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Object Localization
The following slides describe
Object Localization, including the
Right Angle Technique and the
Tube Shift Technique.
Object Localization
A periapical film will identify the location of an object
vertically and in a horizontal (mesiodistal) direction.
However, we cannot tell where the object is located
buccolingually, since the periapical film is twodimensional. Therefore we need another method for
locating objects in a buccolingual direction. The two
primary methods of determining the buccolingual
location of objects are:
Right-Angle Technique (Occlusal projection)
Primarily identifies buccolingual location, but may
also confirm mesiodistal location seen on periapical
Tube-shift Technique (SLOB rule, Clarks rule)
Utilizes two films with different horizontal or vertical
angulations
incisors
canine
premolar
molar
In moving from the incisor film to the canine film, the
canine film to the premolar film and the premolar film to the
molar film, the tubehead moves distally and the beam is
directed more mesially. There is not much change in
angulation from the premolar to the molar film; the normal
situation would be that the beam is directed slightly more
from the distal (or to the mesial) as the tubehead is moved
distally for the molar projection.
mesial
Horizontal movement
In the diagram at left, the
buccal (yellow) and lingual
(red) objects of interest are
superimposed on each other
because the beam is directed
perpendicular to both of them
and they are in the same
relative position mesiodistally
and vertically. Both images are
located above the second
molar.
distal
distal
mesial
Horizontal movement
mesial
distal
distal
mesial
mesial
Horizontal movement
In the diagram at right, the
tubehead is moved mesially
and the beam is directed
distally. On the radiograph, the
buccal object of interest
(yellow) moves distally
(opposite to tubehead
movement) in relation to the
second molar and the lingual
object of interest (red) moves
mesially (same direction as
tubehead) in relation to the
second molar.
distal
distal
mesial
Maxillary PA
BW
Mandibular PA
In moving from the maxillary periapical to the bitewing
and from the bitewing to the mandibular periapical, the
tubehead moves down and the beam is redirected
upward (opposite direction; decreased vertical
angulation).
Vertical movement
In the diagram at left, the
buccal (yellow) and lingual
(red) objects of interest are
superimposed on each other
because the beam is directed
perpendicular to both of them
and they are in the same
relative position mesiodistally
and vertically. Both images are
superimposed over the
mandibular second premolar.
Vertical movement
In the diagram at left, the
tubehead is moved upward
and the beam is directed
downward. On the radiograph,
the buccal object of interest
(yellow) moves down
(opposite to tubehead
movement) in relation to the
second premolar and the
lingual object of interest (red)
moves up (same direction as
tubehead) in relation to the
second premolar.
Vertical movement
In the diagram at left, the
tubehead is moved downward
and the beam is directed
upward. On the radiograph,
the buccal object of interest
(yellow) moves up (opposite
to tubehead movement) in
relation to the second
premolar and the lingual
object of interest (red) moves
down (same direction as
tubehead) in relation to the
second premolar.
premolar
molar
For the films above, we know that the tubehead was moved
distally from the premolar to the molar film. The zygomatic
process (red arrows) is located at the distal aspect of the
2nd molar on the premolar film and it is located over the
distal aspect of the 1st molar on the molar film. This
indicates that it moved mesially as the tubehead moved
distally. We know that the zygomatic process is buccal to
the teeth and, using the SLOB rule, it follows that the x-ray
beam was directed more mesially on the molar film (Buccal
object moved opposite to tubehead movement).
premolar
molar
canine film
incisor film
The
Is the
restoration
composite
isrestoration
located on on
thetooth
buccal.
# 8The
(arrows)
tubehead
moves
locatedmesially
on the buccal
from the
or canine
lingual?film to the incisor film
(x-ray beam projected more distally) and the composite
moves distally, which is the opposite direction.
2
premolar film
canine film
The
arrow
in the canine
film iscanal.
pointing
the guttamoves
The
arrow
identifies
the lingual
Thetotubehead
percha from
in which
canal of the
first premolar?
mesially
the premolar
filmmaxillary
to the canine
film (beam
directed more distally) and the gutta percha indicated by
the arrow also moves mesially. (See following slide).
lingual
buccal
PID
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This
is
the
canal.
The
tubehead
goes
The
red
arrow
is
pointing
the
gutta
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in
The
arrow
points
ato
threaded
post.
In the
Thepink
post
isbuccal
located
in to
the
lingual
canal.
As
distally
from
the
canine
film
to
the
premolar
film
which
canal
of
this
maxillary
left
first
premolar?
which
canal
of
this
maxillary
left
second
premolar
tubehead
moves
distally
from
the
canine
film
to
and
the
gutta
percha
mesially
to distally
be
is
the
post
located?
the
premolar
film, themoves
post also
moves
positioned
over
thethat
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which
has the
to cover the
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hascanal
all gutta
percha.
threaded post.
premolar film
premolar bitewing
molar film
TheIs
tubehead
movessecond
distally from
the maxillary
the premolar
premolar film
to the molar film.
(arrows)
Thedisplaced
second premolar
also moves
to the buccal
distally,
overlapping
or the
lingual? the first molar
more in the molar film. In moving
from the premolar periapical to the
bitewing, the tubehead moves
down and the premolar also moves
down. The displacement is to the
lingual.
incisor film
canine film
The
Is
the
lateral
displaced
incisor
incisor
is displaced
(arrows)tolocated
the lingual.
on the
The
buccal
or the lingual?
tubehead
moves distally from the incisor film to the
canine film. The lateral incisor also moves distally,
covering half the canine on the canine film.
canine film
premolar film
i n e fi
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a
c
t fo r
n
e
m
lace
p
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lm
PID plac
ement fo
r
premola
r film
root tip
film placement for premolar film
premolar film
incisor film
incisor film
canine film
10
11
12
premolar film
molar film
13
Is the restoration
indicated by the red
arrows located on the
buccal or lingual of the
first premolar?
14
15
premolar film
incisor film
canine film