Week3 D1. Ch 21 Bitewing Technique Flashcards
BITE-WING TECHNIQUE
AKA: INTERPROXIMAL TECHNIQUE
Identifies the crowns of maxillary and mandibular teeth, the interproximal areas, and the areas of crestal bone on the same radiograph
Terminology
CRESTAL BONE
AKA: ALVEOLAR CREST
Coronal portion of alveolar bone found between the teet
CONTACT AREAS
An area of tooth that touches an adjacent tooth
OPEN CONTACTS
Appear as radiolucent lines between adiacent tooth surfa‹
OVERLAPPED CONTACTS
The area of one tooth is superimposed over the contactart
an adjacent tooth
PID ANGULATIONS
ANGULATION
Alignment of the central ray of the x-ray beam in a
horizontal or vertical direction
Use of XCP bite-wing instruments with aiming rings
dictates the proper PID angulation
When a bite-wing tab or loop is used, the dental radiographer must determine the horizontal and vertical angulations
Horizontal Angulation
SIDE-TO SIDE POSITIONING OF THE X-RAY TUBEHEAD
CORRECT HORIZONTAL ANGULATION;
Central ray is directed perpendicular to the curvature of the arch and
through the “contact areas” of the teeth
Contact areas appear *opened” and can accurately be examined for
interproximal caries
Incorrect Horizontal
INCORRECT HORIZONTAL ANGULATION:
Incorrect horizontal angulation results in overlapped ie:
unopened contact areas
This makes the radiograph non diagnostic for interproximal
carious lesions
Vertical Angulation
UP-AND-DOWN POSITIONING OF THE PID
Positive for the maxillary arch; negative for mandibular arch
Measured in degrees on the outside of the tubehead
If the PID is positioned “above” the occlusal plane and the central ray is directed “downward”, the VA is POSITIVE (+)
If the PID is positioned “below” the occlusal plane and the central ray is directed “upward”, the VA is NEGATIVE (-)
Correct vertical Angulation
+10 degree VA is suggested for BW radiographs
Compensate for slight bend of upper portion of the film and
slight tilt of maxillary teeth
Incorrect vertical Angulation
VERTICAL ANGULATION
INCORRECT VERTICALANGULATION:
Incorrect VA in BW exposure results in a distorted image
Eg: If a negative VA is used, the occlusal surfaces of maxillary teeth are evident, and the apical regions of the mandibular teeth are seen
PREMOLAR BITE-WING EXPOSURE
Roll the film and then insert the film into the client’s mouth placing the
lower half ofthe film between the tongue and the teeth
Place the biting surface of the tab on the occlusal surfaces of the teeth
Center the film on the second premolar
The front edge of the film should be aligned with the middle of the
mandibular canine
Using your index finger, hold the bite-wing tab against the buccal
surfaces of the premolars
Ensure that the client’s occlusal plane is parallel with the floor
Instruct the client to lower chin if necessary
PREMOLAR BITE-WING EXPOSURE
Set vertical angulation at +10
Set horizontal angulation by standing in front of the client
Place index finger along the premolar area
Align the open end of PID parallel with your index finger and the
curvature of the arch
Ensure that PID is positioned far enough forward to cover the maxillary
and mandibular canines
Ensure that PID is positioned evenly over the maxillary and mandibular
arches to avoid cone-cut
The middle of the PID should be directed at the level of the occlusal
plane
Direct the central ray through the contact areas
Expose the film
MOLAR BITE-WING EXPOSURE
FOLLOW SAME PROCEDURE AS PREMOLAR BITE-WING
EXPOSURE EXCEPT.
To bettervisualize the curvature of the arch, place your index finger along the molararea Center the film on the second molar
The front edge of the film should be aligned with the middle of the mandibularsecond premolar
VERTICAL BITE-WINGS
Used to examine the level of the alveolar bone; used on
clients with periodontitis
Placed with the long portion of the film vertically
Total of 7 films: 3 anterior (canines, midline); 4 posterior
(premolars, molars)
Size 1 or 2 films may be used (size 1 for anterior; size 2
for posterior)
