12- Dental radiography.pdf

Radiographic Anatomy and Technique Ⅱ .221 AMRR ■ ■ ■ Dr. Elbagir Hamza Manssor, Ph.D. Assistance Professor Dr. Dalia M Ali Bilal, Ph.D. Assistance Professor Dr. Ikhlass Abd Alazeez , Ph.D. Associate professor Applied Radiologic Technology department College of Applied Medical Sciences University o...

Radiographic Anatomy and Technique Ⅱ .221 AMRR ■ ■ ■ Dr. Elbagir Hamza Manssor, Ph.D. Assistance Professor Dr. Dalia M Ali Bilal, Ph.D. Assistance Professor Dr. Ikhlass Abd Alazeez , Ph.D. Associate professor Applied Radiologic Technology department College of Applied Medical Sciences University of Jeddah. Educational Objectives By the end of this lecture you should be able to ■ Describe dental anatomy and dental formula. ■ Explain and demonstrate various types of dental techniques and indications. ■ Describe various types of dental films and various exposure techniques. ■ Dental radiography Indications for dental radiography: 1. Detection of pathology associated with teeth & supporting structures . 2. Detection of anomalies /injuries of maxilla , mandible & adjacent facial structures . 3. Determine the presence /absence of teeth & localize unerupted teeth. 4. Measures the length of the roots of teeth before orthodentic treatment & monitor the progress of the treatment . 5. Enable a preoperative assessment of skeletal & soft tissue patterns before orthodentic surgery. :‫مؤشرات التصوير الشعاعي لألسنان‬ .‫الكشف عن علم األمراض املرتبط باألسنان والهياكل الداعمة‬ .‫ إصابات الفك العلوي والفك السفلي وهياكل الوجه املجاورة‬/ ‫الكشف عن الحاالت الشاذة‬ .‫ غياب األسنان وتوطني األسنان غير املنقطعة‬/ ‫حدد وجود‬ . .‫يقيس طول جذور األسنان قبل عالج تقويم األسنان ومراقبة تقدم العالج‬ .‫تمكني التقييم قبل الجراحة ألنماط الهيكل العظمي واألنسجة الرخوة قبل جراحة تقويم العظام‬ Bite wing: lateral view, demonstrates the crowns .of the teeth . Periapical: lateral view , demonstrates the crown & root of tooth & the surrounding bone . Occlusal: comprises a number of views in which film positioned in Occlusal plane . panoramic : Projection produces an image of both jaws. lateral: oblique Demonstrate large areas of maxilla & mandible . cephalometry: Demonstrates the facial bones for use in implant treatment. . .‫ ﯾﻮﺿﺢ ﺗﯿﺠﺎن اﻷﺳﻨﺎن‬،‫ ﻣﻨﻈﺮ ﺟﺎﻧﺒﻲ‬:‫ﺟﻨﺎح اﻟﻌﻀﺔ‬ .‫ ﯾﻮﺿﺢ ﺗﺎج وﺟﺬر اﻟﺴﻦ واﻟﻌﻈﺎم اﻟﻤﺤﯿﻄﺔ‬،‫ ﻣﻨﻈﺮ ﺟﺎﻧﺒﻲ‬:‫ﺑﯿﺮﯾﺎﺑﯿﻜﺎل‬ .‫ ﯾﻀﻢ ﻋﺪدا ﻣﻦ اﻟﻤﺸﺎھﺪات اﻟﺘﻲ ﺗﻢ وﺿﻊ اﻟﻔﯿﻠﻢ ﻓﯿﮭﺎ ﻓﻲ ﻣﺴﺘﻮى اﻹطﺒﺎق‬:‫اﻹطﺒﺎق‬ .‫ ﯾﻨﺘﺞ اﻹﺳﻘﺎط ﺻﻮرة ﻟﻜﻼ اﻟﻔﻜﯿﻦ‬:‫ﺑﺎﻧﻮراﻣﻲ‬ .‫ ﻣﺎﺋﻞ أظﮭﺮ ﻣﺴﺎﺣﺎت ﻛﺒﯿﺮة ﻣﻦ اﻟﻔﻚ اﻟﻌﻠﻮي واﻟﻔﻚ اﻟﺴﻔﻠﻲ‬:‫ﺟﺎﻧﺒﻲ‬ .‫ ﯾﻮﺿﺢ ﻋﻈﺎم اﻟﻮﺟﮫ ﻻﺳﺘﺨﺪاﻣﮭﺎ ﻓﻲ ﻋﻼج اﻟﺰرع‬:‫ﻗﯿﺎس اﻟﺮأس‬ Primary teeth( deciduous ) : ■ 20 teeth. ■ 5 in each side . ■ Replaced from 6 years by the permanent . ■ There are central incisor , lateral incisor , canine , first & second deciduous molar in each side. Permanent teeth : ■ 32 teeth. ■ 8 in each side . ■ Some teeth may fail to erupt , commonly affecting the third permanent molars( wisdom teeth). ■ There are central incisor , lateral incisor ,canine , first & second premolar , first , second & third molar in each side . :(‫اﻷﺳﻨﺎن اﻷوﻟﯿﺔ )اﻻﻧﻔﻀﯿﺔ‬ .‫ ﺳﻨﺎ‬20 .‫ ﻓﻲ ﻛﻞ ﺟﺎﻧﺐ‬5 .‫ ﺳﻨﻮات ﺑﺎﻟﺪاﺋﻢ‬6 ‫ﺗﻢ اﺳﺘﺒﺪاﻟﮫ ﻣﻦ‬ ‫ اﻟﻀﺮس اﻟﻨﻔﻀﻲ اﻷول‬،‫ ﻛﻼب‬،‫ ﺿﺎطﻊ ﺟﺎﻧﺒﯿﺔ‬،‫ھﻨﺎك ﻗﻮاطﻊ ﻣﺮﻛﺰﯾﺔ‬ .‫واﻟﺜﺎﻧﻲ ﻓﻲ ﻛﻞ ﺟﺎﻧﺐ‬ :‫اﻷﺳﻨﺎن اﻟﺪاﺋﻤﺔ‬ .‫ ﺳﻨﺎ‬32 .‫ ﻓﻲ ﻛﻞ ﺟﺎﻧﺐ‬8 ‫ ﻣﻤﺎ ﯾﺆﺛﺮ ﻋﺎدة ﻋﻠﻰ اﻷﺿﺮاس‬،‫ﻗﺪ ﺗﻔﺸﻞ ﺑﻌﺾ اﻷﺳﻨﺎن ﻓﻲ اﻻﻧﻔﺠﺎر‬ .(‫اﻟﺪاﺋﻤﺔ اﻟﺜﺎﻟﺜﺔ )أﺳﻨﺎن اﻟﻌﻘﻞ‬ ‫ ﺿﺮس‬،‫ ﺿﺮس أول وﺛﺎﻧﻲ‬،‫ ﻛﻼب‬،‫ ﻗﻦ ﺟﺎﻧﺒﯿﺔ‬،‫ھﻨﺎك ﻗﻮاطﻊ ﻣﺮﻛﺰﯾﺔ‬ .‫ ﺛﺎﻧﻲ وﺛﺎﻟﺚ ﻓﻲ ﻛﻞ ﺟﺎﻧﺐ‬،‫أول‬ Tooth consists of: ■ hard , mineralized tissues ■ with a central area , pulp chamber and canal consisting of blood vessels and nerves ■ supported by loose connective tissue. The part above gingiva (gum) is the crown , portion embedded within the jaw is the root . Between the crown & root known as cervical region . :‫ﯾﺘﻜﻮن اﻷﺳﻨﺎن ﻣﻦ‬ ‫اﻷﻧﺴﺠﺔ اﻟﺼﻠﺒﺔ واﻟﻤﻤﻌﺪﻧﺔ‬ ‫ﻣﻊ ﻣﻨﻄﻘﺔ ﻣﺮﻛﺰﯾﺔ وﻏﺮﻓﺔ ﻟﺐ وﻗﻨﺎة ﺗﺘﻜﻮن ﻣﻦ اﻷوﻋﯿﺔ اﻟﺪﻣﻮﯾﺔ واﻷﻋﺼﺎب‬ .‫ﻣﺪﻋﻮم ﺑﺎﻷﻧﺴﺠﺔ اﻟﻀﺎﻣﺔ اﻟﻔﻀﻔﺎﺿﺔ‬ .‫ واﻟﺠﺰء اﻟﻤﻀﻤﻦ داﺧﻞ اﻟﻔﻚ ھﻮ اﻟﺠﺬر‬،‫اﻟﺠﺰء اﻟﻤﻮﺟﻮد ﻓﻮق اﻟﻠﺜﺔ )اﻟﻌﻠﻜﺔ( ھﻮ اﻟﺘﺎج‬ .‫ﺑﯿﻦ اﻟﺘﺎج واﻟﺠﺬر اﻟﻤﻌﺮوف ﺑﺎﺳﻢ ﻣﻨﻄﻘﺔ ﻋﻨﻖ اﻟﺮﺣﻢ‬ Dental formula : Palmer notation : For deciduous teeth: 5 in each quarter , assigned by the letters from A to E , from central deciduous incisor to the second deciduous molar respectively . For the permanent teeth : 8 in each quarter , assigned by the numbers from 1 to 8 , from the central incisor to the third permanent molar respectively . Examples : C upper right deciduous canine 78 - lower left second & third molars Occlusal planes : Plane passes through the biting surfaces of the teeth . Upper occlusal : Lies 4 cm bellow & parallel to a line joining the tragus of the ear to the ala of the nose . Lower occlusal : Lies 2 cm below & parallel to a line joining the tragus of the ear to angle of the mouth with mouth open . .‫ ﺗﻤﺮ اﻟﻄﺎﺋﺮة ﻋﺒﺮ اﻷﺳﻄﺢ اﻟﻌﻀﯿﺔ ﻟﻸﺳﻨﺎن‬:‫اﻟﻄﺎﺋﺮات اﻹطﺒﺎﻗﯿﺔ‬ .‫ ﻣﻦ اﻷﻧﻒ‬ala ‫ وﺑﺎﻟﺘﻮازي ﻣﻊ ﺧﻂ ﯾﺮﺑﻂ ﻋﺒﺮ اﻷذن إﻟﻰ‬ow‫ ﺳﻢ ﻣﻦ‬4 ‫ ﯾﻘﻊ ﻋﻠﻰ ﺑﻌﺪ‬:‫اﻹطﺒﺎق اﻟﻌﻠﻮي‬ .‫ ﺳﻢ أدﻧﺎه وﺑﺎﻟﺘﻮازي ﻣﻊ ﺧﻂ ﯾﺮﺑﻂ ﻋﺒﺮ اﻷذن إﻟﻰ زاوﯾﺔ اﻟﻔﻢ ﻣﻊ ﻓﺘﺢ اﻟﻔﻢ‬2 ‫ ﯾﻘﻊ ﻋﻠﻰ ﺑﻌﺪ‬:‫اﻹطﺒﺎق اﻟﺴﻔﻠﻲ‬ Equipment for intra–oral dental radiography : ■ 60-70 Kvp . ■ 1.5 aluminum filter . ■ Beam diameter at patient's skin surface not more than 20 mm. ■ Intra-oral film is non screen film ,extra-oral is screen film . :‫ﻣﻌﺪات اﻟﺘﺼﻮﯾﺮ اﻟﺸﻌﺎﻋﻲ ﻟﻸﺳﻨﺎن داﺧﻞ اﻟﻔﻢ‬ .‫ ﻛﯿﻠﻮ ﻓﻮﻟﺖ ﻓﻲ ﺑﻲ‬70-60 .‫ ﻓﻠﺘﺮ أﻟﻮﻣﻨﯿﻮم‬1.5 .‫ ﻣﻢ‬20 ‫ﻗﻄﺮ اﻟﺸﻌﺎع ﻋﻠﻰ ﺳﻄﺢ ﺟﻠﺪ اﻟﻤﺮﯾﺾ ﻻ ﯾﺰﯾﺪ ﻋﻦ‬ .‫ ﺧﺎرج اﻟﻔﻢ ھﻮ ﻓﯿﻠﻢ اﻟﺸﺎﺷﺔ‬،‫اﻟﻔﯿﻠﻢ داﺧﻞ اﻟﻔﻢ ھﻮ ﻓﯿﻠﻢ ﻏﯿﺮ ﺷﺎﺷﺔ‬ Film identification : dot at the crown surface of the teeth , For the upper teeth crown facing downward , for lower it is facing upward . :‫ﺗﺤﺪﯾﺪ اﻟﻔﯿﻠﻢ‬ ،‫ﻧﻘﻄﺔ ﻋﻠﻰ ﺳﻄﺢ ﺗﺎج اﻷﺳﻨﺎن‬ .‫ وﻟﻸﺳﻔﻞ ﯾﻮاﺟﮫ ﻷﻋﻠﻰ‬،‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﺘﺎج اﻷﺳﻨﺎن اﻟﻌﻠﻮي اﻟﻤﻮاﺟﮫ ﻟﻸﺳﻔﻞ‬ Film should be parallel to the teeth to avoid distortion . Bite wing : ■ Intra -oral film packet with tab attached for the patient to bite on. ■ Patient head must be supported adequately , with medial plane vertical and occlusal plane horizontal . ■ Film place in the lingual sulcus . ■ Correct tube angulation is needed . CR & CP: .‫ﯾﺠﺐ أن ﯾﻜﻮن اﻟﻔﯿﻠﻢ ﻣﻮازﯾﺎ ﻟﻸﺳﻨﺎن ﻟﺘﺠﻨﺐ اﻟﺘﺸﻮﯾﮫ‬ :‫ﺟﻨﺎح اﻟﻌﻀﺔ‬ .‫ﺣﺰﻣﺔ أﻓﻼم داﺧﻞ اﻟﻔﻢ ﻣﻊ ﻋﻼﻣﺔ ﺗﺒﻮﯾﺐ ﻣﺮﻓﻘﺔ ﻟﻠﻤﺮﯾﺾ ﻟﯿﻌﻀﮭﺎ‬ ‫ ﻣﻊ اﻟﻤﺴﺘﻮى اﻹﻧﺴﻲ اﻟﺮأﺳﻲ‬،‫ﯾﺠﺐ دﻋﻢ رأس اﻟﻤﺮﯾﺾ ﺑﺸﻜﻞ ﻛﺎف‬ .‫واﻟﻤﺴﺘﻮى اﻹطﺒﺎﻗﻲ اﻷﻓﻘﻲ‬ .‫ﻣﻜﺎن اﻟﻔﯿﻠﻢ ﻓﻲ اﻟﺘﻠﻢ اﻟﻠﻐﻮي‬ ■ .‫ھﻨﺎك ﺣﺎﺟﺔ إﻟﻰ ذﺑﺤﺔ اﻷﻧﺒﻮب اﻟﺼﺤﯿﺤﺔ‬ :CP‫ و‬CR Periapical radiography : Film is stabilize by patient's finger. For the incisors and canine long axis of the film is placed vertically, for premolar and molar long axis is horizontal . ■ Patient head must be supported adequately , with medial plane vertical and occlusal plane horizontal ( upper occlusal for the upper teeth , the lower occlusal for the lower). Insure examined teeth in the center of the film . Instruct patient to gently support the film using index or thumb. Direction & centering of x-ray beam: For upper teeth tube angulation :Periapical ‫اﻟﺘﺼﻮﯾﺮ اﻟﺸﻌﺎﻋﻲ‬ .‫ﯾﺘﻢ ﺗﺜﺒﯿﺖ اﻟﻔﯿﻠﻢ ﺑﺈﺻﺒﻊ اﻟﻤﺮﯾﺾ‬ ‫ ﻷن اﻟﻤﺤﻮر‬،‫ ﯾﺘﻢ وﺿﻊ اﻟﻤﺤﻮر اﻟﻄﻮﯾﻞ ﻟﻠﻔﯿﻠﻢ ﻋﻤﻮدﯾﺎ‬،‫ﺑﺎﻟﻨﺴﺒﺔ ﻟﻠﺤﺎطﻊ واﻟﻜﻨﯿﺐ‬ .‫اﻟﻄﻮﯾﻞ ﻗﺒﻞ اﻟﻀﺮس واﻟﻤﻮﻟﻲ أﻓﻘﻲ‬ ‫ ﻣﻊ اﻟﻤﺴﺘﻮى اﻹﻧﺴﻲ اﻟﺮأﺳﻲ وﻣﺴﺘﻮى اﻹطﺒﺎق‬،‫ﯾﺠﺐ دﻋﻢ رأس اﻟﻤﺮﯾﺾ ﺑﺸﻜﻞ ﻛﺎف‬ .(‫ واﻻﻧﺴﺪاد اﻟﺴﻔﻠﻲ ﻟﻸﺳﻨﺎن اﻟﺴﻔﻠﯿﺔ‬،‫اﻷﻓﻘﻲ )اﻻﻧﺴﺪاد اﻟﻌﻠﻮي ﻟﻸﺳﻨﺎن اﻟﻌﻠﻮﯾﺔ‬ .‫ﺗﺄﻛﺪ ﻣﻦ ﻓﺤﺺ اﻷﺳﻨﺎن ﻓﻲ وﺳﻂ اﻟﻔﯿﻠﻢ‬ .‫اطﻠﺐ ﻣﻦ اﻟﻤﺮﯾﺾ دﻋﻢ اﻟﻔﯿﻠﻢ ﺑﻠﻄﻒ ﺑﺎﺳﺘﺨﺪام اﻟﻔﮭﺮس أو اﻹﺑﮭﺎم‬ :‫اﺗﺠﺎه وﺗﻮﺳﯿﻂ ﺷﻌﺎع اﻷﺷﻌﺔ اﻟﺴﯿﻨﯿﺔ‬ For lower teeth tube angulation incisor 60 incisor 20-30 canine 50 canine 20 premolar 40 premolar 10 molar 30 molar 0 ■ More angulation : foreshortened image & vice versa . .‫ ﺻﻮرة ﻗﺼﯿﺮة واﻟﻌﻜﺲ ﺻﺤﯿﺢ‬:‫■ اﻟﻤﺰﯾﺪ ﻣﻦ اﻟﺰواﯾﺎ‬ Occlusal : Necessary for full examination of the dental arches . Upper occlusal (maxillary): Patient head must be supported adequately , with medial plane vertical and occlusal plane horizontal ( upper occlusal). Film is positioned in patient's mouth far back to include the molars, with tube side facing upwards . Patient bite gently. Direction and centering of the beam : Along the median sagittal plane centered downwards( caudally) through the long axis of the upper central incisors . .‫ ﺿﺮوري ﻟﻠﻔﺤﺺ اﻟﻜﺎﻣﻞ ﻷﻗﻮاس اﻷﺳﻨﺎن‬:‫اﻹطﺒﺎق‬ :(‫اﻹطﺒﺎق اﻟﻌﻠﻮي )اﻟﻔﻚ اﻟﻌﻠﻮي‬ ‫ ﻣﻊ اﻟﻤﺴﺘﻮى اﻹﻧﺴﻲ اﻟﺮأﺳﻲ‬،‫ﯾﺠﺐ دﻋﻢ رأس اﻟﻤﺮﯾﺾ ﺑﺸﻜﻞ ﻛﺎف‬ .(‫وﻣﺴﺘﻮى اﻹطﺒﺎق اﻷﻓﻘﻲ )اﻹطﺒﺎق اﻟﻌﻠﻮي‬ ‫ ﻣﻊ‬،‫ﯾﺘﻢ وﺿﻊ اﻟﻔﯿﻠﻢ ﻓﻲ ﻓﻢ اﻟﻤﺮﯾﺾ ﺑﻌﯿﺪا ﻟﯿﺸﻤﻞ اﻷﺿﺮاس‬ .‫ﻣﻮاﺟﮭﺔ ﺟﺎﻧﺐ اﻷﻧﺒﻮب ﻷﻋﻠﻰ‬ .‫ﯾﻌﺾ اﻟﻤﺮﯾﺾ ﺑﻠﻄﻒ‬ :‫اﺗﺠﺎه وﺗﻮﺳﯿﻂ اﻟﺤﺰﻣﺔ‬ ‫ﻋﻠﻰ طﻮل اﻟﻤﺴﺘﻮى اﻟﺴﮭﻤﻲ اﻟﻤﺘﻮﺳﻂ اﻟﻤﺘﻤﺮﻛﺰ ﻷﺳﻔﻞ )ذﯾﻠﯿﺎ( ﻣﻦ‬ .‫ﺧﻼل اﻟﻤﺤﻮر اﻟﻄﻮﯾﻞ ﻟﻠﻘﺴﻢ اﻟﻤﺮﻛﺰﯾﺔ اﻟﻌﻠﯿﺎ‬ ■ Lower occlusal ( mandibular ): Patient head must be supported adequately , with medial plane vertical and occlusal plane horizontal ( lower occlusal). Film is positioned in patient's mouth far back to include the molars, with tube side facing downwards . Patient bite gently. Direction and centering of the beam : Along the median sagittal plane centered upwards( cranially) through the line joining the first premolars ‫ ﯾﺠﺐ دﻋﻢ رأس اﻟﻤﺮﯾﺾ‬:(‫■ اﻹطﺒﺎق اﻟﺴﻔﻠﻲ )اﻟﻔﻚ اﻟﺴﻔﻠﻲ‬ ‫ ﻣﻊ اﻟﻤﺴﺘﻮى اﻹﻧﺴﻲ اﻟﺮأﺳﻲ وﻣﺴﺘﻮى اﻹطﺒﺎق‬،‫ﺑﺸﻜﻞ ﻛﺎف‬ .(‫اﻷﻓﻘﻲ )اﻹطﺒﺎق اﻟﺴﻔﻠﻲ‬ ‫ ﻣﻊ‬،‫■ ﯾﺘﻢ وﺿﻊ اﻟﻔﯿﻠﻢ ﻓﻲ ﻓﻢ اﻟﻤﺮﯾﺾ ﺑﻌﯿﺪا ﻟﯿﺸﻤﻞ اﻷﺿﺮاس‬ .‫ﻣﻮاﺟﮭﺔ ﺟﺎﻧﺐ اﻷﻧﺒﻮب ﻷﺳﻔﻞ‬ .‫■ ﯾﻌﺾ اﻟﻤﺮﯾﺾ ﺑﻠﻄﻒ‬ :‫■ اﺗﺠﺎه وﺗﻮﺳﯿﻂ اﻟﺤﺰﻣﺔ‬ ‫■ ﻋﻠﻰ طﻮل اﻟﻤﺴﺘﻮى اﻟﺴﮭﻤﻲ اﻟﻤﺘﻮﺳﻂ اﻟﻤﺘﻤﺮﻛﺰ ﻷﻋﻠﻰ )ﺑﺸﻜﻞ‬ ‫ﺣﺮﻛﻲ( ﻣﻦ ﺧﻼل اﻟﺨﻂ اﻟﺬي ﯾﻨﻀﻢ إﻟﻰ اﻟﻀﻮاﺣﻚ اﻷوﻟﻰ‬ Extra-oral technique : Lateral oblique : 13x18 cm cassette . As the lateral projection of mandible . center of the film is 5cm bellow the angle of the mandible remote from the film . Central ray is angled 30 cranially directed 5cm bellow the angle of the mandible remote from the film . ■ :‫■ ﺗﻘﻨﯿﺔ ﺧﺎرج اﻟﻔﻢ‬ :‫■ ﻣﺎﺋﻞ ﺟﺎﻧﺒﻲ‬ .‫ ﺳﻢ‬18 × 13 ‫■ ﺷﺮﯾﻂ ﻛﺎﺳﯿﺖ ﻣﻘﺎس‬ .‫■ ﻛﺈﺳﻘﺎط ﺟﺎﻧﺒﻲ ﻟﻠﻔﻚ اﻟﺴﻔﻠﻲ‬ .‫ ﺳﻢ أدﻧﺎه زاوﯾﺔ ﺟﮭﺎز اﻟﺘﺤﻜﻢ ﻋﻦ ﺑﻌﺪ اﻟﻔﻚ اﻟﺴﻔﻠﻲ ﻣﻦ اﻟﻔﯿﻠﻢ‬5 ‫■ ﻣﺮﻛﺰ اﻟﻔﯿﻠﻢ ھﻮ‬ .‫ ﺳﻢ أدﻧﺎه زاوﯾﺔ ﺟﮭﺎز اﻟﺘﺤﻜﻢ ﻋﻦ ﺑﻌﺪ اﻟﻔﻚ اﻟﺴﻔﻠﻲ ﻣﻦ اﻟﻔﯿﻠﻢ‬5 ‫ ﻣﻮﺟﮭﺔ ﺑﺸﻜﻞ ﻣﺘﺤﻒ‬30 ‫■ اﻟﺸﻌﺎع اﻟﻤﺮﻛﺰي ﺑﺰاوﯾﺔ‬ Ortho-pan-tomography (OPG) Contraindication for (OPG): ■ ■ Patient suffering from involuntary movement . Children unable to remain motionless for exposure time . :(OPG) ‫ﻣﻮاﻧﻊ اﻻﺳﺘﻌﻤﺎل ل‬ .‫اﻟﻤﺮﯾﺾ اﻟﺬي ﯾﻌﺎﻧﻲ ﻣﻦ اﻟﺤﺮﻛﺔ اﻟﻼإرادﯾﺔ‬ .‫اﻷطﻔﺎل ﻏﯿﺮ ﻗﺎدرﯾﻦ ﻋﻠﻰ اﻟﺒﻘﺎء ﺑﻼ ﺣﺮاك ﻟﻮﻗﺖ اﻟﺘﻌﺮض‬ Principle of panoramic image formation : The movement of x-ray tube & film equal but opposite in direction . .‫ ﺣﺮﻛﺔ أﻧﺒﻮب اﻷﺷﻌﺔ اﻟﺴﯿﻨﯿﺔ واﻟﻔﯿﻠﻢ ﻣﺘﺴﺎوﯾﺔ وﻟﻜﻨﮭﺎ ﻣﻌﺎﻛﺴﺔ ﻓﻲ اﻻﺗﺠﺎه‬:‫ﻣﺒﺪأ ﺗﻜﻮﯾﻦ اﻟﺼﻮرة اﻟﺒﺎﻧﻮراﻣﯿﺔ‬ Patient remove all opaque materials from head & neck . Patient stand or sit , exposure time (12 to 20 sec ). .‫ﯾﺰﯾﻞ اﻟﻤﺮﯾﺾ ﺟﻤﯿﻊ اﻟﻤﻮاد اﻟﻤﻌﺘﻤﺔ ﻣﻦ اﻟﺮأس واﻟﺮﻗﺒﺔ‬ .(‫ ﺛﺎﻧﯿﺔ‬20 ‫ إﻟﻰ‬12) ‫ وﻗﺖ اﻟﺘﻌﺮض‬،‫وﻗﻮف اﻟﻤﺮﯾﺾ أو اﻟﺠﻠﻮس‬ Position of patient & film : 15x30cm film insert to cassette carrier . Ask patient to walk straight into the machine , gripping the handle , ask him adopt upright then head lowered down towards the floor . Turn on the positioning lights: Sagittal plane light should be down the middle of the face . AP light centered distal to upper lateral incisor . :‫ﻣﻮﻗﻒ اﻟﻤﺮﯾﺾ واﻟﻔﯿﻠﻢ‬ .‫ ﺳﻢ إﻟﻰ ﺣﺎﻣﻞ اﻟﻜﺎﺳﯿﺖ‬30 × 15 ‫إدراج ﻓﯿﻠﻢ‬ ‫ واطﻠﺐ ﻣﻨﮫ‬،‫ وإﻣﺴﺎك اﻟﻤﻘﺒﺾ‬،‫اطﻠﺐ ﻣﻦ اﻟﻤﺮﯾﺾ اﻟﺴﯿﺮ ﻣﺒﺎﺷﺮة إﻟﻰ اﻟﻤﺎﻛﯿﻨﺔ‬ .‫اﻟﺘﺒﻨﻲ ﻣﻨﺘﺼﺒﺎ ﺛﻢ اﺗﺠﮫ ﻷﺳﻔﻞ ﻧﺤﻮ اﻷرض‬ :‫ﻗﻢ ﺑﺘﺸﻐﯿﻞ أﺿﻮاء ﺗﺤﺪﯾﺪ اﻟﻤﻮاﻗﻊ‬ .‫ﯾﺠﺐ أن ﯾﻜﻮن ﺿﻮء اﻟﻄﺎﺋﺮة اﻟﺴﮭﻤﯿﺔ أﺳﻔﻞ ﻣﻨﺘﺼﻒ اﻟﻮﺟﮫ‬ .‫ اﻟﺒﻌﯿﺪ إﻟﻰ اﻟﻘﺎطﻊ اﻟﺠﺎﻧﺒﯿﺔ اﻟﻌﻠﯿﺎ‬AP ‫ﻣﺤﻮر ﺿﻮء‬ Ask patient to bite into bite block groove . Patient chin on chin rest . Check film with patient mandible . Ask patient to stay still for about 20 sec and make the exposure .‫اطﻠﺐ ﻣﻦ اﻟﻤﺮﯾﺾ أن ﯾﻌﺾ ﻓﻲ أﺧﺪود ﻛﺘﻠﺔ اﻟﻌﺾ‬ .‫ذﻗﻦ اﻟﻤﺮﯾﺾ ﻋﻠﻰ راﺣﺔ اﻟﺬﻗﻦ‬ ‫ﺗﺤﻘﻖ ﻣﻦ اﻟﻔﯿﻠﻢ ﻣﻊ اﻟﻤﺮﯾﺾ اﻟﻔﻚ اﻟﺴﻔﻠﻲ‬ .‫ ﺛﺎﻧﯿﺔ ﺗﻘﺮﯾﺒﺎ واﻟﺘﻌﺮض‬20 ‫اطﻠﺐ ﻣﻦ اﻟﻤﺮﯾﺾ اﻟﺒﻘﺎء ﺳﺎﻛﻨﺎ ﻟﻤﺪة‬ Cephalometry : Use for orthodentic treatment , surgery and assessment of dento -facial abnormalities ■ Projection taken : Lateral & PA . ■ Cephalometric attachment to panoramic unit .‫ ﯾﺴﺘﺨﺪم ﻟﻌﻼج ﺗﻘﻮﯾﻢ اﻷﺳﻨﺎن واﻟﺠﺮاﺣﺔ وﺗﻘﯿﯿﻢ ﺗﺸﻮھﺎت اﻷﺳﻨﺎن واﻟﻮﺟﮫ‬:‫■ ﻗﯿﺎس اﻟﺮأس‬ .PA‫ ﺟﺎﻧﺒﻲ و‬:‫■ اﻹﺳﻘﺎط اﻟﻤﺄﺧﻮذ‬ Lateral : Patient stand ,mid sagittal plane parallel to the film. ear pieces place carefully to external auditory meati. ■ Nose support is positioned against the nasion .patient is instructed to close the mouth Centered to the external auditory meati . :‫■ ﺟﺎﻧﺒﻲ‬ .‫ ﺗﻀﻊ ﻗﻄﻊ اﻷذن ﺑﻌﻨﺎﯾﺔ إﻟﻰ ﻣﯿﺘﻲ اﻟﺴﻤﻊ اﻟﺨﺎرﺟﻲ‬.‫ وﺳﻂ ﻣﺴﺘﻮى اﻟﺴﮭﻤﻲ اﻟﻤﻮازي ﻟﻠﻔﯿﻠﻢ‬،‫■ ﻣﻮﻗﻒ اﻟﻤﺮﯾﺾ‬ ‫ ﯾﺘﻢ ﺗﻮﺟﯿﮫ اﻟﻤﺮﯾﺾ ﻹﻏﻼق اﻟﻔﻢ‬.‫■ ﯾﺘﻢ وﺿﻊ دﻋﻢ اﻷﻧﻒ ﺿﺪ اﻷﻧﻒ‬ .‫■ ﺗﺘﻤﺤﻮر إﻟﻰ اﻟﻤﯿﺘﻲ اﻟﺴﻤﻌﻲ اﻟﺨﺎرﺟﻲ‬ PA: Equipment rotated 90 degrees , patient set up for PA projection with OM line parallel to the floor . Ear pieces insert to external auditory meati. Centered through the cervical spine to the level of rami of the mandible. :PA .‫ ﻣﻮاز ﻟﻸرﺿﯿﺔ‬OM ‫ ﺗﻢ إﻋﺪاد اﻟﻤﺮﯾﺾ ﻹﺳﻘﺎط اﻟﺴﻠﻄﺔ اﻟﻔﻠﺴﻄﯿﻨﯿﺔ ﻣﻊ ﺧﻂ‬،‫ درﺟﺔ‬90 ‫ﺗﺪور اﻟﻤﻌﺪات‬ .‫ﺗﻀﺎف ﻗﻄﻊ اﻷذن إﻟﻰ ﻣﯿﺘﻲ اﻟﺴﻤﻌﻲ اﻟﺨﺎرﺟﻲ‬ .‫ﺗﺘﻤﺤﻮر ﻣﻦ ﺧﻼل اﻟﻌﻤﻮد اﻟﻔﻘﺮي اﻟﻌﻨﻘﻲ إﻟﻰ ﻣﺴﺘﻮى راﻣﻲ اﻟﻔﻚ اﻟﺴﻔﻠﻲ‬