Upload
celia-rendall
View
216
Download
2
Tags:
Embed Size (px)
Citation preview
Welcome !
1
Dental anatomy and Imaging
With Eriks
Oct 2012
2
Dental Anatomy
3
General naming of teeth:Tip: Views always look into the patients mouth (not your own).
Maxillar (Upper)
Mandibular(Lower)
Dental Anatomy
4
“Directions”:
Dental Anatomy
5
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 !
Dental Anatomy
6
Intraoral imaging:
7
Periapical image:
Bitewing:(interproximal)
Health of teeth, roots, bone.
Interproximal decay (caries)
Intraoral imaging:
8
Occlusal image:
exploring calcifications of the sublingual salivary glands.
Magnification
Equal image enlargement
Caused by long object-sensor distance and short source-object distance
Minimized by controlling distance factors & focal spot
Intraoral imaging technique:
Shape Distortion
Variation of the true shape of the object
Vertical distortion results in elongation foreshortening or
Horizontal distortion results in image widening and overlapping
Intraoral imaging technique:
11
Intraoral imaging technique:
Assembled Instruments
1. Anterior PA viewsright and leftmaxillary and mandibular
2. Bitewing viewsright and left
3. Posterior PA viewsright and leftmaxillary and mandibular
Paralleling Periapical Technique
Applies most rules of accurate image formation
Most accurate periapical technique
Preferred technique for periapical imaging
Bitewing Technique Applies principles of paralleling technique to imaging the teeth crowns
Used to record interproximals
Most accurate view of the crowns and bony margins
Intraoral imaging technique:
+20º
0º
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.
Bisecting Angle Periapical Technique
Applies one of the rules for accurate image formation
Angle is formed by sensor and object
Produces images with shape distortion and magnification
Intraoral imaging technique:
Intraoral imaging technique: FMX (Full Mouth X-Ray) obsolete!
FMX
Not to be confused with (although you might need dental a FMX after this):
Foreshortening
Short image from too much vertical angulation
Correction - place receptor parallel to tooth long axes and reduce the vertical angle
Placement Errors
Elongation
Long image from not enough vertical angulation
Correction - place receptor parallel to tooth long axes and increase the vertical angle
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
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
Placement Errors
Receptor not placed in proper position to cover desired structures
Use receptor placement guidelines
Placement Errors
Positioning Error
Exposure Error
System will correct for most over or underexposures
Overexposure – exposure factors set too high
Underexposure – exposure factors set too low
Dental Anatomy
25
Digital Pan Landmarks & Positioning Errors
Hyoid bone
Outline of Ear Eye Socket
Sinus
Calcification of carotid
Necklace shadowEagles
TMJSpine
Nasal fossa/Airways
Sinus
Mandibular canal
Mandib
ular
canal
Mental foramen
Septum
Patient demonstrates too much smile – chin is positioned too far down26
P1…Panoramic P1C…25% Magnification & Special Needs
P1A…Artifact Reduced
P12…Anterior Views
S1…Sinus Frontal
TM1…Lateral TMJOpen / Closed
MS1…Slices(molar region)
BW1…Bitewing View BW2
ORTHOPHOS XG 3D Ready 2D PROGRAMS
T h e D e n t a l C o m p a n y
Right - Left
Upper - Lower
P2 =Dentition – P2A Artifact Reduced – P2C Constant Magnification also for Compromised PatientsP10…Pediatric
Upper
Lower
6 TMJ views offered4 Sinus views
27
ORTHOPHOS XG 3D Ready 2D PROGRAMS
T h e D e n t a l C o m p a n y
Easy Patient Positioning(select appropriate bite piece, contact segment, or chin rest)
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 Pad Assists with Correct SelectionsTap on P1, P1A, P1CTo access sub programsTap to Scroll through programs ( ) (+) touch pad
28
ORTHOPHOS XG 3D Ready 2D PROGRAMS
T h e D e n t a l C o m p a n y
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 restDigital Pan LCD Display• Shows snapshot of image - tap screen to
remove image
• Send image to PACS
29
Support : 1 800 659 5977 opt. 2, opt. 2
Patient Positioning DevicesOne Piece Yellow Bite Block and Contact Segment – For Panoramic Images
Bite Block Contact Segment
Patients with anterior front teethanterior 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 issuesPatients with anterior front teeth Patients with missing front teeth
30
Support : 1 800 659 5977 opt. 2, opt. 2
Patient Positioning Devices -ContinuedMore Positioning Guides: Universal Positioners
Used with/for: Use Recommendations
AutoFunction
Reorder Foam Inserts Cat. #
Auto Position Function
61 41 449 -100 pcs. EA
For patients with and withoutAnterior teeth. Assists operator with proper Occlusal and Frankfurt Positioning. Eliminates chin cut off.
All Purpose -Sliding Bite Piece Positioner-Optional
Sliding Positioner Cat. #
Universal for Pan, TSA, etc. // Optional – may be purchased as accessory.
61 41 431 EA.
For patients with and withoutAnterior teeth. One positioning piece for all Panoramic Programs
==
31
Support : 1 800 659 5977 opt. 2, opt. 2
Patient Positioning Devices -ContinuedMore Positioning Guides: Sinus Views
Used with/for: Use Recommendations
Short Blue PositioningContact Segment & BiteBlockPatient isPositioned Lower to permit SINUS Areain FOV (field of view)
Check Programs on LCDEasy Pad for correct positioning piece
Programs: S1 & S3
Programs: S2 & S4
32
Support : 1 800 659 5977 opt. 2, opt. 2
Patient Positioning Devices -Continued
TMJ Images
Panoramic
TMJ Programs
Forehead and Temple Supports
Red Frankfurt and Mid Sagittal Light Lines33
TMJ Lateral - Medial
LateralLateral
Medial Medial
TM 1.1 TM 1.1TM 1.2 TM 1.2
closed closedopen open
TMJ Head Positioner and Stabilizer
34
Support : 1 800 659 5977 opt. 2, opt. 2
Patient Tilted
AIR (to remove have patient swallow just before image is taken)
Hyoid shadowHyoid shadow
Positioning Errors
35
Pan with Necklace shadowand too much smile
36
Lead blocker– does this office use a Lead Apron? OR was this patient In a wheelchair with metal bar on headrest? Necklace shadow
Poor Patient Positioning plus artifacts
37
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
Right
=L
Interfereswith beam
38
Cephalometric image Lateral Full Skull Ceph View with Landmarks
SIDEXIS XG
Nasion
Orbital
Anterior Nasal Spine
Subspinale
Pogonion
Pterygomaxillary Fissure
Sella Turcia
Porion
Basion
39
Ceph tracing Anatomy
40