Veterinary dental radiography allows for a more thorough diagnosis, but it also brings its own unique challenges!
Introducing dental radiography into your practice opens the door to a more thorough diagnosis of your patient’s oral conditions. It also gives you the opportunity to develop a complete treatment plan and plan your approach to that treatment—all leading to better overall outcomes for your dental patients.
What the brochure didn’t tell you was that dental radiography would also bring its own unique challenges—including a new radiography technique steeped in geometrical mystery to master!
In this series, you’ll find Top Tips for gaining those troublesome images.
Maxillary Canine Root Tip in Large Dogs
The Maxillary Canine tooth in large-breed dogs is deceptively long. It makes it challenging to achieve diagnostic radiographic images of the apex of the root and surrounding bone.
Here are 3 Top Tips for imaging this tooth:-
Tip 1: The Bigger the Patient, the Bigger the Plate!
Firstly, let’s look at the equipment at your disposal. Do you have a plate/sensor large enough to accommodate the size of this tooth? If the plate/sensor you have is smaller than the length of the tooth, it will be difficult to image the entirety of the tooth as well as the surrounding bone. Larger patients require larger imaging plates. Consider incorporating a Size 5 phosphor plate into your equipment armoury.
Tip 2: There is no Rule that says ‘the Crown & the Root have to be in the same image’!
This involves exposing the tooth in sections – the crown on one image, then the root section on a second – and then carrying out an assessment using both images. The placement of the plate and coordinated movement of the tube are key to the success of this technique. Place the tip of the crown on the corner of the plate for the first image. Then use a ‘step off’ technique in placement for the second image by moving the plate more palatal and caudal – the tube movement should correspond to this.
Tip 3: The 70o Alternate Projection
This involves tube shift on both the horizontal and vertical planes. X-rays are 2-dimensional images of 3-dimensional structures, so let’s think about this tooth in the 3rd Dimension. If you were looking from above, you could still see the tooth clear of other structures that can superimpose over the roots. An acrylic skull model is a useful tool in helping visualise the root structures. Incorporate a large phosphor plate that can accommodate the length of the tooth across its diagonal.
Place the plate horizontally in the mouth with the crown tip on the rostral outer corner of the plate. Orient the tube to 45o to the midline in the horizontal plane (Fig.1), then to 70o in the vertical plane (Fig. 2). Ensure the fine focal distance allows for the divergence of the beam to expose the entire plate. The resulting image allows visualisation of the entire maxillary canine tooth with surrounding bone structure. (Fig.3)