University of Guayaquil

Pilot Faculty of Dentistry

DENTAL RADIOLOGY I

RADIOGRAPHIC TECHNIQUES
BITE WING– OCCLUSAL– OF CLARK

GROUP #1
 UNIVERSITY OF GUAYAQUIL

MISSION

It is a center of knowledge that generates, disseminates, and applies knowledge, skills and
destrezas, con valores morales éticos y cívicos, a través de la docencia, investigación y
linkage with the community, promoting progress, growth, and development
sustainable sustainable of the country, to improve the quality of life of society.

VISION
The UG will be a center of higher education with leadership and national projection.
international, integrated into academic, technological, scientific, cultural, social development,
environmental and productive; committed to innovation, entrepreneurship, and cultivation of
moral, ethical, and civic values.
 PILOT SCHOOL OF DENTISTRY

MISSION
The Pilot Faculty of Dentistry of the University of Guayaquil is a center of
higher education with a high degree of academic excellence and interdisciplinary focus in health, which to
through teaching, research, pre-professional practices, and connection with the
community is responsible for the comprehensive training of professionals with high scientific capability
and humanist for the resolution of oral health problems, coordinating
health programs to improve the quality of life of society.

VISION
The Faculty of Dentistry at the University of Guayaquil will be the leading institution.
in the training of students with specific knowledge of the stomatognathic system and
its relationship with the rest of the organism, through ongoing training by
continuing education programs, postgraduate studies, research, and outreach, with responsibility
in the prevention, promotion, protection of health, and resolution of the problems that arise there
they present with ethical, moral values and a strong social commitment.
 GRADUATE PROFILE

The graduate of the Pilot Faculty of Dentistry of the University of Guayaquil

has a solid humanistic, scientific, and technical background, accompanied by the highest
ethical and moral values, highly responsible and committed to social development,
owner of a high spirit of service vocation, contributes to the defense of rights
humans and contributes from their fields of action in the defense of the rights of nature.

Its most important area of action is oral health, as an important contribution.

to improve the biopsychosocial process of individuals, through prevention, diagnosis,
treatment of problems affecting the mouth and oral cavity.

The ideal profile that a graduate of the Dentistry Degree should have is:

Ability to integrate received knowledge with skills and abilities

developed in all areas of the career, which allows for effective work and
bioethical.
To socialize dental services to the most needy population with actions
community-based and dental care brigades, promoting programs of
interdisciplinary linkage.
Having a great interest in the search for truth through research
scientific and critical reading of dental evidence, which prepares him in the
application of the scientific method, to generate new knowledge and development
continuing education programs.
Prevents, identifies, differentiates, diagnoses, and responsibly treats normality.
and pathologies of the stomatognathic system of pregnant women, children, the elderly and
patients with special needs
Format knowledge on how to prevent oral diseases, understand
what are the diseases that present systemic manifestations or that are
oral manifestations of these last ones.
Having a practice based on scientific evidence, distancing itself from empiricism and bad
practice.
Thoroughly understand and apply biosecurity standards to prevent
communicable diseases through their practice.
CONTENT

University of Guayaquil..................................................................................................... 2
MISSION.............................................................................................................................................. 2
VISION............................................................................................................................................... 2
PILOT FACULTY OF DENTISTRY..................................................................................... 3
MISSION.............................................................................................................................................. 3
VISION............................................................................................................................................... 3
GRADUATE PROFILE.......................................................................................................................... 4
OBJECTIVES.......................................................................................................................................... 7
- GENERAL OBJECTIVE. 7
- SPECIFIC OBJECTIVES. 7
FISH FIN TECHNIQUE.................................................................................................... 8
BASIC CONCEPTS. 8
TERMINOLOGY. 9
PRINCIPLES OF BITE WING TECHNIQUE.10
BEAM ALIGNMENT DEVICE AND BITE FLANGE TAB .........................10
Bite Wing Device for Beam Alignment.................................................10
ANGLE DEVICE POSITION INDICATOR.14
Horizontal angulation.................................................................................................................14
Vertical angulationl ......................................................................................................................15
RULES OF THE FISHING BAIT TECHNIQUEA..............................................................................16
STEP BY STEP PROCEDURE.17
PATIENT PREPARATION..........................................................................................17
EQUIPMENT PREPARATION...............................................................................................17
SEQUENCE OF EXPOSITION FOR THE LOCATION OF THE RECEIVERR ...................................................18
PLACEMENT OF BITE WING RECEIVER.....................................................................19
PLACEMENT OF THE BITE WING RECEPTORS.20
- RIGHT AND LEFT PREMOLAR EXPOSURESO .......................................20
- MOLAR EXPOSURES RIGHT AND LEFT..........................................23
VERTICAL DEATH WING.25
MODIFICATIONS OF THE BITE WING TECHNIQUE.25
EDENTULOUS SPACES.26
Bone GrowthS......................................................................................................................26
OCCLUSAL TECHNIQUE........................................................................................................................27

BASIC CONCEPTSS ...................................................................................................................27

 TERMINOLOGY
PURPOSE AND USE.27
MAXILLARY OCCLUSAL PROJECTIONS.28
MAXILLARY TOPOGRAPHIC OCCLUSAL PROJECTION.28
Maxillary Lateral Occlusal Projection.........................................................................................29
Maxillary Pediatric Occlusal Projection.....................................................................................30
MANDIBULAR OCCLUSAL PROJECTIONS.31
Topographic Occlusal Projection of the Mandible..........................................................................31
Occlusal Projection Cross Section Mandibler .............................................................32
Pediatric Mandibular Occlusal Projection..............................................................................33
VERTICAL ANGLES.34
STEP BY STEP PROCEDURE.34
PATIENT PREPARATION.35
PREPARATION OF THE PATIENT FOR THE OCCLUSAL TECHNIQUE.35
EQUIPMENT PREPARATION.35
PREPARATION OF THE EQUIPMENT FOR THE OCCLUSAL TECHNIQUE.35
CLARK TECHNIQUE......................................................................................................................36
INTRODUCTION.36
GENERALITIES.36
FUNDAMENTAL PHYSICAL PRINCIPLES.37
PURPOSE AND USE.39
DEVELOPMENT OF THE TECHNIQUE.40
STEP BY STEP PROCEDURE.40
PATIENT AND EQUIPMENT PREPARATION.40
CENTRAL RAY CONDITIONSL ...................................................................................................40
INDICATIONS.42
RECEIVER PLACEMENTS AND THE COMPARISON OF IMAGEN ..................................................43
BUCA OBJECT RULEL ...............................................................................................43
BIBLIOGRAPHY.................................................................................................................................44
REAGENTS.......................................................................................................................................45
OBJECTIVES

GENERAL OBJECTIVE
Describe the essential characteristics of the techniques used in dental radiology.
to obtain diagnostic X-rays.

SPECIFIC OBJECTIVES
Define the purpose and use of the bite fin image.
Expose the basic principles and their angles of the occlusal technique.
Describe the use and the procedure of the CLARK technique.
Expose each of the horizontal and vertical angles of the techniques.
 BITE WING TECHNIQUE

The dental radiologist must master a variety of intraoral imaging techniques. The
bite wing technique is used to examine the interproximal surfaces of the
teeth. An image of a bite wing includes the crowns of the maxillary teeth and
mandibular areas, interproximal areas, and the areas of the crest bone in the same image.
Bite wing images are used to detect interproximal caries.
dental) and they are particularly useful in the detection of early cavities that are not
clinically evident. Bite wing images are also useful for examining
the levels of the bony crest between the teeth.

Before the dental radiologist can use this important technique, it is done
necessary to understand basic concepts, including terminology and the
principles related to the bite wing technique. In addition, the dental radiologist must
understand patient preparation, equipment preparation, sequencing of the
exposition, and the placement procedures of the receivers used in the technique of
bite fin.

The purpose of this topic is to present the basic concepts and describe the preparation.
of the patient, the preparation of the equipment, as well as the placement procedures of the
receivers used in the bitewing technique. This chapter also describes
the advantages and disadvantages of the bite wing technique and review the useful tips.

BASIC CONCEPTS

The bite wing technique (also known as the interproximal technique) is

a method used to examine the interproximal surfaces of the teeth. Before that
the competent dental radiologist must have knowledge of this technique
deep understanding of the terminology, principles, and the basic reviews of the bite wing technique.
In addition, knowledge of beam alignment devices is also necessary.
sizes of the receivers, and the angles of the position indication device (PID)
that is used with the bite wing technique.
TERMINOLOGY

The understanding of the following basic terms is necessary before describing the technique.
of bite fin:

Interproximal: Between two adjacent surfaces

Interproximal exam: Intraoral examination used to inspect the crowns of
the teeth of both maxillary and mandibular jaws in a single image.
Bitewing receptor: Type of receptor used in the examination
interproximal. The bitewing receptor has a "wing" or tab, and the patient
bite the fin to stabilize the receiver.
Alveolar bone: Bone that supports and surrounds the roots of the teeth.
Bone crest: Coronary portion of the alveolar bone found between the teeth, also
known as the alveolar ridge.
Contact areas: It is the area of a tooth that touches an adjacent tooth, the area
where the adjacent surfaces of the tooth come into contact with each other.
Horizontal bite wing: The bite wing receptor is placed in the mouth
with the long part of the receiver in a horizontal direction.
Open contacts: In a dental image, open contacts appear thin.
radiolucent lines between the surfaces of adjacent teeth.

Overlapping contacts: In a dental image, it refers to the area where the zone of
the contact of one tooth overlaps the contact area of an adjacent tooth
this is called overlapping contacts.
 Vertical bite wing: The X-ray film receptor is placed in the mouth.
with the long portion of the receiver in a vertical direction.

PRINCIPLES OF THE BITE WING TECHNIQUE

The basic principles of the bite wing technique can be described as follows:

The receiver is placed in the mouth parallel to the crowns of both teeth.
maxillae
2. The receiver stabilizes when the patient bites on the tab of the fin.
Bite or on the alignment device of the X-ray film.
3. The central ray of the X-ray beam is directed through the contacts of the teeth,
using a vertical angle of +10 degrees.

BEAM ALIGNMENT DEVICE AND THE FLANGE OF THE

BITE WING

In the bite wing technique, a beam alignment device or a tab

The bite wing is used to stabilize the receiver.

Bite Wing Device for Beam Alignment

It is a beam alignment device used to position an intraoral receiver.

in the mouth and to keep the receptor in position during the radiographic procedure.
The beam alignment device eliminates the need for the patient to stabilize the
receptor with the tab of the bite fin. An example of a fin device
The commercially available intraoral bite for beam alignment is the instrument of
XCP bite tab; this instrument can be used to establish the receptor of the tab
of bite in a horizontal or vertical direction.

Bite wing instruments Rinn XCP (Rinn Corporation, Elgin, IL).

bite wing instruments include: horizontal and vertical bite block,
plastic rings with target, and metal indicator arm. To reduce the amount of
radiation that the patient receives, a ring collimator with resource can be added
the plastic ring with a lens. These beam alignment devices are
reusable and must be sterilized after each use.

Rinn XCP bite alert instruments with collimators are recommended for
the exhibitions with bite tabs. These devices include rings with a target that
assist in the alignment of the DIP and collimators, noticeably reducing the amount
of exposed radiation. These instruments are simple to place and easy to style. According to the
American Dental Association (ADA) and the American Academy of Oral and Maxillofacial
Radiology recommends the use of a rectangular collimator to reduce the amount of
radiation that the patient receives. For information on the use of the fin instruments
In bite Rinn XCP, the dental radiologist must refer to the provided instructions.
by the manufacturer.

Bite Fin Tab

As an alternative to a beam alignment device, a receiver can be adjusted.

with a biting tab (also called bite the loop or bite the tab).
The bite tab is a heavy cardstock tab or a tight loop.
around a receiver and is used to stabilize the receiver during the procedure.
When using film, the bite wing is oriented towards the bite strip which is the
portion of the tab that extends from the white side (tube side) of the film. The
bite wing receptors can be purchased with unit tabs, or they can be
built by assembling a periapical receptor and a bite tab.
bite wing tabs can be used in horizontal interproximal projections or
vertical, the bite ties are available in various sizes and bite tabs
adhesive.
BITE WING RECEPTORS

There are 3 sizes of bite wing receptor available.

Size 0; is used to examine the posterior teeth of children with dentition.

primary. This receiver is always placed with the long portion of the receiver in a
horizontal direction (oblique).
Size 2; is used to examine the posterior teeth in adults and can be
place horizontally or vertically. For most fin exhibitions
bite, a size 2 receiver is placed with the long side of the receiver in a
horizontal direction. When a vertical fin subsequent exposure is indicated.
bite, a receiver of size 2 is placed with the long portion of the receiver in a
vertical direction.
Size 3; is longer and narrower than the standard size 2 receiver and is used
only for the bite fin exhibitions. A receptor is exposed in each
side of the arch to examine all contact areas of the premolars and molars.
A size 3 receptor is placed with the long portion of the receptor facing
horizontal.
 In the adult patient, a size 2 receptor is recommended for exposures of
biting wing. Size 3 receiver is not recommended. With a size 3 receiver,
overlapping contacts often result due to the difference in the curvature of the arch between
the areas of the premolars and molars. Additionally, the areas of the bony ridges cannot be seen
adequately in the dental images of patients with bone loss due to the
narrow shape of the receptor.

ANGLE DEVICE POSITION INDICATOR

In the bite wing technique, the angulation of the DIP is critical. The angulation is
a term used to describe the alignment of the central ray of the X-ray beam in
both planes, horizontal and vertical. The angular shape can be varied by moving the DIP in
a horizontal or vertical direction. The use of the XCP bite block instruments with
rings with target dictate the appropriate angular shape of the DIP. However, when used
a bite tab, the dental radiologist must determine angles of angulation,
horizontal and vertical.

Horizontal Angle

It refers to the placement of the central ray in the horizontal plane, or from side to side. The
bite wing techniques, parallelism, and the bisector all use the same principles of
horizontal angulation.

Correct horizontal angulation: with the correct horizontal angulation the central ray
it is directed perpendicular to the curvature of the arc and through the areas of
 contact of the teeth. As a result, the contact areas in the exposed image
They appear 'open' and can be examined to evidence the caries.
Incorrect horizontal angulation: incorrect horizontal angulation results in
result of overlapping contact areas (not open). An image with areas of
superimposed interproximal contact cannot be used to examine the areas
interproximal areas of the teeth to evidence cavities.

Vertical angulation

Refers to the placement of the DIP in the vertical plane, or from top to bottom. The
vertical angulation can be positive or negative and is measured in degrees according to those seen in the
exterior of the headpiece. If the DIP is placed on the occlusal plane and the central ray is directed
Downward, the vertical angular shape is called positive (+).

If the DIP is placed below the occlusal plane and the central ray is directed upward, the shape
angular vertical is called negative (-).

Correct vertical angulation: when a

bite tab, an angle is recommended
vertical of +10 degrees for the image of the fin of
bite. The vertical angle of +10 degrees is used
to compensate for the slight curve of the upper portion of
receptor and the slight inclination of the maxillary teeth.
 Incorrect vertical angulation: when incorrect vertical angulation is used in the
bite fin exposure results in a distorted image. By
For example, if a negative vertical angulation is used, the surfaces are evidenced.
occlusal surfaces of the maxillary teeth, and the apical regions of the teeth can be seen
mandibulars. An image of a bite wing exposed with excessive angulation
negative vertical does not serve for diagnosis.

RULES OF THE BITE WING TECHNIQUE

Five basic rules must be followed when using the bite fin technique:

Placement of the receiver: the bite wing receiver must be positioned covering
the area of the teeth prescribed to be examined. The specific placements are
they are detailed in the procedures described in the following section.
2. Position of the bite receptor: the bite wing receptor must be positioned parallel to the
crowns of the teeth of both jaws. The receptor must be stabilized when
the patient bites the tab of the bite wing or in the aligner device
from the bite fin beam.
3. Vertical angulation: when a bite-wing tab is used, the central beam
the X-ray beam must be directed at +10 degrees.
4. Horizontal angulation: when a bite wing tab is used, the ray
the center of the X-ray beam must be directed through the areas of contact between
the teeth.
5. Exposure of the receptor: the beam of X-rays must be centered on the receptor to
ensure that all areas of the receptor are exposed. Failures to center the beam of
 X-rays will result in a partial image on the bitewing receptor or a section.
of cone.

STEP BY STEP PROCEDURE

The step-by-step procedure for the exposure of bitewing receptors

includes patient preparation, equipment preparation; placement methods of the
receptor. Before exposing any dental bite tab, they must be completed with
the infection control procedures.

PATIENT PREPARATION

After completing the infection control procedures and preparation

for the area and supplies, the patient must be seated. After seating the patient, the
The dental radiologist must prepare the patient for the radiographic procedure.

1. Brief explanation of the image acquisition procedure to the patient beforehand

to begin the procedure.
2. Place the patient in an upright position in the chair. Adjust the chair's level to a
comfortable working height.
3. Adjust the headrest to support and position the patient's head. The head
The patient's arm should be positioned in such a way that the upper arch is parallel to the
the floor and the midsagittal plane (midline) are perpendicular to the ground.
4. Place and secure the lead apron with a thyroid collar on the patient.
5. Have the patient remove all objects from the mouth (e.g., removable dentures,
retainers, chewing gum) that may interfere with the procedure. The lenses
They should also be eliminated.

EQUIPMENT PREPARATION

After the patient preparation, the equipment must be prepared to expose any
of the receptors.
 1. Establish the exposure factors (milliamperage, kilovoltage, and time) of the
X-ray unit according to the recommendations of the receptor manufacturer.
2. If a beam alignment device uses the bite tab technique, open the
sterilized package that contains the device and mount the device in an area of
covered work.
3. If a bite tab is used, place the tab on the white side of the
movie, or the right side of the receiver.

EXPOSITION SEQUENCE FOR THE LOCATION OF

RECEIVER

When using the bite wing technique there must be a sequence of exposure, or it must be
to be followed the defined order for the placement and exposure of the receptor. The radiologist
dental must have an established routine in exposure to prevent errors and to make a
efficient use of time. Working without a sequence of exposure can lead to omissions.
an area or to expose an area twice.

A complete series of radiographs of the mouth is an intraoral series of dental images.

that shows all the dental areas of the maxilla and the mandible. The CMRS may consist of
periapical images alone, vertical bite wings anterior and posterior, or a
combination of periapical images and bite-wing images. The bite-wing exposures of
Bite will only be used in areas where the teeth have interproximal contact with others.
teeth.

The number of bitewing images needed for a patient is based on the

curvature of the arch and the number of teeth present in the posterior areas. The curvature of the
The arch often differs between the premolar and molar areas.
 If the curvature of the arc is different, it is not possible to open all contact areas.
posterior in a bite fin image. Consequently, two fin receptors of
Bite is typically exposed to each arc loop. Because of the curvature of the arc.
It differs in most adult patients, a total of 4 bite tabs are exposed: 1
right premolar, 1 right molar, 1 left premolar, and 1 left molar.

When the posterior teeth are missing (e.g., in patients where the
premolars have been extracted as part of orthodontic treatment), an exposure of
bite wing on each side of the arch (instead of two) may be enough to cover the
number of teeth present.

In the patient who requires both periapical and bitewing exposures, the
sequence after recommended exposure is:

First of all, expose all the anterior periapical receptors.

2. Proceed with the posterior periapical receivers.
3. Finish with the bite wing exposures.
The sequence ends with bite fin exposures because of these
receptors are relatively easy for the patient to tolerate. It is not wise to end the
exam with difficult exposures (e.g., painful locations or that provoke the reflex
nauseating)

In the patient who only requires a bite splint, the following is recommended
exposure sequence for each side of the mouth:

1. Expose the premolar to the bite wing first. (This receptor is

easier for the patient to tolerate and is less likely to evoke the gag reflex.)

2. Expose the molar with the bite wing last.

PLACEMENT OF THE BITE WING RECEPTOR

When exposing the bite wing, each exposure has a prescribed location. Placement of
receptor, or the specific area in which the receptor must be placed before exposure,
is dictated by the teeth and the surrounding structures that must be included in the
result of the bite fin image. The specific locations described are for a
period of four series of size 2 receivers and the bite fin tabs.
variations in placement, receiver size, or the total number of exposures can
to be recommended by other reference sources or individual professionals.

GUIDELINES FOR THE PLACEMENT OF THE BITE WING RECEPTOR

1) When using film, the white side of the film always faces the tooth.
The point of identification in the film is not important in the placement of
bite fin movie.
2) In the series of posterior bite wing, the receptors are positioned horizontally or
vertically.
3) When placing the receiver, it should always be centered over the area to be
examined (as defined in the prescribed locations)
4) When placing the receiver, ask the patient to 'gently bite' on the tab of
the bite tab or in the bite block of the beam alignment device.

PLACEMENT OF THE BITE WING RECEPTORS

The placement of receivers for the four bite fin exposures includes the
next:

Right and left premolar exposures

Right and left molar exposures

It is important to note that in the procedures for premolars and molars, the exposures
with bite wing, it is recommended that the receptor be placed in the patient's mouth
after the vertical and horizontal angles have been established.

RIGHT AND LEFT PREMOLAR EXPOSURES

Exhibition of the Bite Edge of the Premolar with Bite Tab

Aleta de mordida del [Link]ón del [Link] Resultante

Adjust the vertical angle by +10 degrees.

2) To establish the horizontal angulation, stand in front of the patient. Examine

the posterior curvature of the arch. To better visualize the curvature of the arch, place your
Index finger along the premolar area. Align the open end of the device of
position indication (DIP) parallel to your index finger and the curvature of the arch in
the premolar area, and direct the central ray through the contact areas.

A. To better visualize the curvature of the arc, place your index finger along the
premolar area. B. Correct horizontal angulation of the premolar area

3) Make sure that the DIP is positioned far enough forward to

cover both upper and lower canines and position them evenly
About the upper and lower arches to avoid a cutting cone. The middle of the DIP
It must be directed at the level of the occlusal plane. After the vertical angulation, the
horizontal angulation, and the position of the DIP has been established, the DIP should not be
adjusted, and the receiver must be placed without moving the DIP.
 The central DIP must be directed to the level of the occlusal plane.

4) Fold the bite tab flap in half and tuck it in. Insert the receiver.
in the patient's mouth, and place the lower half of the receiver between the patient's tongue.

patient and the teeth. Place the surface of the tab where it is bitten on the
occlusal surface of the lower jaw teeth; the front edge of the receptor is
It should align with the midline of the lower canine. Use the index finger.
hold the bite tab of the fin against the oral surfaces of the
premolars. Keep the tab in place in steps 5 and 6.

5) Ensure that the patient's occlusal plane is parallel to the floor. In case of
necessity, it is necessary to ask the patient to lower their chin.
To check the cone cut, stand directly behind the head and
look along the DIP. No part of the receiver should be visible, the receiver is
must cover the opening of the DIP. If the receiver is not visible, ask the patient
slowly close
bite. If any portion of the receptor is visible, it will result in a conical cut. In such cases
 cases, the DIP has been placed correctly, ask the patient to 'close
slowly" while holding the bite tab flap.
7) Exponga el receptor

MOLAR EXPOSITIONS RIGHT AND LEFT

Exhibition of the Bite Wing of the Molar with Bite Tab

Angle adjustment to +10 degrees.

To establish the horizontal angulation, stand in front of the patient.
Examine the posterior curvature of the arch. To better visualize the curvature of the arch,
Place your index finger along the molar area. Align the open end of the
position indication device (PID) parallel to your index finger and the curvature
from the arch in the area of the molar, and direct the central beam through the contact areas.

A. To better visualize the curvature of the arc, place your index finger along the
molar area. B. Correct horizontal angulation of the molar area.

3) Make sure that the DIP is positioned far enough forward as

to cover the two upper and lower premolars and to position itself from
uniformly over the upper and lower arches to avoid a cutting cone.
 Half of the DIP must be directed at the level of the occlusal plane. After that, the
vertical angulation, horizontal angulation, and the position of the DIP have been established,
the DIP should not be adjusted, and the receiver should be placed without moving the DIP.

4) Fold the tab of the bite fin in half, and fold it. Insert the
receptor in the patient's mouth, and place it in the lower half of the receptor between the
tongue and the patient's teeth. Place the biting surface of the tab on the
occlusal surfaces of the mandibular teeth. Center the receptor on the second
molar mandibular; the front edge of the receptor must be aligned with the midline
of the lower second premolar. Using the index finger, hold the tab of the flap
bite against the buccal surfaces of the molars. Hold the tab in your
place during steps 5 and 6.
5) Make sure that the patient's occlusal plane is parallel to the floor. In case of
need, you have to ask the patient to lower their chin.
To check the cone cut, stand directly behind the head and
look along the side of the DIP. No portion of the receiver should be visible; the
the receptor must be covered by the opening of the DIP. If the receptor is not visible, ask the
patient who "closes slowly" while you still hold the tab of the
bite wing. If any portion of the receptor is visible, it will result in a cone cut.
In such cases, the DIP should be adjusted to cover the receiver. After the DIP
it has been placed correctly, ask the patient to 'close slowly' while
that holds the tab of the bite fin.
7) Expose the receiver
VERTICAL DEATH WING

A vertical bite wing image can be used to examine the level of the bone.
alveolar in the mouth. This bite wing is placed on the long part of the receptor facing up
and downwards, or in a vertical direction. Vertical images of bite fins are used to
meat as post-treatment or in follow-up images for patients with loss
bone due to periodontal disease.

A modified CMRS can be used with vertical bitewing images.

A total of 7 projections (3 anterior and 4 posterior) are used to cover the incisor,
canine, premolar, and molars. Size 2 receptors can be used for all the
exhibitions, or a combination of size 1 (anterior teeth) can be used.
size 2 (posterior teeth). For the projections in the anterior region, one more flap
A long bite plate is often necessary for the patient to be able to close.
completely. The patient should be instructed to bite on the end tab.
extreme in the occlusal relationship.

MODIFICATIONS OF THE BITE WING TECHNIQUE

The modifications in the bite fin technique can be used to adapt to

variations in anatomical conditions. These modifications may be necessary in
patients who have edentulous spaces or bone growths.
Edentulous spaces

An edentulous space is an area where teeth are no longer present. An edentulous space
it can cause problems in the placement of the bite wing receptor, and a ... is necessary
modification in the technique.

A cotton roll should be placed in the area of the tooth (or teeth) to support the tab.
from the bite wing or the beam alignment device. When the patient closes, it must
include the teeth placed on the cotton roll and support the tab of the bite wing
the beam alignment device. The lack of support from the bite tab fin or
The beam alignment device results in an inclined occlusal plane in the image.
resultant.

BONE GROWTHS

Tori (plural tori) is a bony growth in the oral cavity. Mandibular tori are
bone growths along the lingual side (tongue side) of the mandible. When
the bite wing technique is used, mandibular tori can cause problems in the
placement of the receiver, and a modification in the technique becomes necessary.

The receptor must be placed between the torus and the tongue (not in the torus) and exposed to
continuation. With the large toris, the receptor is pushed away from the teeth. Like
resultado, los pacientes muerden en el extremo de la pestaña de la aleta de mordida para
stabilize the receptor, making it difficult for the dental radiologist to achieve proper placement
correct. In such cases, it is recommended to use a fin beam alignment device.
bribe.
 OCCLUSAL TECHNIQUE

The occlusal technique is used to examine large areas of the maxilla or mandible.
Before the dental radiologist can use the occlusal technique, it is necessary to have a
complete understanding of the basic concepts. In addition, knowledge of
step by step procedure.

BASIC CONCEPTS

TERMINOLOGY

Before describing the principles of the occlusal technique, a number of basic terms must
to be defined as follows:

Occlusal surfaces: Chewing surfaces of the back teeth.

Occlusal examination: It is a type of intraoral radiographic examination to inspect.
large areas of the maxilla or mandible in a single image.
Occlusal technique: Method used to expose a receptor in the occlusal examination.
Occlusal receptor: In the occlusal technique, an intraoral receptor of size 4 is used.
The receptor is called that because the patient "occludes", or bites, on the entire receptor.
Size 4 receptors are the largest intraoral receptors, measuring 3 x 2.25.
inches. In adults, size 4 is used in the occlusal examination. In children,
however, the size 2 receiver is typically used.

PURPOSE AND USE

The occlusal technique is a complementary radiographic technique that is commonly used in
combination with periapical images or bitewing images. The occlusal technique is used
when large areas of the maxilla or mandible need to be visualized. Image
occlusal is preferred when the area of interest is larger than what a periapical receptor can capture.
it can cover, or when the placement of intraoral receivers becomes too difficult
for the patient. Occlusal images can be used for the following purposes:

To locate the retained roots of extracted diets.

To locate supernumerary (extra) teeth that are unerupted or impacted
To locate foreign bodies in the maxilla or jaw
 To locate salivary calculi in the duct of the submandibular gland
To locate and assess the extent of the lesions in the maxilla or in the mandible
To evaluate the limits of the maxillary sinus
To evaluate fractures of the maxilla or the mandible
To facilitate the examination of patients who cannot open their mouths more than a few
millimeters
Examine the area of a cleft palate
To measure changes in the size and shape of the maxilla or the mandible.

Principles

The basic principles of occlusal technique can be described as follows:

1. When using film, it is placed with the white side towards the arch that is being
exposing.
The receiver is placed in the mouth between the occlusal surfaces of the teeth.
superiors and inferiors.
3. The receiver stabilizes when the patient bites gently.
the surface of the receptor.

MAXILLARY OCCLUSAL PROJECTIONS

Three maxillary occlusal projections are commonly used: (1) topographic, (2) lateral
(right or left), (3) pediatric.

MAXILLARY TOPOGRAPHIC OCCLUSAL PROJECTION

The maxillary topographic occlusal projection is used to examine the palate and the teeth.
anterior of the upper jaw.

Position the patient in such a way that the upper arch is parallel to the ground.
2. Place a size 4 movie with the white side facing the upper jaw and the
wide edge in one direction from side to side.
3. Insert the receiver into the patient's mouth, placing it later in position.
as the patient's anatomy allows.
 4. The patient is taught to bite gently on the receiver, maintaining the position.
from end to end of the bitten receptor.
5. Place the position indication device (DIP) in such a way that the beam
center towards the center of the receiver through the midline of the arch.
Place the DIP so that the central ray is directed at +65 degrees of angulation.
vertically towards the center of the receptor. The top edge of the DIP is placed between the
patient's eyebrows over the bridge of the nose.

Lateral Maxillary Occlusal Projection

The lateral maxillary occlusal projection is used to examine the palatal roots of the
molars. They can also be used to locate foreign bodies or lesions in the area.
posterior of the maxilla.

Position the patient so that the upper arch is parallel to the ground.
Place a size 4 film with the white side facing the upper jaw and the
wide edge in one direction from front to back. Insert the receiver into the mouth of the
patient, subsequently placing it as allowed by the anatomy of the
 patient. Change the receiver on the side (right or left) of the area of interest. The
the wide edge of the receiver should extend approximately ½ inch beyond the
vestibular surfaces of the posterior teeth.
3. Teach the patient to bite gently on the receptor, maintaining the position
from end to end of the bitten receptor.
4. Place the position indication device (DIP) in such a way that the beam
the central directs through the areas of interest contact.
5. Position the DIP so that the central beam is directed at +60 degrees angulation.
vertical towards the center of the receiver. The top edge of the DIP is placed over the
corner of the patient's eyebrow.

Pediatric Maxillary Occlusal Projection

The pediatric occlusal projection is used to examine the anterior teeth of the maxilla and
It is recommended for use in children 5 years or older.

The child's position must be such that the upper arch is parallel to the ground.
2. Place a size 2 film with the white side facing the upper jaw and the edge in
a side-to-side direction. Insert the receiver into the child's mouth
3. Instruct the child to bite gently on the receptor, maintaining the position of the receptor.
biting from end to end
 4. Position the position indication device (DIP) so that the central beam
Drive through the middle line of the arch towards the center of the receiver.
5. Position the DIP so that the central ray is directed at +60 degrees of vertical angle.
towards the center of the receiver. The upper edge of the DIP is placed between the child's eyebrows in the
bridge of the nose.

MANDIBULAR OCCLUSAL PROJECTIONS

Three mandibular occlusal projections are commonly used: (1) topographic, (2) section
transversal, (3) pediatric.

Topographic Occlusal Projection of the Mandible

The topographic occlusal projection of the mandible is used to examine the anterior teeth.
from the jaw.

Position the patient so that the mandibular arch is parallel to the ground.

2. Place a size 4 film with the white side facing the jaw and the long edge in
a side-to-side address. Insert the receiver into the patient's mouth, placing it
subsequently as allowed by the patient's anatomy.
3. Instruct the patient to bite gently on the receptor, maintaining the position of the
receptor biting from end to end.

4. Place the position indication device (DIP) so that the central beam is
drive through the middle of the arc towards the center of the receiver

5. Place the DIP so that the central ray is directed at -55 degrees of vertical angulation
toward the center of the receiver. The DIP should be centered approximately 1 inch below
from the patient's chin.

Occlusal Projection Mandibular Cross Section

The occlusal projection of the mandibular cross-section is used to examine aspects

buccal and lingual surfaces of the mandible. It is also used to locate foreign bodies or
salivary calculations in the area of the base of the mouth.

1. Position the patient so that the mandibular arch is parallel to the floor.

2. Place a size 4 film with the white side facing the jaw and the long edge in
a side-to-side direction. Insert the receiver into the patient's mouth, placing it
subsequently as allowed by the patient's anatomy.

3. Instruct the patient to gently bite on the receptor, maintaining the position of the
receiver biting from end to end.

4. Position the position indication device (DIP) so that the central beam
drive through the middle of the arch towards the center of the receptor
5. Position the DIP so that the central ray is directed 90 degrees of vertical angulation.
towards the center of the receiver. The DIP should be centered approximately 1 inch below
from the patient's chin.

Pediatric Mandibular Occlusal Projection

The pediatric mandibular occlusal projection is used to examine the anterior teeth of
the jaw and is recommended for use in children 5 years or older.

Position the patient so that the mandibular arch is parallel to the ground.

2. Place a size 2 film with the white side towards the maxilla and the long edge in
a side-to-side address. Insert the receiver into the child's mouth,

3. Instruct the patient to gently bite on the receptor, maintaining the position of the
receiver biting from end to end.

4. Position the position indication device (DIP) so that the central beam
drive through the middle of the arch towards the center of the receiver

5. Position the DIP so that the central beam is directed at a vertical angle of -55.
degrees. The DIP should be centered below the child's chin.

horizontal changes when the distal DIP is changed, and the object in question moves towards
mesial in the image, the object is located on the buccal side (buccal = opposite).

The mnemonic 'ILOV' can be used to remember the rule of the oral object, of the
in the following way:
Equal lingual; Opposite-Vestibular

In other words, when the two images are compared, the object that is found in
lingual seems to have moved in the same direction as the DIP, and the object that is located in
The vestibular seems to have moved in the opposite direction of the DIP.

VERTICAL ANGLES
The recommended vertical angulations for all maxillary occlusal exposures and
mandibular

Oclusal projections and their corresponding angles

VERTICALS
Occlusal projection VERTICAL ANGLE (DEGREES)
Maxillary topography +65
Maxillary lateral (right and left) +60
Pediatric maxilla +60
Mandibular topography -55
Mandibular cross-section 90
Pediatric mandibular -55

STEP BY STEP PROCEDURE

The step-by-step procedure for the presentation of occlusal images includes preparation.
of the patient, preparation of equipment and methods for placing the receiver. Before exposing
No occlusal receptor, infection control procedures are mandatory.
PATIENT PREPARATION

After the completion of infection control procedures and preparation

In the treatment and supply area, the patient must be seated.

After seating the patient, the dental radiologist must prepare the patient for the
exhibition of the receptors.

PATIENT PREPARATION FOR OCCLUSAL TECHNIQUE

1. Briefly explain the radiographic procedure to the patient.

2. Place the patient in an upright position in the chair, it should be adjusted to a height of
comfortable work.
3. Adjust the headrest to support and position the patient's head. For
maxillary occlusal exposures, the patient's head should be positioned in such a way
so that the upper arch is parallel to the ground and the midsagittal plane (line
media) is perpendicular to the ground. For some lower occlusal exposures, the
the patient's head should be tilted and positioned in such a way that the plane
the occlusal is perpendicular to the ground. For others, the patient is positioned in such a way that
the occlusal plane is parallel to the floor.
4. Put the lead apron with the collar for the thyroid on the patient, and secure it.
5. Ask the patient to remove all objects from their mouth that may interfere with the
procedure (e.g., removable prosthetics, retainers, chewing gum.) The lenses
they must also be removed.

EQUIPMENT PREPARATION

After preparing the patient, the team must also be ready before the
exposure of the receptor.

PREPARATION OF THE EQUIPMENT FOR THE

Oclusal Technique

Establish the exposure factors regarding the unit of

X-rays (kilovoltage, milliamperage, and time) accordingly
with the manufacturer's recommendations for the receiver. The
position indicator device (DIP) can be used with the occlusal technique, either
short (8 inches) or long (16 inches).

CLARK TECHNIQUE

INTRODUCTION

In 1910, Clark introduced his technique known as the oral object rule, parallax rule.
the same opposing lingual arch. Its principle is based on the change of position of
un objeto presente en el examen radiográfico, cuando se modifica el Angulo de proyección
(using 2 periapical radiographs and varying the horizontal angulation)

GENERALITIES

In order to achieve perfect localization of any element that is intraosseous...

lower jaw in addition to pathologies and other injuries that the use of the technique may have
periapical complemented by a normal occlusal technique (90oprovides us with optimal
results.

In the upper jaw, the occlusal technique that complements another perpendicular incidence,
For the same purposes, it should be the same normal sagittal occlusion, with the precise indication.
That the standard inclination of 90 degrees must be emptied in the degrees of inclination.
necessary for the central ray to follow the direction of the axes of the previous pieces, in the
the element to be located is in that area.
In order to avoid the normal sagittal occlusal incidents for the upper jaw, by
require more energy and radiation than periapical techniques, in addition to
Inconvenience of the addition of the different bone planes that must be crossed, it is used the
Clark method that is based on the use of three X-rays taken with technique
periapical.

FUNDAMENTAL PHYSICAL PRINCIPLES

If two semitransparent objects present themselves in front of our view (for example, one is spherical
and another cube) aligned one behind the other, we will visualize them overlapped but unable to
identify which is in front and which is behind.

If we transfer these effects to the imaginary case of a retained upper jaw canine.
interosseous, which is located buccally or palatally with respect to the dental arch, we see that
we can only establish its position on the front plane, without being able to determine its
vestibular or palatine location with respect to this.

To elaborate on what has been presented, we can see in the following image, two location variants.
vestibular or palatine of the mentioned canine; either of them, when projected onto a
radiographic film, they provided us with a similar image of retention, but without defining its
palatal or vestibular location with respect to the dental arch.
Returning to the example, it is observed that to clearly visualize both objects, we must.
move laterally, as illustrated in the figure, thus allowing us to see them individually
as if they had each run in the opposite direction to each other project
visual

This is how, thanks to the virtual displacement of this optical effect, we were also able to locate its
respective positions highlighting that the object, which apparently moved in the direction
of our displacement, it is the one that is farthest away and the one that did it in a sense
contrary to ours, it is closer to us. To verify our
observation, we made the same displacement in the opposite direction and observed that
produce the mentioned virtual shift of these elements, but in the opposite direction.
PURPOSE AND USE.
Dental radiology is a two-dimensional photograph of a three-dimensional object; it shows the
object in its superior-inferior and anteroposterior relationship. However, it does not show the relationship

vestibular-lingual or depth of the object. There are times when it is necessary to establish the
vestibulo-lingual position of a structure, such as a foreign body or impacted tooth
Within the maxillae, localization techniques are used to obtain this information.
three-dimensional and locate the following:

Foreign bodies
Impacted teeth
Impacted teeth
Retained roots.
Root positions
Salivary calculations
Jaw fractures
Broken needles and instruments
Filling materials

Oral object norm:

The norm of the oral object is governed by the orientation of the structures represented in two
X-rays exposed at different angles, using the appropriate technique and angulation.
expose a periapical receptor, or a bitewing receptor, next, after
change the direction of the X-ray beam, a second periapical receptor or a
bite wing receptor using a different angle, horizontal or vertical.

The horizontal changes when the DIP is changed distally, the target in question moves towards.
mesial, in the image the object is located in the vestibular.

The mnemonic 'ILOV' can be remembered to recall the rule of the buccal object.
next way

Lingual; vestibular opposite

In other words, when both images are compared, the object that is found in linguistic.
seems to have moved in the same direction as the DIP and the object that is located in
the vestibular appears to have moved in the opposite direction of the DIP.

DEVELOPMENT OF TECHNIQUE

The positioning of the patient, the size of the radiographic films that are used, the
distribution and position of them, the centralization and immobilization of these and the
the focal-object distance is governed by the same conditions used in the bisection technique.

STEP BY STEP PROCEDURE

The step-by-step procedure of localization techniques includes the localization of

patient and placement of the receiver and comparisons.

PATIENT AND EQUIPMENT PREPARATION

Before exposing the receivers using the localization techniques, they must be
completed the infection control procedures and the repaired equipment must
be completed.

CONDITIONS OF THE CENTRAL RAY

According to what has been seen, Clark develops his method aimed at achieving the palatine location or

vestibular of any element that is located within the maxillae and that consists of
perform two periapical X-rays maintaining the same vertical inclination as the
used in the original X-ray, but varying the horizontal incidence. The latter
modification does not comply (due to necessity)
One of the conditions of the central ray that indicates it should strike perpendicular to the plane that

determine the vestibular surface of the dental pieces in the area.

Taking the original incidence on the horizontal plane as a guide representing the technique of
the bisector of a retained canine, as shown in the figure. The two are added
mentioned incidents: one of them must be carried out by shifting the head towards me
of X-rays, approximately 10 oregarding the normal incidence, how it is diagrammed in the
figure but moving the headpiece distally at a similar angle, as shown
in the figure.

According to the diagram with the three presented radiographic images:

[Link] incidencia normal, en la radiografía se observa la cúspide del canino proyectada

about the pulp canal of the lateral incisor.
In the second radiograph, which was taken with mesial incidence, the cusp of the
It is virtually located on the distal wall of the root of the lateral incisor.
moves in the opposite direction to our focus).
In the third X-ray taken while distally angling the incidence, the cusp of the canine.
it is projected onto the interradicular space of the lateral incisor and the central incisor (it
confirms its movement in the opposite direction to our approach)

These virtual displacements would indicate that the studied canine is located vestibularly.
the dental arch confirming one of the mentioned principles that refers to the fact that the
nearby objects move in the opposite direction to the observer (in this case to the
incident of the central ray.

If we consider the reverse possibility, the case in which the canine would be located palatally of the
dental arch, the displacement would be opposite to what is seen, thus in the radiograph with
musicalized incidence, this dental piece would virtually shift distally, that is,
following the same direction as the incident X-ray.

To expand on these concepts and taking the example that reinforces what has been seen, the case is presented

of a second premolar germ that has not completed its formation, which until the
the moment is formed by its crown.

This example is identified in the images of the figures, where in the first X-rays
with normal incidents (A). The mentioned germ would be found between the first premolar and the
first molar, in the second image (B) with mesialized incidence, is observed projected.
about the first premolar and in the third image (C) about the mesio-buccal root of the first
molar

The respective X-rays are accompanied by a diagram of them.

From these virtual movements of the obtained images, it is deduced that, if the piece in
study accompanies the incidents (focusing on the incident taken from mesial and
distal rising in the incidence taken from distal) its location above is evidenced
palatine regarding the dental pieces of the arch. If this piece under study had
displaced in the opposite direction to what was seen, its location would be vestibular.

INDICATIONS

For the localization of any element found within the bone tissue and the
maxillae, for example, a foreign body, a dental piece of normal count but
retained, an intraosseous supernumerary dental piece, odontomas, etc.
COLLOCATIONS OF THE RECEIVER AND THE COMPARISON OF
IMAGE

ORAL OBJECT RULE

Example:

The oral object rule can be used to determine the position of a tooth.
Endodontically treated with gutta-percha (endodontic filling material) in
a maxillary second premolar
Position the patient so that the maxillary arch is parallel to the floor.
2) Expose a periapical molar receptor using the appropriate technique and angulation.
3) Change the position indicator device (DIP) mesially and expose.
another periapical receptor premolar.
In the second image, when the DIP moves in a mesial direction, the gutta-percha
it moves in the opposite direction so the location of the gutta-percha is in the
root that is found in vestibular (vestibular = opposite).
BIBLIOGRAPHY

Basic bibliography

Radiografía Dental Principios y técnicasJoen M. Lannucci, Laura Jansen Howerton

4th Edition 2013
REAGENTS

1) What is the bite tab technique used for:

A. To examine the interproximal surfaces of the teeth.
B. To examine large areas of the maxilla.
C. To examine large areas of the jaw.
D. To examine occlusal surfaces.

2) What is a bitewing device for beam alignment?

A. Used to inspect the crowns of the teeth of both jaws and
mandibulars in a single image.
B. Coronal portion of the alveolar bone found between the teeth.
It is used to position an intraoral receptor in the mouth and to hold the receptor.
in the position during the radiographic procedure.
D. It is the area of a tooth that touches an adjacent tooth.

3) What is the utility of the Bite Tab?

It is used to stabilize the receiver during the procedure.
B. In a dental image
C. The long part of the receiver in a horizontal direction.
It is used to set the bite wing receptor in one direction
horizontal or vertical.

4) What is the size 0 of the bite gauge receivers.

A. To examine the posterior teeth in adults and it can be placed
horizontally or vertically.
It is used to examine the posterior teeth of children with primary dentition.
C. It is used only for bite edge exposures, it is longer and
narrow.
It is standard size.

5) Indicate the basic rules that must be followed when using the fin technique.
bribe
a) Placement of the receiver and Position of the receiver
b) Vertical and horizontal angulation
c) Exposure of the receptor
d) All of the above.

6) During the patient's preparation (before exposure to X-rays) how

Is the patient placed in the chair?
A. In a horizontal position
B. In vertical position
C. A and B are correct
 D. None of the above

7) Is it necessary for the patient during their preparation before exposure to the
Should all objects from the mouth be removed for X-rays?
A. True
B. False

8) What is the basis for the number of bite wing images that are necessary?
for a patient?
A. In the curvature of the arc
B. The number of teeth present in the posterior areas
C. In the curvature of the arc and the number of teeth present in the anterior areas.
D. In the curvature of the arch and the number of teeth present in the posterior areas.

9) Which direction does the white side of the radiographic film face?
A. Towards the palatine vault
B. Hacia la mucosa bucal
C. Towards the tooth that is going to be exposed
D. None of the above

10) Within the bite wing technique, both in exposures to molars and
premolars What is the correct vertical angulation?
+10 degrees
-10 degrees
C. +20 degrees
-20 degrees

11) A vertical bitewing image can be used for:

A. Examine large areas of the maxilla and mandible.
B. Examinar el nivel del hueso alveolar de la boca.
C. Examine retained roots of extracted teeth.
D. Examine the palatal roots of the molars.

12) The mandibular tori are:

A. Bone growths along the gums.
B. Bone growth along the gingival groove.
C. Bone growth along vestibular surfaces.
D. Bone growths along the lingual side.

13) Indicate the correct answers.

Three maxillary occlusal projections are commonly used:
A. Topographic
B. Cross section
Pediatric
 D. Lateral

14) In a maxillary topography, it should have a vertical angulation of:

+60°
B. +65°
C. +50°
D. +55°

15) The pediatric mandibular occlusal projection is recommended for use in:
A. 10-year-old children
B. 13-year-old children
C. Five-year-old children
D. Children of 8 years

16) According to the fundamental principle of Clark's technique, select the...

correct.
The receiver is placed in the mouth between the occlusal surfaces of the teeth.
superiors and inferiors
B. The central ray of the X-ray beam passes through the contacts of the
teeth, using a vertical angle of +10 degrees.
C. The change in position of an object present in the radiographic examination, when it
modify the projection angle (using periapical radiographs and varying
the horizontal angling
The receiver stabilizes when the patient gently bites softly.
on the surface of the receptor.

17) In which year was the oral object rule technique introduced?
A. 1994
B. 1919
C. 1910
D. 1813

18) Referring to the rule of the oral object, in what situations could it be used?
A. Determinar la posición de un diente, tratado endodonticamente con material de
filling in a second maxillary molar.
B. To examine the front teeth of the lower jaw and it is recommended for its
use in children 5 years old or younger.
C. To examine the palatal roots of the molars.
D. To examine the occlusal surfaces exclusively.

19) Referring to the preparation of the patient for the occlusal technique, what about it?
What position should the head be in for lower jaw presentations?
A. The patient's head must be positioned so that the upper arch is
parallel to the ground and the sagittal midplane (midline) perpendicular to the ground.
 B. The patient's head should be reclined and positioned in such a way that the
the occlusal plane is perpendicular to the ground.
The patient is positioned in such a way that the occlusal plane is parallel to the floor.
D. The patient positions themselves in such a way that the upper arch is elevated and has a
angle of 45

20) According to the oral object standard, select the correct concept.
The orientation of the structures represented in two exposed X-rays is governed.
at different angles, using the appropriate technique and angling, a is exposed
periapical receptor, or a bite wing receptor.
B. The orientation of the structures is governed as represented in two exposed radiographs.
at different angles, using the appropriate technique and angling, a is exposed
occlusal receptor, or a bite wing receptor.
C. It is governed by the bone structure of the structures represented in multiple
X-rays.
D. Se rige a la toma de varias radiografías de una estructura utilizando un mismo
angle.