Dental radiography techniques

1. BITEWING RADIOGRAPHIC
TECHNIQUE
DR. T.J OCHOLA

2. OBJECTIVE
• To develop your knowledge of the principles of the posterior bitewing
technique and the skills to undertake diagnostic bitewing
examinations

3. OUTCOME
• At the end of this chapter, the Trainee should be able to;
• 1. State the indications for bitewing radiography
• 2. Demonstrate the procedure for:
• 3. Correct patient seating and head positioning Exact film or sensor
placement for molar, premolar and anterior bitewing examinations
• 4. Correct film or sensor by operator and patient
• 5. Correct Centering the central ray and alignment for horizontal and
vertical angulation
• 6. Recognize the diagnostic Bitewing radiographic image
• 7. Recognize errors in the procedures from radiographs and probable
causes

4. INTRODUCTION
• Bitewing radiography is the technique in which the patient is required
to bite on a small wing attached to an intraoral sensor. Modern
sensor holders now have eliminated the need for the wing (now
termed a tab).
• A bitewing radiograph is used to examine the interproximal surfaces
of teeth; crestal bone.

5. Anatomical structures on a bitewing film

6. INDICATIONS
• Indications
• • Detection of interproximal caries especially in detecting early
carious lesions that are not evident clinically.
• • Monitoring the progression of dental caries.
• • Assessment of existing restorations.
• • Assessment of the periodontal status, especially in examination of
the crestal bone levels between teeth

7. TECHNIQUES
• BITEWING TECHNIQUES
• There are two main techniques:
• • Bitewing tab using a tab attached to the Sensor.
• • Sensor Holder—using a sensor holder with beam aiming device.

8. Film is
placed
parallel to the
crowns X-ray beam:
X-ray beam: is
directed through
the contacts of
the teeth.
Stabilization: Patient
bites on the bite-wing
tab or film holder.
Patient preparation
1. Explain procedure
2. Position the patient upright in the
chair
3. Adjust the headrest
4. Place and secure the lead apron
5. Remove all objects from the mouth

9. SENSOR PLACEMENT

10. HORIZONTAL AND VERTICAL ANGULATION

11. EXPOSURE AND PROCESSING

12. DIAGNOSTIC BITEWINGS

13. BITEWING TECHNIQUE ERRORS
1. SUPERIMPOSED CONTACTS

14. BITEWING TECHNIQUE ERRORS
2. INCORRECT FILM PLACEMENT

15. BITEWING TECHNIQUE ERRORS
3. CONE CUT

16. BITEWING TECHNIQUE ERRORS
4. PATIENT NOT BITING CORRECTLY

17. DIAGNOSTIC BITEWINGS