RADIOGRAPH PLACEMENT & CRITERIA FOR EACH FILM

I.  Bitewing Exposures

           A.      General Considerations; Each Bitewing should have:

1.        Equal distribution of both maxillary and mandibular teeth on the film

2.        Occlusal plane (Curve of Spee) straight across the horizontal midline of the film or  slightly curved upward in the distal

3.          Appropriate contact areas open on respective views providing no natural overlap exists

4.        No dimensional distortion (magnification or enlargement) of the crowns of the teeth

5.        Sufficient density and contrast between black and white shadows in each film to permit detection of pathology in all areas

6.        Correct centering of position indicating device

7.        Clear distinct images of the teeth with no processing and handling errors such as scratched, fingerprints, chemical staining and/or artifacts that interfere with differential diagnosis

B.       Specific Considerations; Criteria for each placement:

1.        Premolar Bitewing

Anterior border of film should cover the distal of the canine

Retake necessary � if distal of canine is not visible; excessive horizontal overlapping; occlusal angled so one arch is not visible; distorted crowns exist

2.        Molar Bitewing

Anterior border of film should cover the distal of the second premolar and all molar contacts should be revealed

Retake necessary � if distal of second premolar is not visible in either PM or M bitewing; excessive horizontal overlapping; occlusal angled so one arch is not visible; distorted crowns exist 

II.  Periapical Exposures

A.       General Considerations;  Each PA should have:

             1.  The entire crown and root structure of appropriate teeth centered on 
                          the film   (with the apex of each tooth visible at least once)

2.        No overlapping of intercrestal bone with 1-2 mm crestal bone visible

3.        Sufficient density and contrast between black and white shadows in each film to permit detection of pathology in all areas

4.  Clear and distinct images of the teeth and other structures with no processing and  handling errors such as scratched, fingerprints, chemical staining and/or artifacts that interfere with differential diagnosis

5.        At least � of alveolar bone visible beyond the apex of each tooth

6.        The plane of occlusion parallel with the edge of the film

7.        1/8� 1/4 margin of film next to the occlusal/incisal edge

8.        No dimensional distortion

9.       The embossed dot next to the occlusal/incisal edge (helps with mounting)

10.     Correct centering of position indicating device (PID)

B.       Specific Considerations;  Criteria for each placement:

1.        Maxillary or mandibular CENTRAL exposure-

Both central and lateral incisor should be included in good detail

2.        Maxillary or mandibular CANINE exposure-

Entire canine should be at the midpoint of the film with lateral, canine, and/or 1^st premolar open contacts

Retake necessary � if apex of lateral, canine, and/or premolar is missing; excessive elongation or foreshortening; or incisal one-third cut off

3.        Maxillary or mandibular PREMOLAR exposure-

Distal one-half of canine on the anterior border of film with both premolar and 1^st molar apices and variable amounts of 2^nd molar revealed

Retake necessary � if apex of 1^st premolar or 1^st molar not visible; excessive elongation or foreshortening; excessive overlapping or coronal one-third cut off

4.        Maxillary or mandibular MOLAR exposure-

Anterior border should reveal the distal of 2^nd premolar and /or entire 2^nd and 3^rd molars (if present) with maxillary tuberosity of ramus visible on respective views

Retake necessary � if any molar apex not visible; excessive horizontal overlapping, elongation, or foreshortening exists, or coronal one-third cut off

5.        Special projections-

In special cases of horizontal impactions or unusually high unerupted maxillary 3^rd molars, the entire 3^rd molar may not be included in the molar film.  In such cases, a retake of the molar area is not necessary, but a special projection of the 3^rd molar area should be made with instructor supervision.  

III.  Mounting

A.      All films should be mounted for labial viewing (embossed dot towards the person)

B.       Each mount should contain:

-          patient name

-          date

-          dentist�s name-     

C.       All films exposed, processed, and mounted should be kept in the patient�s chart and be of diagnostic quality