3. Dental radiograph
I – Extra oral
II- Intraoral : Periapical
Bite wing
Occlusal
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4. Occlusal radiography is defined as those
intraoral radiographic techniques taken using
a dental X-ray set where the film packet (5.7 x
7.6 cm) or a small intraoral cassette is placed
in the occlusal plane.
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6. Before exposures
• Obtain informed consent
• Explain procedures to the patient
• Be confident
• Be compassionate as patients may have had a
bad experience before
7. Before exposure- some “DOs”
• Make settings on machine before placing
film in patient’s mouth
• Ask patient to remove all intraoral objects and
eyeglasses
8. Before exposure-some “Do not”s
for intraoral radiographs
• Don’t use the word ”Hurt”
• Don’t say “Ooops” if you make a mistake
• Don’t pickup anything you drop on floor
• Don’t start the exposures in the molar area
• Don’t position the film on a torus
9. Cont’d
• Follow a definite order or sequence in placing
and exposing films
• Align the BID with the aiming ring of the film
holder
• Ask the patient not to move
10. What can you do to reduce gagging
• Start with films in the anterior region
• Tell the patient that the gagging may occur
and that everything will be OK
• Remedies for gagging:
- Topical on tongue or palate
- Put some salt on tongue
- Distract the patient
11. Patient refuses x-rays due to fear of
radiation
• Explain to patient that the doses of radiation
are small compared to the BENEFIT of
diagnosing problems
• Explain that the doctor cannot give a full exam
without the x-rays
• Postpone x-rays during pregnancy
17. Main clinical indications
• Periapical assessment of the upper anterior teeth, especially in
children but also in adults unable to tolerate periapical films
• Detecting the presence of unerupted canines,supernumeraries and
odontomes
• As the midline view, when using the parallax method for determining
the bucco/palatal position of unerupted canines
• Evaluation of the size and extent of lesions such as cysts or tumors in
the anterior maxilla
• Assessment of fractures of the anterior teeth and alveolar bone. It is
especially useful in children following trauma because film
placement is straightforward.
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18. Technique and positioning
1. The patient is seated with the head supported and with the
occlusal plane horizontal and parallel to the floor and is
asked to support a protective
thyroid shield.
2. The film packet, with the white (pebbly) surface facing
uppermost, is placed flat into the mouth on to the occlusal
surfaces of the lower
teeth. The patient is asked to bite together gently. The film
packet is placed centrally in the mouth with its long axis
crossways in adults and anteroposteriorly in children.
3. The X-ray tubehead is positioned above the patient in the
midline, aiming downwards through the bridge of the nose
at an angle of 65°-70° to the film packet
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25. Upper oblique occlusal
This projection shows the posterior part of the
maxilla and the upper posterior teeth on one
side.
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26. Main clinical indications
Periapical assessment of the upper posterior teeth,
especially in adults unable to tolerate periapical films
• Evaluation of the size and extent of lesions such as
cysts, tumours or osteodystrophies affecting the
posterior maxilla
• Assessment of the condition of the antral floor
• As an aid to determining the position of roots displaced
inadvertently into the antrum during attempted
extraction of upper posterior teeth
• Assessment of fractures of the posterior teeth
and associated alveolar bone including the tuberosity.
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27. Technique and positioning
1. The patient is seated with the head supported and with
the occlusal plane horizontal and parallel to the floor.
2. The film packet, with the white (pebbly) surface facing
uppermost, is inserted into the mouth on to the
occlusal surfaces of the lower teeth, with its long axis
anteroposteriorly. It is placed to the side of the mouth
under investigation, and the patient is asked to bite
together gently.
3. The X-ray tubehead is positioned to the side of the
patient's face, aiming downwards through the cheek at
an angle of 65°-70° to the film,centring on the region of
interest
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29. Note: If the X-ray tubehead is positioned too far
posteriorly, the shadow cast by the body of the
zygoma will obscure the posterior teeth.
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31. Vertex occlusal
This projection shows a plan view of the tooth bearing
portion of the maxilla from above. To obtain this
view the X-ray beam has to pass
through a considerable amount of tissue, delivering a
large dose of radiation to the patient. An intraoral
cassette containing intensifying screens is
used for this projection to reduce the dose.
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33. Technique and positioning
1. The patient is seated with the head supported and with the
occlusal plane horizontal and parallel to the floor.
2. The cassette is placed inside a small plastic bag to prevent
salivary contamination and cross infection.
3. It is then inserted into the mouth on to the occlusal surfaces of
the lower teeth, with its long axis anteroposteriorly and the
patient is asked to bite on to it.
4. The X-ray tube head is positioned above the patient, in the
midline, aiming downwards through the vertex of the skull.
The main beam is therefore aimed approximately down the
long axis of the root canals of the upper incisor teeth.
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34. Disadvantages
There is a lack of detail and contrast on the film because
of the intensifying screens, the mass of tissue the X-ray
beam has to penetrate and the consequent scatter.
• The primary X-ray beam may be in direct line with the
reproductive organs.
• A relatively long exposure time is needed(about 1
second) despite the use of intensifying screens.
• There is direct radiation to the pituitary gland and the
lens of the eye.
• If the X-ray beam is positioned too far anteriorly,
superimposition of the shadow of the frontal bones
may obscure the anterior part of the maxilla.
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