Occlusal radiography Terminology and classification I Maxillary occlusal

Occlusal radiography

Terminology and classification I. Maxillary occlusal projections Ø Upper standard occlusal (standard occlusal) Ø Upper oblique occlusal (oblique occlusal) Ø Vertex occlusal (vertex occlusal)

II. Mandibular occlusal projections Ø Lower 90 degrees occlusal (true occlusal) Ø Lower 45 degrees occlusal (standard occlusal) Ø Lower oblique occlusal (oblique occlusal)

Standard maxillary occlusal

Standard maxillary occlusal

Main clinical indications Ø Periapical assessment of the upper anterior teeth in patients unable to tolerate periapical films Detecting the presence of unerupted canines, supernumeraries and odontomes Ø As the midline view, when using the parallax method for determining the bucco/palatal position of unerupted canines Ø

Ø Evaluation of the size and extent of lesions such as cysts or tumors in the anterior maxilla Ø Assessment of fractures of the anterior teeth and alveolar bone, especially useful for children

Upper oblique occlusal

Upper oblique occlusal

Main clinical indications Ø Periapical assessment of the upper posterior teeth, especially in adults unable to tolerate posterior periapical films Ø Evaluation of the size and extent of lesions in the posterior maxilla Ø Assessment of the condition of the antral floor

Ø Determination of the position of roots displaced inadvertently into the antrum during attempted extraction of upper posterior teeth Ø Assessment of fractures of the posterior teeth and associated alveolar bone including the tuberosity

Ø Clinical indications- assessment of the bucco/palatal position unerupted canines Ø Disadvantages: - There is a lack of detail and contrast on the film because of the intensifying screens, the mass of tissues the X-ray beam has to penetrate and the consequent scatter

Disadvantages The primary X-ray beam may be in direct line with the reproductive organs Ø A relatively long exposure time is needed (about 1 second) despite the use of intensifying screens Ø There is direct radiation to the pituitary gland the lens of the eye Ø If the X-ray beam is positioned too far anteriorly, superimposition of the shadow of the frontal bones may obscure the anterior part of the maxilla Ø

Lower 90 degrees occlusal

Main clinical indications Detection of the presence and position of radiopaque calculi in the submandibular salivary ducts Ø Assessment of the bucco/lingual position of unerupted mandibular teeth Ø Evaluation of the bucco/lingual expansion of the body of the mandible by cysts, tumours or osteodystrophies Ø Assessment of displacement fractures of the anterior body of the mandible in the horizontal plane Ø

Lower 45 degrees occlusal

Main clinical indications Ø Periapical assessment of the lower incisor teeth, especially useful in adults and children unable to tolerate periapical films Ø Evaluation of the size and extent of lesions in the anterior part of the mandible Ø Assessment of displacement fractures of the anterior mandible in the vertical plane

Lower oblique occlusal

Lower oblique occlusal

Main indications Ø Detection of radiopaque calculi in a submandibular salivary gland Ø Assessment of the bucco/lingual position of impacted lower wisdom teeth Ø Evaluation of the extent and expansion of lesions in the posterior mandible