intraoral imaging

Question 1

Size (0) receptor

Answer 1

used for children

Question 2

Size (1) receptor

Answer 2

used for children and adult anteriors

Question 3

Size (2) receptor

Answer 3

used for adult bitewings and periapicals. Also used for children’s occlusal images

Question 4

Size (3) receptor

Answer 4

longer version of the bitewing, only one image is taken on each side.

Question 5

Size (4) receptor

Answer 5

used for occlusal techniques

Question 6

Periapical (PA)

Answer 6

captures the crown, CEJ, root, and surrounding areas

Used mainly for diagnosis of periodontal disease, pathology, endodontic therapy, and implants

Question 7

Bitewing (BWX)

Answer 7

captures the crown, contact, and height of alveolar bone of posterior teeth

• Used mainly for diagnosis of dental caries (only interproximal)
• Vertical bitewings can detect early periodontal disease if the bone level is visible
• The occlusal plane should be parallel to the floor. The x-ray tube should have a +10 degree vertical angulation
• The premolar bitewing image should include the distal half of the canines, both premolars, and the first molar
• The molar view should be centered over the second molar

Question 8

Occlusal

Answer 8

captures remnants of roots (extracted), supernumerary teeth, impacted teeth, fractures, clefting, bone surrounding the teeth, floor of the mouth, sialolith (stone), and shape of the arch of a larger area

• Patient gently bites on the receptor with the maxillary and mandibular teeth
• Useful when patient has limited jaw opening
• # 4 receptor is used for adults while #2 receptor is used for children

Question 9

Full-mouth series (FMX)

Answer 9

represent the entire dentition using a combination of PAs and BWs

usually 16-20 images (12 PAs and 4-6 BWX); varies by patient

Question 10

Bitewings are not needed for what?

Answer 10

Edentulous dentition

loss of all dentition

Question 11

Bisecting technique

Answer 11

based on the rule of isometry (two triangles are equal when they share one complete side and have two equal angles)
- The primary beam hits at a 90° angle to the bisected line

Question 12

Bisecting Line

Answer 12

created by film and long axis of the tooth

Question 13

bisecting technique

where is the receptor placed?

Answer 13

directly against the teeth to be exposed and this creates an angle between the receptor and long axis of the tooth

Draw an imaginary bisecting line of this angle

Question 14

does the bisecting techique produce more distortion than the paralleling technique?

Answer 14

yes, because of the position of the palate and the difficulty of visualizing the bisecting line

the bisecting technique is an alternative to a paralleling technique for patients with a small mouth, tori, or shallow palate

Question 15

Angulations

canines

Answer 15

+45 to +55 (maxillary), -20 to -30 (mandibular

Question 16

Angulations

incisors

Answer 16

+40 to +50 (maxillary), -15 to -25 (mandibular)

Question 17

Angulations

premolars

Answer 17

+30 to +40 (maxillary), -10 to -15 (mandibular)

Question 18

Angulations

molars

Answer 18

+20 to +30 (maxillary), -5 to 0 (mandibular)

Question 19

Paralleling technique

Answer 19

(long-cone, right-angle technique)
the receptor is parallel to the long axis of the tooth

Question 20

T/F

the paralleling technique provides more accurate image with less distortion than bisecting technique

Answer 20

True

Question 21

how is the receptor positioned when using a paralleling technique?

Answer 21

the receptor is positioned farther from the tooth surface, which therefore creates magnification, but this can be compensated by an increased tube-to-tooth distance

Question 22

Paralleling technique

at what angle should the primary beam hit the receptor and at what axis of the tooth?

Answer 22

90 degree angle, long axis

Question 23

Paralleling technique

where are the x-ray beams directed through?

Answer 23

the contact areas (between teeth)

Question 24

who is the paralleling technique not feasible for?

Answer 24

patients with a shallow palate, tori, or small mouth

Question 25

# occlusal techniques Mandibular occlusal technique

Answer 25

head tilted backward, negative 55° vertical angulation | Central rays are directed **through the chin**

Question 26

# occlusal techniques Maxillary occlusal technique

Answer 26

occlusal plane parallel to the floor, positive 65° vertical angulation | Central rays are directed through the **tip of the nose**

Question 27

# occlusal techniques Cross-sectional maxillary occlusal technique

Answer 27

occlusal plane parallel to the floor | Beams are perpendicular to the receptor & directed between the *eyebrows

Question 28

# occlusal techniques Cross-sectional mandibular occlusal technique

Answer 28

head tilted backward until the ala-tragus (“**ala” meaning side of the nose, “tragus” meaning flap of the ear**) line is almost perpendicular to the floor | Beams are perpendicular to the receptor & directed *inferior to the chin

Question 29

buccal object rule ## Footnote slob: same lingual, opposite buccal

Answer 29

Shows whether an artifact is lingual or buccal. A radiograph is a two-dimensional image of a three-dimensional space. Therefore, a bitewing or PA only shows the anteroposterior location of the artifact ## Footnote **Two** images needed, whether they are PA or BWX. The second image is taken from a **different** horizontal or vertical angulation

Question 30

# slob why should the two images be compared?

Answer 30

to see if the artifact moves towards the same or opposite direction compared to the change in the tube head position

Question 31

object is located **lingually** if?

Answer 31

Tube head and object moved in the **same** direction

Question 32

object is located **bucally** if?

Answer 32

Tube head and object moved in the **opposite** direction

Question 33

Patient Positioning

Answer 33

* Patient must sit upright * Adjust the headrest to support the patient’s head * Secure the lead apron and thyroid collar * For bitewings, the occlusal plane should be parallel to the floor * Maxillary arch exposure: head is upright * Mandibular arch exposure: head is tipped back slightly * Angulation positioning device can help align the x-ray beams to the receptor. If a bitewing tab is used, the clinician needs to determine the horizontal and vertical angulation.

Question 34

Assembly

Answer 34

* Assemble the receptor holding kit with clean gloved hands * Allow the patient to observe the process to demonstrate proper infection control measures * With digital sensor, use a plastic barrier to cover the sensor

Question 35

# technique errors Overlap

Answer 35

inappropriate **horizontal** angulation → direct beams through contacts

Question 36

# technique errors Foreshortening

Answer 36

too much **vertical** angulation → decrease angulation

Question 37

# technique errors Elongation

Answer 37

too little **vertical** angulation → increase angulation.

Question 38

# technique errors Circular white border

Answer 38

cone cut → PID should cover the entire surface of the film

Question 39

Amalgam

Answer 39

completely radiopaque

Question 40

Gold

Answer 40

completely radiopaque, even in crown, inlay, and onlay

Question 41

Retention Pins

Answer 41

radiopaque, used to stabilize the radiograph

Question 42

Base material

Answer 42

slightly radiopaque, used to protect the pulp

Question 43

Gutta-perch

Answer 43

slightly radiopaque, substance that fills tooth canals

Question 44

Silver point

Answer 44

radiopaque, used to obliterate canals during endodontic therapy

Question 45

Composite

Answer 45

radiopaque, the density of opacity **varies** with the composition of the material

Question 46

Porcelain

Answer 46

slightly radiopaque

Question 47

Orthodontics

Answer 47

radiopaque

Question 48

Implants

Answer 48

radiopaque, resembles a screw

Question 49

PFM | porcelain fused to metal

Answer 49

radiopaque, the underlying layer is metal

Question 50

Which anatomical landmark can potentially be seen with periapicals of the **maxillary** central incisors?

Answer 50

median palatine suture ## Footnote the union of the two horizontal palatal plates and appears as a thin radiolucent line between the maxillary central incisors

Question 51

Panoramic imaging

Answer 51

useful for assessing trauma or development of the jaw, but they may not provide enough clarity for detecting signs related to periodontal diseases or carious lesions

Question 52

Failing to have the x-ray beam in a position that’s perpendicular to the receptor in a paralleling technique will result in?

Answer 52

foreshortening and elongation