Taking good implant X-rays made easy!

PD Dr. Kristina Bertl, PhD MSc MBA

To be able to diagnose peri-implant diseases correctly, it is helpful to have good-quality, informative X-rays. However, periapical bitewing X-rays of implants in particular can often turn out blurry. There is, however, one very simple rule you can follow to correct these images and to depict implant threads clearly and precisely, thus enabling exact determination of the patient’s bone level. Furthermore, this rule is easy to remember and, above all, can be implemented rapidly in daily clinical practice:

If right blur, then raise the beam & left blur, then lower the beam!“
or
„RB-RB / LB-LB“

What does this mean exactly? Regardless of whether you are taking an X-ray of an implant in the first/fourth or second/third quadrant, if the right side of the implant in the X-ray is blurred, then the beam must be raised. This means the beam must be ‘aimed’ higher, in order to image the right side of the implant more clearly. But if the left side of the implant in the X-ray is blurred, then the beam must be lowered. This means the beam should be ‘aimed’ lower, in order to image the left side of the implant more clearly.

Reference

1. Schropp L, Stavropoulos A, Spin-Neto R, Wenzel A. Evaluation of the RB-RB/LB-LB mnemonic rule for recording optimally projected intraoral images of dental implants: an in vitro study. Dentomaxillofac Radiol. 2012 May;41(4):298-304. doi: 10.1259/dmfr/20861598.