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Shortcomings of conventional bitewings
• Overlapped contacts
• Poor contrast
• Movement artifact
• Diagnosis of Incipient enamel carious lesions
Challenge with conventional bitewings
PaX – i Insight Bitewing Projection
Overlapped Contact Between #18 and #19Non-Overlapped # 18Non-Overlapped # 19
Overlapped contact between # 18 and #19
Advantage:
Layered Images of Insight Can
Unmask Overlapping
PaX – i Insight Bitewing Projection:
Healthy Asymptomatic Individual
Incipient Enamel Lesion
Advantage:
Improved Diagnosis of Interproximal caries
PaX – i Insight Bite wing Projection
Wear facets on occlusal surface from
bruxing/clenching
Advantage:
Sharp Image with Improved
Contrast Shows Minor Tooth
Changes
PaX – i Insight Bite wing Projection
Traditional Panoramic Positioning
Minimal to no-interproximal overlapping
Flat Plane Panoramic Positioning
Interproximal overlapping
Advantage:
Reduced Interproximal
Overlapping
Depth added 2D
PaX-i Insight
Insight1
Patient has high caries index evidenced by multiple fillings and crowns
Overlapped contact between teeth # 6 and #7. Similar issue of overlapped
contacts is common on Periapical and Bite Wing radiographs
Q. Caries on mesial of tooth # 6 Or, distal of tooth # 7?
Panoramic slice # 19 clearly shows non-overlapped Mesial surface of #6
Panoramic slice # 14 clearly shows non-overlapped Distal surface of #7
Thus, providing non-overlapped superior images possibly assisting
in superior interproximal caries identification and diagnosis
Insight1
Radiolucency distal to tooth # 30
Q. Is this radiolucency a cyst? Is this radiolucency communicating with distal root?
In addition, lets evaluate Mesial root
Slice # 23 shows lamina dura, suggesting that radiolucency
is not a cyst and not originating from tooth
Slice # 26 shows possible perforation/stripping of mesial root
and short fill on mesial root
Insight1
Evaluation of existing restorations on right maxillary posterior teeth
Slice # 26 shows marginal discrepancy on distal surface of
tooth # 3
Insight1
Right Sinus Floor vs. Left sinus floor
Left Floor is clear with no sign of pathology
Right Floor exhibits soft tissue density, labelled by red oval
Q. Is Right floor intact? Or, if pathology is destroying right maxillary sinus floor
Slice # 22 clearly shows normal root architecture and intact floor of
maxillary sinus.
Thus, requiring no further imaging or treatment of right maxillary sinus
Insight1
Endodontically treated tooth # 20
Q. Interpretation of apical end of tooth # 20
Slice # 23 clearly shows missing lamina dura in apical third
Suggestive of persistent/ resolving apical periodontitis
Superimposition observed on right TMJ
Slice # 10 clearly shows Right TMJ
Q. Tooth # 3 – PARL?
Slice # 18 shows widening of periodontal ligament space
around Non – Superimposed MB root
Anterior teeth are difficult to image on traditional panoramics
Q. Extent of root resorption on mandibular anterior teeth
Slice # 25 clearly shows extent of root resorption on anterior teeth
Q. Any significant finding associated with mandibular molars?
Slice # 22 shows radiolucency in Mesial cervical portion of tooth # 30
Normal Surface
Possible Caries/
Root Resorption
Thank You.

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Parashar PaX-i Insight

  • 1.
  • 2. Shortcomings of conventional bitewings • Overlapped contacts • Poor contrast • Movement artifact • Diagnosis of Incipient enamel carious lesions Challenge with conventional bitewings
  • 3. PaX – i Insight Bitewing Projection Overlapped Contact Between #18 and #19Non-Overlapped # 18Non-Overlapped # 19 Overlapped contact between # 18 and #19 Advantage: Layered Images of Insight Can Unmask Overlapping
  • 4. PaX – i Insight Bitewing Projection: Healthy Asymptomatic Individual Incipient Enamel Lesion Advantage: Improved Diagnosis of Interproximal caries
  • 5. PaX – i Insight Bite wing Projection Wear facets on occlusal surface from bruxing/clenching Advantage: Sharp Image with Improved Contrast Shows Minor Tooth Changes
  • 6. PaX – i Insight Bite wing Projection Traditional Panoramic Positioning Minimal to no-interproximal overlapping Flat Plane Panoramic Positioning Interproximal overlapping Advantage: Reduced Interproximal Overlapping
  • 8. Insight1 Patient has high caries index evidenced by multiple fillings and crowns Overlapped contact between teeth # 6 and #7. Similar issue of overlapped contacts is common on Periapical and Bite Wing radiographs Q. Caries on mesial of tooth # 6 Or, distal of tooth # 7? Panoramic slice # 19 clearly shows non-overlapped Mesial surface of #6 Panoramic slice # 14 clearly shows non-overlapped Distal surface of #7 Thus, providing non-overlapped superior images possibly assisting in superior interproximal caries identification and diagnosis
  • 9. Insight1 Radiolucency distal to tooth # 30 Q. Is this radiolucency a cyst? Is this radiolucency communicating with distal root? In addition, lets evaluate Mesial root Slice # 23 shows lamina dura, suggesting that radiolucency is not a cyst and not originating from tooth Slice # 26 shows possible perforation/stripping of mesial root and short fill on mesial root
  • 10. Insight1 Evaluation of existing restorations on right maxillary posterior teeth Slice # 26 shows marginal discrepancy on distal surface of tooth # 3
  • 11. Insight1 Right Sinus Floor vs. Left sinus floor Left Floor is clear with no sign of pathology Right Floor exhibits soft tissue density, labelled by red oval Q. Is Right floor intact? Or, if pathology is destroying right maxillary sinus floor Slice # 22 clearly shows normal root architecture and intact floor of maxillary sinus. Thus, requiring no further imaging or treatment of right maxillary sinus
  • 12. Insight1 Endodontically treated tooth # 20 Q. Interpretation of apical end of tooth # 20 Slice # 23 clearly shows missing lamina dura in apical third Suggestive of persistent/ resolving apical periodontitis
  • 13.
  • 14. Superimposition observed on right TMJ Slice # 10 clearly shows Right TMJ
  • 15. Q. Tooth # 3 – PARL? Slice # 18 shows widening of periodontal ligament space around Non – Superimposed MB root
  • 16. Anterior teeth are difficult to image on traditional panoramics Q. Extent of root resorption on mandibular anterior teeth Slice # 25 clearly shows extent of root resorption on anterior teeth
  • 17. Q. Any significant finding associated with mandibular molars? Slice # 22 shows radiolucency in Mesial cervical portion of tooth # 30 Normal Surface Possible Caries/ Root Resorption