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Welcome !. 1. Dental anatomy and Imaging With Eriks Oct 2012. 2. Dental Anatomy. General naming of teeth: Tip: Views always look into the patients mouth (not your own). Maxillar (Upper). Mandibular (Lower). 3. Dental Anatomy. “Directions”:. 4. Dental Anatomy.

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dental anatomy and imaging with eriks oct 2012
Dental anatomy

and Imaging

With Eriks

Oct 2012

2

dental anatomy
Dental Anatomy

General naming of teeth:

Tip: Views always look into the patients mouth (not your own).

Maxillar (Upper)

Mandibular

(Lower)

3

dental anatomy1
Dental Anatomy

“Directions”:

4

dental anatomy2
Dental Anatomy

Tooth numbering: Always look into the patients mouth (not your own).

ADA System:

International System:

Kids (1st set of teeth) have there own “numbering” with letters !

5

intraoral imaging
Intraoral imaging:

Periapical image:

Health of teeth, roots, bone.

Interproximal decay (caries)

Bitewing:(interproximal)

7

intraoral imaging1
Intraoral imaging:

Occlusal image:

exploring calcifications of the sublingual salivary glands.

8

magnification
Magnification

Intraoral imaging technique:

  • Equal image enlargement
  • Caused by long object-sensor distance and short source-object distance
  • Minimized by controlling distance factors & focal spot
shape distortion
Shape Distortion

Intraoral imaging technique:

  • Variation of the true shape of the object
  • Vertical distortion results in elongation foreshortening or
  • Horizontal distortion results in image widening and overlapping
assembled instruments
Assembled Instruments
  • Anterior PA views
    • right and left
    • maxillary and mandibular
  • Bitewing views
    • right and left
  • Posterior PA views
    • right and left
    • maxillary and mandibular
paralleling periapical technique
Paralleling Periapical Technique
  • Applies most rules of accurate image formation
  • Most accurate periapical technique
  • Preferred technique for periapical imaging
bitewing technique
Bitewing Technique

Intraoral imaging technique:

  • Applies principles of paralleling technique to imaging the teeth crowns
  • Used to record interproximals
  • Most accurate view of the crowns and bony margins
slide15

Vertical Angulation (with tabs)

When the film is positioned in the mouth, the upper portion of the film is angled approximately +20° as it contacts the palate. In the mandible, the film is upright (0° angle). The average between these two angles is +10°. This +10° is the vertical angulation selected when using bitewing tabs.

+20º

bisecting angle periapical technique
Bisecting Angle Periapical Technique

Intraoral imaging technique:

  • Applies one of the rules for accurate image formation
  • Angle is formed by sensor and object
  • Produces images with shape distortion and magnification
slide18

FMX

Not to be confused with (although you might need dental a FMX after this):

foreshortening

Placement Errors

Foreshortening
  • Short image from too much vertical angulation
  • Correction - place receptor parallel to tooth long axes and reduce the vertical angle
elongation

Placement Errors

Elongation
  • Long image from not enough vertical angulation
  • Correction - place receptor parallel to tooth long axes and increase the vertical angle
horizontal overlap

Placement Errors

Horizontal Overlap
  • Teeth widening and overlapped contacts from diagonal entry of the x-ray beam
  • To correct, place receptor parallel to horizontal plane, direct beam through
  • proximal contacts
cone cut

Placement Errors

Cone Cut
  • Zone of non-exposure from not centering x-ray beam over receptor
  • To correct, direct central ray through entry point and to the center of the receptor
slide23

Placement Errors

Positioning Error

  • Receptor not placed in proper position to cover desired structures
  • Use receptor placement guidelines
exposure error
Exposure Error
  • System will correct for most over or underexposures
  • Overexposure – exposure factors set too high
  • Underexposure – exposure factors set too low
digital pan landmarks positioning errors

Digital Pan Landmarks & Positioning Errors

Spine

Eye Socket

Outline of Ear

TMJ

Nasal fossa/Airways

Sinus

Sinus

Septum

Eagles

Mandibularcanal

Necklace shadow

Hyoid bone

Mandibular canal

Mental foramen

Calcification of carotid

Patient demonstrates too much smile – chin is positioned too far down

slide27

T h e D e n t a l C o m p a n y

ORTHOPHOS XG 3D Ready 2D PROGRAMS

P1…Panoramic

P1A…Artifact Reduced

P1C…25% Magnification & Special Needs

Upper - Lower

Right - Left

P2 =Dentition – P2A Artifact Reduced – P2C Constant Magnification also for Compromised Patients

P12…Anterior Views

P10…Pediatric

BW1…Bitewing View

BW2

Lower

Upper

TM1…Lateral TMJOpen / Closed

MS1…Slices(molar region)

S1…Sinus Frontal

4 Sinus views

6 TMJ views offered

slide28

T h e D e n t a l C o m p a n y

ORTHOPHOS XG 3D Ready 2D PROGRAMS

General Information –

Cover all patient contact surfaces with hygienic covers

Patient must remove:

Glasses

 All jewelry above the neck, to include earrings, necklaces, metal hair pins

 All removable appliances in the mouth that are removable

Easy Patient Positioning

(select appropriate bite piece,

contact segment, or chin rest)

Tap on P1, P1A, P1C

To access sub programs

Easy Pad Assists with Correct Selections

Tap to Scroll through programs (­) (+) touch pad

slide29

T h e D e n t a l C o m p a n y

ORTHOPHOS XG 3D Ready 2D PROGRAMS

  • Review:
  • Workstation
  • Select patient from Worklist or Register patient in SIDEXIS
  • Select PAN GREEN flashing light indicates Ready
  • Digital Pan
  • On LCD Screen Select Program – Patient Type, Etc.
  • Position Patient (if using lead apron solid is to back)
  • Use light to make certain Mid and Frankfurt correct
  • Remind Patient to swallow, place and keep tongue at
    • Roof of mount, and keep lips closed during digital
    • Image taking.
  • Remote Exposure Station – Confirm Selections
  • Press and hold to initiate exposure 14 sec. until
    • you hear (3) beep-beep-beep sound the
    • procedure is complete and unit is at rest
  • Digital Pan LCD Display
  • Shows snapshot of image - tap screen to remove image
  • Send image to PACS
slide30

Patient Positioning Devices

One Piece Yellow Bite Block and Contact Segment – For Panoramic Images

Bite Block

Contact Segment

Patients with anterior front teeth

anterior teeth in groove

Patients with missing anterior teeth

Position under nose with cotton roll

or 4x4 for space relationship

Chin Rest – for patients with stability issues

Patients with anterior front teeth Patients with missing front teeth

slide33

Patient Positioning Devices -Continued

TMJ Programs

TMJ Images

Panoramic

Forehead and Temple

Supports

Red Frankfurt and Mid Sagittal Light Lines

tmj lateral medial

TMJ Head Positioner and Stabilizer

TMJ Lateral - Medial

open

closed

open

closed

Medial

Medial

Lateral

Lateral

TM 1.1

TM 1.2

TM 1.2

TM 1.1

slide35

Positioning Errors

Patient Tilted

AIR (to remove have patient swallow just before image is taken)

Hyoid shadow

Hyoid shadow

pan with necklace shadow and too much smile
Pan with Necklace shadow

and too much smile

slide37

Poor Patient Positioning plus artifacts

Lead blocker– does this office use a Lead Apron? OR was this patient

In a wheelchair with metal bar on headrest?

Necklace shadow

metal around neck causes artifact

Metal around Neck causes ARTIFACT

Patient with Metal around neck (like necklace) causes artifact on image

Always have patient remove necklace that lays above C7/T1 vertebra.

Wrong

=

Interferes

with beam

Right

=

L

cephalometric image lateral full skull ceph view with landmarks

Cephalometric image Lateral Full Skull Ceph View with Landmarks

Pterygomaxillary Fissure

Sella Turcia

Nasion

Orbital

Porion

Anterior Nasal Spine

Subspinale

Basion

Pogonion

SIDEXIS XG