This document discusses dental radiography and its importance in diagnosis and treatment planning. It describes different types of intraoral and extraoral radiographs including periapical, bitewing, occlusal and panoramic images. Panoramic radiography provides a single view of the entire maxillomandibular region and is especially valuable for complete denture patients. Radiographs are important diagnostic tools that reveal abnormalities, impacted teeth, bone quality and other details to inform prosthodontic care for edentulous patients.

1. MASTICATION,
ORIENTATATORY
LINES AND
DENTAL XRAY

2. DEFINITION OF DENTAL ARCH
The sum total of the teeth housed in
the sockets of the upper jaw and the
lower jaw constitute the dental arches.

3. DENTAL ARCHES
• The dental arches are the two arches of teeth, one on each jaw, that together
constitute the dentition.
• In humans and many other species; the superior dental arch is a little larger than the
inferior arch, so that in the normal condition the teeth in the maxilla slightly overlap
those of the mandible both in front and at the sides.
• The way that the jaws, and thus the dental arches, approach each other when the
mouth closes, which is called the occlusion, determines the occlusal relationship of
opposing teeth, and it is subject to malocclusion if facial or dental development was
imperfect.

4. THE STRUCTURE OF THE DENTAL
ARCHES
• There are a total of 32 teeth in our mouths, divided equally between the upper arch, which
holds 16 teeth, and the lower arch, where 16 more are found.
• The bone that supports the upper teeth is the maxillary bone, while that housing the lower
teeth is the mandibular.
• Taken all together, the upper teeth make up the upper dental arch, which includes:
 4 incisors
 2 canines
 4 premolars
 6 molars (including the wisdom teeth)
• The same holds for the lower dental arch.

5. CURVE OF SPEE
• In anatomy, the Curve of Spee is defined as the curvature of the mandibular occlusal
plane beginning at the premolar and following the buccal cusps of the posterior teeth,
continuing to the terminal molar.
• According to another definition the curve of Spee is an anatomic curvature of the
occlusal alignment of the teeth, beginning at the tip of the lower incisor, following the
buccal cusps of the natural premolars and molars and continuing to the anterior
border of the Ramus.
• In antero-posteriori direction
• The lowest point is in area od 2nd premolar and 1st molar in lower jaw

6. WILSON CURVE
• The curve, viewed from the front, that contacts the buccal and lingual cusps of the
molars, being lower in the middle due to the lingual inclination of the long axes of the
mandibular molars.
• In cross direction (frontal point of view)
• Inclination of oral surfaces of teeth in lower jawlingual
• Inclination of oral surfaces of teeth in upper jawbuccal

7. OCCLUSAL PLANE
• an imaginary surface that is related anatomically to the cranium and that theoretically
touches the incisal edges of the incisors and the tips of the occluding surfaces of the
posterior teeth; it is not a plane in the true sense of the word but represents the mean
of the curvature of the surface.
• “A line passing through one half of the cusp heights of the first permanent molars and
one half of the overbite of the incisors” Functional occlusal plane a horizontal line from
the posterior most occlusal contact of the last fully erupted mandibular molars
extending anteriorly to the anterior most occlusal contact of the fully erupted
premolars.

8. CAMPERS LINE & BIPUPILLAR LINE
• A line from the lower border of the ala of the nose to the upper border of the tragus of
the ear. It is used as a reference line in orthodontics, radiography, and the construction
of complete dentures.
• The mid-pupillary(bipupillar) line, a line running vertically down the face through the
midpoint of the pupil when looking directly forward.

9. FRANKFORT HORIZONTAL LINE
• An imaginary line that projects from the median line of the occipital bone and upper
rim of the external auditory canal–the auricular point, to the lower rim of the orbit–the
infraorbital point; to the lower rim of the orbit–the infraorbital point; the FHL divides
the head into upper and lower halves from gnathion to trichion, and is used for
craniometric studies–as it approximates the base of the skull and may be used as a
point of reference in otoplasty.

11. OCCLUSION
Occlusion, in a dental context, means simply the contact between teeth. More technically, it is the relationship between the
maxillary and mandibular teeth when they approach each other, as occurs during chewing or at rest.
Static occlusion refers to contact between teeth when the jaw is closed and stationary, while dynamic occlusion refers to
occlusal contacts made when the jaw is moving.
The masticatory system also involves the periodontium, the TMJ (and other skeletal components) and the neuromusculature,
therefore the tooth contacts should not be looked at in isolation, but in relation to the overall masticatory system.

12. ANGLE’S CLASSIFICATION OF
MALOCCLUSION
According to Edward H. Angle, the normal occlusion (bite) exists when the mesiobuccal cusp of the
upper first molar occludes with the buccal groove of the lower first molar. Any diversion from this
alignment falls under the three classifications of malocclusion, and these categories are as follows:
• Class I malocclusion: A normal molar relationship is present, but there is crowding, misalignment of
the teeth, rotations, cross-bites, and other alignment irregularities.
• Class II malocclusion: The mesiobuccal cusp of the maxillary first molar occludes anterior to the buccal
groove of the mandibular first molar. Class II is categorized into two further parts:
a. Class II, Division 1: The anterior maxillary teeth are tilted forward or proclined, presenting a large
overjet.
b. Class II, Division 2: The anterior maxillary teeth are retroclined, creating a deep overbite.
• Class III malocclusion: The mesiobuccal cusp of the upper first molar falls posterior to the buccal
groove of the lower first molar.

13. ANGLE’S CLASSIFICATION OF
MALOCCLUSION

14. MASTICATORY SYSTEM DEFINITION
The masticatory system is a functional unit
com- posed of the teeth; their supporting
structures, the jaws; the temporomandibular
joints; the muscles involved directly or
indirectly in mastication (including the muscles
of the lips and tongue); and the vascular and
nervous systems supplying these tissues.

15. MASTICATION
• Mastication, in which food is crushed and mixed with saliva to form a bolus for
swallowing, is a complex mechanism involving opening and closing of the jaw,
secretion of saliva, and mixing of food with the tongue.
• Mastication is a rhythmical automatic movement similar to breathing or walking, and is
a characteristic movement that can intentionally be made faster, slower, or even
stopped.
• The neural circuits, together with regulation of breathing, walking, posture, and blood
circulation, are programed in the lower brainstem. Rhythmical movement of the jaw
and tongue is regulated by the lower brainstem, mainly as a mechanism of rhythm
formation based on the information generated during mastication from sensory
receptors in the oral cavity and masseter muscles
• A knowledge of masticatory function in normal physiological conditions of the
stomatognathic system is the first step to understanding subsequent alterations or
pathologies.

16. FUNCTION OF MASTICATION
1.Enables the food bolus to be easily swallowed
2. Enhances the digestibility of food by:
a. Decreasing the size of particles to increase the surface area for enzyme activity
b. b. Reflexively stimulating the secretion of digestive Juices (saliva and Gastric Juice)
3.Mixes the food with saliva, initiating digestion by the activity of salivary amylase
4.Prevent irritation of the GI system be large food masses
5.Enusres healthy Growth and development of the oral tissues.
6. Increase in Digestive efficiency, the Primary purpose of mastication

17. MECHANISM
• Mastication occurs by the convergent movements of max. & man. Teeth. Most foods are
first crushed by vertical movements of the mandible before being sheared by lateral to
medial movements of the mandible to make a bolus.
• The initial crushing of the food does not require full occlusion of the teeth. Indeed, it is
often only after the food has been well softened that the maxillary and mandibular teeth
eventually contact.
• Once the cusp can interdigitate, the ridges on the slopes of the cusp shear the food as the
mandibular teeth move across the maxillary teeth.
• Mastication is not simply a result of rhythmically closing teeth of a particular form on a
piece of food. Also it includes the placement of food between the occluding surfaces of the
teeth by the tongue and the selection by the tongue of those pieces of food in the mouth.

18. MASTICATORY CYCLE
1) puncture/crushing :hard food is first crushed and pierced between the teeth without
direct tooth-to-tooth contact. This results in wear of the teeth, especially at the tips
of the cusps.
2) Shearing stroke. This method involves tooth contacts that take place only after the
food has been reduced. This type of movement produces attrition facet with
characteristic directional scratch lines on the faces of the cusps.
• The mean of the vertical dimension of the chewing cycle are between 16 and 20 mm
and between 3 and 5 for lateral movements.
• The duration of the cycle varies between 0.6 and 1second depending on the type of
food .

20. MASTICATORY CYCLE

21. MUSCLES OF MASTICATION
• The muscles of mastication are associated with movements of the jaw
(temporomandibular joint). They are one of the major muscle groups in the head – the
other being the muscles of facial expression. There are four muscles:
Masseter
Temporalis
Medial pterygoid
Lateral pterygoid
• The muscles of mastication develop from the first pharyngeal arch. Thus, they are
innervated by a branch of the trigeminal nerve (CN V), the mandibular nerve.

23. TMJ=TEMPOROMANDIBULAR JOINT
• In anatomy, the temporomandibular joints (TMJ) are the two joints connecting the
jawbone to the skull.
• It is a bilateral synovial articulation between the temporal bone of the skull above and
the mandible below; it is from these bones that its name is derived.
• This joint is unique in that it is a bilateral joint that functions as one unit.
• Since the TMJ is connected to the mandible, the right and left joints must function
together and therefore are not independent of each other.

24. MEDICAL DOCUMENTATION
Medical documentation within the meaning of the Regulation are collections of data and
medical information related to the provided health services created in a healthcare facility.
1. Medical documentation is divided into:
1) individual medical documentation relating to designated persons using the institution's
health services,
2) collective medical documentation relating to all persons using the health services of the
institution or specific groups of these persons.
2. Individual medical records are prepared and kept in the form of standardized forms or
forms or other records relating to designated persons.
3. Collective medical documentation is prepared and kept in the form of books, registers or
files.

25. INFO FROM DR TO DENTAL LAB
• Gender of tha patient and age(it it important during teeth adjustment)
• Colour of the teeth for prosthetic restaration(according to for example VITA)
• Patient’s allergies to any product of dental restoration(eg. Metal)
• Prosthetic restoration plan already made by dr (include):
Fixed or removable? It may be also mixed
Prefered material for the restoration( cost of restoration depends on that)
Together with this diagnostic models are send

26. THE IMPORTANCE OF THE DENTAL
RECORD
• The dental record contains personal and dental treatment information generated by
the practice. The original documents of the record are owned by the dental practice
with the dentist of the practice considered to be the legal guardian.
• The patient can have access to, and request copies of, this information at any time,
even if they have a monetary balance with the practice.
• The original documents must remain with the practice and the requested copies must
be sent within a reasonable time frame. Should the patient move or change to a
different dental practice, copies should be forwarded.

27. IMPRESSIONS AND MODELS DIAGNOSTIC
– ANALYSIS DIAGNOSTIC MODELS
Constructing many types of restorations prosthetic dentures requires a replica of
patient’s teeth. A good prosthesis is only possible based on good impressions of the
prosthetic field, taken by a doctor. Taking an impression involves placing in units of
plastic material (impression material) with the impression tray and keep it there until
solidification. Then, when the impression is removed, it remains sent to the laboratory for
model casting - replicas of oral tissues.
• Impression - "negative" of the prosthetic field.
• Model - "positive" prosthetic field which is obtained by filling the impression plaster.

28. DENTAL MODELS
Division:
1) Diagnostic (indicative) models.
2) Working models.
Each model should meet the basic requirements:
- model the ground with the surrounding area
tissues,
- recreate the current occlusal conditions,
- have adequate hardness, so as not to be damaged,
-made neat and aesthetic without unnecessary artifacts,

29. DIAGNOSTIC MODELS
Wrongly called introductory or guides provide valuable information helpful in planning
treatment. Should be carefully cast, fixed in the articulator - indispensable for complex
design restorations.
We evaluate on the models:
● type of bite, occlusion,
● quality of pillars:
- length,
- height,
- slope,
- shifts.

30. DIAGNOSTIC MODEL
We distinguish:
• preliminary (initial) models
• intra-medication models
• end models
They reflect the ground tissues at rest, they represent documentation of treatment
stages.
They allow the doctor to make a careful assessment of the substrate before treatment,
they are complementary to the examination intraoral.
They are not only complementary medical records, but are helpful with treatment
planning, assessment of treatment progress. Final models allow to evaluate the effects of
therapy!

31. X-RAY
Radiographic examinations are one of the primary
diagnostic tools used in dentistry to determine disease
states and formulate appropriate treatment. Digital imaging,
plain and computed tomography, magnetic resonance
imaging and other techniques such as cone beam CT are
now part of the armamentarium in this specialty.
Improvement in the understanding of disease states have
also been the result of efforts by this specialty.
In all areas of medicine and dentistry, the first step in
patient management is the diagnosis of the patient’s
problem and medical/ dental radiography plays an
important role in achieving this.

32. INTRAORAL RADIOGRAPHY
Intraoral radiographic examinations are the backbone of dental radiography. There are three categories of intraoral radiographs: periapical, bitewing and occlusal projections.
lntraoral radiographs have limited role in edentulous patients. They can be used in locating any localized abnormalityorthe examination of tuberosities.
Radiographs are important aids in the evaluation of sub-mucosal conditions in patients seeking prosthodontic care. The presence of abnormalities in edentulous jaws may be
unsuspected because of absence of any clinical signs or symptoms they show the relative thickness of alveolar ridge and the muco periosteum, the quality of the bone.
lt is of great diagnostic value for removable partial dentures.

33. EXTRAORAL RADIOGRAPHY
These techniques imply that the film is
placed outside the oral cavity, against
the side of the face to be radiographed
and the X-ray beam is directed towards
it.
Extraoral radiographs in complete
denture can provide survey of the
patient’s denture foundation and
surrounding structures, evaluate the
status of impacted teeth, trauma,
temporomandibular joint area.

34. PANORAMIC RADIOGRAPHY
Panoramic imaging is a technique for producing a single tomographic image of the facial structures that includes both the
maxillary and mandibular dental arches and their supporting structures.
Panoramic Radiography is of special value in the diagnosis and treatment planning for the complete denture patient. It
provides a view of entire maxillomandibular region on a single film without inconveniencing the patient and with minimal time
expenditure.
The radiographs were evaluated for the presence of retained root fragments, impacted teeth, radiolucencies, radiopacities and
foreign bodies, location of the mental foramina at or near the crest of the residua alveolar ridge. Maxillary sinus proximity to
the crest of the residual alveolar ridge. It is used for the longitudinal assessment of the success of the implant.
Panoramic images provide a broader visualization of the jaws and adjoining anatomic structures. These are widely available
and can be used as screening radiograph. They are also used to assess the crestal alveolar bone and cortical boundaries of the
mandibular canal, maxillary sinus and nasal fossa.

35. CONE-BEAM COMPUTED TOMOGRAPHY
It uses adivergentor “cone” -shaped source of ionizing radiation and a twodimensional area detector fixed on a rotating gantry to acquire multiple
sequential projection images in one complete scan around the area of interest.
In this new method for the fabrication of complete dentures using a Dental 3D CBCT System was used to digitize the dentures.
In this scanning method, only refined dentures that maintain the maximal intercuspal position are scanned quickly. Therefore, not only the 3D
morphological data of the denture space but also the jaw registration are obtained without exposing the human body to radiation.
CBCT provides cross-sectional images of the alveolar bone height, width, and angulations and accurately depicts vital structures such as the inferior
alveolar dental nerve canal in the mandible or the sinus in the maxilla.
ln many instances a diagnostic stent is made with radiographic markers and inserted at the time of the scan .This provides a precise reference of the
location of the proposed implants or teeth.
CBCT also provides adequate visualization of the TMJ.

36. DIGITAL RADIOGRAPHY
The term digital radiography refers to a
method of capturing a radiographic
image using a sensor, breaking it into
electronic pieces and presenting and
storing the image using a computer.
This system is not limited to intraoral
images; panoramic and cephalometric
images may also be obtained.
Image enhancement and the digital
measuring techniques, can help the
surgeon in establishing the optimum
depth and orientation of the implants.
The image can be manipulated to
change the density and contrast and to
measure the bone density at specific
sites.

37. SOURCES
https://en.wikipedia.org/wiki/Occlusion_(dentistry)
https://www.researchgate.net/figure/a-Jaw-arch-curve-b-Dental-arch-curve_fig2_283090760
https://sbdmj.com/053/053-03.pdf
https://www.slideshare.net/indiandentalacademy/occlusal-plane
https://en.wikipedia.org/wiki/Temporomandibular_joint
https://www.slideshare.net/asmitasodhi/iimportance-of-keeping-records-in-dental-practice
https://dentodontics.com/2015/09/09/angles-classification-of-malocclusion/
https://www.umb.edu.pl/photo/pliki/WL_jednostki/zaklad_technik_dentystycznych/tematyka_wykladow_i_rok_13.12.18r._/prope
deutyka_wyklady_/propedautyka_6_modele.pdf
https://www.slideshare.net/vinay_bedre2009/physiology-of-mastication-amp-swalloing
http://www.ramauniversityjournal.com/pdf_december2017/5.pdf
https://technikadentystycznadlastudentow.files.wordpress.com/2016/05/49-561.pdf

38. THANK YOU!
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