Foreshortening of radiographic images is caused by:

Correct answer: D. Excessive vertical angulation

• A. Incorrect horizontal angulation causes overlapping of proximal contacts, not foreshortening.
• B. Insufficient (too little) vertical angulation causes elongation of the image, not foreshortening.
• C. Film/sensor distance affects image magnification, not foreshortening specifically.
• D. Correct. Foreshortening occurs when the vertical angulation is excessive (too steep), causing the image to appear shorter than the actual tooth. The X-ray beam intersects the long axis of the tooth at too acute an angle.