apex and the bone levels/structures around the apex
What is captured in a bitewing image?
- Maxillary teeth
- Mandibular teeth
- Alveolar bone
What image is ideal for alveolar bone loss?
Bitewing radiograph
What type of bitewing is used for periodontal evaluation?
Vertical bite wing
What periapical radiograph technique is most commonly used to produce radiographs with minimal distortion?
Paralleling technique
Bisecting angulation ranges for maxillary teeth?
- Incisors: +40 to +50
- Canines: +45 to +55
- Premolars: +30 to +40
- Molars: +20 to +30
Bisecting angulation ranges for mandibular teeth?
- Incisors: -15 to -25
- Canines: -20 to -30
- Premolars: -10 to -15
- Molars: -5 to 0
Where do you place the sensor for maxillary central incisors PA?
Level to the second premolar for maximum palatal height
Where do you place the sensor for maxillary lateral incisors PA?
Deep in oral cavity parallel to the long axis of the mesiodistal plane of lateral incisor
Where do you place the sensor for maxillary canines PA?
Deep in oral cavity parallel to the long axis and the mesiodistal plane of canine
Where do you place the sensor for maxillary premolars PA?
Parallel to the buccal of the premolars, centered over second premolar
What should be included in a maxillary premolar PA?
Distal third of canine, both premolars, and first molar
What should be included in a maxillary molar PA?
All three molars and part of tuberosity
Where do you place the sensor for maxillary molars PA?
Centered over the second molar
Where do you place the sensor for mandibular central and lateral PA?
Lingual sulcus
Where do you place the sensor for mandibular cuspid PA?
As far lingual as the the tongue permits, centered over the canine
What should the mandibular cuspid PA include?
Entire canine
Where do you place the sensor for mandibular premolar PA?
Lingual sulcus parallel to the buccal of the premolar
What should the mandibular premolar PA include?
Distal third of the canine, premolars, and first molar
What should the mandibular molar PA include?
All three molars
What should ALL PAs include?
2-3mm of periapical space
What is the correct horizontal angulation for a premolar bitewing?
Buccal surfaces of the premolars are parallel to the receptor and PID, X-ray beam is perpendicular to the tooth and interproximal contacts
What is the correct horizontal angulation for a molar bitewing
Buccal surfaces of the molars are parallel to the receptor and PID, X-ray beam is perpendicular to the tooth and interproximal contacts
What is the correct vertical angulation?
- X-ray beam is perpendicular to tooth and sensor
- Positive angulation of +7 to +10 degrees is acceptable too
