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Copyright © 2003 by The American Association of Endodontists VOL. 29, NO. 6, JUNE 2003
The inability of certain patient populations to ac- itate a diagnostic radiograph. Most of these aids (i.e. Rinn XCP
cept intraoral films and/or sensors can cause com- holders, snap-a-ray, etc.) rely on conventional intraoral radiogra-
plications in the performance of endodontic ther- phy. In this technique, the film is placed lingual to the tooth. The
apy. An alternative technique (extraoral film X-ray cone is placed directly buccal to the tooth causing the X-ray
beam to pass through the tissues, exposing the film (1).
placement) can be used to obtain clinically diag-
Some patients are unable to tolerate the conventional intraoral
nostic radiographs. This article describes the al- technique. This group has increased in size with the advent of
ternative technique. digital radiography. The digital sensor is larger and more rigid than
a standard X-ray film. The authors have found certain patients have
difficulty with the “added bulk” of the sensor. An alternative
procedure may be utilized while performing endodontic therapy for
The need for radiographs in all phases of endodontic therapy has these patients.
been well established. The clinician has a variety of aids to facil- Possible indications for this alternative technique include:
1. Developmentally disabled patients
2. Patients with exaggerated gag reflex
3. Pediatric patients
4. Dental phobic patients
5. Trauma/trismus patients
FIG 1. Extraoral radiographic technique for the maxillary arch. FIG 2. Extraoral radiographic technique for the mandibular arch.
419
420 Newman and Friedman Journal of Endodontics
Case 1
Technique
Dr. Newman is a former second year resident and Dr. Friedman is the
FIG 8. Mandibular preoperative.
Director of Endodontics, State University of New York at Stony Brook, Stony
Brook, NY. Address requests for reprints to Scott Whitney, DDS, School of
Dental Medicine, 140 Rockland Hall, State University of New York at Stony
the floor of the mouth. She became agitated and upset when a Brook, Stony Brook, NY 11794.
conventional periapical radiograph was attempted. A decision was
made to utilize the extraoral technique (Figs. 7, 8, and 9), and the
patient tolerated the procedure well as a result.
References