RADIOGRAPHY DIAGNOSIS IN
ORTHODONTICS
DR PALLAVI (PGT 1)
INTRODUCTION
• Orthodontic records are used by the orthodontist as a study aid in order
to provide the best orthodontic treatment plan possible for patients.
HISTORY
• German physicist Wilhelm Conrad Roentgen discovered X rays in 1895
• Within a year of Roentgen’s discovery the first dental radiographs were
taken in 1896
• Dr Otto Walkhoff German scientist is credited with creating the first dental
radiographs in 1896
DENTAL RADIOGRAPHS
INTRAORAL RADIOGRAPHS EXTRAORAL RADIOGRAPHS
• Periapical • Orthopantomogram(OPG)
• Bitewing • CBCT
• occlusal • Cephalometrics
• Hand wrist
• Cervical Vertebrae
Maturation(CVM)
INTRAORAL
PERIAPICAL RADIOLOGY
• The intraoral radiographs are the easiest to take for most orthodontic patients. They formed
the mainstay for all orthodontists till the advent of the orthopantomogram
• A full set of ten IOPAs was recommended before the advent of the orthopantomogram. They
covered all the present teeth and the adjacent teeth
To evaluate the position of the canine buccolingually two periapical films are taken of the same area,
with the horizontal angulation of the cone changed when the second film is taken. If the object in
question moves in the same direction as the cone, it is lingually positioned. If the object moves in the
opposite direction, it is situated closer to the source of radiation and is therefore buccally located . This
is called Tube-shift technique or Clark's rule or (SLOB) rule.
BITEWING
RADIOGRAPH
• They are seldom used but are ideal for the detection of proximal caries and
the study of interdental bone height in these areas.
OCCLUSAL RADIOGRAPH
• lntraoral occlusal radiographs are of special interest to an orthodontist
when dealing with impacted teeth or for the study of the labio-lingual
position of the root apices in the anterior segments of the maxillary and the
mandibular dentition.
• They are particularly useful in the maxillary arch, for assessing root form of
the incisors, the presence of midline supernumerary teeth and canine
position, either alone or in combination with additional views using parallax.
ORTHOPANTOMOGRAPHY
• The first attempt to build a dental digital panoramic was of McDavid et al. at
University of Texas Health Science Center at SanAntonio (1985-1991), based on a
linear pixel array (single pixel column) sensor which was not appropriate for such
an application.
• USES
• To detect diseases, lesions and conditions of the jaw (eg: Carcinoma in
relation to the jaws), or Diagnosis of developmental anomalies such as
Cherubism, Cleidocranial dysplasia.
• To examine extent of large lesions
• To evaluate tempero-mandibular joint dysfunctions and ankylosis.
• To evaluate trauma, periodontal bone loss and periapical involvement.
• Assessment for the placement of dental implants.
CONE BEAM COMPUTED
TOMOGRAPHY
• The introduction of cone-beam computed tomography (CBCT) for
views of the face and jaws in the early 21st century has resulted in
the dosage being reduced and the resolution significantly
improved, with its adaption and refinement for imaging of the teeth
and jaws now providing a useful three-dimensional diagnostic tool.
ORTHODONTIC APPLICATIONS OF CONE
BEAM COMPUTED TOMOGRAPHY
The ability to view structures from all three planes of space without any
superimposition and geometric distortions is the key advantage of CBCT
over conventional images. Synthetic cephalometric and panoramic
images also can be produced.
CEPHALOMETRICS
• Two types of cephalograms
Lateral
FRONTAL
LANDMARKS
PLANES
Frontal cephalograms
landmarks
COMPUTER AIDED SURGERY
• Computer-aided surgery (CAS) is now being introduced that will allow
surgical planning and simulation using the information captured from
CBCT. This technology offers a number of potential exciting possibilities:
HAND WRIST RADIOGRAPH
CERVICAL VERTEBRAE
MATURATION
REFERNCES
• White and Pharoah’s oral radiology : Principles and interpretation,8th Ed
• Panoromic Radiology: Seminars on Maxillofacial Imaging and
Interpretation 1st Ed
• Oral Radiology :Principles and Interpretation 7th Ed
