Applying the paralleling technique in intraoral periapical radiographs for Japanese patients by analyzing CT images

Oral Radiol. 2021 Apr;37(2):311-320. doi: 10.1007/s11282-020-00454-x. Epub 2020 Jun 20.


Objectives: The aim of this study was to investigate the size of the teeth and palatal heights to determine if it is possible to apply the paralleling technique in the upper molar region in Japanese patients.

Methods: The medical computed tomography (CT) data of ten patients were analyzed. A minimum intensity projection image with 8-mm slice thickness was created for each second premolar, first molar, and second molar tooth. We traced the tooth, the alveolar bone, the plate bone surface, and the cheek skin surface on a tracing paper. Tooth length (TL), palatal height (PH), distance between a tip of the cheek and each tooth (D1), and distance between each tooth and the receptor (D2) were measured. The measurements were performed by two observers, and the measurements were repeated twice by each observer. Two potential situations were considered for application of the paralleling technique.

Results: We analyzed whether there was a possibility for application of the paralleling technique comparing the TL and the PH for each case by considering the magnification rate calculated from D1 and D2, the palatal mucosa thickness, and the safety margin within the resultant image. The data suggested that applying the paralleling technique was impossible in 95% of cases. In the cases where application of the paralleling technique was impossible, the incident angle of X-ray increased by 31.6°.

Conclusions: We concluded that the paralleling technique could not be applied in Japanese patients due to insufficient space for the image receptor in the upper maxilla region.

Keywords: Dental radiography; Radiographic magnification; Radiography; Radiologic technology; X-rays.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Humans
  • Japan
  • Molar*
  • Radiography
  • Tomography, X-Ray Computed
  • Tooth*