Intra Oral Radiography: - Presented by

Intra oral radiography
• Presented by
Submitted to:
peeyush shivahare
Department of oral
• Shila Bhandari medicine and radiology
Content
• Periapical radiography
• Bitewing
• Occlusal
• Localization technique
Periapical radiography
Indication
• Tooth related related indication

• Alveolar bone related
• Surrounding bone related
• Other
Paralleling Technique
This is a technique where film is kept
parallel to the teeth and x-ray beam if
focused perpendicular to the film.
Also called;
-long cone technique
-extension cone paralleling
technique(XCP)
Principle of paralleling technique
film is kept parallel to the teeth using 2 principle:
-film is kept far away from the tooth.
-increased focal spot-film distance so called long cone technique.
Holder used:XCP
(extended cone paralleling)
Advantages
• geometrically accurate images are produced with little
magnification.
• the periodontal ligament bone level are well represented.
• the periapical tissues are accurately shown enabling the

detection of proximal caries.
• the horizontal and vertical angulation of the x-ray tube
head are automically determined by the position indicating
devices if placed correctly.
• reproducible radiographs are possible at differant visits
and with different visits and with different operators.
Disagvantages
• positioning of the film packet can be very uncomfortable
for the patient, particularly for posterior teeth, which aften
causes gagging.
• positioning holders within the mouth can be difficult for

inexperienced operators.
• the anatomy of the mouth sometimes makes the technique

imposssible eg shallow flat palate.
• it is more time consuming than the bisecting angle

technique.
• difficult to practice in endodontics

Bisecting Angle Technique
• This is a technique
where film is kept as
near to the teeth and
x-ray beam if
focused to the
bisecting line of film
and the tooth.
• Also called short
cone technique
Principle of bisecting angle technique
this technique works based on the ciesyski's rule/rule of
isometry,which states that two triangles are equal if they have two
equal angle and share a common side.
Steps in taking periapical
radiography
• 1.Proper position of the patient.
2.proper evaluation of target area for exposure.
3.placement of the film.
4. To check proper head orientation
5. Position the tube head/check for the
vertical angulation and horozontal angulation
Vertical angulation
-It is determined by the imaginary bisecting between the tooth and the
film(as per Ciesyski’s rule)
-For maxilla: position indicating device should be directed downward
called positive angulation
-For mandible: position indication device should be directed upward
called negative angulation.
Horizontal angulation
-Horizontal angulation must be 0 ie there should not be any tube head
tikting on either right or left
Point of entry of central beam of x-ray
• Central incisor
• Lateral incisor
• Canine
• 1st and 2nd molars
• 3rd molar
Advantages
-relatively simple and quick procedure
-comfortable for patient.
-the film csn be adapted to shape of the most dental arches.
more teeth may be demonstrated on one film without
overlap
-it is easily adaptable for endodontic treatment.
Disadvantages
-chances of film faults are more like

magnification,distortion, cone cut, overlapping, etc.
-the crowns of the teeth are often distorted thus
preventing the detection of proximal caries.
-the periodontal bone levels are poorly shown.
-the horizontal and vertical angles have to be assessed
for every patient and considerable skill required.
-it is not possible to obtain reproducible views.
Bitewing radiography
• This is a type of intraoral radiography in which crown of upper

and lower teeth seen together in a radiograph.
Indication
• detection of proximal caries(incipient)
• evaluation of alveolar bone height
• evaluating periodontal status
• to detect overhanging restoration.

Principles and steps
Film sizes
Film holder
• Bitewing loop-can be custom made or readymade
• Bite wing tab
• Rinn XCP holder

• Advantages
-simple and inexpensive procedure

-the tabs are disposable so chances of cross
contamination is less
-the use of XCP holder decreases the chances
of overlapping
--crown of 4-6teeth can be seen in one
radiograph so decrease the patient exposure.
Disadvantages
• dislodgement of film in case if manual bite is used
• chances of overlapping if centre of beam is not

passing through the exact contact area.
Occusal radiography
• The image receptor is placed over the occusal
surfaces of the teeth to be examined.
• Occlusal film size-57mm*76mm
Indication
-in patient having diffuculty in mouth opening due to various reasons.
-to locate supernumerary, unerupted or impacted teeth.
-to locate retained roots of extracted teeth.
-to evaluate the fracture.
-to locate and evaluate the extent of lesions.
-to locate foreign bodies in maxilla or mandible.
-to see lingual or buccal cortical plate expansion in case of cyst or tumor.
-in maxilla to examine cleft lip and palate,boundaries of maxillary sinus
-in mandble to locate salivary stone in the duct of the submandibular gland.
Maxillary occlusal radiographic technique
Mandibular occlusal radiographic technique
Object localization technique
• Indication: to evaluate
-embedded, supernumerary and unerupted teeth. -foreign

bodies
-evaluation of cyst, tumor
-broken needles ,dental implant-broken endodontic or surgical instrument
-filling materials in the alveolar process
-localization of the roots and root canals in the endodontic radiology.
-retained roots in the jaws and maxillary antrum.
-traumatic injuries ,soft tissue calcifcation

localization technique
• clark's technique(most common)
• Miller’s right angle technique
• stereoscopy
• computed tomography
• magnetic resonance imaging

Clark’s technique(SLOB technique)
• Principle:
-relative position of radiographic images of two seperate objects change, when projection
angle at which images were made is changed.
-shift in horizontal angulation of x-ray beam move the
position of objects on x-ray film in mesial or distaldirection.
-vertical angulation should not be changed
-if the object is on lingual
aspect then the object appears to have moved in the same direction of tube ie same
lingual. -if the object is on buccal aspect then the object apears
to have moved in the opposite direction of tube ie opposite direction.
Miller’s right angle technique
• the technique uses two
radiographs made separately with
films positioned at right angles to
each other and then study
together to localize a structure.
• for eg:
-one radiograph is periapical and

another will be occusal.
-occusal and panoramic radiograph.

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Intra oral radiography

• Tooth related related indication

• the periapical tissues are accurately shown enabling the

• positioning holders within the mouth can be difficult for

• the anatomy of the mouth sometimes makes the technique

• it is more time consuming than the bisecting angle

• difficult to practice in endodontics

-chances of film faults are more like

• This is a type of intraoral radiography in which crown of upper

• evaluation of alveolar bone height

• evaluating periodontal status

• to detect overhanging restoration.

• Bite wing tab

• Rinn XCP holder

-simple and inexpensive procedure

• dislodgement of film in case if manual bite is used

• chances of overlapping if centre of beam is not

-to locate supernumerary, unerupted or impacted teeth.

-to locate retained roots of extracted teeth.

-to evaluate the fracture.

-to locate and evaluate the extent of lesions.

-to locate foreign bodies in maxilla or mandible.

-in maxilla to examine cleft lip and palate,boundaries of maxillary sinus

-embedded, supernumerary and unerupted teeth. -foreign

-evaluation of cyst, tumor

-broken needles ,dental implant-broken endodontic or surgical instrument

-filling materials in the alveolar process

-localization of the roots and root canals in the endodontic radiology.

-retained roots in the jaws and maxillary antrum.

-traumatic injuries ,soft tissue calcifcation

• clark's technique(most common)

• Miller’s right angle technique

• magnetic resonance imaging

-one radiograph is periapical and

-occusal and panoramic radiograph.

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