intra oral radiographs

INTRA ORAL RADIOGRAPHIC TECHNIQUES

MELBIA SHINY FIRST yr MDS

contents

Periapical Bite wing Occlusal specialised

Basic principles

Types

Periapical Bite wing occlusal

Full mouth set

Periapical radiography

Radiographic technique of oral structure taken by placing film in oral cavity while X ray source is outside oral cavity.

Paralleling technique Bisecting angle technique

Indication

Apical lesion ,cyst & apical surgery Dental caries Mixed dentition analysis Pulp pathology Periodontal status Trauma Unerupted tooth Endodontic treatment & implant

prosthesis

Limitation

Trismus Gagging Large cyst & tumours Two dimensional image

Image receptor

Film Charge coupled device (CCD) Complementary metal oxide

semiconductors(CMOS) Sensors Storage phosphorous plates

Paralleling/fitzgerald technique

Principle

Receptor holding instrument Rinn XCP film holder Rinn XCP-

DS solid state

digital sensor

holder

Digital phosphor plate holder

Masel precision all in one metal holder

Hawe Neos holder

Patient positioning

Angulation of tube head

Receptor placement

Maxillary central incisors

Maxillary lateral incisors

Maxillary canine

Maxillary premolars

Maxillary molars

Distal oblique

Mandibular incisors

Mandibular canines

Mandibular premolars

Mandibular molars

Distal oblique

Bisecting angle technique/ short cone Cieszynski’s rule of isometry

Indications

Large rigid sensors Anatomy of patient

Receptor holding instruments

Receptor placement

Flim & its placement

Position of patient

Angulation of tube head

Vertical : max

mad Incisors +40

-15 Canines +45

-20 Premolars +30

-10 Molars +20

-5

Horizontal angulation

Tube head position

Le master technique/modified bisecting angle technique

Maxillary

central incisors lateral incisor

Maxillary canine

Maxillary

Premolar

Molar

Third molar

mandibular

incisors canine

Mandibular

Premolars molars

Third molar

comparison

Bisecting Paralleling technique1)Distortion of image <2)Superimposition of nozygomatic bone3)Cone cut not4)Alveolar bone fills Interproximal space true relation5)Easier & < space6)Long teeth seen by Vertical angulation

Bite wing/interproximal technique

Interproximal caries Secondary caries Periodontal condition Calculus Deciduous & permanent

Principle

Films

Angulation

Horizontal bite wing receptor

Hawe neos kwikbite horizontal holder

Horizontal bite wing

Rinn XCP DS solid planmeca solid state

statedigital sensor digital sensor

holder

Vertical bite wing receptor

Premolar molar

Anterior bite wing

Occlusal radiography/sandwich radiography

Intra oral technique in which large occlusal areas of maxilla & mandible is recorded.

Indication

Trismus Precise location of roots,

supernumerary, unerupted, & impacted teeth.

Calculi in salivary gland duct Maxillary sinus Trauma Size & extend of cyst & tumours Position of unerupted canine

Maxillary anterior occlusal

Anterior Mandibular occlusal

Maxillary cross section

Mandibular crossection

Lateral Maxillary occlusal

Lateral Mandibular occlusal

Specialized intra oral techniques

1)Mandibular third molarSurgical needle holder technique/

& using film holder

A - emmenix /snap -A-rayB – worth film holderC – artery forceps

Two radiograph technique

Modified X ray cone technique

Gagging /retching

Area sensitive to gagging

management

Attitude Time limit < Exposure sequence – anterior Divert attention Application of LA spray, undiluted

mouth wash,placebo medicines,ice cold water,table salts

Use Bite block & film holding device

Place film packet flat on occlusal plane

Endodontics

Taping film packet

Special endodontic film holder Endo ray film holder

Two different radiographs for separation of root canal

Thin apex Small X ray beam & low KV Rubber dam & saliva ejector

Root length assesment

Edentulous ridge

Paralleling technique with cotton rolls

Paediatric patient

Film size – 0 < 10 yrs – 50% reduce mA ,10 to 15

yrs – 25% reduce mA Show & tell approach Iead apron & thyroid collar.

Modified bisected angle technique

Reverse bite wing radiography

Object localization

Foreign objects Salivary gland stones Canal position Impacted teeth Root piece Broken needle

Buccal object rule/Clark rule/tube shift cone/SLOB

Principle of parallex

Right angle technique

stereoscopy

Radiopaque wire technique

Edentulous patient

Shallow palate

Bony growth

Lingual frenum

Premolar area

Supine position radiography