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Page Title: INTERPROXIMAL (BITEWING) EXAMINATION
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Average vertical angulation
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Dental Technican, Volume 2 - Dentist training manual for military dentists
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PARALLEL  PLACEMENT  TECHNIQUE

2. Position the patient as shown in figure 1-23 for maxillary  radiographs  or  figure  1-24  for  mandibular radiographs.  Remember  that  the  patient's  midsagittal plane must be perpendicular to the floor. 3. Position the film packet in the patient's mouth. Have the patient hold the film packet in place with a pair of hemostats or other holding device. 4.  Set  the  vertical  angulation  of  the  tube  head accord ing to the chart in figure 1-26. 5.   Center the tube head cylinder on the area to be radiographed. To simplify this process, the numbered anatomical landmarks are provided in figure 1-30. Take radiographs  of  the  area  by  centering  the  tube  head cylinder on these landmarks: Mandibular  cuspid  area:  Landmark  6,  directly below landmark 2 1/4 inches above the lower border of the mandible. Mandibular incisor area: Landmark 5, the tip of the chin. Maxillary  molar  area:  Landmark  4,  below  the outer  angle  of  the  eye  and  below  the zygomatic bone. Maxillary bicuspid area: Landmark 3, below the pupil of the eye. Maxillary  cuspid  area:  Landmark  2,  beside the ala of the nose. Maxillary  incisor  area:  Landmark  1,  the  tip  of the nose. Figure 1-30.—Cylinder positioning landmarks for periapical radiographs. Mandibular  bicuspid  area:  Landmark  7, directly  below  landmark  3  1/4  inches  above the lower border of the mandible. Mandibular molar area: Landmark 8, directly below landmark 4 1/4 inches above the lower border of the mandible. 6.   When you have the tube head cylinder centered on the horizontal landmark, double check to make sure that  you  have  the  correct  horizontal  angulation.  The central X-ray beam should be projected straight through embrasures of the teeth to be radiographed. 7. Make the exposure. 8.   Remove   the   film   packet   from   the   patient's mouth  and  place  it  in  a  clean  paper  cup.  Place  the disposable  container  in  a  lead  container  or  behind  a protective screen before making the next exposure. INTERPROXIMAL  (BITEWING) EXAMINATION The   interproximal   examination   reveals   the presence   of   interproximal   caries,   certain   pulp conditions,   overhanging   restorations,   improperly fitting  crowns,  recurrent  caries  beneath  restorations, and resorption of the alveolar bone. A   typical   interproximal   radiograph   (fig.   1-31) records in a single exposure the coronal and cervical portions of both maxillary and mandibular teeth, along with the alveolar bone of the region. Bitewing   X-ray   film   packets   are   used   for   the interpromixal  examination.  The  bitewing  film  packet (fig.  1-32)  has  a  paper  tab,  or  wing,  that  the  patient bites on to hold the packet in place during the exposure (thus the name bitewing). Interpromixal  radiographs  can  be  made  using either the paralleling technique or the bisecting angle technique. Figure 1-31.—Typical interproximal (bitewing) radiograph. 1-22

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