INTRAORAL

RADIOGRAPHIC
TECHNIQUES
DR.HARITMA NIGAM
 PARALLELING TECHNIQUE
(Right Angle or Long Cone Technique)

• Basic Principles

• PRINCIPLE
• The paralleling technique of intraoral
radiography is so named because the object
(tooth), receptor (film packet), and end of the
position indicating device (PID) are all kept
on parallel planes.
 Film Holding Devices

• RINN-XCP (extension cone paralleling) with

localizing rings.
Patient Positioning
Maxillary Central/Lateral Incisors
Maxillary Canines
Maxillary Premolars
Maxillary Molar Region
Mandibular Central/Lateral Incisors
Mandibular Canines
Mandibular Premolars
Mandibular Molars
 ADVANTAGES
• It has very good dimensional accuracy
• It is simple and easy
• No elongation and foreshortening.
• Periodontal and periapical uses are well
represented.
 DISADVANTAGES
• The film holding device is difficult to place
especially in child patient.
• This method is difficult for inexperienced
operators.
• Patient discomfort.
• In this technique there is increase in radiation
exposure.
• It is more space consuming.
 BITE WING RADIOGRAPHY
• INDICATIONS
• 1. Detection of interproximal caries / calculus.
• 2. Monitoring progression of dental caries.
• 3. Detection of secondary caries below
restorations.
• 4. Evaluating periodontal conditions.
 Ideal technique requirements
• The tab or bite-platform should be positioned
on the middle of the film packet and parallel
to the upper and lower edges of the film
packet.

• The film packet should be positioned with its

long axis horizontally for a horizontal bitewing
or vertically for a vertical bitewing.
• Horizontal plane, the X-ray tubehead should
be aimed so that the beam meets the teeth
and the film packet at right angles, and
passes directly through all the contact areas .

• Vertical plane, the X-ray tubehead

should be aimed downwards (approximately
10° to the horizontal) to compensate for the
upwardly rising curve of Monson.
 Positioning techniques
• Using a tab attached to the film packet and
aligning the X-ray tubehead by eye.
• Size film
• A. Large film packets (31 x 41 mm) for adults
• B. Small film packets (22 x 35 mm) for
children under 12 years.

• Once the second permanent molars have

erupted the adult size film is required.
• The patient is asked to close the teeth firmly
together on to the tab.

• As the patient closes the teeth, the operator

pulls the tab firmly between the teeth to
ensure that the film packet and the teeth are
in contact.

• Positioning the exposure is made.

Advantages

• • Simple

• • Inexpensive

• • The tabs are disposable, so no extra

crossinfection control procedures required

• • Can be used easily in children.

Disadvantages
• • Arbitrary, operator-dependent assessment
of horizontal and vertical angulations of the X-
ray tubehead.
• • Radiographs not accurately reproducible, so
not suitable for monitoring the progression
of caries.
• • The tongue can easily displace the film
packet.
 Occlusal radiography

(SANDWICH RADIOGRAPHY)

• Occlusal radiography is defined as those

intraoral radiographic techniques taken using
a dental X-ray set where the film packet
(5.7 x 7.6 cm) is placed in the occlusal plane.
MAXILLARY
MANDIBLE
 INDICATIONS

• • Unerupted canines, supernumeraries and

odontomes.

• • Evaluation of the size and extent of lesions

such as cysts or tumours.

• • Assessment of fractures of the anterior

teeth and alveolar bone.
 Classification of Occlusal Views
• I. Maxillary II. Mandibular
• 1. Cross-sectional 1. Cross-sectional
• 2. Topographic 2. Topographic
• i. Anterior i. Anterior
• ii. Posterior/lateral ii. Posterior/lateral
• 3. Pediatric 3. Pediatric
 Basic Principle

• 1. Film is positioned with the white side facing

the arch that is being exposed.

• 2. Film is placed in the mouth between the

occlusal surfaces of the maxillary and
mandibular teeth.

• 3. The film is stabilized when the patient

gently bites on the surface of the film.
• 4. For maxillary occlusal films the patient’s head
must be positioned so that the upper arch is
parallel to the floor and the midsagittal plane is
perpendicular to the floor.

• 5. For mandibular occlusal films the patient’s

head must be reclined and positioned so that the
occlusal plane is perpendicular to the floor.
 Maxillary Cross-sectional View
• Film placement: The film is placed cross wise into
the mouth and gently pushed back until it
contacts the anterior border of the rami.

• Projection of the central ray: The central ray is

directed at a vertical angulation of +65° and a
horizontal angulation of 0° towards the middle of
the film.

• Central ray : Bridge of the Nose.

Image field: palate, the
anterior-inferior aspects of
each antrum, nasolacrimal
canals, teeth from the right
second molar to the left
second molar and the nasal
septum.
MAXILLARY TOPOGRAPHIC VIEW—ANTERIOR

• Film placement: The film is placed with the

exposure side towards the maxilla and the
long dimension crosswise in the mouth.

• Projection of the central ray: The central ray is

directed towards the middle of the film, the
vertical angulation is +45° and horizontal
angulation is 0°.

• Central ray : the tip of the nose.

Image field: Anterior maxilla
and it’s dentition,anterior floor
of the nasal fossa and the teeth
from canine to canine.
 Maxillary Topographic View—Lateral
• Film placement: The film is placed with it’s long axis
parallel to the sagittal plane and on the side of
interest, with the pebbled side towards the maxilla in
question.

• The lateral border should be positioned parallel to the

buccal surfaces of the posterior teeth and extending
laterally approximately 1/4th inch past the buccal
cusps.

• Projection of the central ray: The central ray is

projected to a point 2 cm below the lateral canthus of
the eye and directed towards the center.
Image field: Alveolar ridge of
the maxilla, infero-lateral
aspect of the antrum, teeth
from the lateral incisor to the
third molar.
 Mandibular Cross-Sectional View
• Film placement: The film is placed in the
mouth with its long axis perpendicular to the
sagittal plane and the pebbled side towards
the mandible. The anterior border of the film
should be approximately ½ an inch anterior
to the mandibular central incisors.

• Projection of the central ray: floor of the

mouth approximately 3 cm below the chin.
Image field: Soft tissues of
the floor of the mouth and
delineates the lingual, buccal
plates of the jaw bone and
the teeth from second molar
to second molar.
 Mandibular Topographic View—Anterior

• Film placement: The film is placed with the

long axis parallel with the sagittal plane and as
far posteriorly as possible, with the pebbled
side down.

• Projection of the central ray: The central ray is

directed towards the middle of the film with –
55° angulation in respect to the plane of the
film. The point of entry of the central ray is in
the midline and through the tip of the chin.
Image field: Anterior portion
of the mandible, the dentition
from canine to canine and the
inferior border of the
mandible.
 Mandibular Topographic View—Lateral

• Film placement: The film is placed length wise in the mouth

with its long axis directed dorsoventrally and the pebbled
side towards the mandible.

• The film is placed as far back posterior as possible, so that

the lateral border is parallel to the buccal surfaces of the
posterior teeth and extending laterally approximately 1cm.

• Projection of the central ray: The central ray is directed

perpendicular to the centre of the film.
• The point of entry of the central ray is beneath the chin and
approximately 3 cm posterior to the chin and 3 cm lateral to
the mid line.
Image field: soft tissues of
half of the floor of the mouth,
buccal and lingual cortical
plates of half of the mandible
and teeth from lateral incisor
to the third molar.
INTRAORAL LOCALIZATION TECHNIQUES

• These are methods used to locate the position

of a tooth or an object in the jaws.

• The dental radiograph is a two dimensional

picture of a three dimensional object.

• It depicts the object in the superior-inferior

and anterior-posterior relationship.
 INDICATIONS
• Foreign bodies.
• Impacted teeth.
• Unerupted teeth.
• Retained roots.
• Salivary stones.
• Jaw fractures.
• Broken needles and instruments.
• Root positions.
• Filling materials
 BUCCAL OBJECT RULE
(TUBE SHIFT TECHNIQUE OR
CLARK’S RULE)

• PRINCIPLE : ‘The relative position of the radiographic

images of two separate objects changes when the
projection angle at which the projection was made is
changed.’

• A different horizontal angle is used when trying to locate

vertically aligned images, e.g. root canals.

• A different vertical angulation is used when trying to

locate a horizontally aligned image, e.g. mandibular canal.
 Method
• Two radiographs of the object are taken.

• First, using the proper technique and

angulations as prescribed .

• Second, radiograph is taken keeping all other

parameters constant and equivalent of those of
the first radiograph, only changing the direction
of the central ray either with a different
horizontal or vertical angulation is used.
 INTERPRETATION
• When the dental structure or object seen in the
second radiograph appears to have moved in the
same direction as the shift of the position
indicating device (PID), the structure or the object
in question is said to be positioned lingually.

• But, if the object appears to have moved in a

direction opposite to the shift of the PID, then the
object in question is said to be positioned buccally.
• SLOB rule: Same side Lingual. Opposite side
Buccal.
QUESTIONS…………

• 1.What is the meaning of the term ‘X’ in X

ray ?

• 2. First OMDR Department?

• 3. Difference between Bisecting and

paralleling cone technique?
63
QUESTIONS…..
• Collimation – Material, Function ?

• Difference between stochastic and

deterministic effect ?
• Identify ?

• Who exposed first Dental Radiograph

• Stages of oral mucositis ?