Endodontic Radiography Technique: Video Instructional

Terry Pannkuk, DDS, MScD Instructional, Clinical Endodontic Technique Instruction, Diagnosis

Highlights of the Endodontic Radiography Video Instructional:

General Clinical Principles:

  1. First check in the mouth for unusual positions of teeth, tilting, or rotations

  2. Anticipate difficulties like a narrow jaw, floor of mouth restriction, and tori or exostoses

  3. Place the sensor quickly with confidence to avoid gagging

  4. Avoid having the sensor rock upward on a mesial fulcrum tooth

  5. Rotate the patient's head to facilitate aiming the x-ray beam

  6. Take the bitewing (horizontal) radiograph first then adjust to get the periapical images.

  7. Adjust sensor tilt for the Curve of Spee

  8. Bicuspids may require mesial angulation

  9. Narrow arches require that the sensor be placed away from the tooth

  10. Cuspids can be aligned more like a bicuspid or more like an anterior tooth

  11. If the sensor is spaced away from the tooth (target), the x-ray head needs to be pulled back to avoid a distorted image; incorporate the bisecting angle technique if necessary

  12. Train the patient to keep the sensor in position without moving


  1. Mandibular Molar Radiography: Mandibular molar periapical radiographs should be taken from straight and from mesial off angle

  2. Mandibular Bicuspid Radiography

  3. Mandibular Cuspid Radiography

  4. Mandibular Anterior Radiography

  5. Maxillary Molar Radiography: upper molar periapical radiographs should be taken from straight and from distal off angle. The posterior maxillary molar strategy is to "dodge" away from the zygoma. Place the sensor in the center vault of the palate aligned vertically, not slanted toward the tooth

  6. Maxillary bicuspid radiographs

  7. Maxillary cuspid radiographs

  8. Maxillary anterior radiographs

After viewing this instructional video the dentist or dental assistant will be able to take excellent diagnostic radiographs for endodontic diagnosis and assessment.

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