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HORIZONTAL OVERLAPPING

Horizontal overlapping adalah salah satu dari beberapa kesalahan dalam dental radiography atau radiology, penyebab terjadiya kesalahan ini bervariasi, tergantung tipe radiographic yang digunakan.

Panoramic Radiography

Overlapping pada gambaran panoramic radiography dapat disebabkan karena

Kesalahan posisi asimetris, dapat menyebabkan gambaran radiography dari gigi-gigi posterior maksila dan mandibula saling tumpang tindih [PA]

Fig. 26a Improper positioning of the median saggital plane. The less than perpendicularly (black) positioned median saggital plane (red) leads to a varying overlapping effect of the opposing arch and to apparent widening of the far lingually positioned mandibular angle on the left side, with apparent enlargement [PA]

Intraoral Dental Radiographs

Pada Intraoral Radiographs, a Because the central ray was not targeted perpendicularly to the plane of the IR, but rather distal excentric, severe overlapping of the proximal crown surfaces occurred. Early detection of proximal caries cannot be achieved with such projections. b It appears that the bitewing IR was placed obliquely and that the patient did not completely close

the jaws; the image is blurred because of movement by the patient, an indication of a pain response.

Pada Intraoral Periapical Radiographs, If the central ray is targeted obliquely from above and steeply from the mesial aspect, the maxillary premolars will exhibit overlapping and, as depicted here, the laterobasal wall of the nasal cavity will be visible in the image.

Pada Apical and Periodontal Projection, (fig. 68b) Incorrect positioning for taking a radiograph of the maxillary molars, with an excessively steep central ray projection. This photograph shows the most common technical error when taking intraoral radiographs of the maxillary molars. The excessively steep vertical angle results in superimposition and overlapping of the zygomatic bone over the molars, especially the second molar (addition effect).

Pada Bitewing Radiographs, (fig. 81) Bitewing radiographs using the long bitewing films from Kodak. Given ideal tooth position in the jaws, and with an extremely carefully performed bitewing technique, it is often possible in adults to completely depict the posterior arch segments using only two exposures. Excessively faint radiographs made with very low exposure doses are not indicated for early caries diagnosis because of the superimposition

(overlapping) with intact segments of enamel. Note the radiolucency distally on the cervical area of tooth 37, which is due to the subtraction effect of the transparent dental sac, a burn-out effect.

Paralleling and BisectIng-Angie Technique

Berdasarkan letak objek yang diposisikan, horizontal overlapping dapat terjadi karena If the tube is shifted and directed at the reference object (e.g., the apex of a tooth) from a more mesial angulation and the object in question also moves mesially with respect to the reference object, the object lies lingual to the peference object.

FIG. 5-11 The position of an object may be determined with respect to reference structures using the tube shift technique. In A, an object on the lingual surface of the mandible may appear apical to the second premolar. When another radiograph is made of this region angulated from the mesial, B, the object appears to have moved mesially with respect to the second premolar apex ("same lingual" in the acronym SLOB)

Alternatively, if the tube is shifted mesially and the object in question appears to move distally, it lies on the buccal aspect of the reference object (Fig. 5-12). These relations can be easily remembered by the acronym SLOB: Same Lingual, Opposite Buccal. Thus if the object in question appears to move in the same direction with respect to the reference structures as does the x-ray tube, it is on the lingual aspect of the reference object; if it appears to move in the opposite direction as the x-ray tube, it is on the buccal aspect. If it does not move with respect to the reference object, it lies at the same depth (in the same vertical plane) as the reference object.

FIG. 5-12 The position of an object can be determined with respect to reference structures using the tube shift technique. In A, an object on the buccal surface of the mandible may appear apical to the second premolar. When another radiograph is made of this region angulated from the mesial, B, the object appears to have moved distally with respect to the second premolar apex ("opposite buccal" in the acronym SLOB).

Examination of a conventional set of full-mouth films with this rule in mind demonstrates that the incisive foramen is indeed located lingual (palatal) to the roots of the central incisors and that the mental foramen lies buccal to the roots of the premolars. This technique assists in determining the position of impacted teeth, presence of foreign objects, and other abnormal conditions. It works just as well when the xray machine is moved vertically as horizontally.

The dentist may have two radiographs of a region of the dentition that were made at different angles, but no record exists of the orientation of the x-ray machine. Comparison of the anatomy displayed on the images helps distinguish changes in horizontal or vertical angulation. The relative positions of osseous landmarks with respect to the teeth helps identify changes in horizontal or vertical angulation. Fig. 5-13 shows the inferior border of the zygomatic process of the maxilla over the molars. This structure lies buccal to the teeth and appears to move mesially as the x-ray beam is oriented more from the distal. Similarly, as the angulation of the beam is increased vertically, the zygomatic process is projected occlusally over the teeth.

FIG. 5-13 The position of the maxillary zygomatic process in relation to the roots of the molars can help in identifying the rientation of projections. In A, the inferior border of the process lies over the palatal root of the first molar, whereas in B, it lies posterior to the palatal root of the first molar. This indicates that when A was made, the beam was oriented more from the posterior than when B was made. The same conclusion can be reached

independently by examining the roots of the first molar. In A, the palatal root lies behind the distobuccal root, but in B, it lies between the two buccal roots.