Extraoral Radiographic AnatomyRichard P Madden, DDS, MSAdjunct Associate ProfessorDiagnostic & Biological [email protected] 3Unit 3 Intraoral and extraoral radiographic anatomy• Responsible for:– Auto-tutorial contentshttp://www1.umn.edu/dental/courses/orad_anatomy/• “Intraoral anatomic landmarks” contents• “Extraoral anatomic landmarks” contents– White & Pharoah 6thedition • pages 46-52, 152-206Mandibular Oblique Lateral Projection (Lateral Jaw, Lateral oblique)• The film is placed against the side of the patient’s face • X-ray beam is directed postero-anteriorly from the opposite side Mandibular Oblique Lateral Projection (Lateral Jaw, Lateral oblique)Mandibular Oblique Lateral Projection (Lateral Jaw, Lateral oblique)A. Coronoid ProcessB. CondyleC. Sigmoid notchD. Zygomatic archE. Mandibular foramenF. Hyoid boneMandibular Oblique Lateral Projection (Lateral Jaw, Lateral oblique)A. Maxillary tuberosityB. Lower border of mandible (side away from film)C. Mental foramenD. Superior border of tongueE. Styloid processF. Mandibular canalMandibular Oblique Lateral Projection (Lateral Jaw, Lateral oblique)Mandibular Oblique Lateral Projection (Lateral Jaw, Lateral oblique)A. Zygomatic process of maxillaB. Vertrebral columnC. Lower border of mandible (side closer to film)D. ZygomaE. Zygomatic archMandibular Oblique Lateral Projection (Lateral Jaw, Lateral oblique)A. Lower border of orbitB. Neck of condyleC. Vertebral columnD. Hyoid boneMandibular Oblique Lateral Projection (Lateral Jaw, Lateral oblique)• Identify the structuresMandibular Oblique Lateral Projection (Lateral Jaw, Lateral oblique)Lateral Skull Projection(Lateral head plate)• Midsagittal plane of the patient’s head is parallel to the film• X-ray beam is perpendicular to the filmMidsagittal planeLateral Skull ProjectionLateral Skull Projection• Center portion of Lateral Head PlateLateral Skull Projection• A= Frontal sinus• B= Floor of the anterior cranial fossa• C= Anterior clinoid process• D= Posterior clinoid process• E= Pituitary fossaLateral Skull Projection• A= Nasal bone• B= Zygomatic process of the maxilla closer to the film• C= Ethmoid sinus• D= Pterygomaxillary fissureLateral Skull ProjectionLateral Skull Projection• A= Orbital plates of frontal bone• B= Orbit• C= Sphenoid sinus• D= Cross section of the greater wing of the sphenoid (ant. wall of middle cranial fossa)Lateral Skull Projection• Lower portion of Lateral Head PlateLateral Skull Projection• A= Zygomatic process of the maxilla closer to the film• B= Zygomatic process of the maxilla further to the film • C= Dorsal border of tongue• D= Pterygoid plate complex• E= Soft palateLateral Skull Projection• A= Hard palate• B= Lingual cortical plate of mandible (anterior part)• C= NasopharynxLateral Skull ProjectionPostero-Anterior (PA) Skull Projection• Midsagittal plane of the head is perpendicular to the film • Forehead and the nose touch the film • X-ray beam is perpendicular to the film *See the auto-tutorial for Antero-posterior (AP) View Postero-Anterior (PA) Skull Projection• Upper portion of PA ViewPostero-Anterior (PA) Skull Projection• A= Orbital plate of frontal bone• B= Frontal spine• C= Sup. border of orbit• D= Sphenoid sinusPostero-Anterior (PA) Skull Projection• A= Lesser wing of sphenoid• B= Ethmoid sinus• C= Middle nasal meatus• D= Oblique orbital line (innominate line)• E= Floor of posterior cranial fossaPostero-Anterior (PA) Skull Projection• A= Lacrimal canal• B= Middle nasal concha• C= Vomer• D= Mastoid air cells• E= Atlas-occipital condyle articulationPostero-Anterior (PA) Skull Projection• Lower portion of PA ViewPostero-Anterior (PA) Skull Projection• A= Zygomatic process of maxilla• B= Anterior border of ascending ramus• C= Coronoid process• D= Odontoid process of axis• E= Maxillary tuberosityPostero-Anterior (PA) Skull Projection• A= Inferior nasal concha• B= Inferior nasal meatus• C= Occipital condyle• D= Maxillary sinusPostero-Anterior (PA) Skull Projection• A= Wall of nasal fossa• B= Angle of the mandible• C= Body of the mandible• D= Maxillary sinus• E= Nasal septumPostero-Anterior (PA) Skull ProjectionWater’s Projection(Water's (PA Oblique) View)• Midsagittal plane of the head is perpendicular to the film • chin touches the film• X-ray beam is perpendicular to the filmWater's Projection• A= Frontal sinus• B=Crista galli• C=Supraorbital notch• D=Lesser wing of sphenoidUpper portion of Water’sWater's Projection• A= Foramen rotundum• B= Foramen ovale• C= Nasal septum• D= Floor of middle cranial fossaCenter portion of Water’sWater's Projection• A= Sphenoid sinus• B= Infraorbital foramen and canal• C= Superior orbital fissureCenter portion of Water’sWater's Projection• A= Inferior aspect of the base of skull• B= Odontoid process of axis• C= Inferior border of body of mandibleLower portion of Water’sWater's ProjectionSubmentovertex (SMV) Projection • Midsagittal plane is perpendicular to the film • The central beam enters perpendicular to the image receptor and is centered about 2 cm anterior to the condyles• See the auto-tutorial for anatomical landmarksSubmentovertex (SMV) ProjectionLateral Transcranial View of TMJ• Midsagittal plane of the head is parallel to the film• X-ray beam enters the opposite side from a point approximately 2” superior and 1” posterior to the external auditory meatus • Beam is directed postero-anteriorlyLateral Transcranial View of TMJLateral Transcranial View of TMJLateral Transcranial View of TMJLateral Transcranial View of TMJOPEN VIEWPanoramic radiograph • Panogram• A= Infraorbital rim• B= Zygomatic process of maxilla• C= Condyle• D= Coronoid process• A= Common nasal meatus• B= Inferior nasal concha• C= Hard palate• D= Superior border of the tongue• A= Nasal septum• B= Hyoid bone• C= Zygomatic process of temporal bone• D= Inferior nasal meatus• A= Posterior wall of maxillary sinus• B= Hard palate• C= Soft palate• D= Maxillary tuberosity• A= Inferior border of mandibular canal• B= Left maxillary sinus• C= Ear lobe• D= Mental foramenA. Articular eminenceB. Sigmoid notchC. Shadow of contralateral mandibleD. Glenoid fossaE. Posterior border of ramusF. Inferior border of mandibleQuiz