Br Dent J. Apr 7;(7) doi: / Guidelines on the timing and frequency of bitewing radiography: a systematic review. 0 Bitewing TechniqueThe following slides describe techniquesused in the mouseholding an x-ray tubehead or you are done reading aslide. The film packet should be positioned with its long axis horizontally for a horizontal bitewing or vertically for a vertical bitewing.


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Radiographs are essential for detecting bitewing radiography caries. The best technique should be recognized for accurate detection of caries.


The aim of this study was to compare the accuracy of detection of proximal caries using intraoral bitewing, extraoral bitewing, improved interproximal bitewing radiography, improved orthogonality panoramic and conventional panoramic radiographs.

In this descriptive cross sectional study, extracted human teeth with and without proximal caries were used. Intra and extraoral radiographs were taken. Images were evaluated and scored by two observers. bitewing radiography

Scores were compared bitewing radiography the histological gold standard. Microscopic evaluation of proximal surfaces revealed that The differences in the area under the ROC curve Az value among the five techniques bitewing radiography not statistically significant.


Improved interproximal panoramic and extraoral bitewing radiographs were superior to conventional panoramic radiography for detection of proximal caries ex vivo and should be considered for patients with contraindications for intraoral radiographs. Placing the bite tab on the incorrect side of the film places it into the mouth backwards, bitewing radiography an image that is reversed.

When using the film, the image will also appear lighter less dense and have a herringbone pattern along one side. bitewing radiography

Incorrectly positioning the bite tab positions the film incorrectly, so that a disproportionate amount of each arch is imaged on the film. This allows equal coverage bitewing radiography the maxillary and mandibular crowns of the teeth simultaneously. BWs should also provide simultaneous imaging of both the maxillary and mandibular alveolar crests, so that if significant alveolar bone loss is present, Vertical Bitewings bitewing radiography to be taken.

When taking both types of BWs, ensure that the film is positioned parallel to the teeth and curvature of the arch that are being imaged. When positioning BWs in a partially edentulous arch, cotton rolls may be of assistance in providing stabilization.

Anterior bitewing bitewing radiography the film is positioned so bitewing radiography the distal aspect of the cuspid providing a view that shows dentin is visible on the film. Posterior bitewing — the film is positioned so that the distal aspect of the last erupted crown is visible on the film Common errors: Instruct the patient to bite their teeth together, position their head straight with thier occlusal plane parallel to the floor.

Guidelines on the timing and frequency of bitewing radiography: a systematic review.

If the patient, film or x-ray tube bitewing radiography moving during the exposure, blurring of the image may result. Occlusal caries, crestal alveolar bone level and secondarily for eruption patterns, caries and restoration proximity to pulp spaces, primary molar furcation pathology and developmental anomalies may also be detected with bitewing bitewing radiography.

The frequency of bitewing radiographic examination is based on caries risk assessment.

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