Intraoral and panoramic equipment, techniques, · Bisecting angle (isometric, Cieszyński)...

Intraoral and panoramicradiography:equipment, techniques, indications.

Stanisław JalowskiDepartment of Dental and Maxillofacial

Radiology

Radiography techniques

✓ Summary

+ +

✓ Layer

3

Periapical radiograph techniques

✓ Paralleling (right angle, long cone)

✓ Bisecting angle (isometric, Cieszyński)

Localization techniques

✓ tube-shift (Clark’s rule)

✓ buccal-object rule (Richard’s) - horizontal angulation

SLOB

Periapicals

Indications:

• Caries assessment

• Periodontal assessment (marginal and apical)

• Treatment evaluation

• Endodontic treatment planning

• Dental trauma assessment

• Extraction planning

• Implant osteointegration assessment

Essential elements

✓ Dental X-ray units

✓ Receptor

✓ Shielding

✓ Knowledge

Essential elements

✓ Dental X-ray units

✓ focal spot

✓ Generator (DC / HF)

Effects of the size of the focus

Zone of unsharp edges

Object

Effective focalspot

Actual focal spot

Actual focalspot

Electron beam Electron beam

The advantages of DC generator

- setting up of time exposure every 1/100 sek.

- 20 – 30 % lower dose then using analog detectors, 50% - then digital

- good contrast quality at 70kVp

The advantages of HF generator

Shielding

ALARA

Collimation

Collimation

two standard (OF) distances:- 20 cm (8 cali)- 40 cm (16 cali)

Effects of distance between the focus and the object

Focal spot

Focal spotFocal spot Focal spot

Collimation

Collimation

X-Ray Machine Collimator - SABIC Innovative Plastic’s LNP* Thermocomp* X-Ray Shielding Specialty Compound

Collimation

Reverse square inverse rule

Self protection

„ Position and distance rule”

Image interpretation

24

XCP – extension cone paralleling

Receptor-Holding Instruments

27

BAI – bisecting angle technique

Vertical angulation

Focal spot

Focal spot

30

Setting up

- the anatomy of the maxilla, mandible & teeth;- position of the patient head;- position of the x-ray tube;- the "target point" of the x-ray beam.

PLANES

33

The Camper lineshould be

horizontallyfor MAXILLA teeth imaging

34

That lineshould be

horizontallyfor MANDIBLEteeth imaging

(with mouth wide open)

35

Upper incisors

+550

36

Upper canines

+500

37

Upper premolars

+400

38

Upper molars

+300

39

Lower incisors

-200

40

Lower canine

-150

41

Lower premolars

-100

42

Lower molars

-50

43

-5-10-15-20

+30+40+50+55

Żuchwa

Szczęka

TrzonowePrzedtrzonoweKłySieczne

Incisors Canines Premolars Molars

upper +40 +45 +30 +20

lower -15 -20 -10 -5

44

CMX – complet-mouth x-ray survey

FMX – full-mouth survey

45

CMX – complet-mouth x-ray survey

FMX – full-mouth survey

Localization techniques

SLOB

Same Lingual Opposite Buccal

Localization techniques

SLOB

20o

49

In orthoradial projection: the central ray should be perpendicular to the tangent of segment of the dental arch and should create the appropriate angles with the sagittal plane

In oblique projection: the central ray shoud be shifted mesially or distally

BITEWING EXAMINATIONS

Include the crowns of the maxillary and mandibular teeth and the alveolar crest on the same receptor

Indications :

• Interproximal caries detection

• Secondary caries detection

• Periodontits marginalis assessment (alveolar bone crest, changes in bone height)

51

52

53

54

VERTICAL

HORIZONTAL

55

Occlusal x-rays

axial oblique(tophographic, izhometric)

lateralanterior

(standard)dekstrasinistra

56

Occlusal axial x-rays

57

Occlusal oblique anterior x-rays(standard)

58

Occlusal oblique lateral x-rays

59