Taking bitewing x rays

Taking bitewing x rays. Schweiz Monatsschr Zahnmed 2010; 121 : 12–24. 0 film required significantly more periapical radiographs than for those taken with No. 3- Into the outer part of the dentine layer. recommend an interval of 12 Feb 15, 2024 · Dental X-rays are typically quick to perform and involve minimal discomfort. Bitewing x-rays help dentists detect decay Bitewing radiographs are one of the most valuable special investigation tools used to assist diagnosis in primary molars in the paediatric dental patient. Periapical X-rays. Nov 28, 2015 - Pacific Dugoni's radiology department shares tips and tricks for taking bitewing x-rays. X Hand-held X-ray Units dentist must weigh the benefits of taking dental radiographs against the risk of exposing Posterior bitewing exam at 6-12 month intervals if proximal surfaces Jun 6, 2013 · How to avoid common mistakes When taking digital X-rays. However, a study by Myers et al. They also help assess the best fit of a crown or cast Aug 8, 2012 · Having served as a full-time dental hygienist prior to becoming a DEXIS Sales Manager, Lisa Brooks, RDH, gained extensive hands-on experience with both film and digital x-rays. bite tabs. Contrast Difference in densities between Dec 7, 2015 · 1. Panoramic X-rays may be used now and then. They are used to capture images of the upper and lower back teeth. The dental technician will place a lead apron over your chest and wrap a thyroid collar around your neck. 36 months is appropriate. Select all the important (critical) factors you need to consider so your film is diagnostic. It is a graph of categories of patients joined to possible appropriate radiographs, along with a listing of clinical situations where radiographs might be recommended. 1 By comparison, because radiation is part of our environment, people in the United States are exposed, on average, to 3. Bitewing X-rays are used during checkups to look for tooth decay. Papers that reported a correlation between dental diagnostic X-ray exposure and overall health of dental practitioners were identified. Lead aprons and thyroid collars can also block the primary X-ray beam, preventing dentists from capturing the image they need. The present study identified two papers on occupational groups [17,35]. One of the most routine and useful types of x-rays dentists take is the bitewing x-ray that shows both the upper and lower set of teeth. Bitewing X-rays detect tooth decay, bone loss, and adjustments in bone density due to gum disease. 0:00 Intro0:10 X-ray Unit Description1:56 Barriers3:34 Inserting Sensor into Posterior Rinn5:08 Inserting Sensor into Anterior Rinn6:06 Inserting Sensor into bitewing. This monitor had an initial luminance level of 250 cd/m2, and a There are standup machines that are capable of taking bwx’s and all you’d have to do is bite on a bite-stick with your front teeth. Jul 19, 2020 · 0:00 Intro0:20 Seating the Patient and Getting Set Up0:58 Placing the Bitewing X-Rays3:30 Dismissing the Patient3:47 Completed Horizontal BitewingsThis video Feb 22, 2023 · The most common are intraoral X-rays, like: Bitewing: This technique involves biting down on a special piece of paper so that your dentist can see how well the crowns of your teeth match up. Adults with Good Oral Health: Adults without a history of cavities or gum disease usually need bitewing X-rays every 2 to 3 years. Taking X-rays that are not in accord with the standards of dental practice may be considered negligence. Twenty digital bitewing images were displayed on a 19-inch LG monitor (Flatron E1960, LG, Seoul, Korea) with a resolution of 1,360×768 pixels and 32-bit color. To read a bitewing radiograph you sh Jan 1, 2011 · The collimator rings for the anterior XCP and the bitewing XCP are both similarly shaped, so the anterior XCP collimator ring can be attached to the bitewing metal rod and be used when taking bitewing x-rays. 2- Up to but not through the enamel/dentine border. In these instances, clinicians may find it necessary to use a round collimator. Below is a link for the machine I am referencing. However, conventional bitewing x-rays are uncomfortable and time-consuming. Bitewing X-rays. They’re not as sharp and detailed as an FMX, but are able to show anatomy around the teeth that isn’t visible in a full mouth series. Thomson, BSDH, MS On Jun 6, 2013 0 While the benefits of digital radiography, including reduced radiation exposure and improved efficiency, are numerous, the use of digital sensors and photostimuable phosphor plates (PSPs) can present challenges for clinicians who are However, the use of a customized and individualized bitewing holder (using wax or hard-curing silicone) might have ensured a more optimal x-ray projection for the radiograph [7]. Another Jun 15, 2015 · Radiation exposure using bitewing digital x-rays is minimal, often quoted as being 80 percent less than conventional methods of dental x-rays involving film. Interproximal Radiograph See bitewing radiograph. DENTAL ASSISTING CH. >aka the inter proximal X-ray. Mar 18, 2019 · Bite-wing x-rays are the type that most people are familiar with. This is the norm that most offices go by. Oct 20, 2016 · The small film used for periapical x-ray is also the one used in this type of dental x-ray. It is a large dark grey area located on the side of the tooth. Mar 8, 2022 · Bitewing radiographs are dental x-rays that provide an image of the crowns of the top and bottom teeth on a single film. 18372 The frequency of taking x-rays depends greatly on the total health of the person. To assist in diagnosing dental problems such as infections, abscesses, and gum disease. How to take a good dental x-ray is not only about proper technique but actually understanding what you are looking for in the image is super important too Sep 1, 2018 · Placing that huge x-ray holder in a little mouth is a challenge for both patient and dental professional. 1 ). By the time that decay is visible to the Jun 1, 2004 · Taking X-rays of diagnostic quality is easy to achieve — if the clinician follows basic, simple rules. Common x-rays used in the dental office include bite-wing, periapical, and panoramic x-rays. There are several types of dental X-rays, each serving a different purpose: Bitewing X-rays show details of the upper and lower teeth in one area of your mouth. This Mar 21, 2023 · Having trouble getting great bitewing X-rays without an XCP ring? This video is for you! 🙂🦷For business inquires: Makaylatiara94@gmail. Science. comIG: theechocolate X-ray examinations. >usually at recall appointments. edu. May 10, 2020 · The use of smaller film sizes has been suggested to facilitate taking of X-rays in young patients. Because most children have immature brushing Besides showing clear images of the teeth and roots, a bitewing X-ray also shows occlusal positioning. ”. Radiographs are an important part of dental diagnosis and treatment planning. This means that general medical health, lifestyle, habits, diet, existing conditions and past medical and dental history need to be assessed. Bitewing x-rays show the position of the upper and lower teeth. Photographs, if available, may also be submitted for review. For children with Jan 12, 2015 · Bitewing radiography. Google Scholar Mar 12, 2024 · Bitewing X-rays are a common type of dental X-ray that captures images of the upper and lower teeth in one area of the mouth. Apr 26, 2024 · 1. With the extraoral bitewing feature common in modern panorex X-ray systems, these concerns are a thing of the Jan 9, 2023 · There are many types of dental X-rays, but bitewing, periapical, and panoramic radiographs are the most common ones. Dental X-rays are scheduled when you need them based on your age, risk for disease, and signs of disease. 5- All the way through into the dental pulp or nerve. The size and location of the sensor Jan 16, 2024 · Bitewing X-rays. Figure 5. There are several landmarks recorded on molar bitewing radiographs whether vertical or horizontal in orientation. Learn about Bitewing Surveys from Intraoral Radiographic Anatomy dental CE course & enrich your knowledge in oral healthcare field. org. The most common structures observed are the external oblique ridge and maxillary tuberosity. Dentists use bitewing X-rays to detect decay and bone, assess the fit of restorations and crowns, and evaluate the integrity of fillings. >useful in detecting caries in posterior teeth. Bitewing x-rays are among the easiest and most accurate to take, giving distortion-free results necessary for the accurate assessment and diagnosis of dental decay between the teeth. Each bitewing captures the exposed (visible) part of your upper and lower teeth as well as half of their roots and supporting bone. 2 films. Because the shape of the bitewing is a bit awkward, it can be hard to breathe through your mouth, and trying to do so can set off your gag reflex. For many dentists this is the method of choice to determine the presence and extent of decay. While the levels of radiation associated with bitewing digital x-rays are low, dentists still take precautions to limit patients’ exposure by only taking x-rays when needed and by Such a simple concept of taking images of teeth, but sometimes difficult due to its simplicity. a periapical view shows the tooth from the occlusal surface or incised edge to about _____ mm beyond the apex to show the periapical bone. holders that use a sticky or slip on the film, patient bites on tab. Children: Since their teeth and jaws are developing, children often need X-rays more often than adults, typically every 1-2 years. Maybe make some phone calls to see if any reputable offices in your area utilize them. Dec 13, 2013 · Rectangular collimation is easy to use for bitewing X-rays, but can be challenging when taking periapical X-rays in patients with very long roots or severe gagging tendencies; during endodontic treatment; and in patients wearing rubber dams. Sep 14, 2022 · How Are Bitewing X-rays Taken? Reveal Diagnostics provides an optimised collimated interproximal projection with a low dose to study dental crowns. Modern techniques use holders, as shown later, which have eliminated the need for the wing (now termed a tab ), and digital image receptors (solid-state Jun 1, 2020 · Learn how to assemble bitewing, anterior and posterior X-ray Rinns for dental radiography in this easy-to-follow video tutorial. Panoramic X-rays are commonly used in dentistry to diagnose What is the basic principles of the bite-wing technique ? -The receptor is placed in the mouth parallel to the crowns of both maxillary and mandibular teeth. Film is placed parallel to the crowns X-ray beam: is directed through the contacts of the teeth. Your dentist may request one or multiple bitewing x-rays during your check-up. This allows the X-ray machine to capture detailed images of the teeth and their supporting structures How long should you wait between dental X-rays? Bitewing radiographs of the back teeth (usually two to four films) are the most common films captured. View these guidelines at www. Apr 7, 2017 · adults in the low risk category, the majority advocate that an interval of between 24-. The sensitivity and specificity of bitewing radiography for the detection of The ADA encourages dentists and patients to discuss dental treatment recommendations, including the need for X-rays, to make informed decisions together. These x-rays must depict the entire implant. The name "bitewing" comes from the way the patient bites on a small tab of paper or plastic while the X-ray is taken. Bitewing radiographs take their name from the original technique which required the patient to bite on a small wing attached to an intraoral film packet (see Fig. When using an x-ray sensor, it is important to always: place the sensor parallel to the incisal or occlusal edge of the teeth. Jun 8, 2018 · Bitewing X-rays . These x-rays provide information not Nov 21, 2018 · The correlation of X-rays with brain and thyroid cancers has been reported for many decades and seems to explain this finding. As employed by my Commercial Drive dentist, bitewing X-rays are specifically designed to detect cavities between teeth, a common area where decay can occur unnoticed. X-rays allow dentists to identify problems or potential issues, such as cavities, impacted teeth, tooth decay, and more. com. 1967 32 consensus$. When taking bitewing x-ray, a small tab is used to position the film besides the involved teeth. Bitewings tabs Feb 3, 2017 · How to Take Bitewing and occlusal X-rays on a childDr. Cone The pointed or open-ended cylinder (PID) through which the x-rays travel after leaving the tube. Bitewings. Central ray entry points will help with x-ray beam centering, as will using the lines on the PID that indicate the direction of the x-rays exiting the collimator. During a bitewing X-ray, you will be asked to bite down on a small piece of plastic while the X-ray machine captures images of your teeth. Ionizing Radiation Radiation, including x-rays, that produces ions when interacting with Each one helps the dentist see different areas of your mouth. Periapical radiography is a commonly used intraoral imaging technique in radiology and may be a component of your radiologic examination. 005 mil-lisieverts (mSv) of radiation (a millisievert is a unit of measure). >every six months. Study with Quizlet and memorize flashcards containing terms like When taking a bitewing x-ray, where should the dot be? When taking a periapical x-ray?, How do you produce a quality radiograph?, What do you see on a bitewing x-ray? and more. Feb 25, 2022 · The first main difference between intraoral and extraoral bitewing x-rays is how they are taken. Every bitewing scan shows a tooth from its crown to around the level of the supporting bone. The main aim of taking bitewings is to check for decay between teeth and if are problems associated with existing fillings. dental. In this article, Brooks will discuss the benefits of using digital radiography and DEXIS digital x-ray in particular. For example, the following panoramic radiographic x-ray is nondiagnostic. Sep 12, 2016 · Bitewing x-ray imaging is the procedure of preference for investigating the existence and degree of decay where back teeth touch each other and in addition, it requires evaluating any bone loss. Occlusal X-ray: This X-ray (also known as Palatal) shows the entire arch of teeth in either the top or bottom jaw. -The central ray of the x-ray beam is directed through the contacts of teeth May 8, 2004 · Only 17% would consider taking bitewing radiographs in children under 6 years, and the majority of dentists (61%) reported that they would first consider taking radiographs in the 6–11-year-old Nov 27, 2023 · In general, bitewing X-rays are primarily used to detect cavities between teeth and assess the fit of dental fillings, crowns or bridges. Ali B. However, as with primary carious lesions, it is also usually more suitable for lesions at proximal restoration margins, where the lesion is situated ‘within’ the X-ray beam. Aug 1, 2020 · Intraoral radiographs are X-rays taken with image receptor placed within the oral cavity. They are not typically done on front (anterior) teeth. 186 terms. Hold your breath or breathe through your nose. Similarly, the bitewing XCP collimator ring can be attached to the anterior XCP metal rod and be used when taking anterior x-rays. Generally, these x rays are taken once per year and are used to diagnose decay that is found in between the teeth and in new or recurring decay under existing fillings. The ADA/FDA guidelines 3 recommend intervals of six to 12 months between bitewing X-ray exams for children or adolescents with existing tooth decay or increased risk of decay. Periapical X-ray: Focusing on one or two teeth, a periapical radiograph shows the entire length of the tooth, from crown to root. Intraoral Radiograph Media placed in the oralcavityandlingualtotheteeth. These radiographs can also show developing teeth in children and adolescents. 2 mSv every year from background sources of radiation. The most common types of intraoral x-rays are bitewing, periapical and occlusal. You will also see the correct placement and positioning of the Jul 14, 2017 · Bitewing X-rays, which deliver a relatively low dose of radiation and can reveal cavities between teeth, an area that dentists can’t visually inspect. Jan 16, 2024 · General Guidelines. A full-mouth series of periapical X-rays (about 14 to 21 X-ray films) is most often done during a person's first visit to the dentist. pacific. Bite-wing x-rays help the dentist check for tooth decay between the back teeth or under dental fillings. Visit her Web site at www. When radiographs are not of diagnostic quality, it can result in a 1- Just the outer enamel. 41. Another Jan 16, 2024 · Panoramic dental X-rays, or panoramic radiographs, are a type of dental imaging that captures a wide view of the entire mouth. Cone-cutting Failure to center the x-ray beam on the media, leading to unexposed areas. Bitewing X-rays display details of the upper and lower teeth in a mouth area. There are other ways to collect radiographic records, such as a panorex, child-size sensors or films, or piggyback bitewing tabs on the sensor to move it toward the center of the palate to avoid contact and gagging. At Naperville Dental Specialists , we use the NOMAD handheld x-ray device in conjunction with digital sensors to take comfortable x-rays in half the time with no drooling . Radiographs, or X-rays, are an integral part of dental practice. Dentists use bite-wings to get a picture of the back (posterior) teeth. Jan 27, 2015 · Pacific Dugoni's radiology department shares tips and tricks for taking bitewing x-rays. Because it shows the mouth as a whole, panos are useful for Dec 1, 2004 · To contact Glasscoe for speaking or consulting, call (301) 874-5240 or email [email protected]. They consist of 4 “bitewing” x-rays, two on each side of your mouth. To identify decay or other issues beneath existing dental fillings. Radiology. Unlike the bitewing dental x-ray which shows a close up of your teeth, a panoramic dental x-ray gives a panoramic view of a patient's head and neck. A bitewing x-ray is used to look at one specific area of your mouth. Intraoral x-rays (x-rays taken from inside of the mouth) are an essential part of your dental care. She also will share tips on how you can capture vertical bitewings for optimal diagnosis. The patient bites down on the tab so the image will show both top and bottom teeth. The images that are taken capture the molars and premolars. Bitewing X-rays show details of the upper and lower teeth in one part of the mouth, from the tooth’s crown down to its supporting bone. bitewings are taking. Ogtaylor22. bitewing radiographs—two to four images of the back teeth—expose a patient to about 0. They focus on the teeth and provide crisp detail. Set + 10 vertical angulation. This always makes me feel uncomfortable, because the feeling I get is that the patient thinks he or she knows more Apr 28, 2021 · Bitewing radiographs (BWR) are the standard method of diagnosing interproximal dental caries. Remember, the enamel is the slightly whiter cap on the top of the tooth, the dentine is the darker layer underneath and the nerve, or pulp is Oct 22, 2020 · Bitewing radiography is also a valuable aid for the detection of secondary caries. Feb 1, 2024 · Evidence indicates that modern digital X-ray equipment and restricting the beam size only to the area that needs to be imaged better protect patients against radiation exposure to other parts of their body. Every now and then, a patient refuses to let me take X-rays. Our rule: Our office sees an average of 4160 patients per year for routine cleanings. A term used to describe the alignment of the central ray of the x-ray beam in both horizontal and vertical planes Horizontal angulation Refers to the positioning of the central ray in a horizontal, or side-to-side, plane Dec 25, 2022 · The types of intraoral X-rays dentists include: Bitewing X-rays. Preferably, the receptor orientation dot or plate marker should be placed toward the crowns of the teeth for periapical images and toward the mandible for bitewing images to reduce interference with viewing the structures of interest on the recorded image. You may be prescribed radiographs that will be used along with your clinical examination. Adults with Past Dental Problems: If you’ve had cavities You are going to take 4 bitewing radiographs for your patient using tabs or loops to hold the film. ADA. Here is a help overview of taking bitewings with digital sens Jul 27, 2022 · Dental radiographs, or X-rays, contain images of your teeth that a dentist can use to monitor your oral health. While the levels of radiation associated with bitewing digital x-rays are low, dentists still take precautions to limit patients’ exposure by only taking x-rays when needed and by Jan 9, 2023 · The name comes from the wing-shaped device you bite down on while the X-ray is taken. Nov 28, 2022 · A panoramic x-ray is a two-dimensional x-ray that captures a picture of a patient’s entire mouth in just one image. Most patients do not have any problems or discomfort when taking X-rays. -The receptor is stabilized when the patient bites on the bite-wing tab or the bite-wing beam alignment device. X-rays may also determine if there’s Aug 9, 2021 · As a general rule, dental bitewing x-rays, aka "checkup x-rays," are recommended ONCE a year. Doing these x rays will give an accurate diagnosis of dental decay in-between the teeth. The display ratio of the images was 1:1. 2. The following intraoral radiographs are available: Periapical (taken by means of paralleling technique or bisected angle technique), bitewing and occlusal—maxillary and mandibular, standard, lateral and axial. Dec 2, 2023 · 1. Depending on teeth and jaw size of the child, we typically start taking bitewing x-rays around the age of 4 or 5. The X-ray sensor or film will be placed in your mouth for the picture. May 13, 2013 · bite wing. 19 terms. It fails to clearly depict implant placement at site #9. Jan 2, 2024 · Dental X-rays are taken with you sitting upright in a chair. AttaieKids Dental Village, PChellosmile Practice Management Group (helloPMG) Apr 28, 2023 · X-rays should be taken to check for development of wisdom teeth. Apr 7, 2017 · Caries risks and appropriate intervals between bitewing x-ray examinations in schoolchildren. mp. The tragus/ala line is parallel to the floor, and patient is facing forward. May 21, 2020 · Intraoral x-rays are the most commonly used. 1 Posterior bitewing examination at six- to 12-month intervals if proximal surfaces cannot be exam-ined visually or with a probe Posterior bitewing examination at six- to 18-month intervals Not applicable Recall Patient* With No Clinical Caries and Not at Increased Risk of Developing Caries‡ Posterior bitewing examination at 12-to 24-month Nov 28, 2015 · With Bitewing x-rays the dentist captures details of both the upper and lower teeth, from the crown all the way to the supporting bone, in one area of the mouth. In the chapter there are discussed A panoramic X-ray is one that encircles the mouth from one side to the other, showing the entire mandible, TMJ, upper jaw and nasal sinuses. In correspondence with the name, intraoral bitewings are x-rays where the film (or with digital x-rays the sensor) is placed inside the mouth, and extraoral bitewings are taken outside the mouth. >height of alveolar bone crest. www. Bitewing X-rays help detect cavities, decay, and bone loss. Occlusal: An occlusal x-ray shows the whole dental arch viewed from the biting (occlusal) surface of the teeth. Placement on the opposing teeth or too close to the teeth will cause the receptor to displace when it contacts bony anatomy. Periapical X-rays are useful for focusing on just one or two teeth. Medicine. May 20, 2015 · Basic principlesBasic principles Stabilization: Patient bites on the bite-wing tab or film holder. 4- Deep into the dentine. Digital bitewing radiograph obtained by photo stimulable phosphor plate. Dec 15, 2023 · X-ray images are an essential diagnostic tool in dentistry. Add one to start the conversation. This is the norm that most insurance companies cover. This is an alternative to intraoral bitewings, with a less invasive and more comfortable procedure. It's also called a full mouth or panorex. 10. By Evelyn M. These are taken with a small film or digital sensor that you bite with your back teeth. Bitewing X-ray . In Japan, bitewing radiographs are rarely used. Instead, try to breathe through your nose, or simply hold your breath until the x-ray is done — which should only be a second. While intraoral bitewings may be more common Oct 1, 2010 · The tab should be aligned with the teeth contacts, which will indicate the correct horizontal angulation to use to enter the contacts. These x-rays provide a high level of detail and the capability to enhance an image, dentists can easily examine slides for conditions like cavities Horizontal Angulation The aiming of the x-ray beam in the horizontal plane. Types of Dental X-rays. These are used to check for decay between teeth and to show how well your teeth align. ( 1984 ) found that children with extensive caries whose bitewing radiographs were taken with No. pro fessionaldentalmgmt. ti,kf,kw. During this procedure, the patient bites down on a special paper holder, which positions the film to capture an image of the crowns of both the upper and lower Jul 4, 2023 · Dental X-rays are a standard procedure that’s usually performed for one of the following reasons: To detect and assess dental decay that may be hidden between teeth. Bitewing X-rays are done to locate early signs of decay between back teeth or bicuspids (teeth in front of the molars). They get their name from a tab on the x-ray film. Chapter 5- humerus and shoulder girdle. Unlike traditional dental X-rays focusing on a specific area of the mouth, panoramic X-rays show the teeth, jaws, and surrounding structures in a single image. 6 Selection criteria are version was used for the assessment, taking 12 bitewing$. Preview. For adults aged 56 and over, however, Pitts & Kidd 16. mareuther813. Feb 21, 2013 · Bitewing x-rays should be taken as soon as the back molars start touching each other, as children become prone to cavities in between the teeth as soon as the contacts are tight together. Oct 1, 2007 · In 2005, the ADA and the FDA issued a document titled “Guidelines for Prescribing Dental Radiographs. They are often taken during routine dental check-ups. The ADA recently released new guidance in JADA on safety and regulatory aspects of radiography, which updates portions of the 2012 FDA/ADA recommendations for dental radiographic examination. Incisal Edge The cutting edge of the anterior teeth. Performing bitewing X-rays typically involves taking up to four images with a digital sensor or dental film to isolate certain areas. If you look at the x ray above, you can see a large cavity on an upper pre molar tooth. A full series of X-rays is indicated when there is evidence of dental disease or history of extensive decay. This retrospective observational study was conducted to measure the potential economic impact of carious lesions left undiagnosed and untreated due to this omission of bitewing radiographs. Low radiation levels create a still image of a patient’s gums and teeth. Bitewing X-rays are one of the most common types of dental X-rays. Periapical X-rays provide a more detailed view of individual teeth and their surrounding structures, making them useful for diagnosing a broader range of Apr 28, 2022 · We must receive post-operative x-rays of implant placement to determine payment of benefits on paid claims. That should help alleviate your strong gag reflex. When taking these pictures, the technician will ask you to bite a small device used to capture the images. The term ‘bitewing’ (BW) refers to the little tab (or wing) in the centre of the X-ray film on which the patient bites to hold it in place, thus providing an equal image of both the Jun 15, 2015 · Radiation exposure using bitewing digital x-rays is minimal, often quoted as being 80 percent less than conventional methods of dental x-rays involving film. Adults with teeth. However, the use of a customized and individualized bitewing holder (using wax or hard-curing silicone) might have ensured a more optimal x-ray projection for the radiograph [7]. Sometimes it isn't possible, but little tricks, such as using bitewing tabs instead of the bulkier X-Ray holders (this takes skill on the part of the hygienist or other person taking the film due to having to "eyeball" the films position in the mouth while using a bite wing holder makes it virtually fool proof!), using smaller size films Central Ray The theoretical center of the x-ray beam as it leaves the tube head; the most direct line of radiation. az lm fb vl wi hj kl pe tw vy