PROJECTION

GEOMETRY
 • Introduction
• Image characteristics
• Image sharpness and resolution

• Image size distortion[magnification

CONTENTS
• Image shape distortion

• Object localization

• Peripheral egg shell effect

  A conventional radiograph is made with a
stationary x-ray source and displays a two-
dimensional image of a part of the body. Such
images are often
called plain or projection views (in contrast to
ultrasound, computed tomography [CT],
Introduction magnetic resonance imaging, or nuclear
medicine).
 In plain views, the entire volume of tissue
between the x-ray source and the image receptor
(digital sensor or film) is projected onto a two-
dimensional image.
To obtain the maximal
value from a
The principles of
radiograph, a clinician
projection geometry
must have a clear
describe the effect of Clinicians use these
understanding of
focal spot size and principles to maximize
normal anatomy and
relative position of the image clarity,
mentally reconstruct a
object and image minimize distortion,
three-dimensional
receptor (digital sensor and localize objects in
image of the anatomic
or film) on image the image field
structures of interest
clarity, magnification,
from one or more of
and distortion.
these two-dimensional
views.
Image Characteristics

 The degree and pattern of film darkening depend on numerous

factors, including the energy and intensity of the x-ray
beam ,composition of the subject imaged, film emulsion used and
characteristics of film processing
 It include density, contrast, speed, and latitude.
 Radiographic density

 The overall degree of darkening of an exposed film is referred to as radiographic

density. Measured as the optical density of an area of an x-ray film, where
 Io
OPTICAL DENSITY = Log 10 ----------
It

 I o – intensity of incident light(from view box)

 I t - intensity of light transmitted through the film.
 The measurement of film density is also a measure of the opacity of the film.
 -when optical density is 0 means 100% of the light is transmitted.
 -Optical density is 1 means 10% of the light is transmitted.
 -Optical density is 2 means 1% of the light is transmitted.
 A plot of the relationship between film
optical density and exposure is called a
characteristic curve.(fig).
 A film is of greatest diagnostic value when
the structures of interest are imaged on the
relatively straight portion of the graph,
between 0.6 to 3.0 optical density units.
Fig : characteristic curve of direct
 Gross fog or base plus fog : an unexposed exposure film. The contrast (slope of
film, when processed , shows some density the curve is greater in the high-density
caused by the inherent density of the base , region than in the low-density region.
added tint and he development of unexposed
silver halide crystals.
 The optical density of gross fog is 0.2 to 0.3
 Radiographic density is influenced by
 Exposure
 Subject thickness and
 Subject density
A ) Exposure : - the overall film density depends on the number of photons absorbed
by the film emulsion.
kVp
the no. of photons reaching the film and thus
mA

exposure time distance density of the radiograph

between, the focal spot
and film
 B) subject thickness: the thicker the
subject, the more the beam is
attenuated and the lighter the resultant
image.
 The exposure (either kVp or time
should be vary according to the
patient’s size to produce radiographs of
optimal density.

Fig : a) aluminum step wedge. B) graph of the optical density of a

radiograph made by exposing the step wedge . As the thickness of
the aluminum decreases, more photons are passed through the
wedge and are available to expose the film and the image becomes
progressively darker.
C ) subject density : the greater the density of a structure within the subject, the
greater the attenuation of the x-ray beam.
 In the oral cavity , the relative densities of various natural structure, in order of
decreasing density are enamel, dentin, and cementum , bone, muscles , fat and
air.
 Metallic objects (e.g. restorations) are far denser than enamel and hence better
absorbers.
 Dense objects (which are strong absorbers) cause the radiographic image to be
light and are said to be radiopaque. Less dense object (which are weak absorbers)
cause the radiographic image to be dark and are said to be radiolucent.
 Radiographic contrast
 Defined as the difference in densities between light and dark
regions on a radiograph.
High contrast
(short gray scale of contras) shows both light areas and dark
areas.
low contract
(long gray scale of contract) composed only of
light gray and dark gray

zone Figure : radiograph of a dried mandible

revealing low contrast (a) and high
contrast(b)
 A ) subject contrast :
 Influenced largely by the subject’s thickness,
density and atomic number.
 Also is influenced by beam energy and
intensity.
 As the kVp of the x-ray beam increases,
subject contrast decreases low kVp energies
are used, subject contrast increases
 Changing the time or mA of the exposure
(KVp constant) also influences subject Figure : seven radiographs of a step wedge made
contrast. at 40 to 100kVp shown side by side density. As the
kVp increased, the mA was reduced to maintain a
 If the film is excessively light or dark, roughly uniform middle-step density. Note the
contrast of anatomic structures is diminished. long gray scale (low contrast) image with high
kVp and the short scale (high contrast) image
when using low kVp.
 B ) Film Contrast:-
 Describes the capacity of radiographic
films to display differences in subject
contrast.
 A high-contrast film reveals areas of small
difference in subject contrast
 Properly exposed films have more contrast
than underexposed (light films)
 Film processing influences film contrast. Figure ; characteristic curves of two films
demonstrating the greater inherent contrast of film A
 Film contrast is maximized by optimal film compared with film B. the slope of the film A is
processing conditions. greater than the slope of the film B; film A shows a
greater change in optical density than film B for a
constant change in exposure. The fact that film A is
faster than film B in this figure is unrelated to the film
 Improper handling of the film, such as
a) Storage at too high a temperature,
b) Exposure to excessively bright safe, degrades film lights
contrast.
c) Light leaks in the darkroom
 Fog on an x-ray film results in increase film density in turn
reduces the film contrast. Common causes of film fog are
a) Improper safelighting
b) Storage of film at too high a temperature, and
c) Development of film at an excessive temperature or for a
prolonged period.
Film fog can be minimized by proper film processing and storage
 C) Scattered radiation:
 Scattered radiation results from photons that have interacted with
the subject by compton or coherent interactions.
 Scattered radiation causes fogging of a radiograph.
 Scattered radiation can be reduced by
a) Use a relatively low kVp
b) Collimate the beam to the size of the film to prevent scatter from
an area outside the region of the image, and
c) Use grids in extraoral radiography.
 RADIOGRAPHIC SPEED

A fast film requires a

Refers to the amount of relatively low exposure to Controlled largely by the
radiation required to produce a density of 1, size of the silver halide
produce an image of a whereas a slower film grains and their silver
standard density. requires a longer content.
exposure .

INSIGHT film is preferred

The films most often used because it requires only
are kodak ultraspeed about half the exposure of
(group D) and kodak ultra speed film and offers
INSIGHT (group E or F). comparable contrast and
resolution.
TABLE : INTRAORAL FILM SPEED CLASSIFICATION per ISO 3665 and
ISO 5799
FILM SPEED GROUP SPEED RANGE (RECIPROCAL ROENTGENS )

C 6- 12

D 12 - 24

E 24-48

F 48 - 96
 F-speed film is faster than the D-speed film
because tabular crystal grains are used in the
emulsion of F-speed film.
 Film speed can be increased by processing
the film at a higher temperature
 Processing in depleted solutions can lower the
effective speed.
 It is always preferable to use fresh processing
solutions and follow the recommended Figure : characteristic curves for INSIGHT and
processing time and temperature. ultra-speed film.. INSGHT film is faster and
has essentially the same contrast(slope) as
ultra-speed film. INSGHT film requires only
half as much patient exposure and is the
preferred film.
 FILM LATITUDE:
Measure of the range of exposure that can be
recorded as distinguishable densities on a film.
 A film with a characteristic curve that has a long
straight-line position and a shallow slope has a
wide latitude.
 Wide latitude have lower contrast
 Wide-latitude films are useful when both the
osseous structures of the skull and soft tissues of Figure : characteristic curves for two
the facial region must be recorded. films demonstracting greater inherent
latitude of film B compared with film
 A high kVp produces images with a wide latitude A. the slope of film B is less steep than
the slope of film A; film B records a
and low contrast. Recommended for imaging
greater range of exposure within the the
structures with a wide range of subject densities. useful density range than film a
 RADIOGRAPHIC NOISE
 Is the appearance of uneven density of a uniformly exposed radiographic
film. Seen on a small area of film as localized variations in density.
 Primary causes of radiographic noise are
A) Radiographic mottle
B) Radiographic artifact
A)Radiographic Mottle:-
1. On intraoral dental film, mottle may be seen as film graininess
2. Graininess is most evident when high temperature processing is used
3. Mottle is also evident when the film is used with fast intensifying
screens
 Two important causes of radiographic mottle in intensifying screens
are
1) Quantum mottle – caused by a fluctuation in the number of
photons per unit of the beam cross-sectional area absorbed by the
intensifying screens.
2) Screen structure mottle is graininess caused by screen phosphors.

 B) Radiographic Artifacts: Radiographic artifacts are defects

caused by
1. Errors in film handling, such as finger prints or bends in the film, or
2. Errors in film processing, such as splashing developer or fixer on a
film or marks or scratches from rough handling.
 RADIOGRAPHIC BLURRING
Sharpness – ability of a radiograph to define an edge precisely (e.g.,
dentino enamel junction, a thin trabecular plate).
Resolution, or resolving power, is the ability of a radiograph to
record separate structures that are close together.
 Usually measured by radiographing an object made up of a series
of thin lead strips with alternating radiolucent spaces of the same
thickness.
 The resolving power is measured as the highest number of line Figure: radiograph of a
pairs per millimeter. resolving power target
consisting of group of
 Panoramic film-screen combinations can resolve about five line radiopaque lines and
pairs per millimeter. radiolucent space. Numbers
at the each group indicate
 Periapical film has better resolving power, can delineate clearly the number of line pairs per
millimeter represented by
more than 20 line pairs per millimeter. the group.
 Radiographic blur is caused by
A) Image receptor (film and screen) blurring
B) Motion blurring, and
C) Geometric blurring
A. Image receptor blurring:
1. with intraoral dental x-ray film, the size and number of silver grains in
the film emulsion determines image sharpness.
Finer the grain size finer the sharpness slow-speed films have fine
grains and faster films have larger grains
2. use of intensifying screens in extra-oral radiography has an adverse effect
on image sharpness.
 In intensifying screens parallax
distortion contributes to image
unsharpness because light from one
screen may cross the film base and
reach the emulsion on the opposite
[Link] can be solved by
incorporating dyes into the base that
absorb the light emitted by the screens Figure : parallax unsharpness result when
double-emulsion film is used because of
the slightly greater magnification of the
object on the side of the film away from
the x-ray source. Parallax unsharpness is a
minor problem in clinical practice.
B) Motion Blurring:
 Image sharpness also can be lost through movement of the film, subject or
x-ray source during exposure.
C) Geometric Blurring:
 Several geometric factors influence image sharpness
 Image sharpness is improved by
a) Using as small focal spot area as possible
b) Increasing the distance between the focalspot ad the object (and
film)
c) Reducing the distance between the object and the image receptor
(film)
  Image Sharpness measures how well a
boundary between two areas of differing
radiodensity is revealed.
Image  Image spatial resolution measures how
well a radiograph is able to reveal small
Sharpness objects that are close together.
and  Although sharpness and resolution are two
distinct features, they are interdependent,
Resolution being influenced by the same geometric
variables. For clinical diagnosis, it is
desirable to optimize conditions that result in
images with high sharpness and resolution.
 originate from different
x rays are produced at the
points and travel in
target in an x-ray tube
straight lines,

their projections of a
the image of the edge of
feature of an object do not
an object is slightly
occur at exactly the same
blurred rather than sharp
location on an image
and distinct.
receptor.
 FIGURE 1 : Photons
originating at different places
on the focal spot (red) result
in a zone of unsharpness on
the radiograph. The density of
the image changes from a
high background value to a
low value in the area of an
edge of enamel, dentin, or
bone. On the left, a large focal
spot size results in a wide
zone of unsharpness
compared with a small focal
spot size on the right, which
results in a sharper image
(narrow zone of unsharpness)
 There are three means to maximize image sharpness:
 1. Use as small an effective focal spot as practical. Dental x-ray machines preferably
should have a effective focal spot size of 0.4 mm because this greatly adds to image
clarity,the size of the effective focal spot is a function of the angle of the target with
respect to the long axis of the electron beam.

A large angle distributes the electron beam

over a larger surface and decreases the A small angle has a greater wearing
heat generated per unit of target area, thus effect on the target but results in a
prolonging tube life; however, this results smaller effective focal spot and
in a larger effective focal spot and loss of increased image sharpness
image clarity.
 FIGURE 2: As the angle of
the target becomes closer to
perpendicular to the long axis
of the electron beam (as
shown on the right) the actual
focal spot becomes smaller,
which decreases heat
dissipation and tube life. The
more perpendicular angle also
decreases the effective focal
spot size, increasing the
sharpness of the resulting
image.
 2. Increase the distance between
the focal spot and the object by
using a long, open-ended
cylinder. As increasing the focal
spot-to-object distance reduces
image blurring by reducing the
divergence of the x-ray beam. A
longer focal spot-to-object distance
minimizes blurring by using
photons whose paths are almost
parallel. The benefits of using a
long focal spot-to-object distance
support the use of long, FIGUREopen- 3:Increasing the distance between the focal spot and the
ended cylinders as aiming devices
object results in an image with increased sharpness and less
on dental x-ray machines. magnification of the object as seen on the right
 3. Minimize the distance
between the object and the
image receptor. as the object-
to-image receptor distance is
reduced, the zone of
unsharpness decreases,
resulting in enhanced image
clarity. This is the result of
minimizing the divergence of
the x-ray photons

FIGURE 4 Decreasing the distance between the object

and the image receptor increases the sharpness and
results in less magnification of the object as seen on the
left
 Image Size Distortion

 Image size distortion (magnification) is the increase in size of the image on

the radiograph compared with the actual size of the object.
 The divergent paths of photons in an x-ray beam cause enlargement of the
image on a radiograph.
 Image size distortion results from the relative distances of the focal spot-to-
image receptor and object-to-image receptor (Figs. 3 and 4).
 Increasing the focal spot-to-image receptor distance and decreasing the
object-to-image receptor distance minimizes image magnification.
 The use of a long, open-ended cylinder as an aiming device on an x-ray
machine thus reduces the magnification of images on a periapical view.
 As previously mentioned, this technique also improves image sharpness by
increasing the distance between the focal spot and the object
Image Shape Distortion

 Image shape distortion is the result of unequal magnification of

different parts of the same object.
 This situation arises when not all the parts of an object are at the same
focal spot-to-object distance.
 The physical shape of the object may often prevent its optimal
orientation, resulting in some shape distortion. Such a phenomenon is
seen by the differences in appearance of the image on a radiograph
compared with the true shape
 To minimize shape distortion, the
practitioner should make an effort to
align the tube, object, and image
receptor carefully according to the
following guidelines:
 1. Position the image receptor parallel to
the long axis of the object. Image shape
distortion is minimized when the long
axes of the image receptor and tooth are
parallel. The central ray of the x-ray
beam is perpendicular to the image
receptor, but the object is not parallel to
the image receptor.
Fig 5 : foreshortening of a radiographic images results when the
central ray is perpendicular to the image receptor but the object is
not parallel with image receptor.
 The resultant image is distorted because
of the unequal distances of the various
parts of the object from the image
receptor.
 This type of shape distortion is
called foreshortening because it causes
the radiographic image to be shorter than
the object. The x-ray beam is oriented at
right angles to the object but not to the
image receptor; this results
in elongation, with the object appearing
longer on the image receptor than its
actual length.

Fig 6 : elongation of a radiograph image results when the

central ray is perpendicular to the object but to the image
receptor.
2. Orient the central ray perpendicular
to the object and image receptor.
 Image shape distortion occurs if the
object and image receptor are parallel,
but the central ray is not directed at
right angle to each.
 This distortion is most evident on
maxillary molar views
 If the central ray is oriented with an
excessive vertical angulation, the palatal
Fig 7 : the
roots appear disproportionately central ray should be perpendicular to the long axes of the tooth
longer
than the buccal roots. and the images receptor. If the direction of the x-ray beam is not at right
angles to the long axis of the tooth,the appearance of the tooth is distorted,
typically by apparent elongation of the length of the palatal roots of the
upper molar and distortion of the relationship of the height of the alveolar
crest relative to the cementoenamel junction.
 PARALLELING TECHNIQUE

 The central concept of the

paralleling technique (also
called the right-angle
technique or long technique ) is
that X-ray receptor is supported
parallel to the long axis of the
teeth and the central ray of the
x-ray beam is directed at the
right angles to the teeth and
receptor.
Fig 8 : paralleling technique illustrates the parallelism
between the along axis of the tooth and the receptor. The
central ray is directed perpendicular to each . This
technique minimizes image diction but requires a
receptor holder
 This orientation of the receptor, teeth, and central ray minimizes
geometric distortion and presents the teeth and supporting bone in
their true anatomic relationships.
 To reduce geometric distortion , the x-ray source should be located
relatively distant from the teeth.
 The use of a long source-to-object distance reduces the apparent
size of the focal spot, thus increasing images sharpness and provides
images with minimal magnification.
Receptor holding instruments

 It is also important to use a receptor-holding

instrument that has an external guiding ring.
 This guiding ring is used to align the x-ray
aiming cylinder and ensures that the receptor is
centered in the beam behind the teeth of interest
and the receptor and teeth are perpendicular to
the x-ray beam.
 These should be used with rectangular collimator
to reduce patient exposure. Fig 9 : Receptor–holding instruments. XCP instrument
for anterior views shown with sensor and cord wrapped
in disposable sensor cover for infection control and to
protect the sensor from saliva.
Receptor placement
 For the best images, the receptor should be positioned
parallel to the teeth and deep in the patients mouth; this is
particularly important when rigid sensors are used because
they be larger than film.
 For maxillary projections, the superior border of the receptor
generally rests at the palatal vault in the midline.
 Similarly for mandibular projection, the receptor should be
used to displace the tongue posteriorly or towards the
midline to allow the inferior border of the receptor to rest on
the floor of the mouth away from the mucosa on the lingual
surface of the mandible.
 Angulation of the tube head

 Orient the aiming cylinder of the x-ray machine in the vertical and
horizontal plane to align with the aiming ring.
 The horizontal direction of the beam primarily influences the degree
of overlapping of the images of the crowns at the interproximal
spaces.(fig)
BISECTING ANGLE
TECHNIQUE

 It is based on simple geometric

theorem, Cieszynski’s rule of
isometry, which states that two
triangles are equal when they share
one complete side and have two
equal angles.
 Receptor holding instrument
 It is undesirable to have the patient support the receptor from the
lingual surface with his or her forefinger.
 Patient often use excessive force and bend the receptor, causing
distortion of the image.
Positioning of the patient

For images of the maxillary When the mandibular teeth

arch, the patient’s head are to be radiographed, the
should be positioned head is tilted back slightly
upright with the sagittal to compensate for the
plane vertical and the changed occlusal plane
occlusal plane horizontal. when the mouth is opened.
 Receptor placement

The receptor is positioned The occlusal or incisal If necessary for the patient’s
behind the area of interest, edge is oriented against comfort, the anterior corner
with the apical end against the teeth with an edge of of a film can be softened by
the mucosa on the lingual or the receptor extending bending it before it is
palatal surface. just beyond the teeth. placed against the mucosa.
 Angulation of the tube head

Horizontal angulation : Vertical angulation :

• the radiation beam is also centered • the clinician ‘s goal is to aim the central
ray of the x-ray beam at right angles to a
on the receptor. This angulation plane bisecting the angle between the
usually is at right angles(in the receptor and the long axis of the tooth.
horizontal projection) to the buccal • This principle works well with flat, two-
or facial surface of the teeth in each dimensional structure, but teeth that have
region. depth or are multirooted show evidence of
distortion.
• Excessive vertical angulation results in
foreshortening of the image, whereas
insufficient vertical angulation results in
image elongation.
 It is a technique used to locate the position of a tooth or object
in the jaws
 PURPOSE AND USE : It is two dimensional picture of a
three dimensional object and it t is used to locate
1. Foreign bodies OBJECT
2. Impacted teeth
3. Unerupted teeth
LOCALIZATION
4. Retained roots
5. Root position
6. Salivary stones
7. Jaw fractures
8. Broken needles and instruments
9. Filling materials
 OBJECT LOCALIZATION contd ….
 The dentist may wish to use radiographs to determine the location of a foreign
object or an impacted tooth within the jaw.
 Three methods are frequently used to obtain such three- dimensional
information.
The first is to examine two images projected at right angles to
each other.

The second method is to use the tube-shift technique employing

conventional periapical views

Third, in recent years, the advent of cone-beam imaging has

provided a new tool for obtaining three- dimensional information
 Method used to localize objects
• Buccal object rule(tube shift technique or clark’s rule)
Basic principle is that the
relative position of the A different horizontal
radiographic images of two
separate objects changes when
angles is used when trying
the projection angle at which to locate vertically aligned
the projection was made is images, e.g : roots canals.
changed.

A different vertical
angulation is used when
trying to locate a
horizontally aligned
image,e.g : mandibular
canal.
  One periapical or bitewing film exposed using
proper technique and angulation.
 A second periapical or bitewing is then exposed
after changing the direction of the x ray beam ,a
different horizontal or vertical angulation is
Method used.
 After the two films have exposed and
processed, the radiograph are compared with
each other SLOB stands for SAME LINGUAL
OPPOSITE BUCCAL
 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
reference object.
Figure : the position of an object may be determined with reference
structures with use of tube shift technique . In FIG A an object on the
lingual surface of the mandible may appear apical to the 2nd
premolar. Another radiograph is made of this region angulated from
mesially ,FIG B shows that object appears to have moved mesially
with respect to the 2nd premolar (“same lingual” in the acronym
SLOB)
  It is the another rule for the orientation of structures seen in
two radiographs.

METHOD :
 One periapical film is exposed using proper technique and

RIGHT ANGLE angulation to show the position of the object in the superior-
inferior and anterior-posterior relationships
TECHNIQUE  Next an occlusal film is exposed directing the central ray at a
right angle or perpendicular to the film.
 The occlusal film shows the object in the buccal- lingual and
anterior – posterior [Link] the two films have
been exposed and processed ,the radiograph are compared
with each other to locate the object in three dimensions .
 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.

Figure : the position of an object can be determined with respect to

reference structures with use of the shift technique. FIG A :- An object on
the buccal surface of the mandible may appear apical to the second
premolar. FIG B :- when another radiograph is made of this region
angulated from the mesial, the object appear to have moved distally with
respect to the second premolar apex(“opposite buccal” in the acronym
SLOB)
 A B

FIG A : periapical radiograph shows impacted canine lying apical to roots of lateral incisor
and first premolar .FIG B : the vertex occlusal view shows that canine lies palatal to the roots
of lateral incisor and first premolar.
 The position of the maxillary
zygomatic process in relation to
the roots of the molars can help
in identifying the orientation of
views.
Figure : a) the inferior border of the zygomatic process lies over
the palatal root of the first molar. B)the inferior border of the
zygomatic process lies posterior to the palatal root of the first
molar. This difference in position of the zygomatic process in
relation to the palatal root indicate that when the image in A as
made, the beam was oriented more from the posterior than when
the image in B was made. The same conclusion can be reached
independently by examining the roots of the first molar. The
palatal root lies behind the distobuccal root in the image in A, but
it lies between the tow buccal roots in the image in B
 PERIPHERAL EGG
SHELL EFFECT
 Projection images , those that project 3- dimensional
volume onto a two-dimensional receptor ,may
produce peripheral egg shell effect
 The top photon has a tangential path through apex
of the egg and a much longer path through the shell
of the egg than does the lower photon ,which strikes
the egg at right angles to the surface and travels
through two thickness of the shell.
 As a result , photons traveling through the periphery
of a curved surface are more attentuated than those
traveling at right angles to the surface
 The periphery of the expanded cortex
is more opaque than the region inside
the expanded border.
 The cortical bone is not thicker on
the cortex than over the rest of the
lesion, but rather the x-ray beam is
more attenuated in this region
because of the longer path length of
photons through the bony cortex on
the periphery.

FIGURE : an expansile lesion on the buccal surface of the

mandible on an occlusal view. The expanded cortex is more
opaque than the region inside the border as a result of the
eggshell effect.
REFERENCES

 Oral Radiology Principles and Interpretations – White and Pharoah edition 5.

 Essentials of Oral and Maxillofacial Radiology by Freny R. Karjodkar
 Principles of Projection Geometry. Neill Serman. August 2000 W&P Chapter 5