Bitewings and periapicals
Recognise projection and exposure errors. Interpret the whole image for caries, bone levels, periapical disease and incidental findings.
Understand
Intraoral images offer detail but are prone to positioning, angulation and processing errors. Overlapping contacts obscure proximal caries; foreshortening or elongation alters apparent roots.
Assess
Evaluate image quality before interpreting. Review the entire field for caries, bone levels, restorations, periapical findings and incidental abnormalities.
Apply
Repeat only when the missing information justifies additional dose. Distinguish a projection artefact from pathology and compare with clinical tests.
Key distinctions
Horizontal angulation affects contact overlap; vertical angulation affects root length appearance and crestal assessment. Positioning, sensor placement and patient movement can mimic or obscure disease. Systematic interpretation includes bone pattern and restorations as well as the target lesion. If a view is inadequate, specify which question remains unanswered before repeating it.
Think through a case
A bitewing shows overlapping premolar contacts. The projection limits proximal caries detection there even if the exposure is otherwise clear.
The distinction to remember
Do not report a surface as caries-free when it was not adequately visualised.
Test your recall
Why might overlapping contacts limit caries assessment?
Show answer
The proximal surfaces are obscured.