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  • Vertical Angulation: Why are the incisal edges/cusp tips not captured on the anterior & posterior periapical images?

Intraoral Imaging Techniques: Beyond the Textbook

Course Number: 660

Vertical Angulation: Why are the incisal edges/cusp tips not captured on the anterior & posterior periapical images?

Maxillary Anterior Periapical: For an ideal image, place the sensor parallel with the long axis of the teeth, best identified by looking at the patient from the side (Figure 15). Realize that the sensor holder can take many positions against the incisal edges, moving the sensor away from parallelism. In the case of a shallow palate or maxillary torus, the sensor’s position is often altered, the aiming ring will have increased vertical angulation, and should not be followed. Figure 16 shows the effects of small changes of the position of the bitepiece and the loss of parallelism of sensor and teeth.

ce660 - Fig 15

Figure 15 - Maxillary anteroir periapical.
Ideal image (B) results when the sensor parallels the long axis of the teeth (A).

ce660 - Fig 16

Figure 16 - Maxillary anterior periapical.
Sensor is not paralleling the long axis, the vertical angulation is excessive, and the incisal edges are cut off of the image.

Maxillary Posterior Periapical: For an ideal image, the sensor should be placed parallel with the long axis of the teeth, which is best identified by looking at the patient from the front (Figure 17). In much the same way, a shallow palate or maxillary torus will push the sensor away and increase the vertical angulation. The crown of a tooth is often ‘cut off’ the image (Figure 18).

ce660 - Fig 17

Figure 17 - Maxillary posterior periapical.
(B) Ideal image results when the sensor parallels the long axis of the teeth (A).

ce660 - Fig 18

Figure 18 - Maxillary posterior periapical.
(A) Sensor is not paralleling the long axis, the vertical angulation is excessive, and the crowns are cut off of the image (B).