Occlusal and Localization Techniques

Purposes of Occlusal Images:

• large areas of maxilla OR mandible on 1 image

• preferred when needing an area larger than what PA covers

• patient unable to handle PA

What do occlusal images show?

• Locate roots of extracted teeth

• Locate supernumerary teeth, unerupted or impacted teeth

• Locate foreign bodies

• Locate salivary stones in duct of submandibular gland

• Evaluate fractures of max./mand.

• Examine area of cleft palate

Principles:

• Place receptor with tube side facing arch being exposed

• Film: white side facing arch being exposed;

• Digital: non-wired side toward arch being exposed

• Place intraorally between occlusal surfaces of arches

• Stabilize by instructing patient to GENTLY close on receptor

Patient Preparation:

• Maxilla: position so occlusal surfaces are parallel with floor and midsagittal plane perpendicular to floor

• Mandible: recline patient so occlusal plane is perpendicular to floor

• Position lead apron/thyroid collar

• Remove eyeglasses and removable appliances in mouth

Topographic Projection: Maxillary

palate and maxillary anterior teeth

(Right or Left) Lateral Occlusal Projection Maxillary

palatal roots of molar teeth; foreign bodies or lesions

Pediatric Occlusal Projection Maxillary

Anterior teeth; children <5 years old

Topographic Occlusal Projection Mandibular

anterior teeth of mandible

Cross-sectional Occlusal Projection Mandibular

buccal and lingual aspects of mandible

Pediatric Occlusal Projection Mandibular

Anterior teeth; children <5 years old

Vertical Angulation for Maxillary Topographic:

+65

Vertical Angulation for Maxillary Lateral:

+60

Vertical Angulation for Maxillary Pediatric:

+60

Vertical Angulation for Mandibular Topographic:

-55

Vertical Angulation for Mandibular Cross-sectional:

90

Vertical Angulation for Mandibular Pediatric:

-55

Localization Techniques Purpose and Use

• foreign bodies

• impacted teeth

• unerupted teeth

• retained roots

• root positions

• salivary stones

• jaw fractures

• broken needles and instruments

• dental restorative materials

Buccal Object Rule

• SLOB

• 2 images exposed at different angulations

Right-Angle Technique

compare to PA and occlusal images to locate object in three dimensions