Mandible & maxilla oblique radiography

DINESH DARSHANARADIOLOGIC TECHNOLOGIST – SRI LANKA

Mandible oblique

Anatomy

According to the anatomy of mandible there are main 3 areas,

Symphysis menti area

Mandible body area

Ramus area

How to demonstrate mandible in a radiograph?It is too hard to clearly demonstrate above 3

areas in one projection.

So there are 3 separate projections to demonstrate interested anatomy.

Interested area should be parallel to IR.

Patient positioning..Patient is standing or sitting next to the upright buckyPlace head in a lateral position with side of interest

against IRIf possible have patient close mouth and bring teeth

together Extend neck (to clear the mandible of the cervical

spine)Rotate the head in an oblique direction (the degree of

obliquity depend upon the section of manible that is of interest) - the area of interest should be positioned parrallel to the IR

How to position the mandible?Head in true lateral position demonstrates ramus 

30° rotation demonstrates body

45 ° rotation demonstrates mentum

10° to 15° rotation provides a general survey of mandible

CR angled 25° cephalad

Direct CR to exit mandibular region of interest

Positioning for Ramus

How the image looks like

Axiolateral Oblique – Body 30°Start from true lateralOblique head 30°

towards IR25° CR angleCR will exit body on

opposite side of mandible

Collimate to mandible on all sides

Positioning for menti

How image looks like…

mandible Oblique- General Survey 10° - 15°

Oblique head 10°-15° towards IR

CR angled 25° cephalad

Area of interest should be demonstrated w/minimal superimposition & foreshortening

Mandible oblique for trauma patients

15- 15 method mandible oblique

If the patient cant keep stand etrect

The central ray is angled 30 degrees cranially and is centred 5 cm inferior to theangle of the mandible remote from the cassette.

Other projections to demonstrate mandibleMandible PAOPGRevers Towns viewTrue Occlusal of mandible to demonstrate

Menti.CT

Maxilla oblique Occlusal

The X-ray tube is positioned towards the side of the face where pathology is suspected and angled downwards (caudad) at 65–70 degrees through the cheek.

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