WS/T 608-2018Basic operation of oral and maxillofacial conventional X-ray practices (English PDF)

5.1 Apex X-ray photography

5.1.1 Preparation before photography

Pre-photography preparation includes the following steps.

a) Check the X-ray examination application form, understand the condition, and clarify the purpose of the examination and the location of the photograph;

b) patients take off glasses, earrings and other accessories in the field of view and obstruction items such as removable partial dentures;

c) wearing a thyroid lead collar for the patient;

d) select an appropriate image receiver according to the inspection site and purpose;

e) Select appropriate exposure parameters based on the site of examination, patient age, tissue thickness, etc.

5.1.2 Indications

Mainly used for rickets, pulp calcification, intra-abdominal absorption, periapical lesions, abnormal tooth development, periodontitis, dental trauma, root fracture, repair Reconstruction, implants and certain systemic diseases involve examination of alveolar bone.

5.1.3 Contraindications

There are no special contraindications, but patients with severe openness, severe craniocerebral injury, and serious systemic diseases or other serious conditions cannot cooperate.

It is not suitable for shooting.

5.1.4 Operating procedures and methods

5.1.4.1 Patient position

The patient is seated and the sagittal plane is perpendicular to the ground. When casting the maxillary posterior teeth, the nasal otoscope line should be parallel to the ground. When casting the maxillary anterior teeth, the upper lip of the front teeth should be perpendicular to the ground. When the mandibular posterior teeth are cast, the listening line should be parallel to the ground. When the mandibular anterior teeth are cast, the head is tilted back and down.

The lip of the anterior teeth should be perpendicular to the ground.

5.1.4.2 Divided line projection

5.1.4.2.1 Technical requirements for angular projection

The X-ray centerline is perpendicular to the angle bisector of the angle between the long axis of the inspected tooth and the image receiver. X-ray centerline should be checked as much as possible the adjacent tangent lines of the teeth are parallel.

5.1.4.2.2 Image receiver placement and fixation

The image receiver should be placed in the entrance so that the image receiving surface of the image receiver abuts the side of the tongue of the inspected tooth. Image reception when shooting the front teeth the vertical position of the device is about 7 mm higher than the cutting edge; when the rear teeth are projected, the image receiver is placed horizontally. Fix the image receiver and project it.

5.1.4.2.3 X-ray centerline position

When casting the apex, the X-ray centerline passes through the middle of the examined root. It is recommended that the position on the body surface be as follows.

a) When the maxillary teeth are cast, the upper edge of the external auditory canal is connected to the tip of the nose as an imaginary connection. The X-ray centerline passes through.

1) Injecting the upper incisor through the tip of the nose;

2) When the unilateral middle incisor and the lateral incisor are cast, the midpoint of the line connecting the nose tip and the projection side nose;

3) When casting a single canine, pass the side of the nose;

4) When the upper premolar and the first molar are cast, the vertical line from the pupil side of the projection side is connected with the upper edge of the external auditory canal and the tip of the nose.

Point, that is, in front of the tibia;

5) When the second molar and the third molar are cast, the vertical line from the lateral side of the projecting side and the upper edge of the external auditory canal and the tip of the nose are intersected.

Point, the lower edge of the humerus;

b) When the mandibular tooth is projected, the X-ray centerline is on the imaginary line 10 mm along the lower edge of the mandible, and then aligned with the part of the examined tooth.

Bit injection.

5.1.4.2.4 Image display

The apical image should meet the following points.

a) complete display of the full length of the tooth, including enamel, dentin, pulp cavity, bone hard plate, periodontal ligament gap, etc.;

b) showing at least 2 mm periapical bone;

c) Image clarity and contrast.

5.1.4.2.5 Precautions

Pay attention to the following points when X-ray photography.

a) If the teeth are not arranged neatly, the jaw is deformed, or there is a large mass in the mouth that prevents the image receiver from being placed in the normal position, Changing the inclination angle of the X-ray center line according to the long axis of the tooth and the position where the image receiver is located;

b) In the case of patients with higher ankle or deeper mouth, the position of the image receiver in the mouth is more vertical, and the angle of the X-ray centerline is inclined.

Should be reduced;

c) For patients with no mouth, no lower jaw, and shallow mouth, the image receiver is placed flat in the mouth and the X-ray centerline is inclined.

The angle should be increased;

d) Children's dental arch development has not been completed, the ankle is low, and the vertical angle of the X-ray centerline should be increased as appropriate.

5.1.4.3 Parallel projection

5.1.4.3.1 Parallel projection technical requirements

The X-rays project the teeth to be inspected horizontally, and the X-ray generator (ball tube) is kept as far as possible from the teeth to be inspected, and a long occlusion tube should be used for projection.

5.1.4.3.2 Projection technology

The image holder should be placed using a holder and a bite pad. The vertical plane of the image receiver should be parallel to the long axis of the tooth. When casting the posterior teeth, the image receiver should be as far away as possible from the tooth, and the edge of the image receiver is located at or over the middle of the chin; when the lower teeth are projected, the image receiver Close to the tooth being illuminated; when the upper anterior teeth are projected, the tissue edge of the image receiver is placed in the hard palate; when the anterior teeth are projected, the image receiver the edge of the tissue should be placed under the tongue. The plane of the image receiver should be parallel to the long axis of the tooth being illuminated. Usually, there is a positioning ring on the outer portion of the holding clip.

When the light is projected, the tube is aligned with the positioning ring to make the X-ray center line vertical image receiver (the long axis of the tooth body) and avoid the cut of the projection.

5.1.4.3.3 Image display

The image display is the same as 5.1.4.2.4.

5.1.4.3.4 Precautions

The centerline of the X-ray should pass through the center of the image receiver and cover the entire image receiver.

5.2 Occlusal X-ray photography

5.2.1 Preparation before photography

Same as 5.1.1.

5.2.2 Indications

It is mainly used to check the adjacent facial ridge, myelite, pulp cavity, the edge of the filling, and the alveolar crest lesion.

5.2.3 Contraindications

Same as 5.1.3.

5.2.4 Operating procedures and methods

5.2.4.1 Patient position

The patient is seated, the sagittal plane of the head is perpendicular to the ground, and the listening line is parallel to the ground.

5.2.4.2 Image Receiver Placement

The short axis of the image receiver is parallel to the long axis of the molar, placed on the lingual side of the mandibular molar, and the flap of the occlusal flap is placed on the occlusal surface of the tooth.

Then ask the patient to bite the flap.

5.2.4.3 X-ray centerline

Align the center of the image receiver at an angle of +8°, and inject 0.5 cm above the occlusal surface of the maxillary molar, and make the X-ray horizontal angle and the tooth being illuminated.

The adjacent faces are parallel.

5.2.5 Image display

Display the upper and lower crowns and the corresponding alveolar bone images.

5.3 Maxillary anterior occlusal X-ray photography

5.3.1 Preparation before photography

Same as 5.1.1.

5.3.2 Indications

It is mainly used to observe the bone lesions of the anterior maxilla and the condition of milk and permanent teeth.

5.3.3 Contraindications

Same as 5.1.3.

5.3.4 Operating procedures and methods

5.3.4.1 Patient position

The patient is seated, the sagittal plane is perpendicular to the ground, and the nasal line is parallel to the ground.

5.3.4.2 Image Receiver Placement

The long axis of the image receiver is parallel to the sagittal plane of the head and placed between the upper and lower jaw teeth. The patient bites the image receiver in the median position.

5.3.4.3 X-ray centerline

The sagittal plane of the head is slanted at an angle of 65° to the foot and is injected into the center of the image receiver from the junction of the nasal bone and the nasal cartilage.

5.3.5 Image display

The image of the anterior maxillary bite should meet the following points.

a) showing the anterior tarsal plate, the anterior maxillary sinus and the nasal septum;

b) Display the upper anterior region dentition and alveolar bone.

5.4 Maximal posterior occlusal X-ray photography

5.4.1 Preparation before photography

Same as 5.1.1.

5.4.2 Indications

Mainly used to observe the lateral maxillary bone lesions.

5.4.3 Contraindications

Same as 5.1.3.

5.4.4 Operating procedures and methods

5.4.4.1 Patient position

The anterior maxillary occlusal piece.

5.4.4.2 Image Receiver Placement

Place the image receiver between the upper and lower jaws as far as possible and back to the side to be inspected. The long axis of the image receiver is flat with the sagittal plane of the head OK, the patient bites the image receiver in the middle bite position.

5.4.4.3 X-ray centerline

It is inclined at an angle of 60° to the foot side, and the horizontal angle is parallel to the adjacent surface of the premolar of the side to be inspected, and is aligned with the outside of the inferior foramina of the side to be examined.

5.4.5 Image display

The image of the posterior maxillary bite should meet the following points.

a) display the upper dentition and alveolar bone of the projection side quadrant;

b) showing the contralateral maxillary incisor to the third molar and maxillary nodules on the projection side;

c) Display the lower part of the maxillary sinus on the projection side.

5.4.6 Precautions

Avoid placing the X-ray tube too far back to prevent the zygomatic arch image from overlapping with the posterior image.

5.5 Mandibular anterior occlusion film photography

5.5.1 Preparation before photography

Same as 5.1.1.

5.5.2 Indications

For the observation of mandibular condyle fractures and other ankle bone lesions.

5.5.3 Contraindications

Same as 5.1.3.

5.5.4 Operating procedures and methods

5.5.4.1 Patient position

The patient is seated, the head is reclined, and the sagittal plane is perpendicular to the ground, giving the image receiver an angle of 55° to the ground.

5.5.4.2 Image Receiver Placement

Place the image receiver between the upper and lower jaws and place it as far back as possible. The long axis of the image receiver is parallel to the sagittal plane and the image is received.

The midline of the long axis of the instrument is located between the two lower incisors, and the patient is bitten in the middle bite position.

5.5.4.3 X-ray centerline

The sagittal plane is aligned at an angle of 0° and is injected by the ankle.

5.5.5 Image display

The image of the anterior mandibular occlusion piece should meet the following points.

a) showing the mandible of the mandible;

b) showing the lower anterior dentition;

c) Display the anterior border of the mandible.

5.6 Mandibular transverse occlusion piece X-ray photography

5.6.1 Preparation before photography

Same as 5.1.1.

5.6.2 Indications

Check the mandibular bone for buccal and lingual swelling, mandibular fracture displacement, foreign body and impacted tooth positioning and submandibular duct stones Wait.

5.6.3 Contraindications

Same as 5.1.3.

5.6.4 Operating procedures and methods

5.6.4.1 Patient position

The patient is seated and the sagittal plane of the head is perpendicular to the ground.

5.6.4.2 Image Receiver Placement

The size and placement are the same as the anterior mandibular occlusal piece.

5.6.4.3 X-ray centerline

The sagittal plane of the head is aligned and the vertical image receiver is injected through the midpoint of the first mandibular first molar.

5.6.5 Image display

The image of the mandibular transverse occlusion piece should meet the following points.

a) display the soft tissue contour at the bottom of the mouth;

b) showing the buccal and lingual bone plate of the mandible;

c) Display the cross section of the mandible and arch.

5.6.6 Precautions

If used to check the mouth of the mouth (such as parotid duct stones), the exposure conditions should be selected for soft tissue projection conditions.

5.7 Curved tomography

5.7.1 Preparation before photography

Pre-photography preparation includes the following steps.

a) Check the X-ray examination application form, understand the condition, and clarify the purpose of the examination and the location of the photograph;

b) the patient removes the obstruction items such as glasses, earrings and removable partial dentures in the field of view;

c) Select appropriate exposure parameters based on patient age and tissue thickness.

5.7.2 Indications

The surface layer applies to the following situations.

a) upper and lower jaw trauma, deformity, tumor, inflammation and vascular lesions;

b) dental and periodontal tissue diseases such as impacted teeth and periodontitis;

c) observe the development and eruption of the teeth;

d) malocclusion;

e) temporomandibular joint disease;

f) Examination of other maxillofacial lesions, etc.

5.7.3 Contraindications

No special contraindications.

5.7.4 Operating procedures and methods

The patient is standing or sitting, the cervical vertebra is in a vertical state or slightly inclined forward, the mandibular ankle is placed in the middle of the chin rest, and the sagittal plane is perpendicular to the ground.

The angle between the squall line and the listening line is parallel to the ground, and the head is fixed with the forehead and the head clip.

5.7.5 Image display

Show bilateral upper and lower mandibular, maxillary sinus, temporomandibular joint and full mouth teeth.

5.8 Cephalometric film X-ray photography

5.8.1 Preparation before photography

Same as 5.7.1.

5.8.2 Indications

It is used to study the morphological structure of teeth, jaw and surface in healthy people and malocclusion patients, and to study the growth and development of craniofacial and anterior and postoperative records.

Changes in the morphology of teeth, jaws, and surfaces. Sometimes used for the positioning of cranial, maxillofacial and facial foreign bodies.

5.8.3 Contraindications

No special contraindications.

5.8.4 Operating procedures and methods

5.8.4.1 Skull lateral cephalometric film

5.8.4.1.1 Patient position

The patient is seated or standing, and the earplugs of the skull positioning frame are adjusted to be flush with the external ear canal of the patient, and the earplugs on both sides are placed into the external ear canal.

At this point, the sagittal plane of the head is parallel to the image receiver. The patient bites in the middle of the bite.

5.8.4.1.2 Image Receiver Placement

The image receiver is perpendicular to the ground.

5.8.4.1.3 X-ray centerline

Align the external auditory canal and ensure that the images of the external ear canal are overlapped with each other, and the X-ray centerline vertical image receiver is projected.

5.8.4.2 Head positive cephalometric film

5.8.4.2.1 Patient position

The patient is sitting or standing and the image receiver is in front of the patient. Adjust the earplugs of the skull positioning frame to be flush with the external auditory canal of the patient.

The earplugs on both sides are placed in the outer ear canal. At this point, the sagittal plane of the head is perpendicular to the image receiver. Make the patient listen to the line parallel to the ground and the image receiver is vertical. The patient bites in the middle of the bite.

5.8.4.2.2 Image Receiver Placement

The image receiver is perpendicular to the ground.

5.8.4.2.3 X-ray centerline

The image receiver is forwarded from the rear of the patient through the midpoint of the external ear canal connection line, and the X-ray center line is perpendicular to the image receiver.

5.9 Craniofacial X-ray photography

5.9.1 Preparation before photography

Pre-photography preparation includes the following steps.

a) Check the X-ray examination application form, understand the condition, and clarify the purpose of the examination and the location of the photograph;

b) wear lead protection for the patient;

c) the patient removes the obstruction items such as glasses, earrings and removable partial dentures in the field of view;

d) Select appropriate exposure parameters based on patient age and tissue thickness.

5.9.2 Walter X-ray photography

5.9.2.1 Operating procedures and methods

See WS/T 389 for details.

5.9.2.2 Image display

See WS/T 389 for details.

5.9.2.3 Precautions

See WS/T 389 for details.

5.9.3 Skull base radiography X-ray photography

5.9.3.1 Indications

Mainly used for examination of skull base lesions, posterior maxillary and infraorbital fossa lesions.

5.9.3.2 Contraindications

No special contraindications.

5.9.3.3 Operating procedures and methods

5.9.3.3.1 Patient position

Place the skull base retainer on the camera table so that the center line of the retainer is aligned with the center line of the camera. The patient is lying on the slope of the retention frame, the head is positive the mid-sagittal face is in the middle of the retainer and the head is reclined. Adjust the cassette holder so that the top of the head is in contact with the image receiver, depending on the length of the patient's neck.

The listening line is parallel to the image receiver. The upper edge of the image receiver is beyond the forehead and the lower edge is beyond the occipital protuberance.

5.9.3.3.2 Image Receiver Placement

The long axis of the image receiver is placed on the center line of the cassette holder.

5.9.3.3.3 X-ray centerline

Align the midpoints of the mandibular angles on both sides and insert the film into the center of the film perpendicular to the cassette. The focus is at a distance of 100 cm from the image receiver.

5.9.3.4 Image display

The structures of the maxillary sinus, nasal cavity, sphenoid sinus, foramen ovale and condyle were displayed on both sides.

5.9.3.5 Precautions

Use a blind tube and a filter when casting.

5.9.4 X-ray photography of the zygomatic arch

5.9.4.1 Indications

Check the shape of the zygomatic arch and its surrounding tissue structure to see if there is a zygomatic arch fracture and the presence of foreign bodies around the zygomatic arch.

5.9.4.2 Contraindications

No special contraindications.

5.9.4.3 Operat...