Investigation into the relationship between deviations in X‐ray angulation and images of proximal overlapping on bite‐wing radiographs

Abstract

Eleven child skulls were radiographed through a range of 50 degrees by varying the horizontal angulation of the X-ray beam in steps of 2 or 5 degrees. The changes in the width of overlapping contact images and the ranges through which no overlap occurred were measured. A linear relationship between changes in X-ray beam angulation and overlap width was found in all the skulls. Using the data it was calculated that for each increase in overlap width of 0.1 mm, 95% of the deviations in X-ray beam angulation were less than 2.5 degrees. The findings of this study suggested that the positioning of the X-ray beam so as to cause no overlapping is at best difficult, and at worst impossible. They also emphasize the importance of using identical projections in estimating the progress of carious lesions on radiographs since small changes can cause overlaps. The use of methods that reduce the error in repositioning the X-ray beam may be important in reducing methodological errors in clinical research.

Tooth–Surface Progression and Reversal Changes in Fluoridated and No–Longer– Fluoridated Communities over a 3–Year Period

“…Admittedly coarse when compared to progression/reversal measurements based on radiographic findings, the epidemiologic indices utilized in the present study offered a straightforward array of clear-cut stages. Furthermore, our conclusions are not open to the reliability questions that radiographic artifacts (mainly the reproducible repositioning of beam angulations) create in smaller study designs based on radiographic records to ascertain progression (reversal) of lesions [Pitts, 1983b;McDonald, 1984;Benn and Watson, 1989;Van der Stelt et al, 1989]. Despite its solid design, the investigation may have suffered from certain shortcomings.…”

The role of stationary intraoral tomosynthesis in reducing proximal overlap in bitewing radiography

“…Unfortunately, caries detection may be hampered by poor technique and unequally trained operators. [2][3][4] Adding to the challenge of correctly exposing SBWs, a systematic review of the literature by Bader et al reported that the median sensitivity value for proximal caries was 49%. 5 One of the primary goals of SBW radiographic technique is to open the proximal contacts so that no superimposition of the tooth surfaces occurs.…”

Reproducibility and overlapping of bitewing radiographs: comparison of Eggen‐bite with Kwik‐bite

“…Both standardized and nonstandardized techniques have been employed. Many authors have emphasized the importance of standardized teehniques and correct angulations in radiographie diagnoses (1_3), SEWERIN (4) and LEIJON (5) have obtained different earies scores simply by changing the horizontal angulation of the X-ray beam, LEIJON concluded that a carious lesion tnay appear as an enamel lesion in one projection and a dentin lesion in another, MCDONALD (6) demonstrated an increase in overlap of 0,1 mm by varying the X-ray beam by less than 2,5° in the horizontal direetion. Referring to his own study and a study made by HOROWITZ (7), he suggested that "the positioning of the X-ray beam so as to cause no overlapping was at best difficult and at worst impossible," SEW- ERIN (8) reported up to 80% overlapping, indicating that overlapping may be a great clinical problem.…”