Endodontic

radiograph

BY

AHMED LABIB

Definition

It is the shadow
features produced by
x-ray on radiographic
film
radiograph is a two
dimensional shadow
of a three
dimensional object.

Terms
and
definitio
ns

Radiolucent:
Objects that can not
absorb x-ray and appear
black on the film.
Such as pulp canal,
carious lesion, foramen,
maxillary sinusetc.
.

Radiopaque:
Objects that absorb x-ray
and appear white on
radiograph Such as
enamel of the tooth,
bone, gutta-percha, metal
filling materials, post, and
some pathological
conditionsetc

Functions of
radiograph:
-

1-Diagnosis:

a-Identifying pathosis.
b-Determining root
pulpal anatomy.
c-Characterizing
normal structure.

2-Treatment
a-Determining the
working length.
b-Moving the
superimposed
structure.
c-Locating the canal.
d-Evaluating the
obturation.

Recall:-3

a-Evaluating the
healing.
b-Identifying the
presence of new
.pathosis

Types of x-ray films:

Extra oral films: such as
Cephalomatric films,
Panoramic films..etc.
Intra oral films: such as
periapical films, bite wing
films, and occlusal films.
-The periapical x-ray films
are the most frequently
used in endodontic therapy.

:General rules for X-ray exposure

Explain to the patient about the procedures
being undertaken and Place the lead
apron on the patient
Examine the patients mouth for any
deviation from the normal which may
require some adjustment of the standard
. radiographic technique
Remove any object from the patients
mouth as removable PD. or orthodontic
.appliances
.Set the exposure factors

.Set the approximate the X-ray tube angel

.Adjust the patient head in correctly positioned

Place the film into the patient mouth properly
.according to the X-ray technique used
.Re-Check the position of the patients head
.The operator must stand behind a lead screen
Remove the film from patients mouth after
exposure and to prevent leakage, dry the
.film before processing

Techniques
of
periapical
x-ray
exposure

a- long cone
technique
or
parallel cone
technique.
b-Bisecting angle
technique

a-Long cone technique:

-The dental films must be placed

parallel to the long axis of the tooth

to be examined.

-The central ray will be directed at a

right angle to the tooth and to the
film this reproduces the correct tooth
length and gives great sharpness of
the image.
-Intra oral long cone radiography
requires supplemental equipments
such as film holders, which hold the
film in a parallel position to the long

:A) Long cone technique

The dental films must be placed-
parallel to the long axis of the tooth to
.be examined
The central ray will be directed at a-
.right angle to the tooth and to the film
It requires film holders, which hold thefilm in a parallel position to the long
.axis of the tooth

Advantages:
1-It gives true lateral projection
of the tooth
2-It results in minimal
enlargement and less distortion
3-Sharp image
4-Demonstrate the true
relationship between the
alveolar crest and the tooth
5-Reduce the importance of the
horizontal positioning
planes,since the film and x-ray
beam are at right angle

Disadvantages:
1-Difficult to be used in
small mouths or patient with
shallow flattened palate
2-Difficult to be used with a
rubber dam in place
3-Apices lie below zygomatic
arch are usually not seen on
radiograph
4-Film holder is required

Bisecting
angle
technique

-The film is placed against the tooth

as straight as possible
-There is an angle between the x-ray
film and long axis of the tooth.
-The central x-ray beam is directed
perpendicular to an imaginary line
which bisects the angle between the
plane of the film and the long axis of
the tooth
-Elongation is produced by too flat
(obtuse) angulations
-While the foreshortening is
produced by too acute angulation

Landmarks for
the direction
of the central
ray

A)MAXILLA

tube touching at the center of the tip of

the nose
2-Upper central and lateral incisors: the
cone of the tube touching the
corresponding side of the tip of the nose
3-Upper cuspid and first bicuspid: the cone
of the tube touching directly on the ala of
the nose
4-Upper bicuspids and first molar: the cone
of the tube touching an imaginary line
passing from the ala of the nose to the
tragus of the ear at a point directly below
the pupil of the eye
5-Upper second and third molars: the cone
of the tube touching an imaginary line
passing from the ala of the nose to the
tragus of the ear at a point directly below
the outer canthus of the eye and

B)MANDIBLE
1-Lower central incisors: the cone of the
tube touching about an inch above the
border of the mandible at a point between
the two centrals
2-Lower central and lateral incisors: the
cone of the tube touching a point between
the central and lateral incisors on the line
previously described
3-Lower cuspid and first bicuspid: the cone
of the tube touching a point opposite the
cuspid on the line previously described
4-Lower bicuspids and first molar: the cone
of the tube touching a point opposite the
second bicuspid on the line previously
described
5-Lower second and third molars: the cone
of the tube touching a point opposite the
second molar on the line previously

Buccal object rule

(changing horizontal
angulation)

Buccal Objective Rule:

(Changing Horizontal Angulations)
Two dimensions view for three
. dimensional objective only in
3rd dimension does not appear in
the
.radiographic film
superimposition of root canals
. over each other

In bi-canalled root, root canals areoriented buccolingually

-So exposing a radiograph with a zero
horizontal angulation will lead to
superimposition of the buccal canal over
the lingual canal on the film so only the
buccal canal will appear
-To avoid such problem and makes both the
buccal and lingual canals appears in the
same radiographic film, we applied the
buccal objective rule, which stated that:
When the x-ray cone is directed mesially,
the canal farthest from the cone (lingual
canal) comes mesially on the film,
and the buccal (the nearest canal to the
cone) directed distally on the same film
(MLM role)

By other meaning we can apply whatis called SLOB (same lingual opposite
buccal) this means that the lingual
canal goes to the same direction of
the x-ray cone and the buccal canal
go to the opposite direction, i.e if the
x-ray cone directed mesially, the
lingual root canal would appear in
the developed x-ray film dircted to
the mesial side (same lingual) and
the buccal root canal would be
directed to the distal side(opposite
buccal)

B
20

.S.L.O.B
Shift

20
h0
.ang

M
Shift

Hazards of x-rays:
1-Dermatitis
2-Alopecioa (loss of hair)
3-Increased production of
white blood cells(leukocytosis)
4-Leukemia
5-Anemia
6-Feeling of loss of attitude
7-Sterility
8-Abortion

THANK YOU