Bitewing Bitewing Technique, Technique,

and and Technique ErrorsTechnique Errors

Bitewing Film

Patient bites a “wing” or tab that had been placed on the film.

Bitewing film

Anatomical structures found in Anatomical structures found in a bitewing filma bitewing film

Crestal bone

Crowns

Interproximal areas

Bitewing films usesBitewing films uses

Interproximal caries

Crestal bone levels

Restorations contours

Bitewing Bitewing holderholder Bitewing tabBitewing tab

Rinn XCP Bite-Wing Instrument

Bite-Wing Tab

Basic principlesBasic principles

Stabilization: Patient bites on the bite-wing tab or film holder.

Film is placed parallel to the crowns

X-ray beam: is directed through the contacts of the teeth.

Patient preparationPatient preparation

1.1. Explain procedureExplain procedure

2.2. Position the patient upright in the Position the patient upright in the chairchair

3.3. Adjust the headrestAdjust the headrest

4.4. Place and secure the lead apronPlace and secure the lead apron

5.5. Remove all objects from the mouthRemove all objects from the mouth

Bitewing Technique -TABSBitewing Technique -TABS

Not recommended. Film slides easily within loop and may end up out of

position antero-posteriorly.

Recommended

Stick on

Molar - Toward front of film

Premolar - Centered A-P

Bitewing Technique -TABSBitewing Technique -TABS

Bite-wing technique - Bite-wing technique - RinnRinn

Bitewing TechniqueBitewing Technique

Head PositionMSP

head supported by headrest

Horizontal Angulation

Bitewing TechniqueBitewing TechniqueFilm Placement

Position of dot doesn’t matter

Premolar

Molars with 3rd molar

Molars without 3rd

molar

Premolar Bitewing: covers the distal of upper and lower canine, both premolars, first molar and at least a portion of second molar.

Molar Bitewing: covers molars.

If third molars are not erupted into the mouth, the film should be positioned more anteriorly. Make sure ¼” of film extends posterior to second molar.

Film PositionFilm Position

PID

Film PositionFilm Position

PID

Film PositionFilm Position

Bite-wing technique - Bite-wing technique - RinnRinn

Correct

IncorrectIncorrect

20º

0º

Vertical Angulation

Bitewing TechniqueBitewing Technique

ONLY WITH TABS!!!!!

Vertical Angulation Vertical Angulation with with TABSTABS

+10

cotton roll

If lingual tori are present, the film must be placed lingual to the torus

Make sure the film clears the palatal gingiva as the patient closes to keep film from being pushed down into mandible

Vertical bite-wingsVertical bite-wings

Long axis of film verticalShow advanced periodontitis

3 anterior, 4 posterior

+10 vertical angulation (tabs)

BITEWING ERRORS

Bite-wing Technique Bite-wing Technique ErrorsErrors

Patient is not biting on the bite block

Bite-wing Technique Bite-wing Technique ErrorsErrors

Film placement

Bite-wing Technique Bite-wing Technique ErrorsErrors

Film placement

Bite-wing Technique Bite-wing Technique ErrorsErrors

Film placement

Bite-wing Technique Bite-wing Technique ErrorsErrors

Film bending

Bite-wing Technique Bite-wing Technique ErrorsErrors

Film bending

Bite-wing Technique Bite-wing Technique ErrorsErrors

Horizontal angulation

Bite-wing Technique Bite-wing Technique ErrorsErrors

Single overlap. Technique OK

Bite-wing Technique Bite-wing Technique ErrorsErrors

Cone cut

Bite-wing Technique Bite-wing Technique ErrorsErrors

Film Reverse