Occlusal radiographyOcclusal radiography

Terminology and classificationTerminology and classification

I.Maxillary occlusal projectionsI.Maxillary occlusal projections

Upper standard occlusal (standard Upper standard occlusal (standard occlusal)occlusal)

Upper oblique occlusal (oblique occlusal)Upper oblique occlusal (oblique occlusal)

Vertex occlusal (vertex occlusal)Vertex occlusal (vertex occlusal)

II.Mandibular occlusal projectionsII.Mandibular occlusal projections

Lower 90 degrees occlusal (true occlusal)Lower 90 degrees occlusal (true occlusal)

Lower 45 degrees occlusal (standard Lower 45 degrees occlusal (standard occlusal)occlusal)

Lower oblique occlusal (oblique occlusal)Lower oblique occlusal (oblique occlusal)

Standard maxillary occlusalStandard maxillary occlusal

Standard maxillary occlusalStandard maxillary occlusal

Main clinical indicationsMain clinical indications

Periapical assessment of the upper anterior Periapical assessment of the upper anterior teeth in patients unable to tolerate periapical teeth in patients unable to tolerate periapical filmsfilms

Detecting the presence of unerupted canines, Detecting the presence of unerupted canines, supernumeraries and odontomessupernumeraries and odontomes

As the midline view, when using the parallax As the midline view, when using the parallax method for determining the bucco/palatal method for determining the bucco/palatal position of unerupted canines position of unerupted canines

Evaluation of the size and extent of lesions Evaluation of the size and extent of lesions such as cysts or tumors in the anterior such as cysts or tumors in the anterior maxillamaxilla

Assessment of fractures of the anterior Assessment of fractures of the anterior teeth and alveolar bone, especially useful teeth and alveolar bone, especially useful for childrenfor children

Upper oblique occlusalUpper oblique occlusal

Upper oblique occlusalUpper oblique occlusal

Main clinical indicationsMain clinical indications

Periapical assessment of the upper Periapical assessment of the upper posterior teeth, especially in adults unable posterior teeth, especially in adults unable to tolerate posterior periapical filmsto tolerate posterior periapical films

Evaluation of the size and extent of lesions Evaluation of the size and extent of lesions in the posterior maxillain the posterior maxilla

Assessment of the condition of the antral Assessment of the condition of the antral floorfloor

Determination of the position of roots Determination of the position of roots displaced inadvertently into the antrum displaced inadvertently into the antrum during attempted extraction of upper during attempted extraction of upper posterior teethposterior teeth

Assessment of fractures of the posterior Assessment of fractures of the posterior teeth and associated alveolar bone teeth and associated alveolar bone including the tuberosityincluding the tuberosity

Clinical indications- assessment of the Clinical indications- assessment of the bucco/palatal position unerupted caninesbucco/palatal position unerupted canines

Disadvantages:Disadvantages:

- There is a lack of detail and contrast on - There is a lack of detail and contrast on the film because of the intensifying the film because of the intensifying screens, the mass of tissues the X-ray screens, the mass of tissues the X-ray beam has to penetrate and the beam has to penetrate and the consequent scatterconsequent scatter

DisadvantagesDisadvantages The primary X-ray beam may be in direct line The primary X-ray beam may be in direct line

with the reproductive organswith the reproductive organs A relatively long exposure time is neededA relatively long exposure time is needed (about 1 second) despite the use of intensifying (about 1 second) despite the use of intensifying

screensscreens There is direct radiation to the pituitary gland There is direct radiation to the pituitary gland

and the lens of the eyeand the lens of the eye If the X-ray beam is positioned too far anteriorly, If the X-ray beam is positioned too far anteriorly,

superimposition of the shadow of the frontal superimposition of the shadow of the frontal bones may obscure the anterior part of the bones may obscure the anterior part of the maxillamaxilla

Lower 90 degrees occlusalLower 90 degrees occlusal

Main clinical indicationsMain clinical indications Detection of the presence and position of Detection of the presence and position of

radiopaque calculi in the submandibular salivary radiopaque calculi in the submandibular salivary ductsducts

Assessment of the bucco/lingual position of Assessment of the bucco/lingual position of unerupted mandibular teethunerupted mandibular teeth

Evaluation of the bucco/lingual expansion of the Evaluation of the bucco/lingual expansion of the body of the mandible by cysts, tumours or body of the mandible by cysts, tumours or osteodystrophiesosteodystrophies

Assessment of displacement fractures of the Assessment of displacement fractures of the anterior body of the mandible in the horizontal anterior body of the mandible in the horizontal planeplane

Lower 45 degrees occlusalLower 45 degrees occlusal

Main clinical indicationsMain clinical indications

Periapical assessment of the lower incisor Periapical assessment of the lower incisor teeth, especially useful in adults and teeth, especially useful in adults and children unable to tolerate periapical filmschildren unable to tolerate periapical films

Evaluation of the size and extent of lesions Evaluation of the size and extent of lesions in the anterior part of the mandiblein the anterior part of the mandible

Assessment of displacement fractures of Assessment of displacement fractures of the anterior mandible in the vertical planethe anterior mandible in the vertical plane

Lower oblique occlusalLower oblique occlusal

Lower oblique occlusalLower oblique occlusal

Main indicationsMain indications

Detection of radiopaque calculi in a Detection of radiopaque calculi in a submandibular salivary glandsubmandibular salivary gland

Assessment of the bucco/lingual position Assessment of the bucco/lingual position of impacted lower wisdom teethof impacted lower wisdom teeth

Evaluation of the extent and expansion of Evaluation of the extent and expansion of lesions in the posterior mandiblelesions in the posterior mandible