Intraoral Radiographic Techniques

Question 1

Periapical

Answer 1

Whatever is present around the apex of the tooth

Question 2

Bitewing

Answer 2

Looking for interdental bone levels
Open up contacts to focus on interproximal areas

Question 3

Crown

Answer 3

Above bone

Question 4

Root

Answer 4

Part of tooth below bone

Question 5

Apex

Answer 5

Terminal part of root

Question 6

How much space is needed above the root apex in the radiograph?

Answer 6

2-3mm of periapical space

Question 7

Radiopaque

Answer 7

• White areas on image
• Objects that absorb X-rays and do not allow free passage

Question 8

What types of areas are radiopaque?

Answer 8

Bone, enamel, dentin

Question 9

Radiolucent

Answer 9

• Black area on an image
• Objects permit the passage of all or some X-rays

Question 10

What types of areas are radiolucent?

Answer 10

Tissue, gingiva, infection

Question 11

How many radiographs are in a standard FMX at VCU?

Answer 11

20 images

Question 12

What does an FMX consist of?

Answer 12

14-16 PAs
4 bitewings

Question 13

Position Indicating Device

Answer 13

Guide where you should place the X-ray tube

Question 14

Suspension arm

Answer 14

Holds X-ray tube on the wall

Question 15

Control panel

Answer 15

Has exposure parameters

Question 16

Image receptor

Answer 16

VCU uses digital sensors
Soon as you do the exposure you’ll be the image on the screen in real time

Question 17

Which periodical radiograph technique is used by VCU?

Answer 17

Paralleling technique

Question 18

How does the paralleling technique work?

Answer 18

Long axis of tooth and image receptor is parallel while X-rays are perpendicular to both

Question 19

Horizontal angulation in paralleling technique

Answer 19

Center of X-ray beam must be directed towards the interproximal contact areas

Question 20

Vertical angulation in paralleling technique

Answer 20

Central ray is directed perpendicular to receptor and long axis of the tooth

Question 21

Bisecting technique

Answer 21

• 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

Question 22

Vertical angulation in bisecting technique

Answer 22

Results in an image identical to the tooth in dimension

Question 23

When would you use the bisecting technique?

Answer 23

• 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

Question 24

Blue

Answer 24

Anterior

Question 25

Red

Answer 25

Bitewing

Question 26

Yellow

Answer 26

Posterior

Question 27

Green

Answer 27

Endo

Question 28

Error A: Missing areas due to incorrect sensor position

Answer 28

Missing apex, periapical bone, part of the tooth and root, bone level

Question 29

Error B: Beam Angulation

Answer 29

- Incorrect horizontal beam leads to overlap of the interproximal contacts - Incorrect vertical angulation leads to elongation or foreshortening and missing anatomy

Question 30

Error C: Cone cut

Answer 30

Incorrect horizontal and vertical angulation, PID is not aligned with the XCP ring

Question 31

What does a periapical radiograph focus on?

Answer 31

Tooth apex and the bone levels/structures around the apex

Question 32

What is captured in a bitewing image?

Answer 32

- Maxillary teeth - Mandibular teeth - Alveolar bone

Question 33

What image is ideal for alveolar bone loss?

Answer 33

Bitewing radiograph

Question 34

What type of bitewing is used for periodontal evaluation?

Answer 34

Vertical bite wing

Question 35

What periapical radiograph technique is most commonly used to produce radiographs with minimal distortion?

Answer 35

Paralleling technique

Question 36

Bisecting angulation ranges for maxillary teeth?

Answer 36

- Incisors: +40 to +50 - Canines: +45 to +55 - Premolars: +30 to +40 - Molars: +20 to +30

Question 37

Bisecting angulation ranges for mandibular teeth?

Answer 37

- Incisors: -15 to -25 - Canines: -20 to -30 - Premolars: -10 to -15 - Molars: -5 to 0

Question 38

Where do you place the sensor for maxillary central incisors PA?

Answer 38

Level to the second premolar for maximum palatal height

Question 39

Where do you place the sensor for maxillary lateral incisors PA?

Answer 39

Deep in oral cavity parallel to the long axis of the mesiodistal plane of lateral incisor

Question 40

Where do you place the sensor for maxillary canines PA?

Answer 40

Deep in oral cavity parallel to the long axis and the mesiodistal plane of canine

Question 41

Where do you place the sensor for maxillary premolars PA?

Answer 41

Parallel to the buccal of the premolars, centered over second premolar

Question 42

What should be included in a maxillary premolar PA?

Answer 42

Distal third of canine, both premolars, and first molar

Question 43

What should be included in a maxillary molar PA?

Answer 43

All three molars and part of tuberosity

Question 44

Where do you place the sensor for maxillary molars PA?

Answer 44

Centered over the second molar

Question 45

Where do you place the sensor for mandibular central and lateral PA?

Answer 45

Lingual sulcus

Question 46

Where do you place the sensor for mandibular cuspid PA?

Answer 46

As far lingual as the the tongue permits, centered over the canine

Question 47

What should the mandibular cuspid PA include?

Answer 47

Entire canine

Question 48

Where do you place the sensor for mandibular premolar PA?

Answer 48

Lingual sulcus parallel to the buccal of the premolar

Question 49

What should the mandibular premolar PA include?

Answer 49

Distal third of the canine, premolars, and first molar

Question 50

What should the mandibular molar PA include?

Answer 50

All three molars

Question 51

What should ALL PAs include?

Answer 51

2-3mm of periapical space

Question 52

What is the correct horizontal angulation for a premolar bitewing?

Answer 52

Buccal surfaces of the premolars are parallel to the receptor and PID, X-ray beam is perpendicular to the tooth and interproximal contacts

Question 53

What is the correct horizontal angulation for a molar bitewing

Answer 53

Buccal surfaces of the molars are parallel to the receptor and PID, X-ray beam is perpendicular to the tooth and interproximal contacts

Question 54

What is the correct vertical angulation?

Answer 54

- X-ray beam is perpendicular to tooth and sensor - Positive angulation of +7 to +10 degrees is acceptable too