Reproducibility of beam alignment using different bite-wing radiographic techniques.

Longitudinal radiographic assessment of crestal alveolar bone plays an important role in the diagnosis and long-term evaluation of periodontal disease in patients. Because practitioners use several radiographic techniques to obtain bite-wing radiographs, horizontal and vertical alignment errors could adversely affect the diagnostic impression gained from this type of radiographic examination. The objective of this study was to determine the alignment reproducibility of three different clinical techniques used to acquire bite-wing radiographs. Patients who require bite-wing radiographs as part of a dental school screening process were radiographed with modified standard bite-wing tabs and two different intraoral positioning devices. Horizontal and vertical angular deviations were measured and alignment errors were calculated for each radiograph. The mean total angular alignment error for the standard bite-wing tab technique was 6.2 degrees, whereas the mean alignment error for both positioning devices was less than 1.8 degrees. The results of this study suggest that an intraoral positioning device for acquiring bite-wing radiographs should be used.