A technical report on the hamular technique for radiographing maxillary anterior teeth using a digital sensor. 2022

M H Jim Pun
Appleseed Family Dental, LLC, 1199 Delaware Ave., Suite 106, Marion, OH, 43302, USA. HT@vr8.org.

Obtaining an intraoral periapical radiograph of the maxillary anterior teeth can be quite challenging, especially in patients where a rigid digital sensor cannot adequately fit in the palatal vault. This technical report presents a periapical radiographic technique that places the sensor in the space surrounding the hamular notch to avoid the spatial restrictions of the hard palate, opening the possibility of parallel alignment of the sensor and the long axis of the tooth, perpendicular alignment of the tube-head to both, and a minimally distorted resultant radiographic image. Four adult patients demonstrated the quantitative and qualitative features of this hamular technique (HT). A human skull demonstrated relative magnification and image quality. While patient and equipment-specific, comparisons of magnification, distortion, and image quality illustrate the potential capabilities and limitations of the HT. The HT radiographs appeared to be less distorted than the variable-angle technique (VAT-a clinical approximation of the bisecting angle technique) but magnified 7.9-21.6%. A radiograph of an implant showed a 2.0% distortion over true aspect ratio. The HT radiograph from a human skull showed a slightly lighter and less sharp image than the VAT radiograph. Preliminary results showed that while the HT images were magnified, lighter, and less sharp that the VAT, they were diagnosable for caries. In all the HT images presented in this technical report, there was less distortion than comparable techniques. Notably, one HT periapical radiograph of a maxillary lateral implant showed virtually no distortion, suggesting that a nearly parallel projection was achieved using the technique. While further research is needed, this report shows that the HT has the potential to produce minimally distorted digital radiographs of anterior teeth in patients where the sensor cannot adequately fit into the palatal vault.

UI MeSH Term Description Entries
D008437 Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the ORBIT, and contains the MAXILLARY SINUS. Maxillae,Maxillary Bone,Bone, Maxillary,Bones, Maxillary,Maxillary Bones,Maxillas
D011859 Radiography Examination of any part of the body for diagnostic purposes by means of X-RAYS or GAMMA RAYS, recording the image on a sensitized surface (such as photographic film). Radiology, Diagnostic X-Ray,Roentgenography,X-Ray, Diagnostic,Diagnostic X-Ray,Diagnostic X-Ray Radiology,X-Ray Radiology, Diagnostic,Diagnostic X Ray,Diagnostic X Ray Radiology,Diagnostic X-Rays,Radiology, Diagnostic X Ray,X Ray Radiology, Diagnostic,X Ray, Diagnostic,X-Rays, Diagnostic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D014070 Tooth One of a set of bone-like structures in the mouth used for biting and chewing. Teeth

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