Why some check up x-rays need to be retaken?

Most dental radiographs are take with the assistance of a XCP holder and if placed in the mouth incorrectly the Over angulation of the x-ray tube in relation to a patients tooth can create distortion of the image.  If the assistant or the hygienist positions the x-ray head with too much vertical angulation, the resulting bitewing radiographs are not terribly diagnostic for reading interproximal decay.

When the bottom of patients nose is parallel to the ground, the angle of the cone should be no more than a positive 10 degrees. If it is 20-30 degrees it can result in radiographs displaying excess cervical burnout and can suggest decay where there is none or not show decay where it is present. If the position of the x ray holder is showing a higher angulation than 10 degrees it probably should be repositioned.

I have seen this be true numerous times in my own dental practice because when I suggest retakes, I usually take the new bitewing myself and sometimes my picture looks vastly different than the one I rejected.

Also the mesial/distal angulation has to be parallel to the contact of the tooth in question so that the bitewing displays no overlap of the proximal surfaces. If the contacts are overlapped, I will take another radiograph myself.

Another common problem is that patients find the position of the holder is place uncomfortable and open their mouths slightly.  Sometimes they can also push it more forward. This causes the radiograph to not show the desired teeth. Some patients just can't tolerate the XCP holder and we have a second less bulky holder that the patient holds themselves that sometimes works better in these situations.




from Ask Dr. Spindel - http://lspindelnycdds.blogspot.com/2018/03/why-some-check-up-x-rays-need-to-be.html - http://lspindelnycdds.blogspot.com/

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