Week 2: Intraoral Radiography Techniques

What are some ways that movement occurs when taking radiographs?

1. radiation source movement: x ray tube is harder to control

2. patient/sensory movement: common as they may talk, have pain, or move their mouth

How should the occlusal plane be placed in patient position and preparation?

parallel to floor

How should the Ala-tragus line be placed in patient position and preparation?

parallel to floor

How should the head be positioned for mandibular periapicals in patient position and preparation?

incline the head backwards

How should the Tragus-corner of the mouth line be positioned for mandibular periapicals in patient position and preparation?

parallel to floor

Maxillary positioning

Mandibular positioning

Where should the mid sagittal plane be in relationship to the floor in patient positioning and preparation?

perpendicular to floor

What should be removed if possible when taking radiographs?

glasses, prothesis (dentures), large earrings, nose rings

What is the axial orientation for posterior teeth?

long axis horizontal

What is the axial orientation for anterior teeth?

long axis vertical

Since we can't use our thumb to hold the sensor in place, what are some other options?

cotton rolls, metal, plastic, styrofoam

XCP (X-tension Cone Paralleling Instrument with plastic guiding

ring).

Masell Precision Instrument (with metal plate ring)

Snap-a-Ray

Hemostat (not really used)

What is the size of the sensor and recorded area for maxillary molar periapicals?

size 2

at least 4 mm distal of the 2nd molar

first molar is captured with premolars

What is the horizontal angulation for maxillary molar periapicals?

position the rectangular PID with a horizontal angle of 80 degrees

What is the vertical angulation for maxillary molar periapicals?

A positive vertical angle of 30 degrees

approximately correct

central ray entry

What is the size of the sensor and recorded area for maxillary premolar periapicals?

size 2

distal of canine, 1st and 2nd premolars, 1st molar

What is the horizontal angulation for maxillary premolar periapicals?

position the rectangular PID with a horizontal angle directed perpendicularly to the facial surface of the first molar

What is the vertical angulation for maxillary premolar periapicals?

positive vertical angle of 25-35 degrees

approximately

correct central ray entry

What is the size of the sensor and recorded area for maxillary canine periapicals?

size 1

mx canine

What is the horizontal angulation for maxillary canine periapicals?

position the rectangular PID with a horizontal angle directed perpendicularly to the facial surface of the canine

What is the vertical angulation for maxillary canine periapicals?

positive vertical angle of 30 degrees

approximately correct central ray entry

What is the size of the sensor and recorded area for maxillary lateral periapicals?

size 1

mx lateral incisor

What is the horizontal angulation for maxillary lateral periapicals?

position the rectangular PID with a horizontal angle directed perpendicularly to the facial surface of the lateral incisor

What is the vertical angulation for maxillary lateral periapicals?

positive vertical angle of 30 degrees

approximately correct central ray entry

What is the size of the sensor and recorded area for maxillary central periapicals?

size 1

mx right and left central incisors

What is the horizontal angulation for maxillary central periapicals?

position the rectangular PID with a horizontal angle of 0 degrees

What is the vertical angulation for maxillary cenral periapicals?

positive vertical angle of 30 degrees

approximately correct central ray entry

What is the size of the sensor and recorded area for mandibular molar periapicals?

size 2

2 mm retromolar area, third molar, and second molar

What is the horizontal angulation for mandibular molar periapicals?

position the rectangular PID with a horizontal angle of 80 degrees

What is the vertical angulation for mandibular molar periapicals?

positive vertical angle of 0 - 5 degrees and approximately correct

central ray entry

(**all md periapicals will be neg VA, this is the EXCEPTION)

What is the size of the sensor and recorded area for mandibular premolar periapicals?

size 2

distal of canine, 1st and 2nd premolars, and 1st molar

What is the horizontal angulation for mandibular premolar periapicals?

position the rectangular PID with a horizontal angle directed perpendicularly to the facial surface of the first molar

What is the vertical angulation for mandibular premolar periapicals?

negative vertical angle of 15 degrees

approximately correct

central ray entry

What is the size of the sensor and recorded area for mandibular canine periapicals?

size 1

canine and lateral incisor

What is the horizontal angulation for mandibular canine periapicals?

position the rectangular PID with a horizontal angle directed perpendicularly to the facial surface of canine

What is the vertical angulation for mandibular canine periapicals?

negative vertical angle of 15 degrees

approximately correct

central ray entry

What is the size of the sensor and recorded area for mandibular incisor periapicals?

size 1

right and left central incisors

What is the horizontal angulation for mandibular incisor periapicals?

position the rectangular PID with a horizontal angle directed perpendicularly to the facial surface of central incisors (0 degree)

What is the vertical angulation for mandibular incisor periapicals?

negative vertical angle of 15 degrees

approximately correct

central ray entry

What is the size of the sensor and recorded area for molar bitewings?

size 2

proximal surfaces of all

erupted molars and 2-3 mm of bone distal to the last erupted molar

What is the horizontal angulation for molar bitewings?

horizontal angle is

determined by paralleling the central ray with the interproximal contact between the first and second maxillary molars

(In the case of erupted third molars, supplemental bitewings may need to be done to record all interproximal contacts)

What is the vertical angulation for molar bitewings?

about +15-20 degrees and +30 is the max

determined by directing the central ray at right angles to the sensor

ensure that the vertical dimension of the rectangular PID (vertical diameter if round PID is used) is parallel to the vertical axis of sensor

What is the size of the sensor and recorded area for premolar bitewings?

size 2

distal of canine, proximal surfaces of 1st and 2nd premolars, and 1st molar

What is the horizontal angulation for premolar bitewings?

horizontal angle is determined by paralleling the central ray with the interproximal contact between the maxillary first molar and second premolar

What is the vertical angulation for premolar bitewings?

about +10-15 degrees

determined by directing the central ray at right angles to the sensor

ensure that the vertical dimension of the rectangular PID (vertical diameter if round PID is used) is parallel to the vertical axis of sensor

Which radiographs use +VA?

all mx, BWXs, md molars

Which radiographs use -VA?

md PM, canine, incisor