How to obtain the best dental radiographs - Veterinary Medicine
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How to obtain the best dental radiographs
Improve your dental radiography technique with this guide for taking both standard and digital radiographs.


VETERINARY MEDICINE SUPPLEMENT


Step 5: Exposing the radiograph

It is strongly recommended that everyone leave the room before exposing the radiograph to reduce X-ray exposure. If this is not possible, stand at least 6 ft away and to the side of the tube head—not in front of or behind it—at a 90-to 130-degree angle to the primary beam. Some practices use outdated human dental X-ray units. These units are not recommended because of the increased radiation exposure (scatter) and, in some cases, the inability to achieve a short enough exposure time for direct digital systems. Regardless of the type of unit used, regular inspections and radiographic monitoring should be performed.

Most dental radiography units have a hand-held switch. When exposing radiographs, if you release finger pressure on the switch during the exposure, the production of X-rays will stop. On a manually adjusted dental radiography unit, this will result in an underexposed or light radiograph, while on a computer-controlled dental radiography unit, an error message will illuminate, and you must restart the process. Make sure to press the button until the machine stops beeping. When using a digital system, this will be a short time.

OBTAINING RADIOGRAPHS OF SPECIFIC TEETH

The various types of teeth in dogs and cats are best imaged by using differing patient positions and projection angles.3,8,9 The techniques listed below are for mesaticephalic dogs and cats. Dolichocephalic and especially brachycephalic breeds may require a slight to marked difference in angles.

Mandibular premolars and molars

Views of the mandibular premolars and molars typically use the parallel technique, which is the most basic veterinary dental radiographic technique.6 An exception to this may be the first and second premolars in dogs and the third premolars in cats because in certain breeds the interference of the mandibular symphysis makes exposing the apices of these teeth impossible with the parallel technique.8 The alternate technique for these teeth is discussed in the "Mesial mandibular premolar teeth" section.




For the parallel technique, place the patient in lateral recumbency with the arcade to be imaged up. Place the film parallel to the teeth on the lingual surface of the teeth or mandible, and position the tube head perpendicular to both the teeth and the film (Figures 3 & 5).

Mandibular incisors and canines

All six mandibular incisors and both mandibular canines can be exposed on the same film in cats and small-to medium-breed dogs.8,9 In some cases, the exposure time may need to be decreased for the incisors, although the angle is the same. Large-breed dogs (and also medium breeds if using digital sensors) will generally require one film for the canines and one for the incisors.9 The angle technique required for these views is a slight modification of the parallel technique.

An important point to consider when imaging the canines and incisors is that the roots curve backward to nearly a 45-degree angle in many cases. Consequently, the roots and crowns have markedly different angles. Since the roots are typically the area of interest, use the angle of the root (not the crown) for your bisecting angle calculation.8,9 Because of the anatomical angle of incisor and canine roots, the technique required for imaging these teeth is similar to the parallel technique.

Also keep in mind that the length of canine teeth is often underestimated. The tip (apex) of the canine roots ends over the mesial root of the second premolar. It is easy for a novice to miss the apices of the root. To ensure imaging the entire canine tooth, place the distal edge of the film behind the second premolar.8,9




To capture the mandibular incisors and canines, place the patient in dorsal recumbency with the neck fully extended. Place the film as parallel to the plane of the mandible as possible, so that the film covers the entire intended area. Center the tube head on the patient's head, perpendicular to the film. Then rotate the tube head in the same vertical plane to an angle about 75 degrees to the film. This should be an accurate bisecting angle for the roots (Figures 6A-6C).

In large-breed dogs, the small size of the dental film may require the incisors to be exposed separately from the canines. In this case, the first view is taken with the front edge of the film sticking out just in front of the incisors. This film will image the incisors. To image the entire canine root, place the film so that the back edge is beyond the level of the second premolar. In larger breeds, this view does not typically image the coronal area of the incisors. Note that there may be a difference in exposure for these two views.


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