Occlusal Radiograph Confusion

[metallicat]

When we take a mandibular (or maxillary for that matter) true occlusal view, such as to find a sialolithiasis, when we look at the radiograph, is it as if we are looking "up" at the floor of the mouth so this sialolith would be on the patients left. Or are we looking down so this sialolith is on the patients right floor of mouth? I have looked up many pictures and it seems there is no consensus. Of course x-rays can be flipped around as well.

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[crax]

You would be looking upwards (the film is "behind" the mandible in this image). So, you can use the anterior portion of the mandible as a reference, imagining you were underneath looking upwards. This would indeed be on the patients left side.

( Similar to a mandibular PA, except imagine rotating the collimator below the chin. ) This applies to the mandibular occlusal view. The reverse would be true for a maxillary, as you'd be looking down.

 

[metallicat]

That is what I thought, your collimator is pointing upwards. My question then is why in the radiograph below, is the sialolith in the right wharton's duct and not the left (according to the associated report with it)? Is this not a true occlusal radiograph or maybe it is some sort of CT reconstruction?

 

[crax]

Not sure, I see it says "trans-occlusal," not sure what that is.

http://openi.nlm.nih.gov/detailedresult.php?img=3389885_poljradiol-75-3-25-g002&req=4

In addition, even though this next link writes "Left," All of the pictures (PAN, Intraoral, Extraoral, Occlusal) show that it's on the right side, and consistent with what you had originally thought.
http://www.jaypeejournals.com/eJour..._eJournals/images/JPLOGO.gif&IID=361&isPDF=NO