Deck 16: The Occlusal Examination

Question 1

Bitewing radiographs are especially useful in detecting caries on which of the following tooth surfaces?

A) Mesial
B) Occlusal
C) Facial
D) Lingual

Answer 1

Mesial

Question 2

The disadvantage of using the largest size image receptor possible to expose a bitewing radiograph is that:

A) unnecessary structures will be imaged.
B) exposure times must be increased.
C) anatomical limitations may hinder ideal placement.
D) it is contraindicated for patients with periodontal disease.

Answer 2

anatomical limitations may hinder ideal placement.

Question 3

Using an image receptor holder with an external aiming device will most likely eliminate what error?

A) Overlapping
B) Unequal distribution of arches recorded
C) Cone cutting
D) Incorrect placement of the image receptor

Answer 3

Cone cutting

Question 4

Each of the following statements regarding preparations for bitewing exams is correct EXCEPT one. Which one is the EXCEPTION?

A) The dental x-ray machine should be turned on and the exposure setting selected prior to placing the image receptor intraorally.
B) The radiographic procedure should be explained to the patient prior to beginning the exposures.
C) The patient's head should be positioned with the mean tangent parallel to the floor.
D) The patient should be asked to remove eyeglasses and all intraoral appliances prior to placement of the image receptor.

Question 5

Recording an unequal distribution of the arches is caused by incorrect:

A) vertical angulation.
B) horizontal angulation.
C) centering of the x-ray beam.
D) aligning of the anterior edge of the image receptor with the teeth of interest.

Question 6

Which of the following statements regarding managing bitewing exposures is correct?

A) The patient should be instructed to close so that the teeth occlude normally.
B) The bite tab should be held firmly against the lingual surface of the mandibular teeth while the patient closes.
C) The film packet should be inserted vertically into the patient's mouth.
D) The bite tab should be held firmly to permit the film to drift bucally.

Question 7

Which of the following is the cause of overlap error, when the overlapping appears to be more severe in the distal or posterior region of the image?

A) The horizontal angulation was directed obliquely from the mesial
B) The horizontal angulation was directed obliquely from the distal
C) The horizontal angulation was directed obliquely from the occlusal
D) The horizontal angulation was directed obliquely from the apical

Question 8

What is the result if a bitewing radiograph is exposed using a negative 10-degree vertical angulation?

A) More maxillary teeth and alveolar bone will be recorded.
B) More mandibular teeth and alveolar bone will be recorded.
C) The image of the arches will appear tilted across the horizontal plane.
D) The image of the arches will appear tilted across the vertical plane.

Question 9

Each of the following statements regarding vertical angulation is correct EXCEPT one. Which one is the EXCEPTION?

A) The correct vertical angulation for bitewing radiographs is +10 degrees.
B) Vertical angulation is indicated on a dial on the side of the tube head.
C) Negative angulation directs the central ray downward toward the floor.
D) Vertical angulation is measured in degrees.

Question 10

For bitewing radiographs, the image receptor is placed near and almost parallel to the teeth of both arches while the patient holds the mouth in an open position.

Question 11

For an adult horizontal or vertical molar bitewing, align the film packet so that the anterior edge lines up:

A) behind the distal half of the first premolar.
B) behind the distal half of the second premolar.
C) in front of the mesial half of the first premolar.
D) in front of the mesial half of the second premolar.

Question 12

Which of these statements regarding the anterior bitewing exam is FALSE?

A) The longer dimension of the image receptor is usually placed vertical.
B) For ease of placement and to avoid bending, the use of a size #1 image receptor is recommended.
C) Use of a longer bite tab allows for placement of the image receptor farther lingually in the mouth.
D) Vertical angulation used for anterior bitewings is increased over that used for posterior bitewings.

Question 13

Which of the following is most likely to result in a retake of a bitewing radiograph?

A) The patient maintained a steady pressure on the bite tab.
B) The patient swallowed during the exposure.
C) There are no large tori or severely malpositioned teeth.
D) The top edge of the image receptor did not contact the lingual gingiva.

Question 14

Which of the following statements regarding bitewing image receptor holders is NOT correct?

A) Disposable bitewing holder tabs and loops are available.
B) Two stick-on paper bite tabs may be attached to lengthen the bite tab.
C) Bitewing loop holders are limited to use with vertical bitewing radiographs.
D) Stick-on bitewing tabs are available for both film and digital sensors.

Question 15

Conecut error results from incorrect:

A) vertical angulation.
B) horizontal angulation.
C) centering the x-ray beam.
D) aligning the anterior edge of the image receptor with the teeth of interest.

Question 16

Each of the following statements regarding horizontal angulation is correct EXCEPT one. Which one is the EXCEPTION?

A) Contact points should appear open or separate from each other on the radiograph.
B) The central ray should be directed parallel to the curvature of the arch.
C) Overlapped contact points result when incorrect horizontal angulation is used.
D) Horizontal angulation is the positioning of the central ray in a side-to-side plane.

Question 17

For an adult horizontal premolar bitewing, position the image receptor so that the anterior edge lines up:

A) behind the distal half of the canine.
B) between the first and second premolars.
C) behind the distal half of the first premolar.
D) in front of the mesial half of the second premolar.

Question 18

Each of the following statements regarding successful patient preparation for bitewing radiographs is correct EXCEPT one. Which one is the EXCEPTION?

A) Position the image receptor close to the lingual surfaces of the teeth.
B) Base image receptor size on the size of the arches.
C) Check for anatomical obstructions before positioning the image receptor.
D) Caution the patient not to swallow or let the teeth separate during the exposure.

Question 19

Which of the following image receptor sizes would necessitate that only two bitewing radiographs be exposed?

A) Size #0
B) Size #1
C) Size #2
D) Size #3

Question 20

Which of the following statements is FALSE?

A) Malaligned teeth may necessitate the exposure of additional bitewing radiographs.
B) Bitewing radiographs are not required if a full mouth series of periapical radiographs is available.
C) When patients present with edentulous areas, bitewing radiographs may not be needed.
D) Children with mixed dentitions may not need bitewings if a visual inspection of the proximal surfaces is possible.

Question 21

Overlap refers to an elongated or foreshortened image on a bitewing radiograph.

Question 22

Traditionally, the image receptor for a bitewing radiograph has been placed with the longer dimension vertically in the posterior region.

Question 23

Sometimes there is a need to expose more than four bitewing radiographs on an individual patient.

Question 24

Where should the anterior edge of the image receptor be placed to record a premolar bitewing radiograph?

Question 25

The size #3 image receptor has two advantages over a size #2 image receptor when exposing a bitewing radiograph.

Question 26

A periodontally involved patient would benefit more from vertical bitewing radiographs than traditionally placed bitewing radiographs.

Question 27

When exposing a set of four posterior bitewing radiographs, it is recommended that the molar bitewing be exposed first, followed by the premolar bitewing on the same side, before switching sides.

Question 28

Bitewings are limited in their ability to image the entire tooth.

Question 29

Periapical radiographs image the alveolar bone crest better than bitewing radiographs.

Question 30

Anterior bitewings should be exposed using a vertical angulation of +20 degrees.

Question 31

Because the proximal surfaces of the molars are in a buccolingual relationship to the patient's sagittal plane, conventional image receptor placement parallel to the buccal surfaces of the molars often results in overlapping of the contact area and closure of the embrasure spaces.

Question 32

The smallest available image receptor should be used to take bitewings on the child patient.

Question 33

The term used to describe the contact point between teeth in the same arch is "proximal surface."

Question 34

There are four radiographs in a posterior bitewing survey.

Question 35

When a class II occlusal relationship presents, the anterior edge of the image receptor should be positioned behind the distal half of the maxillary canine for a premolar bitewing.

Question 36

The true value of bitewing radiographs is that proximal surface caries may be identified.

Question 37

To avoid overlap error, the central ray of the x-ray beam should be directed perpendicular to the mean tangent.

Question 38

The name bitewing is descriptive.

Question 39

If periapical radiographs are available, there is no need to expose additional bitewing radiographs.

Question 40

If the image receptor holder is not positioned precisely, the resultant image may be undiagnostic.

Question 41

What size image receptor is used for bitewing radiographs on a child with primary teeth?

Question 42

What is the main purpose of the bitewing radiograph?

Question 43

What type of error results when the image receptor is not centered within the x-ray beam?

Question 44

Which two angulations are critical to producing quality bitewing radiographs?

Question 45

What is the orientation of a traditionally placed bitewing radiograph in the posterior regions?

Question 46

What is the name of the portion of the image receptor holder that helps the radiographer determine the point of entry?

Question 47

What is the name of the location the central ray is directed toward on the patient's face?

Question 48

For bitewing radiographs, the radiographer should strive to ensure placement of the image receptor so that more of which arch, maxillary or mandibular, will be imaged?