DEN 130 1 H - Dental Radiology- 21

Occlusal and Localization Techniques Study Notes

Chapter Outline

  • Chapter Overview

  • Learning Objectives

    • Lesson 21.1: Occlusal and Localization Techniques

    • Key Terms

    • Purpose of Occlusal Examination

    • Uses of Occlusal Examination

    • Basic Principles of Occlusal Examination

    • Patient and Equipment Preparations

    • Vertical Angulations for Maxillary Projections

    • Vertical Angulations for Mandibular Projections

    • Purpose of Localization Techniques

    • Buccal Object Rule

    • Right-Angle Technique

    • Receptor Placements and Image Comparisons

Learning Objectives

  • Key Definitions and Concepts

    • Define key terms associated with occlusal and localization techniques.

    • Describe the purpose of occlusal examination.

    • List the uses of occlusal examination; discuss basic principles involved.

    • Discuss patient and equipment preparations for the occlusal technique.

    • State recommended vertical angulations for various occlusal projections.

Maxillary Occlusal Projections

  • Topographic Projection (to examine the palate and anterior maxilla)

  • Lateral Projection (to examine palatal roots of molar teeth)

  • Pediatric Projection (for maxillary anterior teeth in children ≤5 years)

Mandibular Occlusal Projections

  • Topographic Projection (for anterior teeth of mandible)

  • Cross-Sectional Projection (for buccal/lingual aspects of mandible)

  • Pediatric Projection (for mandibular anterior teeth in children ≤5 years)

Introduction

  • Purpose

    • Present basic concepts of occlusal and localization techniques.

    • Describe patient preparation, equipment preparation, and film placement procedures for occlusal techniques.

Occlusal Technique

  • Definition

    • A method used to examine large areas of the maxilla or mandible.

Terminology

  • Occlusal Surfaces: The chewing surfaces of the teeth.

  • Occlusal Examination: An examination technique that uses a specialized imaging receptor.

  • Occlusal Technique: Radiographic method to visualize larger areas of interest.

  • Occlusal Receptor: Specialized film or digital sensor used in occlusal examinations.

Purpose and Use

  • Supplementary Imaging

    • Used in conjunction with periapical or bite-wing images.

  • Visualization

    • Preferred when analyzing large areas of interest or difficulties placing periapical receptors.

Principles of Occlusal Techniques

  • Receptor Placement

    • The receptor should be placed with the tube side facing the arch being exposed.

    • Stabilization is achieved when the patient bites on the receptor.

Step-by-Step Procedures

  • Patient Preparation

    • Explain imaging procedure to the patient.

    • Adjust chair and headrest appropriately.

    • Place lead apron with thyroid collar.

    • Ensure removal of eyeglasses and other items in the mouth.

  • Equipment Preparation

    • Set exposure control factors as per manufacturer recommendations.

    • Use either short (8-inch) or long (16-inch) position-indicating device (PID).

Vertical Angulations for Projections

  • Maxillary Projections

    • Topographic: +65°

    • Lateral (right or left): +60°

    • Pediatric: +60°

  • Mandibular Projections

    • Topographic: -55°

    • Cross-sectional: 90°

    • Pediatric: -55°

Localization Techniques

  • Definition

    • Methods used to locate the position of a tooth or object in the jaws.

  • Purpose and Use

    • Imaging provides a two-dimensional view, hence localization techniques are required for depth identification.

    • Used to locate:

    • Foreign bodies

    • Impacted teeth

    • Unerupted teeth

    • Retained roots

    • Root positions

    • Salivary stones

    • Jaw fractures

    • Broken dental instruments

    • Dental restorative materials

Buccal Object Rule

  • Overview

    • A method to interpret the orientation of structures in two images.

    • First, expose a periapical or bite-wing receptor, then expose a second after changing PID direction.

  • Interpretation

    • If the structure appears to move in the same direction as PID: positioned lingually.

    • If it appears to move in the opposite direction: positioned buccally.

  • Mnemonic for Recall: SLOB

    • S = Same

    • L = Lingual

    • O = Opposite

    • B = Buccal

Right-Angle Technique

  • Overview

    • Another rule for interpreting images; incorporates periapical receptor and occlusal receptor.

    • One receptor shows an object’s location; the occlusal receptor shows the object’s relationship in three dimensions.

Step-by-Step Procedures for Localization Techniques

  • Follow previous instructions for patient and equipment preparation.

  • Use Buccal Object Rule to evaluate images:

    • Example scenarios for different tooth locations utilizing the discussed rules and techniques to compare and verify results.

Receptor Placements and Image Comparisons

  • Examples of Application

    • Determine position of endodontically treated tooth with gutta percha.

    • Identify location of impacted extra tooth.

    • Locate radiopaque foreign objects.

    • Use both Buccal Object Rule and Right-Angle Technique for orthodontic wire localization.

Questions?

  • To clarify any remaining topics or concepts related to occlusal and localization techniques, additional information may be requested.