23.1
Occlusal Technique
The occlusal technique is used to examine large areas of the maxilla or the mandible. It is called the occlusal technique because the patient bites, or “occludes” on the entire receptor.
Understanding these basic terms is necessary for learning about the occlusal technique.
Term |
Definition |
| Occlusal Surfaces | Chewing surfaces of posterior teeth |
| Occlusal Examination | A type of intraoral radiographic examination to inspect large areas of the maxilla or mandible on one image |
| Occlusal Technique | Method used to expose a receptor in occlusal examination |
| Occlusal Receptor | In adults size 4, in children size 2 |
Purpose and Use
For the occlusal technique, a supplementary imaging technique is used in conjunction with periapical or bite-wing images and is used when large areas of the maxilla or mandible must be visualized. It is preferred when the area of interest is larger than a periapical receptor or when the placement of periapical receptors is too difficult for the patient. It is used to locate retained roots, supernumerary teeth, foreign bodies, salivary stones, fractures, cleft palate and evaluate lesions.
Principles
Principles to remember for the occlusal technique are the receptor is placed with the tube side facing the arch that is being exposed, the receptor is placed in the mouth between the occlusal surfaces of maxillary and mandibular teeth, and the receptor is stabilized when the patient bites on the surface of the receptor.
Step-by-Step Procedures
The following step-by-step procedures include:
- Patient preparation
- Equipment preparation
- Maxillary occlusal projections
- Mandibular occlusal projections
- Vertical angulations
Patient Preparation
Begin by explaining the imaging procedure to the patient to ensure they understand what to expect. Adjust the chair to position the patient upright, making sure that the chair is at a comfortable working height for you. Next, adjust the headrest to properly support and position the patient’s head. Place a lead apron with a thyroid collar on the patient and ensure it is securely fastened. Ask the patient to remove eyeglasses and any objects from their mouth. Verify that the occlusal plane is parallel to the floor, and confirm that the patient remains upright. Instruct the patient to gently bite down; this is important as it prevents damage to the receptor.
Equipment Preparation
For equipment preparation, the exposure control factors on the x-ray unit should be set according to the recommendations provided by the receptor manufacturer. For the occlusal technique, you may use either a short (8-inch) or a long (16-inch) position-indicating device (PID).
Maxillary Occlusal Projections
The topographic projection is used to examine the palate and the anterior teeth of the maxilla. The lateral projection, which can be either left or right, is utilized to examine the palatal roots of the molar teeth. The pediatric projection is specifically recommended for examining the anterior teeth of the maxilla in children aged 5 years old or younger.
Media Attributions
- Iannuci: Dental Radiography, 6th Edition, Chapter 23, CC BY-NC-ND
