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牙科放射線學 (2) 陳玉昆副教授 : 高雄醫學大學 口腔病理科 07-3121101~2755 Extraoral Radiography 口外放射線攝影術.

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Presentation on theme: "牙科放射線學 (2) 陳玉昆副教授 : 高雄醫學大學 口腔病理科 07-3121101~2755 Extraoral Radiography 口外放射線攝影術."— Presentation transcript:

1 牙科放射線學 (2) 陳玉昆副教授 : 高雄醫學大學 口腔病理科 ~2755 Extraoral Radiography 口外放射線攝影術

2 學 習 目 標學 習 目 標 - 知道口外片攝影術的名稱 - 了解口外片攝影術的適應症 - 明白口外片攝影術的方法

3 參考資料 References: 1. Eric Whaites: Essentials of dental radiography & radiology 3rd edition, Chapters 11-13, p White & Pharoah: Oral radiology: principle & interpretation, 5th edition, Chapter 6, p Harring JI & Jansen L: Dental radiography- principle & techniques 2nd edition, Chapter 23, p Farman AG. Increasing the diagnostic role of the cephalometric attachment. Panoramic Imaging News, volume 2, issue 4,

4 Main Maxillofacial / Skull Projections Standard occipitomental (0 o OM) (Water’s view) 30 o occipitomental (30 o OM) (Water’s view) Postero-anterior of the skull (PA skull) Postero-anterior of the jaw (PA jaw) Reverse Towne’s True lateral skull Oblique lateral Submento-vertex (SMV) Cephalometric radiography Panoramic radiogaraphy External auditory meatus Outer canthus of the eye Radiographic baseline 上學期已講解 Ref. 2

5 Standard Occipitomental (0 o OM) This projection shows the facial skeleton & maxillary antra & avoids superimposition of the dense bones of the skull base Ref. 1 Investigation of maxillary antra Detecting middle facial fractures: - Le Fort I - Le Fort II - Le Fort III - Zygomatic complex - Naso-ethomoidal complex - Orbital blow-out Coronoid process fractures Investigation of frontal & ethmoidal sinuses Investigation of sphenoidal sinus Main indications 頭往上仰

6 30 o Occiptomental (30 o OM) Main indications This projection shows the facial skeleton, but from a different angle from the 0 o OM, enabling certain bony displacements to be detected Detecting the following middle third facial fractures: - Le Fort I - Le Fort II - Le Fort III Coronoid process fracture Ref. 1 頭往上仰

7 Posterio-Anterior of Skull (PA skull) Main indications This projection shows the skull vault, primarily the frontal bones and jaws Fractures of the skull vault Investigation of the frontal sinuses Conditions affecting the cranium - Paget’s disease - Multiple myeloma - Hyperparathyrodism Intracranial calcification Ref. 1 頭往前傾 平行地面

8 Posterio-Anterior of Jaw (PA jaw) This projection shows the posterior parts of the mandible It is not suitable for showing the facial skeleton because of superimposition of the base of the skull & nasal bones Lesions such as cysts or tumors in the posterior third of the body or rami to note any medio-lateral expansion Mandibular hypoplasia or hyperplasia maxillofacial deformities Fractures of the mandible involving the - Posterior third of the body - Angles - Rami - Low condylar necks Main indications Ref. 1 頭往前傾

9 Main indications Reverse Towne’s This projection shows the condylar heads & necks The original Towne’s view is an AP projection, however, all skull views used in dentistry are taken conventionally in the PA direction, the Reverse Town’s (a PA projection) is used High fracture of the condylar neck Intracapsular fracture of the TMJ Investigation of the quality of the articular surfaces of the condylar head in TMD Condylar hypoplasia or hyperplasia Ref. 1 頭往前傾

10 Reverse Towne’s Radiography Refs. 1, 3, 4

11 True Lateral Skull Ref. 1 This projection shows the skull vault & facial skeleton from lateral aspect This view is used when a single lateral view of skull is required Fractures of cranium & cranial base Middle third facial fractures Investigation of frontal, sphenoidal & maxillary sinuses - Paget’s disease - Multiple myeloma - Hyperparathyroidism - Conditions affecting sella turcica - Tumor of pituitary gland in acromegaly Main indications

12 Oblique Lateral Radiography True lateral Oblique lateral Refs. 1, 4

13 Submental-Vertex (SMV) Main indications This projection shows the skull base, spenoidal sinuses and facial skeleton from above Refs. 1, 4 Destructive/expansive lesions affecting palate, pterygoid region or skull base Investigation of sphenodal sinus Assessment of the thickness (medio- lateral) of the posterior part of the mandible before osteotomy Fracture of zygomatic arches

14 Submental-Vertex (SMV) Ref. 3 (Median Sagital Plane)

15 True cephalometric lateral skull m Refs. 2, 3, 4 Cephalometric Radiography

16 Cephalometric postero- anterior of the jaws (PA jaws) Refs. 2, 3

17 Main Maxillofacial / Skull Projections Standard occipitomental (0 o OM) 30 o occipitomental (30 o OM) Postero-anterior of the skull (PA skull) Postero-anterior of the jaw (PA jaw) Reverse Towne’s True lateral skull Oblique lateral Submento-vertex (SMV) Cephalometric radiography Summaries 以上的拍攝方式名稱已記好了嗎?

18 Summaries - Technical aspects of extraoral radiography & resultant images Lat CephSMVWatersPA Ceph Reverse Towne Oblique lateral Body Ramus Ref. 2


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