Fractures of the Zygomatic Arch

• Structures: Zygomatic arch, zygomatic bone.
• Best Views:
  • Submento-Vertex View: Provides a clear view of the zygomatic arch and helps assess fractures.
  • Waters View: Useful for visualizing the zygomatic bone and maxillary sinus.
  • Reverse Townes View: Can also be used to visualize the zygomatic arch.

Base of Skull

• Structures: Base of the skull, cranial fossae.
• Best Views:
  • Submento-Vertex View: Effective for assessing the base of the skull and related fractures.

Maxillary Sinus

• Structures: Maxillary sinus, zygomatic bone.
• Best Views:
  • Waters View: Excellent for visualizing the maxillary sinus and any associated fractures.

Fractures of Zygoma

• Structures: Zygomatic bone, zygomatic arch.
• Best Views:
  • Waters View: Good for assessing zygomatic fractures.
  • PA View: Provides a frontal view of the zygomatic bone.
  • Reverse Townes View: Useful for visualizing the zygomatic arch.

Nasal Septum

• Structures: Nasal septum, nasal cavity.
• Best Views:
  • PA View: Useful for assessing the nasal septum and any associated fractures.

Condylar Neck Fractures

• Structures: Mandibular condyle, neck of the condyle.
• Best Views:
  • Lateral Oblique View (15°): Good for visualizing condylar neck fractures.
  • Transpharyngeal View: Useful for assessing the condylar region.

Medially Displaced Condylar Fractures

• Structures: Mandibular condyle.
• Best Views:
  • Lateral Oblique View (30°): Effective for visualizing medially displaced condylar fractures.

Coronoid Process of Mandible

• Structures: Coronoid process.
• Best Views:
  • PA View of Skull: Can help visualize the coronoid process.

Fractures of Ramus and Body of Mandible

• Structures: Mandibular ramus, body of the mandible.
• Best Views:
  • Lateral Oblique View (15°): Useful for assessing fractures of the ramus and body of the mandible.

Horizontal Favorable and Unfavorable Fractures of Mandible

• Structures: Mandible.
• Best Views:
  • Lateral Oblique View (30°): Effective for evaluating horizontal fractures.

Bony Ankylosis of TMJ

• Structures: Temporomandibular joint.
• Best Views:
  • CT Scan: Provides detailed imaging of bony structures and ankylosis.

Fibrous Ankylosis of TMJ

• Structures: Temporomandibular joint.
• Best Views:
  • CT Scan: Useful for assessing fibrous ankylosis.

Internal Derangement of the Disk

• Structures: TMJ disk.
• Best Views:
  • MRI: The best modality for evaluating soft tissue structures, including the TMJ disk.

Disk Perforation

• Structures: TMJ disk.
• Best Views:
  • MRI: Effective for diagnosing disk perforation.

Arthrography

• Structures: TMJ.
• Best Views:
  • Arthrography: Can be used to assess the TMJ and visualize the disk and joint space.

1. Postero-Anterior (PA) View of Skull

• Head Position: Centered in front of the cassette; canthomeatal line parallel to the floor. For cephalometric applications, the canthomeatal line is 10° above the horizontal, and the Frankfort plane is perpendicular to the film.
• Projection of Central Ray: Passes posterior to anterior, perpendicular to the film.
• Important Features:
  • Used to examine the skull for disease, trauma, and sinuses.
  • Best for viewing the coronoid process; a PA view with a 10° tilt is called the Caldwell projection.

2. Lateral Skull or Cephalometric View

• Head Position: Left side of the face near the cassette; midsagittal plane parallel to the film.
• Projection of Central Ray: Directed towards the external auditory meatus, perpendicular to the film and midsagittal plane.
• Important Features:
  • Assesses facial growth.
  • Reveals soft tissue profile.
  • Surveys skull and facial bones for disease and trauma.

3. Water's Projection

• Head Position: Sagittal plane perpendicular to the film; chin raised so the canthomeatal line is 37° above horizontal.
• Projection of Central Ray: Passes through the maxillary sinus.
• Important Features:
  • Also known as Occipito-mental projection (variation of PA view).
  • Best for demonstrating zygoma fractures, paranasal sinuses, and nasal cavity.
  • Shows the position of the coronoid process between the maxilla and zygomatic arch.

4. Submentovertex (SMV) View

• Head Position: Head and neck extended backward; vertex of the skull at the center of the cassette.
• Projection of Central Ray: Directed towards the vertex of the skull.
• Important Features:
  • Also called BASE, FULL AXIAL, or JUG HANDLE VIEW.
  • Best for viewing the base of the skull and zygomatic arch fractures.
  • Contraindicated in patients with cervical spondylitis.
  • For viewing zygomatic arches, exposure time is reduced to one-third of that used for the skull.

5. Reverse Towne's View

• Head Position: Canthomeatal line oriented 25-30° downward.
• Projection of Central Ray: Directed towards the occipital bone.
• Important Features:
  • Frankfort plane vertically oriented and parallel to the film.
  • Best for viewing condylar neck fractures.
  • Condyles are better visualized if the patient opens their mouth widely.

6. Lateral Oblique Mandibular Body Projection

• Head Position: Tilted towards the side being examined; mandible protruded.
• Projection of Central Ray: Directed towards the first molar region.
• Important Features:
  • Demonstrates the premolar and molar region.
  • Best for viewing the inferior border of the mandible.

7. Lateral Oblique Mandibular Ramus Projection

• Head Position: Tilted towards the side being examined; mandible protruded.
• Projection of Central Ray: Directed posteriorly towards the center of the ramus.
• Important Features:
  • Often used for examining third molar regions of the maxilla and mandible.
  • Provides a view of the ramus from the angle to the condyle.