Occlusal radiography

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Occlusal radiography
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Terminology and classification

• I.Maxillary occlusal projections
• Upper standard occlusal (standard occlusal)
• Upper oblique occlusal (oblique occlusal)
• Vertex occlusal (vertex occlusal)

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II.Mandibular occlusal projections

• Lower 90 degrees occlusal (true occlusal)
• Lower 45 degrees occlusal (standard occlusal)
• Lower oblique occlusal (oblique occlusal)

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Standard maxillary occlusal
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Standard maxillary occlusal
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Main clinical indications

• Periapical assessment of the upper anterior teeth
  in patients unable to tolerate periapical films
• Detecting the presence of unerupted canines,
  supernumeraries and odontomes
• As the midline view, when using the parallax
  method for determining the bucco/palatal position
  of unerupted canines

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• Evaluation of the size and extent of lesions such
  as cysts or tumors in the anterior maxilla
• Assessment of fractures of the anterior teeth and
  alveolar bone, especially useful for children

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Upper oblique occlusal
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Upper oblique occlusal
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Main clinical indications

• Periapical assessment of the upper posterior
  teeth, especially in adults unable to tolerate
  posterior periapical films
• Evaluation of the size and extent of lesions in
  the posterior maxilla
• Assessment of the condition of the antral floor

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• Determination of the position of roots displaced
  inadvertently into the antrum during attempted
  extraction of upper posterior teeth
• Assessment of fractures of the posterior teeth
  and associated alveolar bone including the
  tuberosity

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• Clinical indications- assessment of the
  bucco/palatal position unerupted canines
• Disadvantages
• - There is a lack of detail and contrast on the
  film because of the intensifying screens, the
  mass of tissues the X-ray beam has to penetrate
  and the consequent scatter

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Disadvantages

• The primary X-ray beam may be in direct line with
  the reproductive organs
• A relatively long exposure time is needed
• (about 1 second) despite the use of
  intensifying screens
• There is direct radiation to the pituitary gland
  and the lens of the eye
• If the X-ray beam is positioned too far
  anteriorly, superimposition of the shadow of the
  frontal bones may obscure the anterior part of
  the maxilla

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Lower 90 degrees occlusal
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Main clinical indications

• Detection of the presence and position of
  radiopaque calculi in the submandibular salivary
  ducts
• Assessment of the bucco/lingual position of
  unerupted mandibular teeth
• Evaluation of the bucco/lingual expansion of the
  body of the mandible by cysts, tumours or
  osteodystrophies
• Assessment of displacement fractures of the
  anterior body of the mandible in the horizontal
  plane

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Lower 45 degrees occlusal
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Main clinical indications

• Periapical assessment of the lower incisor teeth,
  especially useful in adults and children unable
  to tolerate periapical films
• Evaluation of the size and extent of lesions in
  the anterior part of the mandible
• Assessment of displacement fractures of the
  anterior mandible in the vertical plane

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Lower oblique occlusal
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Lower oblique occlusal
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Main indications

• Detection of radiopaque calculi in a
  submandibular salivary gland
• Assessment of the bucco/lingual position of
  impacted lower wisdom teeth
• Evaluation of the extent and expansion of lesions
  in the posterior mandible