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Elongation vs. foreshortening on dental radiographs

Teeth that look stretched or squashed come from vertical angulation. Which direction fixes which, and why paralleling avoids both.

Both are vertical angulation errors. Elongation makes the teeth look longer than they are; foreshortening makes them look shorter and stubby. They're opposites, and so are the fixes.

Which way to correct

  • Elongation: the vertical angle was too flat (not enough). Increase the vertical angulation.
  • Foreshortening: the vertical angle was too steep (too much). Decrease the vertical angulation.

Why the paralleling technique avoids this

With the paralleling technique, the receptor sits parallel to the long axis of the tooth and the beam is aimed perpendicular to both. If you use the holder correctly and align the PID with the ring, the geometry is handled for you. Elongation and foreshortening mostly show up when the receptor tips away from parallel (a shallow palate, a gagging patient) or when the bisecting technique is used and the angle is estimated by eye.

A good habit on every exposure: check that the receptor is parallel to the tooth, then that the PID is flush to the ring. Most distortion disappears when both are true.

Quick questions

Which is worse on a bitewing?
Either one can hide interproximal decay or distort bone levels. Bitewings are especially sensitive to vertical angulation because they're read for the crest of the bone.
What about overlapping contacts?
That's a horizontal angulation error, not vertical. The beam needs to pass straight through the contacts; if it angles across them, the teeth overlap on the image.

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