Ch. 41 RHS intraoral imaging

Includes questions about paralleling and bisecting as well as bitewing and periapical

in bisecting technique- the angle formed by the long axes of the teeth and the image receptor is…

bisected into two equal parts

in bisecting the xray beam is directed _______ to the bisecting line

perpendicular

bisecting- Perpendicular means at a ________ to the film

right angle

what is A

sensor

what is B

long axis of the tooth

what is C

central ray

what is D

imaginary bisector

BAI (bisecting-angle instrument; Dentsply Rinn) 

Bisecting or paralleling ?

Bisecting

Bisecting or paralleling ?

Stabe bite-block (Dentsply Rinn)

Bisecting

Bisecting or paralleling ?

EeZee-Grip holder (Dentsply Rinn), previously called the Snap-A-Ray

Bisecting

Angulation

used to describe the alignment of the central ray of the x-ray beam in the horizontal and vertical planes

how to change angulation

moving the PID in a horizontal or vertical direction

Horizontal angulation is it same or different when using paralleling or bisecting

same

with correct horizontal angulation the ray goes

perpendicular to the curvature of the arch and through the contact areas of the teeth

Incorrect horizontal angulation results in

overlapped (unopened) contact areas

Vertical angulation is it same or different when using paralleling or bisecting

different

paralleling technique- vertical angulation

the vertical angulation of the central ray is directed perpendicular to the image receptor and the long axis of the tooth

bisecting technique- vertical angulation

the vertical angulation is determined by the imaginary bisector; the central ray is directed perpendicular to the imaginary bisector

bisecting: bitewing technique- vertical angulation

predetermined; the central ray is directed at +10 degrees to the occlusal plane

Elongate, Foreshorten, Perfect

Elongate- too flat

Elongate, Foreshorten, Perfect

Foreshortened- too short been is too steep

Elongate, Foreshorten, Perfect

Perfect- makes a 90 degree angle

bisecting- you get foreshortened images from

excessive vertical angulation

bisecting- you get elongated images from

insufficient vertical angulation

Elongate, Foreshorten, Perfect

Perfect- 90 degree

bisecting- image receptor should extend beyond the incisal or occlusal aspect of the teeth by about

⅛ inch

bisecting- patient’s midsagittal plane should be

perpendicular to the floor

what size sensor when bisecting anterior

#2 in vertical

what size sensor when bisecting postier

#2 in horizontal

how many films in the maxillary anterior region when bisecting

three films

paralleling technique- X-ray beam is directed to pass…

between contacts of teeth being x-rayed in horizontal dimension

Too much vertical angulation produces

images that are too short (foreshortened)

Too little vertical angulation results in

images that are too long (elongated)

The white side of the film always faces

the teeth

Anterior films are always placed

vertically

Posterior films are always placed

horizontally

The identification dot on the film is always placed in

the slot of the film holder (“dot in the slot”)

Always position the film holder ___ from the teeth and _______ of the mouth

away; toward the middle

Always ____ the film over the areas to be examined

center

Always place the film ____ to the long axis of the teeth

parallel

exposure order- Always begin with the _____ view before the ____ view, for the following reasons:

premolar; molar

which posterior image receptor placement is easier for the patient to tolerate

molar or premolar

premolar

which posterior image receptor placement to begin with

premolar

which posterior exposure is less likely to bring on the gag reflex

premolar

With the paralleling technique, ____ posterior image receptor placements are used: ____ maxillary exposures and ___ mandibular exposures

eight; four; four

posterior exposure- Begin with the ….

maxillary right quadrant is step one

Posterior exposure- For step one maxillary right quadrant Assemble the _______ instrument for this area

posterior XCP

Posterior exposure- Expose the premolar view teeth #s ____ first, then the molar view teeth #s _______.

(teeth 4 and 5); (teeth 1, 2, and 3)

Posterior exposure- Step 2 after maxillary right move to the _____.

mandibular left quadrant

When moving to the mandibular left quadrant from maxillary right do you have to reassemble the XCP.

no

Step 2- in the mandibular left quadrant Expose the premolar view _______ first, then the molar view _______.

(teeth 20 and 21); (teeth 17, 18, and 19)

Step 3- after the _____ quadrant- Move to the _______ quadrant and reassemble the posterior XCP instrument for this area

mandibular left; maxillary left:

when moving to the maxillary left quadrant from the mandibular left quadrant do you have to reassemble the XCP

yes

In the maxillary left quadrant first expose the teeth ______film teeth #s______then the _____ film teeth #s______

premolar; (teeth 12 and 13); molar: (teeth 14, 15, and 16)

The last quadrant to expose is the mandibular right quadrant with _____ film teeth #s _______ first, then the ____ film teeth #s _______

premolar; (teeth 28 and 29); molar; (teeth 30, 31, and 32)

when using direct digital imaging the image _______ appears on the computer screen

most recently exposed

Rinn XCP Step 1- anterior exposure sequence- Begin with the_______. Expose all of the maxillary anterior teeth from _____. End with the __________.

maxillary right canine (tooth 6); right to left; maxillary left canine (tooth 11)

Rinn XCP Step 2- anterior exposure sequence- Begin with the ________. Expose all of the mandibular anterior teeth from______. Finish with the _______.

mandibular left canine (tooth 22); left to right; mandibular right canine (tooth 27)

When exposing periapical views with the paralleling technique, always start with the _________.

anterior teeth (canines and incisors)

The size of the anterior image receptor (#1) is _______.

small and is easier for the patient to tolerate

The patient who is having dental images taken should be seated _____ (before? or after?) the room has been prepared and infection control procedures completed

after

Paralleling technique- Vertical angulation: The central ray of the x-ray beam must be directed _______ to the image receptor and the long axis of the tooth

perpendicular

Paralleling technique- Vertical angulation: The central ray of the x-ray beam must be directed perpendicular to what?

the image receptor and the long axis of the tooth

Paralleling technique- Horizontal angulation: The central ray of the x-ray beam must be directed where?

through the contact areas between the teeth

Paralleling- Central ray: The x-ray beam must be _____ on the image receptor to ensure that all areas are exposed

centered

Paralleling- Image receptor placement: Position the image receptor so that it will __________.

cover the correct teeth to be examined 

Paralleling- Image receptor position: The image receptor must be positioned parallel to what?

the long axis of the tooth

Paralleling- Image receptor position: The image receptor must be positioned _______ to the long axis of the tooth

parallel

Paralleling- The image receptor, in the appropriate holder, must be placed ______ from the teeth and _____ the middle of the mouth

away; toward

Which is preferred, Paralleling or Bisecting and why?

Paralleling technique because it provides the most accurate image with the least amount of radiation exposure to the patient

Situations where the Bisecting technique is preferred?

a shallow mouth, a shallow palate, or tori

what do we know the American Academy of Oral and Maxillofacial Radiology and the American Association of Dental Schools for?

recommending the paralleling technique over the bisecting

what are the two basic techniques for obtaining periapical images?

bisecting and paralleling

For the average adult, a full mouth series consists of _______ images

18 to 20

Generally there are _____ periapical views and ____bitewing views

14; 4 to 6

The _____ region is where the number of images varies

anterior

a periapical image shows the entire tooth from the occlusal surface or incisal edge to about ____mm beyond the apex to show the periapical bone

2 to 3 mm

Periapical images are used to

diagnose pathologic conditions of the tooth, root, and bone as well as tooth formation and eruption

Periapical views are essential in _____ and ________. (What practices? like Ortho, Endo, Pedo etc..)

endodontics; oral surgery procedures

The bitewing image shows the________.

upper and lower teeth in occlusion

Only the _____ and a small portion of the _____ of the teeth are seen in bitewing

crowns; root

bitewing images are used for

detecting interproximal decay, periodontal disease, and recurrent decay under restorations as well as the fit of metallic fillings or crowns

How many bitewings are taken in an adult?

(Four to six bitewing views are taken.)

How many bitewings are taken in an edentulous patient?

(Generally, bitewings are not necessary in an edentulous patient.)

Bitewing views are used to

detect interproximal caries (tooth decay) and are particularly useful in detecting early carious lesions that are not clinically evident and are useful in examining crestal bone levels between the teeth

Is bitewing paralleling or bisecting

Paralleling

For bitewing The central ray of the x-ray beam is __________, using ____ degrees of __________

directed through the contacts of the teeth; +10; vertical angulation

In the bitewing technique, a ________ is used to stabilize the image receptor

film holder or bitewing tab

When using a Rinn type of image receptor, _____ is the universal color for bitewing holders

red

Bitewing images are always ______ views regardless of technique used for the periapical images

parallel

The number of bitewing films necessary is based on the ______ of the arch and the __________ areas

curvature; number of teeth present in the posterior

Because the curvature of the arch differs in most adult patients, a total of four bitewing films are exposed

what are they? 

• One right premolar

• One right molar

• One left premolar

• One left molar

The occlusal technique is used to ________

examine large areas of the upper or lower jaw

Occlusal- In adults, size ______ is used, but __ film is used in children

#4 intraoral film; #2

Occlusal can be used for the following purposes:

• Locate retained roots of extracted teeth

• Locate supernumerary (extra) unerupted or impacted teeth

• Locate salivary stones in the duct of the submandibular gland

• Locate fractures of the maxilla and mandible

• Examine the area of the cleft palate

• Measure changes in the size and shape of the maxilla or mandible

supernumerary meaning

(extra) unerupted or impacted teeth

which x-ray use to Measure changes in the size and shape of the maxilla or mandible

Occlusal 

which x-ray use to Examine the area of the cleft palate

occlusal

which x-ray use to Locate fractures of the maxilla and mandible

occlusal

which x-ray use to Locate salivary stones in the duct of the submandibular gland

occlusal