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Section IV. BITE-WING (INTERPROXIMAL) EXPOSURE TECHNIQUES

4-28. GENERAL

Bite-wing film has many uses. The main use is to detect decay between teeth (including depth of caries) by obtaining an image of the crowns of the teeth without the distortion that often occurs in a periapical examination. This is made possible by using a low vertical angle of projection with the film packet held in a nearly vertical position. No attempt is made to include the apices of the teeth. Bite-wing film is also used to detect calculus and to examine the alveolar crest, margins of restorations, and the pulp chamber. Both the maxillary and mandibular teeth of an area are shown on one film.

4-29. MOLARS AND BICUSPIDS (POSTERIOR TEETH)

For radiographs of posterior teeth, adjust the head so that the occlusal surfaces of the maxillary teeth lie in a horizontal plane. Place a film packet in the mouth so that the resulting radiograph will include the desired teeth. The lower part of the film will lie between the tongue and the mandibular ridge; the upper part will lie against the roof of the mouth. Have the patient slowly close his teeth on the tab. Adjust tube to an average angulation of +8º. Direct the central ray to pass straight through the interproximal spaces to the center of the film at the level of the occlusal plane (see figure 4-29). Follow the manufacturer's instructions for exposure times.

Figure 4-29. Posterior bite-wing technique.

4-30. CENTRAL AND LATERAL INCISORS AND CUSPIDS (ANTERIOR TEETH)

Periapical film with an adapter is used for bite-wing radiographs of anterior teeth. Head positioning for anterior bite-wing exposures is the same as for the posterior teeth. Refer to paragraph 4-29. However, a bite-wing radiograph of anterior teeth is seldom requested by a dentist.

1. Central Area. Place the film packet in the mouth with the center of the film in line with the median plane. The lower part should be placed between the tongue and mandibular ridge. The upper part is then allowed to lie against the roof of the mouth. Have the patient bite tightly end-to-end against the tab. Adjust the tube to an angulation of +8º. Direct the central ray through the interproximal spaces between the central incisors at the level of the incisal plane. Follow the manufacturer's instructions for exposure time.
2. Lateral and Cuspid Area. Place the packet as specified for the central incisor region. Instruct the patient to bite very gently against the tab to hold it in position. Shift the tab distally until its mesial surface of the film is located at the midline of the arch between the central incisors. Then instruct the patient to bite firmly end-toend against the tab. Adjust the tube to an angulation of +8º. Direct the central ray straight through the lateral incisor at the level of the incisal plane. Follow the manufacturer's instructions for exposure time.

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