Abstract
Objective
Obtaining an intraoral periapical radiograph of the maxillary anterior teeth can be quite challenging, especially in patients where a rigid digital sensor cannot adequately fit in the palatal vault. This technical report presents a periapical radiographic technique that places the sensor in the space surrounding the hamular notch to avoid the spatial restrictions of the hard palate, opening the possibility of parallel alignment of the sensor and the long axis of the tooth, perpendicular alignment of the tube-head to both, and a minimally distorted resultant radiographic image.
Method
Four adult patients demonstrated the quantitative and qualitative features of this hamular technique (HT). A human skull demonstrated relative magnification and image quality.
Examples and results
While patient and equipment-specific, comparisons of magnification, distortion, and image quality illustrate the potential capabilities and limitations of the HT. The HT radiographs appeared to be less distorted than the variable-angle technique (VAT—a clinical approximation of the bisecting angle technique) but magnified 7.9–21.6%. A radiograph of an implant showed a 2.0% distortion over true aspect ratio. The HT radiograph from a human skull showed a slightly lighter and less sharp image than the VAT radiograph.
Conclusion
Preliminary results showed that while the HT images were magnified, lighter, and less sharp that the VAT, they were diagnosable for caries. In all the HT images presented in this technical report, there was less distortion than comparable techniques. Notably, one HT periapical radiograph of a maxillary lateral implant showed virtually no distortion, suggesting that a nearly parallel projection was achieved using the technique. While further research is needed, this report shows that the HT has the potential to produce minimally distorted digital radiographs of anterior teeth in patients where the sensor cannot adequately fit into the palatal vault.
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Acknowledgements
Thank you to Dr. D. Collins, Dr. J. Mrozinski-Pierson, and Marion Oral Surgery Specialists for providing the skulls, and Dr. K. A. Galil for assisting in anatomical identification. Thank you to Dr. J. Mrozinski-Pierson and Talent Pho for proofreading the manuscript.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards, except for an ethics committee. The author is not associated with any educational institutions and was unable to get an ethics committee to review the study for ethics approval or waiver. Written informed consents for obtaining the images used for this publication were obtained from the patients. A copy of the consent form is available for review by the Editor of this journal. Informed consent was obtained from all patients in the study.
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Pun, M.H.J. A technical report on the hamular technique for radiographing maxillary anterior teeth using a digital sensor. Oral Radiol 38, 297–307 (2022). https://doi.org/10.1007/s11282-021-00559-x
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DOI: https://doi.org/10.1007/s11282-021-00559-x