Dental Radiography

Radiographic Panel

Panoramic Radiograph

Panoramic radiograph represents a radiological tenchnique for producing a single image of the facial structures.
This single image, includes both the maxillary and the mandibular dental arches and their supporting structures and it is called orthopantomogram.

Panoramic images are most useful for diagnosing the diseases with a broad coverage of the jaws.

The main indications for orthopantomographic imaging include:

  • Conditions where a bony lesion or unerupted tooth is of a size or position that requires its complete demonstration on intraoral radiographs.

  • In the cases of a grossly neglected mouth and extensive oral health problems.

  • As part of an assessment of periodontal bone support often supplemented with periapical radiographs.

  • For the assessment of wisdom teeth prior to planned surgical intervention.

  • As part of an orthodontic assessment where there is a clinical need to know the state of the dentition and the presence/absence of teeth.

  • For assesment of the fractures of all parts of the mandible except the anterior region.

  • To diagnose destructive diseases of the articular surfaces of the temporomandibular joint.

  • To determine the alveolar bone height and position of anatomical structures as part of pre-implant planning.

    Ideal requirements

  • All parts of the maxilla and mandible should be fully shown along with the surrounding structures.

  • The incisal edges of the anterior teeth are centered on the bite notch so that there is no magnification or minification of the anterior teeth.

  • The occlusal plane has a slightly concave appearance on the image.

  • The right and the left side of the image are symmetrical.

  • There is no superimposition of the tongue in the periapical area of the maxillary teeth.

  • There is no superimposition of the cervical spine.

  • There should be no overlap of the anatomical structures on the image.

  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    -to assess teeth and bone pathologies films should be well exposed and show good contrast to allow differentiation between enamel and dentine and to allow the enamel–dentine junction (EDJ) to be seen.
    – to assess the periodontal status films should be underexposed to avoid burn-out of the thin alveolar crestal bone.

  • The image should be free of distortion and blurring.

  • The image should be free of film fog, dark spots and lines, white spots, yellow stains and ghost images.

  • The image should be free of artifacts caused by led apron or foregin metal objects such as jewelry.

  • The image should be comparable with previous panoramic images both geometrically and in density and contrast.

Minimal requirements

  • The areas of interest should be fully shown.
  • There is no magnification or minification of the anterior teeth.
  • The occlusal plane does not deviate significantly from the sightly concave appearance.
  • There are no significant differences in symmetry of the left and right side of the image.
  • The superimposition of the tongue does not compromise the area of interest on the image.
  • The superimposition of the spine does not compromise the area of the interest on the image.
  • There is no significant overlapping of the anatomical strucurees on the image, or the presence of the overlapping does not compromise the area of the interest on the image.
  • There is no significant distortion and blurring on the image.
  • The presence of the film fog, dark spots and lines, white spots, yellow stains and ghost images does not compromise the area of interest on the image.
  • The appearance of artifacts caused by led apron or foregin metal objects does not compromise the area of interest on the image.

Bitewing

Bitewing or interproximal images represent radiographic representation of the maxillary and mandibular tooth crowns and the alveolar crest of maxilla and mandible. Bitewing radiographs take their name from the original technique which required the patient to bite on a small wing attached to an intraoral film packet.
Nowdays, modern techniques use holders, which have eliminated the need for the wing (now termed a tab). Also a digital image receptors: solid-state or phosphor plate can be used instead of film, but the terminology and clinical indications have remained the same.

The main indications for bitewing images include:

  • Detection of the interproximal carious lesions in the early stages of development before it becomes clinically apparent.
  • Monitoring the progression of dental caries.
  • Assessment of existing restorations.
  • Assesment of the secondary or reccurent dental caries. Because of the horizontal angle of the x-ray beam, these radiographs also may reveal secondary caries below restorations that may escape recognition in the periapical views.
  • Assessment of the periodontal status because these imagesprovide a good perspective of the alveolar bone crest, and changes in bone height can be assessed accurately through comparison with the adjacent teeth.
  • Detection of the calculus deposits in the interproximal areas.

There are two main categories of the bitewing projections:

  • Posterior bitewing projections
  • Anterior bitewing projections

Posterior bitewing projection

This projection include alveolar crestal bone and crowns of the maxillary and mandibular posterior teeth. This image should include at least 2mm of crestal bone distal to the most distal tooth present in the upper and lower jaw.

Ideal requirements

Irrespective of the type of image receptor being used, typical quality criteria for a bitewing radiograph should include:

  • The image should have acceptable definition with no distortion or blurring.
  • The image should include from the distal surface of the canine to the distal surface of the second molar – if the third molars are erupted then the 7/8 contact should be included.
  • At least a 2 mm of the bone distal to the most distal tooth on the plane of the occlusion should be shown on image.
  • The occlusal plane/bite-platform should be in the middle of the image so that the crowns and coronal parts of the roots of the maxillary teeth are shown in the upper half of the image and the crowns and coronal parts of the roots of the mandibular teeth are shown in the lower half of the image, and the buccal and lingual cusps should be superimposed.
  • The maxillary and mandibular alveolar crests should be shown.
  • There should be no overlap of the approximal surfaces of the teeth.
  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    – to assess caries and restorations films should be well exposed and show good contrast to allow differentiation between enamel and dentine and to allow the enamel–dentine junction (EDJ) to be seen.
    – to assess the periodontal status films should be underexposed to avoid burn-out of the thin alveolar crestal bone.
  • The image should be free of coning off or conecutting and other film handling errors.
  • The image should be free of film fog, dark spots and lines, white spots, yellow stains.
  • The image should be comparable with previous bitewing images both geometrically and in density and contrast.

Minimal requirements

  • All crowns of the posterior teeth should be shown on the image.
  • At least 2mm of maxillary and mandibular crestal bone should be shown.
  • 2 mm of the bone distal to the distal-most tooth on the plane of the occlusion should be shown on image.
  • Less than 1/3 thickness of enamel overlap present for interproximal caries assesment.
  • The presence of conecutting does not compromise the area of interest on the image.
  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.

Anterior bitewing projection

This projection include alveolar crestal bone and crowns of the maxillary and mandibular anterior teeth.

Ideal requirements

Irrespective of the type of image receptor being used, typical quality criteria for a bitewing radiograph should include:

  • The image should have acceptable definition with no distortion or blurring.
  • The image should include from the mesial surface of the central incisor to the mesial surface of the first premolar.
  • The occlusal plane/bite-platform should be in the middle of the image so that the crowns and coronal parts of the roots of the maxillary teeth are shown in the upper half of the image and the crowns and coronal parts of the roots of the mandibular teeth are shown in the lower half of the image.
  • The maxillary and mandibular alveolar crests should be shown.
  • There should be no overlap of the approximal surfaces of the teeth.
  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    – to assess caries and restorations films should be well exposed and show good contrast to allow differentiation between enamel and dentine and to allow the enamel–dentine junction (EDJ) to be seen.
    – to assess the periodontal status films should be underexposed to avoid burn-out of the thin alveolar crestal bone.
  • The image should be free of coning off or conecutting and other film handling errors.
  • The image should be free of film fog, dark spots and lines, white spots, yellow stains.
  • The image should be comparable with previous bitewing images both geometrically and in density and contrast.

*Minimal requirements+

  • All crowns of the anterior teeth should be shown on the image.
  • At least 2mm of maxillary and mandibular crestal bone should be shown.
  • Less than 1/3 thickness of enamel overlap present for interproximal caries assesment.
  • The presence of conecutting does not compromise the area of interest on the image.
  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.

If all of the required structures can not be shown on the same radiograph, then separate premolar and molar bitewing projections should be performed.


Premolar bitewing projection

This projection include alveolar crestal bone and crowns of the maxillary and mandibular premolar teeth.

Ideal requirements

Irrespective of the type of image receptor being used, typical quality criteria for a bitewing radiograph should include:

  • The image should have acceptable definition with no distortion or blurring.
  • The image should include from the distal surface of the canine to the mesial surface of the first molar.
  • The occlusal plane/bite-platform should be in the middle of the image so that the crowns and coronal parts of the roots of the maxillary teeth are shown in the upper half of the image and the crowns and coronal parts of the roots of the mandibular teeth are shown in the lower half of the image, and the buccal and lingual cusps should be superimposed.
  • The maxillary and mandibular alveolar crests should be shown.
  • There should be no overlap of the approximal surfaces of the teeth.
  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    – to assess caries and restorations films should be well exposed and show good contrast to allow differentiation between enamel and dentine and to allow the enamel–dentine junction (EDJ) to be seen.
    – to assess the periodontal status films should be underexposed to avoid burn-out of the thin alveolar crestal bone.
  • The image should be free of coning off or conecutting and other film handling errors.
  • The image should be free of film fog, dark spots and lines, white spots, yellow stains.
  • The image should be comparable with previous bitewing images both geometrically and in density and contrast.

Minimal requirements

  • All crowns of the premolar teeth should be shown on the image.
  • At least 2mm of maxillary and mandibular crestal bone should be shown.
  • Less than 1/3 thickness of enamel overlap present for interproximal caries assesment.
  • The presence of conecutting does not compromise the area of interest on the image.
  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.

Molar bitewing projection

This projection include alveolar crestal bone and crowns of the maxillary and mandibular molar teeth. from the distal surface of the second premolar to the distal surface of the most posterior tooth. This image should include at least 2mm of crestal bone distal to the most distal tooth present in the upper and lower jaws.

Ideal requirements

Irrespective of the type of image receptor being used, typical quality criteria for a bitewing radiograph should include:

  • The image should have acceptable definition with no distortion or blurring.
  • The image should include from the from the distal surface of the second premolar to the distal surface of the most posterior tooth.
  • At least a 2 mm of the bone distal to the most distal tooth on the plane of the occlusion should be shown on image.
  • The occlusal plane/bite-platform should be in the middle of the image so that the crowns and coronal parts of the roots of the maxillary teeth are shown in the upper half of the image and the crowns and coronal parts of the roots of the mandibular teeth are shown in the lower half of the image, and the buccal and lingual cusps should be superimposed.
  • The maxillary and mandibular alveolar crests should be shown.
  • There should be no overlap of the approximal surfaces of the teeth.
  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    – to assess caries and restorations films should be well exposed and show good contrast to allow differentiation between enamel and dentine and to allow the enamel–dentine junction (EDJ) to be seen.
    – to assess the periodontal status films should be underexposed to avoid burn-out of the thin alveolar crestal bone.
  • The image should be free of coning off or conecutting and other film handling errors.
  • The image should be free of film fog, dark spots and lines, white spots, yellow stains.
  • The image should be comparable with previous bitewing images both geometrically and in density and contrast.

Minimal requirements

  • All crowns of the molar teeth should be shown on the image.
  • At least 2mm of maxillary and mandibular crestal bone should be shown.
  • 2 mm of the bone distal to the distal-most tooth on the plane of the occlusion should be shown on image.
  • Less than 1/3 thickness of enamel overlap present for interproximal caries assesment.
  • The presence of conecutting does not compromise the area of interest on the image.
  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.

Other

Periapical Radiographs

Periapical (retroalveolar) radiographs represent intraoral radiographic images designed to show individual teeth and the periapical region. Periapical radiograph usually shows two to four teeth and provides detailed information about dental crowns, roots, root apices and the surrounding alveolar bone.

The main clinical indications for periapical radiography include:

  • Detection of the pathological conditions in the periapical areas.
  • Evaluation of the periodontal status.
  • Assessment of root morphology prior extractions.
  • Detection of the traumatic injuries to the teeth and associated alveolar bone.
  • Assessment of the presence and position of unerupted teeth.
  • In all phases of endodontic treatment.
  • Preoperative assessment and postoperative appraisal of apical surgery.
  • Evaluation of implants postoperatively.

Ideal quality criteria

Irrespective of the type of image receptor or technique being used, typical quality criteria for a periapical radiograph should include:

● The image should have acceptable definition with no distortion or blurring.
● The image should include the correct anatomical area together with the apices of the tooth/teeth under investigation with at least 3–4 mm of surrounding bone.
● There should be no overlap of the approximal surfaces of the teeth with exception of the canine and first premolar roots on canine periapical image.
● There should not be size and shape distortion of the teeth. The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
– to assess caries, restorations and the periapical tissues films should be well exposed and show good contrast to allow differentiation between enamel and dentine and between the periodontal ligament space, the lamina dura and trabecular bone.
– to assess the periodontal status films should be underexposed to avoid burnout of the thin alveolar crestal bone.
● The images should be free of coning off or conecutting and other film handling errors.
● The images should be comparable with previous periapical images, both geometrically and in density and contrast.

Minimal quality requirements
  • The image should include the correct anatomical area together with the apices of the teeth of interest.

  • Teeth under investigation with at least 2 mm of surrounding bone.

  • The minimal overlapping of the adjacent crowns are acceptable as bitewing radiographs are primarily used for approximal caries detection.

  • The size orthe shape distortion does not compromise the area of the interest on the image.

  • The presence of conecutting does not compromise the area of interest on the image.

  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.

    There are several projections of the periapical radiographs:

    Maxillary periapical projections
Maxillary central incisor projection

The radiograph of this area should include central incisors and their periapical areas.

Maxillary lateral projection

This projection should show the lateral incisor and its periapical area centered on the radiograph, including the mesial interproximal area with the distal aspect of the central incisor with no evident overlapping.

Maxillary canine projection

This projection should show the canine and its periapical region centered on radiograph. The mesial contact area should be open with no evident overlapping. Overplapping of the distal interproximal contact is tolerable because of the anatomical position and relationship with first premolar.

Maxillary premolar projection

The field of view of this periapical projection include: the distal half of the canine, first premolar, second premolar and a space for at the first molar.

Maxillary molar projection

The field of view of this periapical projection include: the distal half of the second premolar, first, second and third molar and part of tuberosity. The same area shhould be included, despite the missing of some or all molars.


Mandibular periapical projections
Mandibular centrolateral projection

The field of view of this periapical projection include central and lateral incisors and their periapical area.

Mandibular canine projection

This projection should show: the entire mandibular canine and its periapical area.

Mandibular premolar projection

The field of view of this periapical projection include: distal half of the mandibular canine, first and second premolar and a first molar.

Mandibular molar projection

The field of view of this periapical projection should include: the distal half of the second premolar, first, second and third molar. If the molar area is edentulous, the radiograph should include edentulous alveolar ridge and retromolar area.


Occlusal Radiographs

Occlusal radiography represent intraoral radiographic technique which displays a relatively large segment of maxillary or mandibular dental arch. Occlusal radiographs include palate and floor of the mouth , partially or completely, depending of the desired field of view, as well as adjacent structures.

The main indications for the occlusal radiography include:

  • For precise localisation of the unerupted and impacted teeth as well as supernumerary teeth and root remnants.
    This technique of imaging is especially useful in evaluation of location and position of the impacted canines.

  • To evaluate the presence of stones in salivary ducts and gland tissue as well as foreign bodies in the jaws and stones in the ducts.

  • To evaluate the integrity and position of the anterior, medial, and lateral outlines of the maxillary sinuses.

  • As a alternative to periapical imaging in patietns with difficulties with mouth opening.

  • To evaluate the location, extent, and displacement of fractures of the mandible and maxilla.

  • To determine the medial and lateral extent of disease (e.g., cysts, osteomyelitis, malignancies).

  • To detect disease in the palate or floor of the mouth.

There are several projections of the occlusal radiographs which are divided in two main categories:

  • Maxillary occlusal projections
  • Mandibular occlusal projections

Maxillary occlusal projections

These projections represent occlusal imaging of the strucutres of the upper jaw.


Anterior maxillary occlusal projection

This projection shows the anterior part of maxilla, anterior upper teeth from canine to canineand anterior floor of the nasal fossa.
The main indications for these radiographs include:

  • To detect the the presence of unerupted canines, supernumerary teeth and tumors.
  • To determine the bucco/palatal position of unerupted canines.
  • Periapical assessment of the upper anterior teeth, especially in children but also in adults unable to tolerate periapical holders and in case of difficulties with mouth opening.
  • Assessment of fractures of the anterior teeth and alveolar bone.

Ideal requirements:

  • The image should have acceptable definition with no distortion or blurring.
  • The image should include anterior part of the maxillary alveolar ridge, crowns, roots and periapical areas of the maxillary anterior teeth from canine to canine, anterior apect of the floor of the nasal fossa, nasopalatine foramen, parts of lateral walls of the nasal fossa and nasal septum.
  • There should be no overlap of the approximal surfaces of the teeth with exception of the canine and first premolar.
  • There should not be size and shape distortion of the teeth.
  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g. – to assess caries, restorations and the periapical tissues films should be well exposed and show good contrast to allow differentiation between enamel and dentine and between the periodontal ligament space, the lamina dura and trabecular bone.
  • The images should be free of coning off or conecutting and other film handling errors.
  • The image should be free of film fog, dark spots and lines, white spots, yellow stains
  • The images should be comparable with previous periapical images, both geometrically and in density and contrast.

Minimal requirements:

  • The image should include the anatomical area of interest.

  • if the area if unterest include teeth, at least 2mm of surrounding bone should be shown on the image.

  • The overlapping of the adjacent structures does not compromise the area of interest on the image.

  • The size or the shape distortion does not compromise the area of the interest on the image.

  • The presence of conecutting does not compromise the area of interest on the image.

  • The presence of the distortion or blurring does not compromise the area of interest on the image.

  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.


    Topographical maxillary occlusal projection

    This projection shows: the hard palate, zygomatic processes of the maxilla, anteroinferior aspects of each antrum, floor of the nasal fosaa, lateral walls of the nasal fossa,nasal septum, nasopalatine foramen, nasolacrimal canals and maxillary teeth from second molar on one side to the second molar on the opposite side.

The main indications for these radiographs include:

  • To detect the the presence of unerupted, supernumerary teeth and tumors.

  • To evaluate the location, extent, and displacement of fractures of the maxilla.

  • To determine the medial and lateral extent of disease (e.g., cysts, osteomyelitis, malignancies).

  • To detect disease in the palate.

    Ideal requirements

  • The image should have acceptable definition with no distortion or blurring.

  • The image should include: the hard palate, zygomatic processes of the maxilla, anteroinferior aspects of each antrum, floor of the nasal fosaa, lateral walls of the nasal fossa,nasal septum, nasopalatine foramen, nasolacrimal canals and maxillary teeth from second molar on one side to the second molar on the opposite side.

  • There should be no overlap of the approximal surfaces of the teeth with exception of the canine and first premolar.

  • There should not be size and shape distortion of the teeth.

  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    – to assess caries, restorations and the periapical tissues films should be well exposed and show good contrast to allow differentiation between enamel and dentine and between the periodontal ligament space, the lamina dura and trabecular bone.

  • The images should be free of coning off or conecutting and other film handling errors.

  • The image should be free of film fog, dark spots and lines, white spots, yellow stains.

  • The images should be comparable with previous periapical images, both geometrically and in density and contrast.

Minimal requirements

  • The image should include the anatomical area of interest.

  • if the area if interest include teeth, at least 2mm of surrounding bone should be shown on the image.

  • The overlapping of the adjacent structures does not compromise the area of interest on the image.

  • The size or the shape distortion does not compromise the area of the interest on the image.

  • The presence of conecutting does not compromise the area of interest on the image.

  • The presence of the distortion or blurring does not compromise the area of interest on the image.

  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.


    Lateral maxillary occusal projection

    This projection shows: a quadrant of maxillary alveolar ridge,inferolateral aspect of the antrum, part of maxillary tuberosity and teeth from the lateral incisor of the one side to the distal surface of the tird molar of the other (contralateral) side.

The main clinical indications for these radiographs include:

  • To evaluate the periapical area of the upper posterior teeth,in adults unable to tolerate periapical holders and in case of difficulties with mouth opening.
  • To evaluate the size and extent of lesions such as cysts, tumours or other bone lesions affecting the posterior maxilla.
  • To determine the condition of the antral floor.
  • To help in determining the position of roots displaced inadvertently into the antrum during attempted extraction of upper posterior teeth.
  • To asses the fractures of the posterior teeth and associated alveolar bone including the maxillary tuberosity.

Ideal requirements

  • The image should have acceptable definition with no distortion or blurring.
  • The image should include:a quadrant of maxillary alveolar ridge,inferolateral aspect of the antrum, part of maxillary tuberosity and teeth from the lateral incisor of the one side to the distal surface of the tird molar of the other (contralateral) side.
  • There should be no overlap of the surrounding strucutres.
  • There should not be size and shape distortion of the teeth.
  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    – to assess caries, restorations and the periapical tissues films should be well exposed and show good contrast to allow differentiation between enamel and dentine and between the periodontal ligament space, the lamina dura and trabecular bone.
  • The images should be free of coning off or conecutting and other film handling errors.
  • The image should be free of film fog, dark spots and lines, white spots, yellow stains.
  • The images should be comparable with previous periapical images, both geometrically and in density and contrast.

Minimal requirements

  • The image should include the anatomical area of interest.

  • if the area if interest include teeth, at least 2mm of surrounding bone should be shown on the image.

  • The overlapping of the adjacent structures does not compromise the area of interest on the image.

  • The size or the shape distortion does not compromise the area of the interest on the image.

  • The presence of conecutting does not compromise the area of interest on the image.

  • The presence of the distortion or blurring does not compromise the area of interest on the image.

  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.


    Mandibular occlusal projections

    These projections represent occlusal imaging of the strucutres of the lower jaw and the mouth floor.

    Anterior mandibular occlusal projection

    This projection shows: anterior part of the mandibular alveolar ridgge, inferior cortical border of the mandible, teeth from the canine on the one side to the canine on the other side and anterior aspect of the mouth floor.

Main indications for these radiographs include:

  • To evaluate the periapical area of the lower anterior teeth, in adults unable to tolerate periapical holders and in case of difficulties with mouth opening.
  • To determine the presence and position of the impacted teeth in the anterior mandibular area.
  • To determine the presence of mandibular fracure or displacement of the anterior part of the mandible.
  • To determine the presence of the salivary calculi in the anterior aspect of the mouth floor.

Ideal requirements

  • The image should have acceptable definition with no distortion or blurring.
  • The image should include:anterior part of the mandibular alveolar ridgge, inferior cortical border of the mandibel, teeth from the canine on the one side to the canine on the other side and anterior aspect of the mouth floor.
  • There should be no overlap of the surrounding strucures and teeth surfaces.
  • There should not be size and shape distortion of the teeth.
  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    – to assess caries, restorations and the periapical tissues films should be well exposed and show good contrast to allow differentiation between enamel and dentine and between the periodontal ligament space, the lamina dura and trabecular bone.
  • to assess the periodontal status or presence of the slaivary calculi, films should be underexposed in order to ensure the optimal visualisation of these pathologies.
  • The images should be free of coning off or conecutting and other film handling errors.
  • The image should be free of film fog, dark spots and lines, white spots, yellow stains.
  • The images should be comparable with previous periapical images, both geometrically and in density and contrast.

Minimal requirements

  • The image should include the anatomical area of interest.

  • if the area if interest include teeth, at least 2mm of surrounding bone should be shown on the image.

  • The overlapping of the adjacent structures does not compromise the area of interest on the image.

  • The size or the shape distortion does not compromise the area of the interest on the image.

  • The presence of conecutting does not compromise the area of interest on the image.

  • The presence of the distortion or blurring does not compromise the area of interest on the image.

  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.


    Topographical mandibular occlusal projection

This projection shows: complete area of the mouth floor, posterior parts of mandibular alveolar ridge, buccal plates of the mandible and teeth from second molar on the one side to the second molar to the opposite side.

The main indications for these radiographs include:

  • To determine the bucco-lingual position of the impacted teeth.
  • To determine the presence of mandibular fracure or displacement of the of the mandible in the horizontal plane.
  • To evaluate the presence of the bucco-lingual bone expansion caused by cyst or tumors.
  • To determine the presence of the salivary calculi in the submandibular salivary ducts.
  • To determine the width of the mandible prior to implant placement.

Ideal requirements

  • The image should have acceptable definition with no distortion or blurring.

  • The image should include:complete area of the mouth floor, posterior parts of mandibular alveolar ridge, buccal plates of the mandible and teeth from second molar on the one side to the second molar to the opposite side.

  • There should be no overlap of the surrounding strucures and teeth surfaces.

  • There should not be size and shape distortion of the teeth.

  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    – to assess caries, restorations and the periapical tissues films should be well exposed and show good contrast to allow differentiation between enamel and dentine and between the periodontal ligament space, the lamina dura and trabecular bone.
    -to assess the periodontal status or presence of the slaivary calculi, films should be underexposed in order to ensure the optimal visualisation of these pathologies.

  • The images should be free of coning off or conecutting and other film handling errors.

  • The image should be free of film fog, dark spots and lines, white spots, yellow stains.

  • The images should be comparable with previous periapical images, both geometrically and in density and contrast.

    Minimal requirements

  • The image should include the anatomical area of interest.

  • if the area if interest include teeth, at least 2mm of surrounding bone should be shown on the image.

  • The overlapping of the adjacent structures does not compromise the area of interest on the image.

  • The size or the shape distortion does not compromise the area of the interest on the image.

  • The presence of conecutting does not compromise the area of interest on the image.

  • The presence of the distortion or blurring does not compromise the area of interest on the image.

  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.


Lateral mandibular occlusal projection

This projection shows: the soft tissue of the one half of the mouth floor, alveolar ridge, buccal and lingual cortical plates of the one side of the mandible and teeth: from the lateral incisor of the one side to the distal surface of the third molar of the opposite side.

The main indications for these radiographs include:

  • To detect the presence of the calculi in the submandibular salivary gland of interest.
  • To evaluate the bucco-lingual position of unerupted lower wisdom teeth.
  • To evaluate the extent and expansion of cysts, tumours or other bone lesions in the posterior part of the body and angle of the mandible.

Ideal requirements

  • The image should have acceptable definition with no distortion or blurring.
  • The image should include:the soft tissue of the one half of the mouth floor, alveolar ridge, buccal and lingual cortical plates of the one side of the mandible and teeth: from the lateral incisor of the one side to the distal surface of the third molar of the opposite side.
  • There should be no overlap of the surrounding strucures and teeth surfaces.
  • There should be no size and shape distortion of the teeth.
  • The desired density and contrast for film captured images will depend on the clinical reasons for taking the radiograph, e.g.
    – to asses teeth and bone pathologies, films should be well exposed and show good contrast.
    -to assess the presence of the salivary calculi, films should be underexposed in order to ensure the optimal visualisation of these pathologies.
  • The images should be free of coning off or conecutting and other film handling errors.
  • The image should be free of film fog, dark spots and lines, white spots, yellow stains.
  • The images should be comparable with previous periapical images, both geometrically and in density and contrast.

Minimal requirements

  • The image should include the anatomical area of interest.

  • if the area if interest include teeth, at least 2mm of surrounding bone should be shown on the image.

  • The overlapping of the adjacent structures does not compromise the area of interest on the image.

  • The size or the shape distortion does not compromise the area of the interest on the image.

  • The presence of conecutting does not compromise the area of interest on the image.

  • The presence of the distortion or blurring does not compromise the area of interest on the image.

  • The presence of the film fog, dark spots and lines, white spots, yellow stains does not compromise the area of interest on the image.