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Oral Surgery · single question

For imaging a suspected SIALOLITH (salivary stone) in the submandibular duct (Wharton's duct), which radiographic view is MOST appropriate?

  1. Occlusal radiograph (floor-of-mouth occlusal view — directly images the submandibular duct pathway)
  2. Periapical radiograph
  3. Lateral cephalometric radiograph
  4. Panoramic radiograph
Show answer and explanation

Correct answer: A. Occlusal radiograph (floor-of-mouth occlusal view — directly images the submandibular duct pathway)

  • A. Correct. The MANDIBULAR OCCLUSAL RADIOGRAPH (floor-of-mouth view) is the BEST initial imaging for suspected submandibular sialolith. The film is placed flat on the floor of the mouth, showing the course of Wharton's duct from the duct orifice to the hilum of the gland. Sialoliths appear as radiopaque calcifications along this pathway. Approximately 80-90% of submandibular sialoliths are radiopaque.
  • B. Periapical radiographs cover a small area and cannot visualize the full duct course.
  • C. Lateral cephalometric is for orthodontic analysis — not for salivary gland stones.
  • D. Panoramic radiograph can sometimes show large posterior sialoliths but is not as specific as the occlusal view.

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