1. Welcome ! 1

2. Dental anatomy and Imaging With Eriks Oct 2012

3. Dental Anatomy General naming of teeth:
Tip: Views always look into the patients mouth (not your own).
Maxillar (Upper)
Mandibular
(Lower) 3

4. Dental Anatomy
“Directions”: 4

5. Dental Anatomy
Tooth numbering: Always look into the patients mouth (not your own).
ADA System:
International System:
Kids (1st set of teeth) have there own “numbering” with letters ! 5

6. Dental Anatomy 6

7. Intraoral imaging: Periapical image: Health of teeth, roots, bone.
Bitewing: (interproximal)
Interproximal decay (caries) 7

8. Intraoral imaging: Occlusal image:
exploring calcifications of the sublingual salivary glands. 8

9. Equal image enlargement
Magnification
Intraoral imaging technique:
Equal image enlargement
Caused by long object-sensor distance and short source-object distance
Minimized by controlling distance factors & focal spot

10. Variation of the true shape of the object
Shape Distortion
Intraoral imaging technique:
Variation of the true shape of the object
Vertical distortion results in elongation foreshortening or
Horizontal distortion results in image widening and overlapping

11. Intraoral imaging technique:11

12. Assembled Instruments
Anterior PA views
right and left
maxillary and mandibular
Bitewing views
Posterior PA views

13. Paralleling Periapical Technique
Applies most rules of accurate image formation
Most accurate periapical technique
Preferred technique for periapical imaging

14. Used to record interproximals
Bitewing Technique
Intraoral imaging technique:
Applies principles of paralleling technique to imaging the teeth crowns
Used to record interproximals
Most accurate view of the crowns and bony margins

15. Vertical Angulation (with tabs)
When the film is positioned in the mouth, the upper portion of the film is angled approximately +20° as it contacts the palate. In the mandible, the film is upright (0° angle). The average between these two angles is +10°. This +10° is the vertical angulation selected when using bitewing tabs.
+20º 0º

16. Bisecting Angle Periapical Technique
Intraoral imaging technique:
Applies one of the rules for accurate image formation
Angle is formed by sensor and object
Produces images with shape distortion and magnification

17. Intraoral imaging technique: FMX (Full Mouth X-Ray) obsolete!

18. FMX
Not to be confused with (although you might need dental a FMX after this):

19. Short image from too much vertical angulation
Placement Errors
Foreshortening
Short image from too much vertical angulation
Correction - place receptor parallel to tooth long axes and reduce the vertical angle

20. Long image from not enough vertical angulation
Placement Errors
Elongation
Long image from not enough vertical angulation
Correction - place receptor parallel to tooth long axes and increase the vertical angle

21. Placement Errors
Horizontal Overlap
Teeth widening and overlapped contacts from diagonal entry of the x-ray beam
To correct, place receptor parallel to horizontal plane, direct beam through
proximal contacts

22. Zone of non-exposure from not centering x-ray beam over receptor
Placement Errors
Cone Cut
Zone of non-exposure from not centering x-ray beam over receptor
To correct, direct central ray through entry point and to the center of the receptor

23. Receptor not placed in proper position to cover desired structures
Placement Errors
Positioning Error
Receptor not placed in proper position to cover desired structures
Use receptor placement guidelines

24. System will correct for most over or underexposures
Exposure Error
System will correct for most over or underexposures
Overexposure – exposure factors set too high
Underexposure – exposure factors set too low

25. Dental Anatomy 25

26. Digital Pan Landmarks & Positioning Errors
Eye Socket
Spine
Outline of Ear
TMJ
Nasal fossa/Airways
Sinus
Sinus
Septum
Mandibular canal
Eagles
Necklace shadow
Hyoid bone
Mandibular canal
Mental foramen
Calcification of carotid
Patient demonstrates too much smile – chin is positioned too far down

27. P1C…25% Magnification & Special Needs TM1…Lateral TMJ Open / Closed
T h e D e n t a l C o m p a n y
ORTHOPHOS XG 3D Ready 2D PROGRAMS
P1…Panoramic
P1A…Artifact Reduced
P1C…25% Magnification & Special Needs
Upper - Lower
Right - Left
P2 =Dentition – P2A Artifact Reduced – P2C Constant Magnification also for Compromised Patients
P10…Pediatric
P12…Anterior Views
BW1…Bitewing View
BW2
Lower
Upper
TM1…Lateral TMJ Open / Closed
S1…Sinus Frontal
MS1…Slices (molar region)
4 Sinus views
6 TMJ views offered

28. ORTHOPHOS XG 3D Ready 2D PROGRAMS
T h e D e n t a l C o m p a n y
ORTHOPHOS XG 3D Ready 2D PROGRAMS
General Information –
Cover all patient contact surfaces with hygienic covers
Patient must remove:
 Glasses
 All jewelry above the neck, to include earrings, necklaces, metal hair pins
 All removable appliances in the mouth that are removable
Easy Patient Positioning
(select appropriate bite piece,
contact segment, or chin rest)
Easy Pad Assists with Correct Selections
Tap on P1, P1A, P1C
To access sub programs
Tap to Scroll through programs (­) (+) touch pad

29. ORTHOPHOS XG 3D Ready 2D PROGRAMS
T h e D e n t a l C o m p a n y
ORTHOPHOS XG 3D Ready 2D PROGRAMS
Review:
Workstation
Select patient from Worklist or Register patient in SIDEXIS
Select PAN GREEN flashing light indicates Ready
Digital Pan
On LCD Screen Select Program – Patient Type, Etc.
Position Patient (if using lead apron solid is to back)
Use light to make certain Mid and Frankfurt correct
Remind Patient to swallow, place and keep tongue at
Roof of mount, and keep lips closed during digital
Image taking.
Remote Exposure Station – Confirm Selections
Press and hold to initiate exposure 14 sec. until
you hear (3) beep-beep-beep sound the
procedure is complete and unit is at rest
Digital Pan LCD Display
Shows snapshot of image - tap screen to remove image
Send image to PACS

30. Patient Positioning Devices
One Piece Yellow Bite Block and Contact Segment – For Panoramic Images
Bite Block
Contact Segment
Patients with anterior front teeth
anterior teeth in groove
Patients with missing anterior teeth
Position under nose with cotton roll
or 4x4 for space relationship
Chin Rest – for patients with stability issues
Patients with anterior front teeth Patients with missing front teeth

31. Patient Positioning Devices -Continued
More Positioning Guides: Universal Positioners
Used with/for:
Use Recommendations
Auto
Function
Reorder Foam Inserts Cat. #
Position
pcs. EA
For patients with and without
Anterior teeth. Assists operator with proper Occlusal and Frankfurt Positioning. Eliminates chin cut off.
All Purpose -Sliding Bite Piece Positioner-Optional
Sliding Positioner Cat. #
Universal for Pan, TSA, etc. // Optional – may be purchased as accessory.
EA.
Anterior teeth.
One positioning piece for all Panoramic Programs = =

32. Patient Positioning Devices -Continued
More Positioning Guides: Sinus Views
Used with/for:
Use Recommendations
Short Blue Positioning
Contact Segment &
Bite
Block
Patient is
Positioned
Lower to
permit SINUS Area
in FOV (field of view)
Check Programs on LCD
Easy Pad for correct positioning piece
Programs:
S1 & S3
S2 & S4

33. Red Frankfurt and Mid Sagittal Light Lines
Patient Positioning Devices -Continued
TMJ Images
TMJ Programs
Panoramic
Forehead and Temple
Supports
Red Frankfurt and Mid Sagittal Light Lines

34. TMJ Lateral - Medial TMJ Head Positioner and Stabilizer Medial Medial
closed
open
open
closed
Medial
Medial
Lateral
Lateral
TM 1.1
TM 1.2
TM 1.2
TM 1.1

35. Positioning Errors Patient Tilted
AIR (to remove have patient swallow just before image is taken)
Hyoid shadow
Hyoid shadow

36. Pan with Necklace shadow and too much smile

37. Poor Patient Positioning plus artifacts
Lead blocker– does this office use a Lead Apron? OR was this patient
In a wheelchair with metal bar on headrest?
Necklace shadow

38. Metal around Neck causes ARTIFACT
Patient with Metal around neck (like necklace) causes artifact on image
Always have patient remove necklace that lays above C7/T1 vertebra.
Wrong =
Interferes
with beam
Right = L

39. Cephalometric image Lateral Full Skull Ceph View with Landmarks
Pterygomaxillary Fissure
Sella Turcia
Nasion
Orbital
Porion
Anterior Nasal Spine
Subspinale
Basion
Pogonion
SIDEXIS XG

40. Ceph tracing Anatomy 40