Intraoral Radiography in Pediatric Dental Practice
Intraoral radiography means that the image detector is placed inside the patient’s mouth and the X-ray machine positioned extraorally, aiming at the image detector. Because the image detector is placed close to the teeth, the detail in the image should be
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Intraoral Radiography in Pediatric Dental Practice
Intraoral radiography means that the image detector is placed inside the patient’s mouth and the X-ray machine positioned extraorally, aiming at the image detector. Because the image detector is placed close to the teeth, the detail in the image should be optimal and the distortion minimal. There are three ways of obtaining intraoral radiographs: parallel technique, bisecting angle technique, and occlusal technique.
3.1
Parallel Technique
Ideally, the image detector should be as parallel and close as possible to the teeth, with the X-ray beam aligned perpendicular to the image detector. This is the so- called parallel technique. This creates geometrically accurate images of teeth and alveolar bone levels. To obtain proper alignment one should use image detector holders which also properly align the X-ray machine with the image detector. An example of such holders was shown in Chap. 1 (Fig. 1.3). The advantage of this technique is the fact that there is an extraoral guide for the X-ray machine. In Fig. 3.1 one can see a representation of the ideal parallel technique for both the maxilla and the mandible. It is clear that the image detector cannot always be placed in contact with the tooth, due to anatomical restrictions (e.g., shape of the palate, the level of the floor of the mouth, or a mandibular torus). The parallel technique is obviously also used for bitewing radiographs (Fig. 3.1), as the image detector needs to be placed parallel to the teeth and the X-rays need to be aimed perpendicular at the detector, allowing for interproximal caries detection and interdental bone level assessment.
© Springer Nature Switzerland AG 2019 J. Aps, Imaging in Pediatric Dental Practice, https://doi.org/10.1007/978-3-030-12354-3_3
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3 Intraoral Radiography in Pediatric Dental Practice
For each image detector, as mentioned in Chap. 1, the proper image detector holder needs to be used. Several brands are available worldwide. Rinn® and Hawe Neos® are among the best known brands but in each country or continent individual manufacturers may provide similar and equally performing equipment. The most important aspect is that the image detector must be able to be placed firmly into the holder without the image detector to be subject to damage. For instance photostimulable phosphor plates are too thin to fit in the Rinn® XCP kit for analog film. Therefore one needs to make sure that the correct equipment is used. If the image detector is not snuggly fitting into the holder, the image detector may become dislodged and the image quality may be affected and require a retake. Worst-case scenario, the child may swallow or even worse inhale the plate when it gets dislodged from the holder.
Fig. 3.1 The parallel technique illustrated schematically for a maxillary (left) and mandibular (right) right molar and for a bitewing radiograph (bottom image)
3.2
Bisecting Angle Technique
In some cases, the parallel technique cannot be performed as the patient does not tolerate
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