Rad exam 2

bite wings aka

aka interproimal

bitewings show

crown of max and mand in one image
also creastal bone

what part of the bone do bite wings show

crestal bone (highest part)

what are bitewings used to detect

caries
both now and potential

Adult bitewing

size 2

pediatric bitewings

size 1 or 0

bitewing size range

0-3

3 principles for bitewings

receptor parallel to crown
receptor stabilized by a bite block
central ray directed +10 angulation

positive angulation

PID downward
tubehead goes up

negative angulation

PID upward
tubehead down

vertical angulation

Refers to the positioning of the PID in a vertical, or up-and-down, plane

0 angulation

pid parallel to occlusal plane

horizontal angulation

Side to side angulation
based on central ray position

horizontal angulation is based on

central ray position

the central ray is what to each contact area

perpendicular

comes into contacts at a different angle

Gendex Sensor size

size 1 for kids/adults

5 bite wing rules

receptor positioned over prescribed teeth to be examined

receptor parallel to crowns

+10 degree vertical angulation

central ray through contacts

occlusal plane parallel to floor

Bite wing exposure sequence

r premolar
r molar
l premolar
l molar

why do we do premolars first

patient gags less and to hold the horizontal angulation

what must be imaged in premolar pics

distal of canine
and premolars 1 2

what needs to be in premolar bitewings

erupted teeth

if no 3rd molar you dont need it in bitewings (unlike PA)

how to use bitewing tab

use finger to find curvature and horizaontal ang

align open end of pid with index finger

pid must cover receptor to prevent cone cut

when do you use vertical bw

periodontal pats with bone loss

vertical bw helps to

see more of bone and can still see images of right tooth

what are 2 modifications for bws

edentulous: use cotton roll

tori: place receptor gently btwn tori and tongue

bw for edentulous pats?

use cotton roll to help biteblock stable

bw for pats with tori

put receptor gently between tori and tongue

adult bw size

size 2

kids bw size

size 0 (or 1 for mnsu)

size receptor for all posterior teeth in 1 img

size 3

what happens when the central ray is not through the contacts

overlapping

what happens when the receptor isnt aligned

conecut

5 bw rules shorter

receptor placement

receptor position

vertical angulation

horizontal angulation

receptor exposure

why do we use 10+ angulation for bws

slight bend of receptor and tilt of max teeth

exposure order

pa max ant
pa mand ant
pa post
bw premolar
bw molar

film mounting is

placement of images in anatomic order

who is responsible for film mounting

me, taker of images

a correct film mount is

in anatomical order
flip/turn if not in right spot

who makes the final interpretation of film mounts

the dentist

5 benefits of film mounting

quick and easy to view
easy to store
less chance of mistaking left from right
less fingerprints/scratches
mount masks illumination around film

what info is on mount lables

pat name
date of exposure
dentsit name
radiographer name

equipment for film mounts

light source (view box)
magnification

when do you view film mounts

right after mounting

where should you view film mounts

in a room with dim light

how do you view film mounts

sequential order

upper left of mount (pat right)
horizontal to upper right of mount
down to mand PAs on right
horizontal to left of mount
up to BW (viewed L to R)

what are you looking for in mounts

unerupted teeth
caries
sinueses
impacted teeth
calculus
periapical areas
missing teeth
jaws
pulp cavities

steps to mount

place films with dot facing out/away

sort by type

how do you sort film mounts
order

1. bw
2. ant pa
3. post pa

the dots for mounts must face

out

spee curved

upward on mand like a smile :)

what do you doulbe check for mounts

dots facing out
correct spot
restorations match
curve of spee

anatomical order

how teeth arranged in dental arch

opaque or clear film better

opaque

labial films have what

dots facing out/facing the viewer

what mounting type is preffered by ada

labial

types of film moutns

labial
lingual

do you need to double check moutns

yes

what do you do after viewing a mount

all findings noted in pat record

Labial vs. lingual mounting

labial preffered
raised dot faces out

lingual
depressed side of dot out (raised dot in)

left of the mount is what on pat

right

and right of mount is left of par

PSP plate

put through scanner (not chemicals) to put into digital

goals of radiography

eliminate errors to produce a dianostic img
eliminate retakes where pat exposed to more radiation
sensor
psp plate
film

Unexposed receptor

Image appears clear

Unexposed Receptor: Cause

Failure to turn on the x-ray machine
Electrical failure
Malfunction of the x-ray machine
fail to align pid
digital software timed out

film exposed to light

Appears: Black
Cause: Exposed to white light
Correction: Protect from white light

exposed parts apper black, if all exposed all black

fully film exposed to light

Overexposed film

appears dark

excessive time/kv/ma

overexposed film causes vs underexposed causes

excessive time/kv/ma overex

not enough of those for udnerex

Underexposed receptor

Image appears light

Absence of Apical Structures: Cause

improper positioning
pat not biting fully
improver vert angle

tipping error

receptor not parallel to occlusal/incisal

pat not biting properly

overlapped contacts

centray ray not through interproximal spaces

correct by changing horz angle

how to fix overlapped contacts

change horizontal angulation

Foreshortened images

vertical angulation too much

blunt, looks smushed

enlongated image

vertical angulation not steep enough
(pid too flat)

long

elongated vs foreshortened causes

elongated vert angle not steep enough

foreshort its too steep

conecut causes

pid not thorugh center of receptor
x ray beam didnt expose entire receptor (bad wrong)

incorrect placement of bw

receptors too far back/not far back enough

too close/too far

overlapped contacts BW

central ray not through interprox spaced

how to fix bw overlap more mesial (ant) vs more distal (post)

bring more ant to fix ant

bring more post to fix post

distorted bw

impromper vertical angulation
occlusal plane should be centered

bending film

rough/excessive handling
curvature of pat pallate

looks like it curves up

creasing film

attepmt to soften film (handle carefully)

improper handling

black lines on pic

debris accumulation

artifacts/scratches on sensor/psp plate

white scratches on xray

debris accumulation vs creasing film

debris is white scratches

creasing is black lines

Phalangioma

Distal phalanx of the finger is seen in the radiograph

double image

Same receptor exposed twice in mouth (used twice)

movement error

tubehead/receptor/pat moved during exposure

blurry

backward placement

clinician holding finger in front of receptor (should be behind)

can happen with film if embrossed side to ray

texture shows up on film

too much vertical angulation results in images that are

foreshortend

not enough vertical angulation

elongation

incorrect horizontal angulation results in images that are

overlapped

what are the BW errors

overlapped
incorrect placement
distorted

Errors with bisecting technique

elong
overlap
concut
phalg.

Interproximal

Between two adjacent surfaces

alveolar bone

thin layer of compact bone that forms the tooth socket

crestal bone

coronal portion of alveolar bone

highest

caries

cavities

contact areas

The area of a tooth that touches an adjacent tooth; the area where adjacent tooth surfaces contact each other

Vertical angulation

Refers to the positioning of the PID in a vertical, or up-and-down, plane