Figure 4.36 Parallel technique.

The film must protrude beyond the ventral margin of the

mandible to include this on the radiograph
Figure 4.37 Parallel technique. Paper towel can be used to keep the film close to the teeth.
Figure 4.38 The film must be placed close and parallel to the teeth.
Figure 4.39 Radiographing the maxillary carnassial tooth using the parallel technique requires
extra-oral placement of the film. A dog skull is used for illustration.
Figure 4.40 Bisecting line technique. The angle formed by the tooth and film axes is bisected.
The incident beam is directed perpendicular to the bisecting line.
Figure 4.41 Bisecting line technique. Film placement for maxillary premolars and molars.
Figure 4.42 Bisecting line technique. Film placement for maxillary incisors and canine teeth.
Figure 4.43 Bisecting line technique. Film and X-ray head placement for radiography of the
maxillary incisors.
Figure 4.44 Radiograph obtained from the positioning in Figure 4.43.
Figure 4.45 Superimposition of structures can complicate diagnosis. Here the mesial root is
superimposed on the palatal root.
Figure 4.46 By moving the incident beam to a more rostral position, the palatal structure
moves to a more mesial position.
Figure 4.47 By moving the incident beam caudally, the mesio-buccal root moves to a more
mesial position.
Figure 4.48 Crown and root elongation occurs when the incident beam is tending to be
perpendicular to the tooth axes.
Figure 4.49 The X-ray head is positioned perpendicular to the incisor teeth axes resulting in
elongation
Figure 4.50 Correct position for radiographing maxillary incisors.

Figure 4.51 Foreshortening occurs when the incident beam is tending to be perpendicular to
the film axis.
Figure 4.52 X-ray head placement which will lead to foreshortening of the maxillary incisors.
Figure 4.53 Correct position for radiographing maxillary incisors.
Figure 4.54 Digital X-ray images are transferred to the computer screen within seconds of
exposure.
Figure 4.55 A size 2 digital dentalimaging sensor.
Figure 4.56 An incomplete set of radiographs of a young puppy mounted using the buccalview mounting configuration.
Figure 4.57 Dental radiographs should be viewed with light passing through the
film only, as peripheral light will affect evaluation. This light box is not ideal.
Figure 4.58 Magnified viewing of dental radiographs is mandatory. Substantially more detail
is visible using magnification.
Figure 4.59 The teeth must be examined systematically evaluating the crown, root/s,
periodontal ligament space, lamina dura, the pulp cavity and root canal. Periapical tissues
must be examined as well.
Figure 4.60 A slightly oblique view of the caudal mental foramen close to the distal root apex
of mandibular left premolar 3 in a cat.
Figure 4.61 The caudal mental foramen can resemble pathology at the distal root of the
mandibular third premolar in the cat.
Figure 4.62 The infra-orbital canal and maxillary recess can resemble periapical lesions when
superimposed on maxillary premolar roots. There are three root fragments remaining in this
dogs maxillus after incomplete extraction of 108.
Figure 4.63 Immature teeth have open roots.

Figure 4.64 The pulp chamber of immature teeth is wide and the dentine walls thin. Note the
persistent 604 in this image.
Figure 4.65 Once the apex has formed the tooth is considered to be mature. Normal dentine
laid down beyond this stage is classed as secondary dentine.
Figure 4.66 The lamina dura of teeth is seen as a radiodense line following the outline of the
root.
Parallel technique
The parallel technique is used to take intra-oral radiographs of mandibular teeth caudal to the
second premolar in dogs. In some patients the second premolar can be included on the first
film. In cats the mandibular third and fourth premolar and first molar teeth are imaged using
the parallel technique. The dental film is placed between the teeth and the tongue, with the
film projecting below the ventral margin of the mandible. The incident X-ray beam is then
directed perpendicular to the teeth and the film giving a realistic image of the teeth on the
radiograph (Figures 4.354.38). The parallel technique can also be used to radiograph the
maxillary carnassial tooth with the film placed in an extra-oral position. The mouth must be
propped open to prevent superimposition of other structures on the tooth being radiographed
(Figure 4.39). If this technique is used, the radiograph should be annotated accordingly as this
radiograph will resemble that taken of the contra-lateral maxillary carnassial using the intraoral placement technique.
Bisecting line technique
The bisecting line technique is used to image the remaining teeth in the mouth, where the film
cannot be placed parallel to the teeth. The angle created by the film axis and the tooth axis is
bisected and the incident X-ray beam is directed perpendicular to the bisecting line (Figures
4.404.44). If the incident beam is perpendicular to the tooth surface, the image will be
lengthened (elongation) (usually with the apex off the edge of the film); if the incident beam

is perpendicular to the film, the image will be shortened (foreshortening). If a tooth is longer
than the film available, two radiographs should be taken to evaluate the whole tooth.

Superimposition of structures
By changing the angle of the incident beam, superimposed structures (Figure 4.45) can be
separated. The SLOB (same lingual opposite buccal) rule is applied to superimposed
structures and defines the direction in which the Radiography different structures move in
relation to the movement of the incident beam. A structure which moves in the same direction
as the incident beam is positioned on the lingual / palatal side. For example, considering the
maxillary carnassial tooth. If the incident beam is directed from a more rostral position the
palatal root will be the most mesial of that tooths structures on the new radiograph (Figure
4.46). Conversely, if the beam is directed from a caudal position the structure which moves in
the opposite direction to become the most mesial structure of the tooth on the new radiograph
will be the mesiobuccal root (Figure 4.47).

Correcting elongation and foreshortening

An elongated tooth (Figure 4.48) results from an incident beam tending towards being
perpendicular to the tooth surface (Figure 4.49). To correct this, the beam should be angled at
an obtuse angle to the tooth surface (Figure 4.50). A foreshortened tooth (Figure 4.51) results
from an incident beam tending towards being perpendicular to the film axis (Figure 4.52). To
correct this, the beam should be incident at an acute angle to the film axis (Figure 4.53).
Knowledge of root anatomy will aid in positioning of the dental film and direction of the
incident beam to produce an accurate diagnostic image of the tooth under examination.

Digital imaging

There are a number of veterinary practices making use of digital dental imaging systems.
There are two systems: direct where the image is captured by a sensor and sent to the
computer screen and indirect where the image is captured on a phosphorescent plate that
must be read by a laser reader and then digitised. The direct system projects the image on a
computer screen (Figure 4.54) after it has been captured by a sensor (Figure 4.55). This takes
the place of the intra-oral dental film.
There are a number of advantages to this system including:
speed of use (image on screen within seconds)
minor adjustments can be made to the position of the sensor if image is not correct on
screen, without having to reposition the X-ray machine
images can be enhanced and digital storage of patient records is facilitated.
Disadvantages include:
price of the equipment and the size of the sensor
The use of this technology in cats is complicated by positioning of the sensor as it is not
flexible and is thicker than the intra-oral X-ray film envelope. Burnout is sometimes seen
even at low exposure settings, and by increasing the X-ray generator sensor focal distance this
can sometimes be alleviated.
Radiology
Dental radiographs are usually mounted using the lingual or buccal view. By convention,
veterinary dental radiographs are mounted using the buccal view. This means that the
radiographs are mounted with the incisal edges of teeth in opposing arcades facing each other
as viewed from the front of the animal.
This means that the patients right arcades will be to the left of the set and the left arcades will
be to the right of the set (Figure 4.56).

Dental radiographs should be examined in a dark room, preferably with light passing through
the radiograph alone (no peripheral light). Peripheral light causes viewer pupillary
constriction which adversely affects evaluation of the radiograph and the structures
radiographed (Figure 4.57). Magnification of the image is an essential aid to accurate
interpretation (Figure 4.58).
Systematic examination of the crown, root/s, pulp chamber/canals, periodontal ligament space
and periapical region is imperative. Discontinuity of the lamina dura and widening of the
periodontal ligament space are indicative of disease and should alert the examiner to
investigate further. It may be necessary to take a second or third view of a structure to gain
further information (Figure 4.59).
There are numerous artefacts to consider when viewing radiographs. The mental foramina are
positioned at the mandibular third and second premolars and between the first and second
incisor teeth in the dog. The middle mental foramen is often mistaken for a periapical
radiolucency at the mesial root of the second premolar (Figures 4.60 and 4.61).
The infra-orbital foramen may create artefacts at the maxillary third or fourth premolars.
(Figure 4.62). The maxillary recess may also appear as a radiolucency. There is no maxillary
sinus in the dog or cat.

Normal radiographic anatomy

In young animals the pulp chamber and canal are wide and the root apex is unformed (Figures
4.63 and 4.64). The dentine formed at this point is known as primary dentine. As the tooth
matures, the apex forms and an apical delta develops through which the pulp receives its
neurovascular supply (Figure 4.65). The dentine formed after this time is known as secondary
dentine. Primary and secondary dentine are indistinguishable radiographically. Radiographs
should be taken of the jaws of young animals where there is suspicion that some teeth may be

missing. Amelogenesis is completed at about three to four months of age and the permanent
tooth buds will be visible radiographically. It is important to remember that the molars and
first premolars do not have deciduous predecessors.
Immature teeth have a wide pulp chamber / canal, relatively narrow (thin) dentine covered by
a thin layer of enamel. Mature teeth have pulp chambers / canals of variable width and
dentinal walls of variable thickness (depending upon the animals age) and an apical delta.
The periodontal ligament space is visible and defined by the lamina dura on one side and the
cementum covering the root on the other. The lamina dura is the cribriform plate of the
alveolus and appears denser than the surrounding bone because it is seen en face (end on)
(Figures 4.66 and 4.67). The periodontal space houses the periodontal ligament which spans
from the cementum to the lamina dura ensuring that the tooth is suspended in the alveolus.
The lamina dura is continuous around the root. The apical periodontal space is slightly
enlarged at canine apices and the apices of mesial roots of mandibular first molars. It is
important to remember that the radiographic image is a two-dimensional representation of a
threedimensional structure.
Under normal circumstances the periodontal ligament and cementum prevent normal bone
turnover from affecting the dentition. The periodontal space becomes obliterated in cases
undergoing root replacement following resorption. The tooth substance becomes continuous
with the surrounding alveolar bone and the tooth is then ankylosed to the bone. Localised
inflammation of the periodontal ligament can also lead to ankylosis of the tooth to the
alveolus when normal bone turnover crosses the periodontal ligament space.
The mesial root of the mandibular carnassial and the distal root of the maxillary carnassial
teeth often have a parallel line visible radiographically at their distal and mesial aspects
respectively, due to the developmental groove in the surfaces of these roots (Figures 4.68 and
4.69).