RHS exam
The dentist
owns the dental radiographs 1. Duplicates can be made and transferred to another dentist or specialist 2. Should be retained indefinitely
Film Position (paralleling)
parallel to the long axis
neutron
particles with no charge
Maxillary arch parallel to floor and midsagital line perpendicular to floor
patient's head positioned before exposing receptors
reversed film
A: light images with a pattern (Herringbone/tiretrack pattern). C: film was placed backwards Co: white towards bite
absense of apical structures
A: no apices on film C: receptor was not positioned correctly CO: correct placement
incorrect horizontal angulation
A: overlapped contacts C: central ray wasn't directed through interproximal space CO: direct xray beam through interproximal space
Elongated teeth
A: teeth appear long and distorted C: vertical angulation was flat CO: use adequate vertical angulation
foreshortened teeth
A: teeth appear short with blunted roots C: excessive vertical angulation CO: Don't use excessive vertical angulation
film creasing
A: thin radiolucent line C: film was creased/ emulsion cracked CO: do not bend film
incorrect molar placement
A: third molar regions are not visible C: film placed to anteriorly CO: make sure film is back enough
dropped film corners
A: tipped or tilted C: edge of receptor wasn't placed parallel CO: place film receptor parallel
Focal trough
Also known as the image layer can be defined as a 3D curved zone in which structures are clearly demonstrated on a panoramic image.
Bite-wing technique
Also known as the interproximal technique is a method used to examine the interproximal surfaces of teeth.
Cortical Bone
Also referred to as compact bone and means "outer layer"
Panoramic imaging
An extraoral technique that is used to examine the maxilla and the mandible on a single projection
Radiograph
An image or picture produced on a receptor by exposure to ionizing radiation, a two dimensional representation of a three dimensional object
high contrast
An image with many black and white areas
low contrast
An image with many shades of gray
Long axis (tooth) (bisecting )
An imaginary line that divides the tooth longitudinally into 2 equal halves
every 1 second
60 impulses
Kilovoltage setting
65-100
Long wavelengths with less energy
65-75 kV produces
Milliamperage setting
7 to 15
k shell electrons
70 kev
will have great intensity
8 inch PID
Tomography
An imaging technique that allows the imaging of one layer, or section, of the body while blurring the images of structures in other planes
Suture (RL)
An immovable joint that represents a line of union between adjoining bones of the skull.
dosimeter badge
Another name for radiation monitoring badge
reduces absorbed dose by 60%
F film speed is used because
The external indicator ring (paralleling)
Attachment should be moved all the way down the metal arm to be as close to the skin as possible without touching the skin
rare green earth
Fast screen (green light)
the tooth's long axis
Film is placed parallel to
Bite wing Receptor
Film used for interproximal examination
Occlusal Receptor
Film used in occlusal examination
Periapical Receptor
Film used in periapical examination
Extraoral Receptor
Film, placed outside the mouth
Dryed
Films must be what before they can be handled or mounted for viewing
Intraoral Receptor
Films, placed inside the mouth to examine teeth and supporting structures.
long and non-penetrating
Filtration of the dental x-ray beam is necessary because the beam contains _____ and ______________ x-rays.
Molar (gag)
Finish with these exposures with a gag patient
Victor Xray Corp, Chicago (1923)
First dental X-ray machine
O. Walkhoff (1896)
First dental radiograph
C.E. Kells (1896)
First dental radiograph in US (living patient)
W.J. Morton (1896)
First dental radiograph in US (skull)
Eastman Kodak Company (1913)
First prewrapped dental films
Kvp and contrast
HIGH kVp = many gray areas = long scale contrast = low contrast = more pentrating low kVp = black and white = short scale contrast = high contrast = less penetrating
Xray tube components
Lead glass housing .Cathode: 1. Tungsten filament 2. Molybdenum Cup Anode: 1. Tungsten target 2. copper stem
appears dark
Overdeveloped film
white or dark areas appear on films
Overlapped films
XCP instruments ( BAD)
PEE = YELLOW = POSTERIOR AQUA = BLUE = ANTERIOR BITE DOWN ON APPLE = RED =BITEWING
Primary Radiation (primary beam)
Penetrating xray beam that is produced at the target of the anode and that exits the tube head.
...
Periaplical film
Beam Alignment Devices
Should be packaged in sterilized bags and dispensed from a central supply area
Panoramic
Shows a wide view of the maxilla and the mandidle.
Radiology
The science or study of radiation.
8th step in x-ray production
The size of the beam is restricted by the lead collimator. The bema travels down the PID and exits the tube head at the opening of the PID.
Receptor placement (bitewing)
The specific area where the receptor must be positioned before exposure, is dictated by the teeth and surrounding structures that must be include on the resulting bite-wing image.
An individual should only be exposed to x-radiation when the benefit of disease detection outweighs the risk of exposure.
Why does the dental radiographer leave the room during x-ray exposure of the patient?
Protects reproductive, blood-forming, and thyroid tissues from scatter radiation (unnecessary radiation exposure).
Why is a lead apron used during x-ray exposure?
No, zero cases have been found that are caused by dental x-ray exposure.
Will dental x-rays cause cancer?
High voltage circuit
Uses 65,000 to 100,000 V and provides the high voltage required to accelerate electrons
Distortion
Variation in the true size and shape of the object being radiographed.
middle
We use the _ ____density seen on the standard stepwedge radiograph for comparison
X-ray
Weightless bundles of energy (photons) without electrical charge that travel in waves with a specific frequency at the speed of light
how image is obtained and size of the receptor plates
What is the difference in direct and indirect imaging?
Bite-wings and Periapicals
What type of images consists of 14-20 images on a FMX?
Vertical Angulation (bitewing)
When a bite-wing tab is used, the central ray of the x-ray beam must be directed at +10 degrees
Horizontal Angulation (bitewing)
When a bite-wing tab is used, the central ray of the x-ray beam must be directed through the contact areas between the teeth.
Malpractice
When a dental practitioner is negligent in the delivery of dental care
Half-value layer (HVL)
When placed in the path of the x-ray beam, the thickness of a specified material (aluminum) reduces the intensity by half
energy is converted into X-rays
When the electrons strike the tungsten target
The electrons are accelerated from the cathode to the anode
When the exposure button is activated
4th step In x-ray production
When the exposure button is pushed, high voltage circuit is activated. The electrons produced at the cathode move across the x-ray tube to the anode. The m. cup in the cathode directs the electrons to the tungsten target in the anode.
heats up and thermionic emission occurs
When the filament circuit is activated
2
When the fixer is at full strength, a film should clear within ______ minutes, without agitation
ion
an atom that gains or loses an electron and becomes electrically unbalanced
Digital Image
an image composed of pixels
Frankfort Plane
an imaginary plane that passes thru the top of the ear canal and the bottom of the eye socket
Foramen (RL)
an opening or hole in bone that permits the passage of nerves and blood vessels.
quanta
another name for photons
Image Receptor
a recording medium; examples include X-rays film, phosphor plate, or digital sensor
mA, kVp, exposure time.
adjustment to these INCREASES intensity
distance
adjustment to this DECREASES intensity
Size 2 film ( bite-wing)
adult dentition, can be vertical or horizontal
Somatic cells
all cells in body expect reproductive cells
3 years
all dental xray machines must be inspected and monitored periodically as mandated by the state every
Lingual Tori
film must be placed lingual to the torus-- attach two tabs to make the film easier to hold on to
Digital Imaging
filmless radiography system.
Fingerprint artifactblack
fingerprint on film
use fresh film
for a reference radiograph
use fresh chemicals
for processing the film for a reference radiograph
Soft Palate and the Uvula (RO)
form a muscular curtain that separates the oral cavity from the nasal cavity.
Lipline (RO)
formed by the positioning of the patient's lips
more damage to cells
large area of tissue exposed to radiation.
more damage occurs
large quantity of radiation
big focal spot
less sharp the image
viewbox
light source that is used to view dental radiographs
Size 3 film ( bite-wing)
one film is used for each side (not recommended-- overlapped contacts)
every 1/60 of a second
one impulse
Milliampere (mA)
one is equal to 1/1000 of an ampere.
kVp
only affects contrast
An image with low contrast
periodontal or periapical disease
Tubehead seal (tube head)
permits the exit of X-rays from the tube head and acts as a filter to the X-ray beam
Film Placement (paralleling)
positioned to cover the prescribed area of teeth to be examined
protons
positively charged particles
short-scale contrast and long scale contrast
preferred in dental radiography images
Teeth too far back on the bite block
teeth appear fat and out of focus
Teeth too far forward on bite block
teeth appear skinny and out of focus
Open contact
teeth dont overlap. thin radiolucent line
10% of the occupational dose
the MAD for nonoccupational exposed people
Roentgen
the unit for exposure.
Scratched film
white lines appear
Film Exposure (paralleling)
x-ray beam must be centered on the film to ensure all areas of the film are exposed
speed of light
x-rays travel
dirt and scratches
xtraoral intensifying screens used within a cassette holder should be periodically examined for the presence of any
Alveolar bone
Bone that supports and encases the roots of the teeth
Total Dose
Quantity of radiation received and absorbed
Scale of contrast
Range of useful densities seen on a dental radiograph
Dose Rate
Rate at which exposure to radiation occurs and absorption takes place
Panoramic receptor
Receptor used in panoramic examination, shows a wide view of the maxilla and the mandible
Collimation
Rectangular reduces 60-70% instead of round one.
Washing
Removes all excess chemicals from the emulsion
Genetic cells
Reproductive cells
Image Magnification and Loss of Definition
Result of film being placed away from the tooth during paralleling technique
appears cracked
Reticulation of Emulsion
One periapical and one occlusal
Right angle technique uses
L shell electrons
12 kev
Cumulative Effects
Injury is additive from repeated radiation exposure
light image
Large patient increase thickness will result in
cone cut with film holder
A: clear unexposed area is seen C: PID wasn't properly aligned CO: align receptor and PID
Overexposed film
A: dark C:recptor was over exposed to radiation CO: check kvp, ma settings
phalangioma
A: finger exposed on film C: finger was placed incorrectly CO: move finger
movement (image)
A: image is blurred C: patient or tube head was moving CO: tell patient to stay still
Film bending
A: images and stretched and distorted C: film was bent excessively Co: check film before exposure
Long term effects examples
1. Cancer 2. birth defects 3. genetic defects
Based on individual needs
.How often should children have dental x-rays?
Sizes of Film (bite-wing)
0- Primary dentition, always horizontal 2- adult dentition, can be vertical or horizontal 3- one film is used for each side (not recommended-- overlapped contacts)
energy
1% converted into xrays
Cross-sectional technique
1. "Cross Cut" 2. circular or elliptical appearance of the teeth, allows to locate tori and impacted or malposition teeth malformation of bony protuberance, and calcifications of soft tissues.
Topographical Technique
1. "Tall Teeth" 2. allows to survey generally a greater amount of information in the alveolar crest and apical areas than perioapical radiographs 3. within limit
Zygoma (RO)
1. "cheekbone" or zygomatic bone 2. articulates with the zygomatic process of the maxilla 3. appears as diffuse RADIOPAQUE band extending posteriorly from the zygomatic process of the maxilla
F.G. Fitzgerald
1. (1947)Introduction of long-cone paralleling technique 2. (1948)Introduction of panoramic radiography 3. (1955)Introduction of D-speed film (kodak ultra speed)
Beam alignment device
1. A device used to align the position indicating device (PID) in relation to tooth and receptor 2. positions the intraoral receptor in the mouth and retains the receptor in position during exposure 3. helps stabilize the receptor in the mouth and reduces the chances of movement, thus reducing the patient's exposure to x-radiation
Importance of Dental Radiographs
1. A necessary component of comprehensive patient care. 2. Essential for diagnostic purposes 3. Enable the clinician to identify many conditions they may otherwise go undetected; and allow the clinician to see many conditions that are not apparent clinically
Ghost image
1. A radiopaque artifact seen on a panoramic image 2. is produced when a radiodense object is penetrated twice by the x-ray beam. 3. appears larger and higher 4. blurred in horizontal and vertical directions
internal oblique ridge (RO)
1. A radiopaque band that extends downward and forward from the ramus 2. When both appear, the external oblique ridge is superior to the internal oblique ridge
Buccal Object Rule
1. A rule governing the orientation of structures portrayed in two radiographs exposed at different angulations 2. Same side lingual opposite side buccal rule ( SLOB Rule) 3. Buccal ALWAYS move away rule (BAMA)
mental foramen (RL)
1. A small ovoid or round radiolucent area located in the apical region of the mandibular premolars 2.Frequently misdiagnosed as a periapical lesion
Lingual mounting
1. A system of mounting that is not recommended where the radiographs are placed in the film mount 2. viewed as if the dental radiographer is inside the pt's mouth and looking out. 3. Read from LEFT TO RIGHT
vertical angulation (+)
1. Above occlusal plane 2. Tubehead tilted DOWN
advantages of the paralleling technique
1. Accuracy: procduces an image that has dimensional accuracy 2. Simplicity: Simple and easy to learn and use 3. Duplication: Easy to standardize and can be accurately duplicated, or repeated, when serial radiographs are indicated.
Short Term effects
1. Acute 2. Effects seen within minutes, days, or weeks following latent period
Radiation Effects on Cells
1. Affects cell nucleus where DNA is located 2. Can caused death of cell or/and disruption of cell function
Confidentiality
1. All information contained in dental record is private 2. State law protects information and prohibits the transfer of such to non-privileged person
Added Filtration
1. Aluminum discs inserted in the dental x-ray machine between the x-ray tubehead seal and collimator; 2. absorbs low-energy x-rays.
Professional Goals
1. Always strive for professional improvement 2. Patient and operator protection, patient education, operator competence and efficiency, and production of quality radiographs.
Bisecting technique
1. An intraoral radiographic technique used to expose periapical receptors 2. the receptor is placed along lingual surface of the tooth; the central ray of x-ray beam is directed perpendicular to the imaginary bisector formed by the receptor and the long axis of the tooth
Position-indicating device (PID)
1. An open-ended, lead-lined cylinder extending from the opening of the metal housing of the tubehead; 2. aims and shapes the x-ray beam
Eye Contact
1. Another nonverbal means of communication that is important in the dental setting 2. Clinician should maintain this with the pt. while listening 3. associated. with interest and attention and plays a powerful role in initiation and development of interpersonal relationships 4. Lack of this is often interpreted as indifference or lack of concern.
Patient Education
1. Another priority 2. Clinician must play an active role in this for pt's concerning radiation exposure, pt. protection, and the value and uses of dental radiographs.
Long Term Effects
1. Appear after years, decades, or generations 2. Usually associated with repeated low levels of exposure over years
Developmental Disabilities
1. Autism, cerebral palsy, epilepsy and other neuropathies, and mental retardation 2. The dental radiographer may experience difficulties in obtaining intraoral images. If coordination is a problem, mild sedation may be useful, care giver may be asked to assist 3. It is important to recognize situations in which the patient cannot tolerate intraoral exposures. in such cases no intraoral exposures must be done. 4. In these patients, extraoral exposures may be used.
Receptor Placement technique
1. Avoid the palate, do not side the receptor along the palate, as this will stimulate the area and cause the gag reflex 2. Demonstrate receptor placement. 3. In the areas that are most likely to elicit the gag reflex, rub a finger along the tissues near the intended area or receptor placement while telling the pt. that is where you'll be placing it. This desensitizes the tissues in the area.
2 ways to stabilize the receptor in the bite-wing technique
1. Beam alignment device 2. bite wing tab
Vertical angulation (-)
1. Below occlusal plane 2. Tubehead tilted UP
government agencies
1. CDC - Influence in development and recommendations 2. OSHA - enforces regulation 3. FDA - regulation of waste products, chemicals, disinfectants
Communication
1. Can be defined as the process by which information is exchanged between 2 or more persons 2. Radiographer with effective skills in this is the basis for developing a successful radiographer-pt. relationship
Radiosensitive Cell
1. Cells that divide more frequently, metabolically more active are immature. 2. Lymphocytes make white blood cells, immune system. 3. most sensitive are young lymphocytes which are kids 4. Blood cells are the second most sensitive 5. Third is immature reproductive cells, young bone cells
Reactions before gag relfex
1. Cessation of respiration 2. Contraction of the muscles in the throat and abdomen
Film Contrast
1. Characteristics of the receptor that influence this. 2. including qualities of the film and film processing, and the qualities of the sensor
Production of Quality Radiographs
1. Clinician must be committed to producing high-quality diagnostic radiographs and must constantly strive to achieve perfection with each radiograph 2. To produce the perfect radiograph the radiographer must carefully position and expose the image receptor, correctly process it, and properly mount and identify the finished radiograph
Tungsten Filament (cathode)
1. Coiled wire made of tungsten, produces electrons when heated 2. The hotter the filament the more electrons
Dose Response Curve
1. Correlates the 'response' or damage of tissues, with the 'dose' or amount of radiation 2. No safe amount of radiation exposure 3. Dose received is small damage does occur with dental radiograph
SI System
1. Coulombs/kilograms (C/kgs) 2. Gray (Gy) 3. Sievert (Sv)
Operatory Preparation
1. Cover the treatment area with barrier prior to x-ray exposure 2. Including computer key board and any device you might use.
treating a patient with a disbaility
1. DO NOT ask personal questions about a disability. 2. DO offer assistance to a person with a disability. 3. DO talk directly to the person with the disability
Recovery Period
1. Damage may not be permanent 2. Cells can repair damage caused by radiation 3. Most damage caused by radiation 4. Most damage caused by low-level radiation is repaired
Importance and uses of Radiographs
1. Detect-lesions diseases and conditions of the teeth and surrounding structure 2. Confim or Classify- suspected diseases 3. Localize-lesions or foreign objects 4. Evaluate-growth and development 5. Illustrate-changes secondary to caries, periodontal disease, and trauma 6. Document-the condition of a patient at a specific point in time
W.C. Roentgen (1895)
1. Discovery of X-rays on November 8th 2. Father of X-rays
types of Particulate radiation
1. Electrons: Beta particles Cathode rays 2. Alpha particles 3. Protons 4. Neutrons.
Patient records
1. Established for every patient 2. LEGAL document 3. Accurately reflects all aspects of patient care 4. Provides legal documentation of a patient's condition 5. Radiographic documentation 6. Confidentiality 7. Dental radiographs are the property of the dentist
purposes and uses of panoramic imaging
1. Examining large areas of the face and jaws. 2. Locating impacted teeth or retained root tips 3. Evaluating trauma lesions, and diseases of the jaws 4. Assessing growth, eruption pattern, and development
Mental Ridge (RO)
1. Extends from the premolar region to the midline and sloped slightly upward 2. thick RADIOPAQUE band extends from premolar region to incisor region often appears superimposed over mandibular anterior teeth
film placement rules (paralleling)
1. Film Placement 2. Film Position 3. Vertical Angulation 4. Horizontal Angulation 5. Film Exposure
Aluminum disks (tube head)
1. Filter out the non penetrating, longer wave length X-rays 2. sheets of 0.5 mm thick
W.D. Coolidge (1913)
1. First Xray tube 2. introduced the hot cathode tube
H.R. Raper (1913)
1. First dental text 2. (1925)Introduction of bite-wing technique 3. (1933)Concept of rotational panoramic proposed
W.H. Rollins (1901)
1. First paper on dangers of xradiation 2. developed the first dental x-ray unit in 1896 3. FATHER OF SCIENCE OF RADIATION PROTECTION
Scatter Radiation
1. Form of secondary radiation and is the result of an X-ray that has been deflected from its path by the interaction with matter. 2. Deflected in all directions by the patients tissue and travels to all parts of the patients body and to all areas of dental operatory.
Atom
1. Fundamental unit of matter. 2. consist of orbiting electrons and central nucleus.
Medical Radiation
1. Greatest contributor to artificial radiation 2. dental radiography, fluoroscopy, radiation therapy Accounts for nearly half of total exposure received
EPA-Registered Disinfectants Classification
1. High-level disinfectant - germicidal, inactivate spores 2. Intermediate-level disinfectant - germicidal, hospital grade and tuberculocidals, iodophors, phenolics, chlorine containing compounds. does not destroy spores 3. Low-level disinfectant - hospital grade disinfectants. Cannot destroy spores, tubercle bacili, or non lipid viruses
Density and exposure time
1. INCREASE exposure time = increase density (blackness) 2. DECREASE exposure time = decrease density (blackness)
Density and Kilovoltage Peak
1. INCREASE kVp = increase density (blackness) 2. DECREASE kVp = decrease density (blackness)
Density and milliamperage
1. INCREASE mA = increase density (blackness) 2. DECREASE mA = decrease density (blackness)
Advantages of Bisecting
1. Image receptor placement may be easier with certain patients: Children, low palatal vaults, tori, gagging, etc. 2. Short PID may be easier to maneuver.
uses of 3D imaging
1. Implant placement 2. impacted teeth 3. definition of anatomic structures 4. endodontic assessment 5. airways and sinus analysis 6. evaluation of temporomandibular join disorders 7. orthodontic evaluation, pathology evaluation
Posture and Body Movement
1. Important nonverbal cues that convey the attitude of the clinician. 2. An attentive posture and leaning slightly toward the pt. with relaxed, still hands, are cues assoc. with interest and warmth. 3. Slumped posture and leaning away with arms folded, fingers tapping are cues that signal indifference and coldness.
advantages of panoramic radiography
1. Increased coverage of supporting structures of the oral cavity 2. Reduced pt. radiation dose over an intraoral full mouth series of radiographs 3. Can be performed in less time than the exposure of a FMX 4. Simple procedure to perform 5. Minimal pt. discomfort 6. May be performed on pt's who can not tolerate placement of an intraoral films/sensor packet 7. Requires minimal pt. instruction and cooperation 8. Infection control protocol minimized 9. Mounting time is eliminated 10. Aids in explaining treatment plan to pt's.
disadvantages of panoramic radiography
1. Increased image distortion 2. Reduced image sharpness 3. increased occurrence of overlapping of the proximal contact areas, especially in the premolar region 4. Focal trough size and shape limits imagery to only those structures which "fit" into the image layer. Teeth with labial or lingual tilting may not image well. 5. Superimposition of structures (e.g. the spinal column) may make interpretation difficult. 6. Not useful in detecting incipient carious lesions 7. Not useful in detecting early periodontal changes 8. Length of exposure time may limit its use on young children and other pt's who cannot remain still throughout the exposure cycle. 10. Cost of panoramic unit is significant
Radiographic documentation
1. Informed consent 2. number and types of radiographs exposed 3. Rationale for exposing radiographs 4. Diagnostic information obtained from interpretation of radiographs
disadvantages of digital imaging
1. Initial set-up costs 2. Image quality 3. Sensor size 4. Infection control 5. Wear and Tear 6. Legal issues
Image receptors preparation
1. Intraoral dental image receptors not needed to be sterile = "Industrially clean" 2. Use barrier envelopes according to the size and seal the envelopes properly 3. Avoid cross-contamination
Infection Control for film Automatic Processor
1. Intraoral film is protected by outer wrapping 2. Open daylight loader lid and place contaminated film in a cup - Close the lid - put dry hands through the sleeves - put gloves on inside the daylight loader with lid closed 3. Open up outer wrapping and remove film without contaminating film, place the film in the other cup 4. Once all film packets are opened, remove contaminated gloves and then load film with dry, clean hands into the automatic processor.
NonVerbal Communication Skills
1. Involves the use of body language 2. Posture, body movement, and eye contact are important 3. Can be used to substitute, or enhance communication 4. If consistent with verbal messages the pt. is more likely to relax and trust the clinician.
Verbal Communication Skills
1. Involves the use of language 2. Clinicians choice of words is important 3. Certain words detract form the professional image 4. Some words are assoc. with negative images and must be avoided. 5.. Excessive use of technical words may cause confusion and result in miscommunication 6. Delivery of speech is important, the clinician should always speak in a pleasant and relaxed manner 7. The use of a soft tone is conveyed as soothing and effective showing warmth and concern. The use of a loud tone is often assoc. with fear, anger or excitement.
Direct Theory (Rare)
1. Ionizing radiation directly hits critical areas within the cell 2. Occurs infrequently 3. most photons pass through cells causing little or no damage
No interaction
1. It is possible for an X-ray photon to pass through matter or the tissue of a patient without any interactions 2. This creates densities.
Anatomy of Alveolar Bone
1. Lamina Dura 2. Alveolar Crest 3. Periodontal ligament space
Sequence of Radiation Injury
1. Latent Period 2. Period of Injury 3. Recovery Period 4. Cumulative Effects
Soft palate
1. Lateral posterior third of the tongue 2. The area that is most likely to elicit the gag reflex when stimulated.
Liability
1. Legal accountability 2. Lies wit the dentist and auxiliary 3. Both can be named in law suit
Long wavelength
1. Less penetrating beam with low frequency 2. measured in meters.
Advantages of 3D imaging
1. Lower radiation does 2. Brief scanning time 3. Anatomically accurate images 4. Ability to save and easily transport images
Quality Administration Procedures
1. Management of the quality assurance in the dental office 2. Keep all records in writing
Maximum Permissible Dose (MPD)
1. Maximum dose equivalent that a body is permitted to receive in a specific period. 2. The dose of radiation that the body can endure with little or no injury.
Voltage
1. Measurement of electrical forces that causes electrons to move from a negative pole to a positive one 2. Measured in Volts or kilovolts
Tubehead components
1. Metal housing 2. Insulating oil 3. tube head seal 4. x-ray tube 5. Aluminum disks 6. Lead collimator 7. PID
Short wavelength
1. More penetrating beam with high frequency 2. measured in nanometers.
Operator Competence
1. Must always be a concern of the clinician, who must strive to maintain or improve this by attending CE courses and lectures, studying professional books and journals and reviewing and updating techniques. 2. both in exposure and processing techniques 3. Avoids errors resulting in non-diagnostic radiographs
Stochastic effects
1. The probability of occurrence increases with increasing absorbed dose. 2. Does not have a threshold
Patient Protection
1. Must be top priority and a primary concern 2. Lowest possible level of x-radiation must be used 3. Unnecessary pt. exposure to x-radiation must be avoided at all times. 4. Techniques used before exposure include proper prescription of radiographs, and use of proper equipment 5. During exposure use of the thyroid collar, lead apron, a fast film, and beam alignment devices 6. Proper selection of exposure factors and good technique 7. After exposure meticulous handling and processing techniques are critical for the production of diagnostic radiographs.
Xray machine performance standards
1. Must meet specific federal guidelines 2. regulate diagnostic equipment performance standards 3. State/Local Gov regulate how dental X-ray equipment 4. used to dictate codes that pertain to the use of x-radiation
Short term effects examples
1. Nausea 2. vomiting 3. Diarrhea 4. Hair loss 5. hemorrhage
to reduce the gag relfex
1. Never suggest gagging 2. Do reassure the patient 3. Do suggest deep breathing 4. Do try to distract the patient 5. Do try to reduce tactile stimuli 6. Do use a topical anesthetic
Milliamperage (mA)
1. Number of electrons passing through the cathode filament. 2. can be increased or decreased on the control panel. 3. regulates the temperature of the cathode filament.
Period of Injury
1. Occurs after latent period 2. Cell death 3. Changes in cell function 4. Breaking or clumping of chromosomes 5. Change in mitotic activity (reproduction cells)
SLOB RULE
1. One periapical/bitewing radiograph taken 2. A second Periapical/bitewing radiograph Taken 3. If the Object of Interest moved In The Same Direction as the Tube (the object is in the Lingual aspect) 4. If the Object of Interest moved In The Opposite Direction to the Tube (the object is in the Buccal aspect)
manage a patient with a hypersensitive gag reflex
1. Operator attitude 2. Patient and equipment preparations 3. Exposure sequencing 4. Receptor placement and technique
Cosmic Radiation
1. Originates from the sun and the stars 2. 150-300 mrads 3. Background radiation exposure daily
dot placement
1. PA's = "dot in the slot" 2. HBW = "dot down" 3. VBW = "dot down" 4. OCC = "dot out"
Different vertical angulations
1. Paralleling Technique: angulation of the central ray is directed perpendicular to the receptor and the long axis of the tooth 2. Bisecting technique: angulation is determined by the imaginary bisector; the central ray is directed perpendicular to the imaginary bisector. 3. Bite-wing technique: angulation is predetermined; the central ray is directed at +10 degrees to the occlusal plane.
Disadvantages of 3D imaging
1. Patient movement and artifacts 2. Size of the field of view 3. Cost of equipment 4. Lack of training in interpretation of image data on areas outside the max and the man
When the bisecting technique principle is applied
1. Pedo patient 2. Shallow palatal 3. Large torus or tori 4. Edentulous regions 5. Gagging patient
Operator Efficiency
1. Performing assigned duties in a time efficient manner 2. Always work carefully but quickly when positioning and exposing dental x-ray image receptors
Exposure sequencing
1. Plays an important role in preventing the gag reflex 2. Always begin with anterior exposures as they are easier for the patient to tolerate and are less likely to elicit the gag reflex 3. For posteriors always expose the premolar receptor before the molar receptor.
Risk management
1. Policies and procedures followed by dental radiographer 2. Reduces chances that patient will file legal action
Radiopaque
1. Portion of a processed radiograph that appears light or white 2. Dense and absorbs or resists the passage of the x-ray beam.
Duties and Responsibilities
1. Positioning and exposure of dental x-ray imaging receptors 2. Processing of dental x-ray films 3. Data retrieval of digital images 4. Mounting and identification of dental radiographs 5. Education of patients about dental radiography 6. Maintenance of darkroom facilities and processing equipment 7. Implementation and monitoring of quality control procedures 8. Ordering of dental x-ray equipment and related supplies.
Diagnostic image
1. Provides a great deal of information 2. the image exhibit proper density and contrast 3. are the same shape and size as the object exposed 4. has sharp outlines
information placed on a film mount
1. Pt's full name 2. Date of exposure not imported date 3. DDS's name/practice name 4. Radiographer's name
purpose of film mounting
1. Radiographs are easier to view and interpret in the correct anatomical position 2. Mounting decreases the chance of error caused by confusing the pt's right and left sides 3. Viewing films side by side allows for easy comparison between different views. 4. Protecting the radiographic images by less handling of individual radiographs results in fewer scratches and fingerprint marks 5. Film mounts mask out distracting side light, making radiographs easier to view and interpret 6. Film mounts provide a means for labeling the radiographs with the Pt's name, date of exposure, name of the practice, and radiographer 7. Mounted films are easy to store 8. Enhance pt education and consultations when films are mounted 9. When mounted labial, radiographic findings can be easily transferred to the pt's dental chart
Rules of Bisecting Technique
1. Receptor placement 2. Receptor position 3. Vertical angulation 4. Horizontal angulation 5. Receptor exposure
disadvantages of the paralleling technique
1. Receptor placement: receptor placement may be difficult for the dental radiographer. 2. Discomfort
To achieve a stable atom
1. Recombine without causing changes in the molecule 2. combine with other free radicals and cause changes 3. combine with ordinary molecules to form a toxin.
Calibration Machines
1. Recommended by American Academy of Dental radiology 2. Annual tests for machines, done by qualified technician or dental staff 3. Keep test log to record results
Listening Skills
1. Refers to the receiving and understanding of messages. 2. Results in less chance of misunderstandings 3. communicates attention and interest; use of nonverbal cues to convey appropriate emotional responses; to paraphrase what the pt. has just stated to confirm what has been heard. 4. Clinician should give undivided attention to the pt., should never interrupt or correct the pt., finish the pt's sentences, look at a clock or watch, or distract the pt. by fidgeting or playing with objects
Chairside manner
1. Refers to the way a clinician conducts themselves at the pt's chairside 2. Conveys confidence, avoids comments such as "oops" and other statements that indicate a lack of control.
Patient Preparation
1. Remove any artifacts that may be in the path of x-ray: partials, dentures, jewelry, glasses, etc 2. Patient consent form = signed by patient 3. RMH, vitals, EO/IO = Signed by Dr or instructor 4.Lead-apron and thyroid collar
Fixation
1. Removes the unexposed, unenergized silver halide crystals from the film 2. Hardens the film emulsion
Federal Government Requirements
1. Responsible for x-ray machine 2. Consumer Patient Radiation Health and Safety Act 3. safe use of dental x-ray equipment 4. Guidelines fro the proper maintenance of x-ray equipment 5. properly trained and certified dental radiographers
Traditional or Standard System
1. Roetgen (R) 2. Radiation Absorbed Dose (RAD) 3. Roentgen Equivalent in man (REM)
Intermediate radiosensitive
1. Salivary gland 2. kidney 3. liver lungs, connective tissues, bone, cartilage
indirect digital imaging examples
1. Scanning traditional radiographs 2. Storage phosphor imaging
Infection Control For PSP Plates
1. Seal the this with plastic barrier envelopes and place them on a separate clean try with barriers - from receptor holding pink tray to blue tray for a pt. 2. Disinfect this after x-ray image is recorded, place the exposed on top of paper towel to soak up the excess saliva. Upon completion of x-ray exposure, wipe the barriers with DisCide to prevent cross-contamination 3. Remove plastic barrier from the image receptor by opening without contaminating, The image receptors are placed in light tight black box 4. Once placed in light tight box, remove the contaminated gloves. Without gloves, carry the black light-tight box into the processing room to scan the image. 5. Put on a new gloves, insert the sensors into the slot of the scanning carrousel to be processed by the laser scanner. 6. If contaminated, use ethyl alcohol on soft 4x4 gauze to disinfectant with gentle circular motion to prevent scratching the surface 7. Deactivate on the view box for 5 min. prior to replacing on the tray for the next operator
Occlusal receptor
1. Size 4 is used. 2. the patient "occludes," or bites on this.
Interpersonal skills
1. Skills that promote good relationships between individuals 2. Radiographer must have effective skills not only to establish trusting relationships with dental patients but also to promote pt. confidence. 3. Must be used in conjunction with technical skills to enhance the quality of pt. care.
Critical organ examples
1. Skin 2. Tyroid- cancer 3. Lens of eye- cataract 4. Bone marrow- leukemia 5. Most sensitive cell are reproductive cells, greatest concern in dental radiography
Nonstochastic effects
1. Somatic effects that have a threshold 2. Increase in severity with increasing absorbed dose.
Radiation Injury
1. Some x-rays are absorbed by the patient's tissues 2. the total transfer of energy from the photon to patient's tissues
PID is changed from 8 to 16
1. Source to receptor distance is doubled. 2. Beam is 1/4 as intense
PID is changed from 16 to 8
1. Source to receptor distance is reduced by half 2. Beam is 4 times as intense.
Licensure Requirements
1. State laws regulates the exposure of dental radiographs 2. Obtain certification in dental radiography 3. Exposure radiographs under direct supervision of dentist 4. Follow restrictions on types of radiographs that may be legally exposed
Dental X-Ray Film
1. Stored properly, protected, used before expiration date 2. Fresh Film test 3. Process new, unexposed 4. If clear with slight blue tint = fresh 5. If expired, been improperly stored or exposed to radiation = fogged
advantages of digital imaging
1. Superior gray-scale resolution 2. Reduced exposure to x-radiation 3. Increased speed of image viewing 4. Lower equipment and film cost 5. Increased efficiency 6. Enhancement of diagnostic image 7. Effective patient education tool
Distances for exposure
1. Target-surface distance 2. Target-object distance 3. Target-receptor distance
High-level Disinfectant
1. The US Environmental Protection Agency (EPA) has classified certain chemicals as "sterilants-disinfectants." 2. can be used to disinfect heat-sensitive semicritical dental instruments
Patient with Hearing Impairment
1. The dental radiographer may ask the caregiver to act as an interpreter, use gestures or sign language, or use written instructions. 2. When the patient can read lips, the dental radiographer must face the patient and speak clearly and slowly.
Patient with Mobility Impairment
1. The dental radiographer may offer to assist the patient in transferring to the dental chair or ask the caregiver to assist in the transfer. If a transfer is not possible, the dental radiographer may attempt to perform the necessary imaging procedures with the patient seated in the wheelchair.
Patient with Vision impairment
1. The dental radiographer must communicate using clear verbal explanations. 2. The radiographer must keep the patient informed of what is being done and explain each step to the procedure before performing it.
Labial mounting
1. The preferred method of mounting dental radiographs 2. radiographs are placed in the film mount as if the viewer is looking directly at the pt. 3. read from RIGHT TO LEFT
Receptor position (bisecting)
1. The receptor must be placed against the lingual surface of the tooth. 2. The occlusal end of the receptor must extend approximately 1/8 of an inch beyond the incisal or occlusal surfaces. 3. The apical end of the receptor must rest against the palatal or alveolar tissues.
Intensity ( x-ray beam)
1. The total energy of the x-ray beam. 2. the product of the quantity (number of x-ray photons) 3. quality (energy of each photon) per unit of area per time of exposure
Facilitation skills
1. These are interpersonal skills used to ease communication and develop a trusting relationship between the clinician and pt. 2. that the clinician will interact in a beneficial way and not in a harmful way; leading the pt. to provide more information and cooperate 3. These skills enhance pt. trust by encouraging questions, answering questions, responding with action, and expressing warmth
First Impressions and Patient Relations
1. This most often involves the dental auxiliary, specifically appearance and greeting. 2. Should always wear a clean uniform and be well groomed, personal hygiene. 3. Should never eat, drink, or chew gum while working with pt's 4. Pt's should always be greeted by proper title and last name. 5. Always introduce yourself to the pt, using both name and title
Uses of digital imaging
1. To detect lesions, diseases, and conditions of teeth and surrounding structures 2. Confirm or classify suspected disease 3. Provide information during dental procedures (root canal therapy instrumentation and surgical placement of implants) 4. Evaluate growth and development 5. To illustrate changes secondary to caries, periodontal disease, or trauma 6. To document the condition of a pt at a specific point in time
Development
1. To reduce the exposed, energized silver halide crystals into black, metallic silver 2. Softens the emulsion
Mandibular Occlusal Projections
1. Topographic 2. Cross-sectional 3. Pediatric
Maxillary Occlusal Projections
1. Topographic 2. Lateral (right or left) 3. Pediatric
Absorption xray
1. Total transfer of energy from the x-ray photon to the atoms of matter through which the x-ray beam passes. 2. x-ray photon collides with inner shell electron. 3. photon gives up ALL its energy.
Systems Used
1. Traditional or Standard System- older 2. (International System of Units)- Newer
components of the pan x-ray machine
1. Tube head 2. Rotation Center 3. Panoramic Rotational Systems. 4. Plane of focus - Focal trough
Molecules
1. Two or more atoms joined by chemical bonds 2. Formed by the transfer of electrons or by the sharing of electrons between the outermost shells of atom -transfer of electrons -sharing of electrons
Bite-wing Receptor
1. Type of receptor used in interproximal examination. 2. has a "wing", or tab, and the patient "bites" on the wing to stabilize the receptor
Intermediate-level Disinfectant
1. U.S. Environmental Protection Agency (EPA)-registered chemical germicides 2. labeled as both "hospital disinfectants" and "tuberculocidals"; 3. recommended for all surfaces that have been contaminated.
Low-Level disinfectant
1. U.S. Environmental Protection Agency (EPA)-registered chemical germicides 2. labeled only as "hospital disinfectants" 3. recommended for general housekeeping purposes.
Coherent scatter
1. UNMODIFIED SCATTER 2. low energy x-ray photon interacts with an outer shell electron 3. no change in atom 4. Accounts for 8% of interaction
Mandibular cross-sectional occlusal projection
1. Used to examine the buccal and lingual aspects of the mandible. 2. It is also used to locate foreign bodies or salivary stones in the region of the floor of the mouth
Maxillary lateral occlusal projection
1. Used to examine the palatal roots of molar teeth. 2. May also be used to locate foreign bodies or lesions in the posterior maxilla
Filament Circuit
1. Uses 3 to 5 V 2. regulates the flow of electrical current to the filament of the X-ray tube
Disadvantages of Bisecting
1. Usually some dimensional distortion. 2. Often superimposes adjacent structures. 3. Estimating the imaginary bisector line may be difficult 4. Short PID may increase radiation dose
Mounting Procedure Generalizations
1. Usually, the roots and crowns of the maxillary anterior teeth are larger and longer than mandibular 2. Canine teeth generally have the longest roots compared to adjacent teeth 3. Maxillary molars have 3 roots 4. Mandibular molars have 2 divergent roots 5. Most roots curve toward the distal
Kilovoltage (kV)
1. Voltage of the X-ray tube current, or the current passing from the cathode to the anode is controlled by the kV adjustment on the control panel 2. can be adjusted according to the individual diagnostic needs of patients.
Orbits/Shells
1. Well defined paths around the nucleus 2. maximum of 7 shells 3. letters K L M N O P Q 4. K is located closest to the nucleus and HIGHEST energy
Exposure time and milliamperage
1. When mA is increases, exposure time must be decreased. 2. When mA is decreased, exposure time must be increased.
Quality Care
1. When the radiographer attains professional goals, the pt. receives the highest quality of care possible 2. This benefits not only the pt. but also the profession of dentistry.
Film Placement Guidelines (paralleling)
1. White side (solid side) of film always faces teeth 2. anterior films placed vertically 3. posterior films placed horizontally 4. identification dot placed slot of film holder 5. place film away from teeth toward the middle of oral cavity 6. center film over area to be examined 7. position film, have patient slowly close on the bite block WITH TEETH
Anterior region of Alveolar Bone
1. normal alveolar appears pointed and sharp between teeth 2. appears as a dense radiopaque
Attitude and Patient Relations
1. Will affect pt. relations and can be defined as a "position of the body, or manner of carrying oneself, indicative of a mood" 2. Must be professional and include such attributes as courtesy, patience, and honesty. 3. Must be courteous and polite toward all pt's at all times. 4. Tolerance and understanding is important. 5. Some procedures are uncomfortable in dental radiograph and the clinician must be honest and inform the pt. of the potential discomfort.
Secondary Radiation
1. X-radiation that is created when the primary beam interacts with matter. 2. Less penetrating
Indirect Theory
1. X-ray photons are absorbed within cell and breakdown water molecule 2. Produces free radical- which form toxins and damage the cell 3. Occurs frequently due to high water content of cells (70%-80%)
Pixel
1. a discrete unit of info 2. make up the silicon CCD
right angle technique
1. a localization technique in which orientation of structures can be seen in 2 radiographs. Used for locating objects in mandibl
Mastoid Process (RO)
1. a marked prominence of bone located posterior and inferior to the TMJ 2.Not seen on periapical.
Digital Subtraction
1. a method of reversing the gray scale as an image is viewed 2. radiolucent images appear white and radiopaque images appear black so it is opposite
Imaginary bisector (bisecting)
1. a plane that divides in half, or bisects, the angle formed by the receptor and the long axis of the tooth 2. This visualized plane creates 2 equal angles and provides a common side for the 2 imaginary equal triangles.
Operator Protection
1. a primary concern 2. Must always avoid the primary beam and maintain an adequate distance, proper position, and proper shielding from x-rays during the procedure. 3. Radiation monitoring
tongue not in contact with the palate
1. a radiolucent shadow appears near apices of the maxillary teeth 2. Inform patient to place this on palate.
Nasal Cavity (RL)
1. also known as nasal fossa 2. Lateral walls of this are formed by the ethmoid bone and the maxillae 3. this is divided by a bony partition or wall called nasal septum 4. appears as a large RADIOLUCENT area superior to the maxillary incisors
Posterior region of alveolar Bone
1. appear flat & smooth between teeth 2. appear less dense & less radiopaque
lips not closed on bite block
1. appear radiolucent shadow that will block the anterior teeth 2. Inform patient to close
If patient's head is not centered
1. appears unequally magnified 2. side farthest from receptor= magnified 3. side closest to receptor=smaller
electrostatic force (binding energy)
1. attraction between the positive nucleus and the negative electrons 2. determined by the distance between the nucleus and the orbiting shells
Patient relations
1. between the pt. and the clinician. 2. Important to all dental professionals: the dentist, hygienist, and assistant
radioresistant cells examples
1. bone 2. muscle 3. nerve
Zygomatic Process of Maxilla (RO)
1. bony projection of maxillary articulates with the zygoma or malar bone 2. composed of dense cortical bone 3. appears as a J-shaped or U-shaped RADIOPACITY located superior to the maxillary first molar region
Floor of Nasal Cavity (RO)
1. bony wall formed by the palatal processes of the maxilla and the horizontal portions of palatine bones 2. floor is composed of dense cortical bone and defines the inferior border of the nasal cavity 3. appears as dense RADIOPAQUE band of bone superior to the maxillary incisors
Lateral Fossa (RL)
1. canine fossa 2. smooth depressed area of the maxilla located just inferior and medial to the infraorbital foramen between maxillary canine and lateral incisors 3. appears RADIOLUCENT between lateral incisors and canine.
Digital Sensors
1. cannot be eat sterilized, so in order to avoid cross-contamination, both barrier techniques and disinfection are required 2. CDC recommends cleaning and disinfecting with an EPA-registered intermediate-level disinfectant after removing the barrier and before using it another pt. 3. must be wrapped in plastic barrier envelopes to protect the sensor from salvia and contamination, much like the barriers used for intraoral films
Ionizing Radiation
1. capable of producing ions by removing or adding electrons to an atom 2. classifications: Particulate radiation & Electromagnetic radiation
Wave concept (electromagnetic radiation)
1. characterizes electromagnetic radiation as waves . 2. Focuses on: Velocity Wavelength Frequency.
Patients who refuse Radiographs
1. compromises the patient's diagnosis and treatment 2. No document can be signed to release the dentist from liability 3. Legally, the patient cannot consent to negligent care, such consent is invalid 4. Chart it.
component parts of x-ray machine
1. control panel 2. extension arm 3. tube head
electromagnetic radiation examples
1. cosmic rays 2. gamma rays, x-rays 3. ultraviolet rays 4. visible light 5. radar waves 6. microwaves 7. radio waves
nucleus
1. dense core of the atom 2. composed of protons and neutrons 3. Occupies very little space
basic elements of quality administration
1. description of plan 2. assignment of duties 3. monitoring schedule 4. maintenance schedule 5. record-keeping log, plan for evaluation 6. revision, in service training
Genetic effects
1. not seen in person irradiated 2. passed onto future generations
PID (tube head)
1. open-ended lead lined cylinder that extends from the opening of the metal housing of the tube head, aims and shapes the X-ray beam. 2. Long = 16 3. short = 8
Uses of Dental Radiographs
1. detection of diseases, lesions, and conditions of the teeth and bones that cannot be identified by clinical examination alone. 2. confirming suspected diseases and for assisting in the localization of lesions and foreign objects. 3. examine the status of teeth and bone during growth and development 4. essential component of the patient record, and any subsequent radiographs can be used for comparative purposes
steps for film processing (automatic)
1. development 2. fixation 3. washing 4. drying
steps for film processing (manual)
1. development 2. rinsing 3. fixation 4. washing 5. drying
types of digital imaging
1. direct imaging 2. indirect imaging
photons (xrays)
1. discrete bundles of energy 2. no mass or weight 3. Travel as waves at the speed of light 4. move through space in a straight line.
Target Film Distance (paralleling)
1. distance between source of the x-ray (tube head) and film 2. PID must be increased (16 in) to ensure parallel rays directed toward tooth
Object-Film Distance (paralleling)
1. distance between the film & the tooth 2. keep increased to keep parallel
Artificial or Man-made Radiation
1. fluorescent dials 2. luminous watches 3. tv 4. consumer products 5. fallout from atomic weapons
Sharpness factors
1. focal spot size 2. film composition 3. movement
Free Radical Formation
1. forms when x-ray photon ionizes water in cells 2. highly reactive and unstable 3. may disrupt cell metabolism and cause permanent cell damage
Informed Consent
1. given by the patient following full disclosure 2. Purpose of the procedure and who will perform it 3. Potential benefits and possible risks 4. Opportunity for patient to ask questions 5. Self determination- legal right to make decisions concerning care 6. May refuse 7. Dentist discusses diagnostic and treatment procedures with patient
X-radiation
1. high energy radiation produced by the collision of a beam of electrons with a metal target in an X-ray tube 2.high energy, ionizing electromagnetic radiation.
Median Palatal Suture (RL)
1. immovable joint btwn the two palatine processes of maxilla 2. extends from the alveolar bone between maxillary central incisors to the posterior hard palate 3. appears as a thin RADIOLUCENT line between the maxillary central incisors
causes of fogged film
1. improper safelighting and light leaks 2. improper film storage 3. outdated film 4. contaminated processing solutions 5. high developer temperature
Misc. items
1. include cotton rolls that can be used to stabilize receptor placement and paper towels hat can be used to remove saliva from exposed receptors. 2. A disposable container (cup or bag) labeled with the Pt's name is necessary to collect the exposed receptors 3. should be dispensed from a central supply area
Kilovoltage Peak Rule
1. increased by 15, exposure time should be decreased by half. 2. decreased by 15, exposure time should be doubled.
State Government Requirements
1. inspection of dental x-ray equipment on a regular basis 2. properly trained and certified dental radiographers
Paralleling Technique
1. intraoral technique used to expose periodical film 2. Other names: (XCP technique, right angle technique, long cone technique)
Compton Scatter
1. ionization 2. x-ray photon collides with outer shell and gives up part of its energy to eject the electron from orbit 3. looses energy at low energy level 4. Accounts for 62% of scatter
Energy Absorption & Photoelectric effect
1. ionization takes place during this 3. photoelectron possessing a negative charge with minimal power 4. effects 30% of x-ray interaction.
Alveolar crest (RO)
1. is the most coronal portion of alveolar bone found between teeth. 2. made up of dense cortical bone & is continuous with lamina dura 3. appear as radiopaque, is typically located 1.5 to 2.0mm below the cemento-enamel junction
Periodontal Ligament Space( PDL)
1. is the space between the root of the tooth & the lamina dura 2. appears as a continuous radiolucent line around the root of a tooth
lamina dura (RO)
1. is the wall of the tooth socket that surrounds the tooth 2. made up of dense cortical bone 3. appear as a dense radiopaque line surrounds the root of a tooth.
Exposure factors
1. kilovolatge (KV) quality 2. milliamperage (mA) quantity 3. exposure time
Intensity is affected
1. kilovoltage peak 2. milliaperage 3. exposure time 4. distance.
Chin is tipped too low
1. mandibular incisors are blurred 2. loss of detail in anterior roots3 3. exaggerated smile line seen
electromagnetic radiation
1. manmade/occurs naturally 2. no mass, no weight, no electric charge 3. propagation of wavelike energy without mass through space or matter 4. move through space as both a particle and wave (concepts)
Septa within Maxillary Sinus (RO)
1. may be seen within maxillary sinus 2. Bony walls or partitions that appear to divide the maxillary sinus into compartments 3. RADIOPAQUE lines within maxillary sinus.
X-ray equipment
1. must be inspected and monitored periodically 2. Co requires every two years 3. Educational every three years
Incisive Foramen (RL)
1. nasopalatine foramen 2. opening/hole in bone located at the midline of the anterior portion of the hard palate directly posterior to the maxillary central incisors 3. Appears as small, ovoid or round RADIOLUCENT area
Maxillary Sinus (RO)
1. paired cavities or compartments of bone located within the maxilla 2. Located superior to maxillary premolar and molar teeth 3. appears as RADIOLUCENT area located superior to the apices of the maxillary premolars and molars. 4. Floor of max sinus is composed of dense cortical bone and appears as radiopaque line
Spine alignment
1. patient must be sitting or standing straight 2. appears radiopacity in center of the image.
Radiolucent
1. portion of a processed radiograph that is dark or black 2. lacks density and permits the passage of x-ray beam with little to no resistance.
Particulate radiation
1. possesses mass 2. travels in straight lines at high speed
appear radiopaque on dental images
1. prominences of bone 2. process 3. ridge 4. spine 5. tubercle 6. tuberosity
Radiation characteristics
1. quality 2. Quantity 3. Intensity
mandible divided into
1. ramus 2. the body 3. alveolar process
Inverted Y (RO)
1. refers to the intersection of the maxillary sinus and the nasal cavity 2. as a RADIOPAQUE upside-down Y formed by the intersection of the lateral wall of the nasal fossa and the anterior border of the maxillary sinus 3.Located superior to the maxillary canine
Exposure Time
1. refers to the interval of time during which x-rays are produced 2. measured in impulses because x-rays create a series of burst.
Quantity
1. refers to the number of x-rays produced in the dental x-ray unit. 2. controlled by mA
quality assurance
1. refers to the special procedures that are used to assure the production of high-quality diagnostic radiographs 2. Includes quality control tests and administration procedures
Gag reflex (pharyngeal reflex)
1. retching that is elicited by stimulation of the sensitive tissues of the soft palate region. 2, This is a protective mechanism of the body that serves to clear the airway of obstruction.
Chin too high
1. reversed smile line is seen 2. the hard palate and floor of the nasal cavity appear too imposed over roots of maxillary teeth 3. loss of detail in maxillary incisors 4. maxillary incisors are blurred and magnified;
Maxillary Tuberosity (RO)
1. rounded prominence of bone that extends posterior to the third molar region 2. blood vessels and nerves enter the maxilla in the region and supply posterior teeth 3. RADIOPAQUE bulge distal to the third molar region
radioresistant organs examples
1. salivary glands 2. kidney 3. liver
Anterior Nasal Spine (RO)
1. sharp projection of the maxilla located at the anterior and inferior portion of the nasal cavity. 2. appears as a V-shaped RADIOPAQUE area located at the intersection of the floor of the nasal cavity and the nasal septum.
Subject thickness
1. small patient ⬇️thickness =⬆️ density /darker 2. Large patient ⬆️ thickness =⬇️ density /lighter
Hamulus (RO)
1. small, hook-like projection of bone extending from the medial pterygoid plate of the sphenoid bone 2. located posterior to the maxillary tuberosity region 3. RADIOPAQUE hook like projection posterior to the maxillary tuberosity region
Charge-Coupled Device (CCD)
1. solid-state detector used in many devices, and image receptor found in the intraoral sensor 2. contains silicon chip that is sensitive to x-radiation or light
appear radiolucent on dental image
1. spaces & depression in bone 2. canal 3. foramen 4. fossa 5. SINUSES
Magnification
1. that appears larger than the actual size of the object it represents. 2. Affected by the target-film distance and the object-film distance.
Nasal Septum (RL)
1. that divides the nasal cavity into the right and left nasal fossae 2.formed by two bones: vomer and a portion of ethmoid bone-and cartilage 3. appears as vertical RADIOPAQUE partition that divides the nasal cavity
Body of the Mandible (RO)
1. the body of the mandible is the horizontal 2. U-shaped portion that extends from ramus to ramus
Kilovoltage peak (kVp)
1. the maximum or peak voltage. 2. Regulates the penetrating power of the x-ray beam by controlling the speed of the electrons traveling between the cathode and the anode.
ionization
1. the production of ions or the process of converting an atom into ions 2. Occurs when x-rays strike patient tissues.
Genial Tubercles (RO)
1. tiny bumps of bone that serve as attachement sites 2. Located on lingual aspect of mandible 3. ring-shaped RADIOPACITY inferior to the apices of the mandibular incisors
electrons
1. tiny negatively charged particles that have very little mass. 2. Travel around nucleus
Superior Foramina of Incisive Canal (RL)
1. two tiny openings/ holes in bone located on the floor of the nasal cavity 2. these two small canals join together to form incisive canal and share common exit. 3. appears as 2 small round RADIOLUCENCIES located superior to the apices of the max central incisors
Quality
1. used to describe the mean energy or penetrating ability of the x-ray beam. 2. controlled by kVp
quality control tests
1. used to maintain and monitor dental x-ray equipment, supplies, and film processing 2. Monitor dental x-ray machines, film. screens. and cassettes & viewing equipment 3. Keep supplies functioning properly and in good repair
Ramus (RO)
1. vertical portion of the mandible that is found posterior to the third molar. 2. That mandible has two rami
Inferior Nasal Conchae (RO)
1. wafer-thin curved plated of bone that extend from the lateral walls of the nasal cavity 2. seen in lower lateral portions of the nasal cavity 3. appears as diffuse RADIOPAQUE mass or projection within the nasal cavity
the alveolar bone
1.. is the bone of the maxilla and the mandible that supports and encases the roots of teeth 2. is composed of dense cortical bone and cancellous bone 3. landmark include the lamina dura, the alveolar crest, & the periodontal ligament space
Highly radiosensitive Organ/Tissue
1.Lymphoid tissues 2. bone marrow (stem cells) 3. testes 4. intestinal mucosa. .
Purpose of the occlusal examination
1.To locate retain roots of extracted teeth. 2.To locate supernumerary, unerrupted, or impacted teeth. 3.To locate foreign bodies in the maxilla or the mandible. 4.To locate salivary stones 5.To locate and evaluate the extent of lesions 6.To evaluate the boundaries of the maxillary 7.To evaluate fractures of the arches 8.To aid in the examination of patients who cannot open their mouths. 9.To examine the area of a cleft palate. 10.To measure changes in size and shape of the arches. 11. Used to examine large areas of the maxilla or the mandible. 12. Preferred when the area of interest is larger than a periapical receptor may cover or when the placement of intraoral receptors is too difficult for the patient.
will have weak intensity
16 inch PID
automatic processor test
2 films, one exposed and one not, both processed
International Commission on Radiation Units and Measures ICRI
3 Quantities : 1. Exposure 2. dose 3. dose equivalent
M shell electrons
3 kev
Underexposed film
A: light C: receptor was underexposed to radiation CO: check kvp ma settings
short wavelength with great energy
85-100 kV produces
heat
99% is lost
Unexposed film
A : clear C: receptor wasn't exposed to radiation CO: turn on xray machine
tori
A bony growth
Septum (RO)
A bony wall or partition that divides two spaces of a fossa or sinus
Fossa (RL)
A broad, shallow, scooped-out or depressed area of bone
Film mount
A cardboard, plastic, or vinyl holder that is used to support and arrange dental radiographs in anatomic order
Exposure sequence
A definite order for periapical receptor placement and exposure that must be followed in the placement and exposure of intraoral films.
mylohyoid ridge (RO)
A dense radiopaque band that extends downward and forward from the molar region
incorrect premolar placement
A: distal surfaces of canine are not present C: receptor was placed to posteriorly CO: put edge of receptor midline of canine
Increase kV, mA, or exposure time
A dental patient has thick soft tissues and dense bones. To compensate for this increase in subject thickness and to provide an image of diagnostic density, the dental radiographer may
Cassette
A device that is used to hold the extraoral film and intensifying screens.
Grid
A device used to reduce the amount of scatter radiation that reaches an extraoral film during exposure.
Collimator
A diaphragm, usually made of lead, used to restrict the size and shape of the x-ray beam.
Nonscreen film
A film that does not require the use of screens for exposure
Thyroid Collar
A flexible lead shield used to protect the thyroid gland from scatter radiation.
Lead Apron
A flexible shield used to protect the patients reproductive and blood forming tissues from scatter radiation.
Radiation
A form of energy carried by waves or a stream of particles The emission and propagation of energy through space or a substance in the form of waves or particles.
Bite-wing tab
A heavy paperboard tab or loop that is fitted around an intraoral receptor and is used to stabilize the receptor during the procedure.
Sinus (RL)
A hollow space, cavity, or recess in bone
Viewbox
A light source or illuminator and is required to view dental radiographs accurately and assist in the interpretation of images.
Ridge (RO)
A linear prominence of projection of bone; an example is the internal oblique ridge of the mandible
Less image magnification
A long PID on magnification
Localization Techniques
A method used to locate the position of a tooth or an object in the jaws.
Cepalostat or craniostat
A panoramic x-ray tubehead is used in conjunction with a special extension arm and a device.
Circuit
A path of electrical current
Physical Disability
A person with this may have problems with vision, hearing, or mobility.
Dental Radiograph
A photographic image produced on film by the passage of X-rays through the teeth and related structures
Image
A picture or likeness of an object
Diagnostic Radiograph
A radiograph that meets certain criteria
submandibular fossa (RL)
A radiolucent area in the molar region below the mylohyoid ridge
mandibular canal (RL)
A radiolucent band outlined by two thin radiopaque lines that represent the cortical walls of the canal
external oblique ridge (RO)
A radiopaque band extending downward and forward from the anterior border of the ramus of the mandible
Tuberosity (RO)
A rounded prominence of bone
FMX
A series of intraoral dental radiographs that show all tooth-bearing areas
Spine (RO)
A sharp, thornlike projection of bone; an example is the anterior nasal spine of the maxilla.
More image magnification
A short PID on magnification
Tubercle (RO)
A small bump or nodule of bone
Identification dot
A small raised bump seen in one corner of each intraoral film packet. Used to determine film orientation
Developmental Disability
A substantial impairment of mental or physical funtioning that occurs before the age of 222 and is of indefinite duration"
Angulation
A term used to describe the alignment of the central ray of the x-ray beam in both horizontal and vertical planes
coronoid process (RO)
A triangular radiopacity superimposed over, or inferior to, the maxillary tuberosity region
Canal (RL)
A tubelike passageway through bone that contains nerves and blood vessels
Fast Film
A type of dental x-ray film that requires less radiation for exposure.
double exposure
A: 2 images on the film C: film was exposed twice Co: make sure change film
Film exposed to light
A: black C: exposed to white light CO: open only in dark room
Cone cut without film holder
A: clear unexposed area is seen C: PID was not directed at center of receptor CO: positon PID Carefully
tiny white spots
Air bubbles
vertically
Anterior PAs are arranged
Dental Radiographer
Any person who positions, exposes, and processes dental x-ray image receptors.
Dental radiographer
Any person who positions, exposes, and processes dental x-ray image receptors.
Radiation Leakage
Any radiation, with the exception of the primary beam, that is emitted from the dental tubehead.
All x-rays are harmful.
Are dental x-rays safe?
more disadvantages than advantages
Bisecting should not be used
Negligence
Diagnosis made or dental treatment delivered falls below the standard of care
the sensor is more sensitive to x-rays
Digital imaging requires less radiation because
No, needed when information about details of the teeth and bone are needed.
Can a panoramic x-ray be taken instead of a complete series?
no, treatment without necessary radiographs is considered negligent.
Can a patient refuse dental x-rays and be treated without them?
Disability
Can be defined as a "physical or mental impairment that substantially limits one or more of an individual's major life activities."
Yes, however patient concerns results in postponing the x-ray procedure
Can dental x-rays be taken during pregnancy?
Yes, provided they are recent and acceptable diagnostic quality.
Can radiographs from a pervious dentist be used instead of taking dental x-rays?
Sharpness
Capability of the receptor to reproduce the distinct outlines of an object.
perpendicular to the film & long axis
Central ray of x-ray beam is directed
Subject Contrast
Characteristics of the subject that influence radiographic contrast
Preparation of Supplies and Equipment
Clinician must also have ready all anticipated supplies and equipment, such as film, sensors, sterilized beam alignment devices, and other misc. items and must make these available in the work area
matched or unmatched densities
Comparison of daily radiographs with the reference radiograph can be interpreted as
CBVT
Cone beam volume tomography
Crestal bone
Coronal portion of alveolar bone found between teeth; also known as the alveolar crest
50 to 90
Exposure times for digital imaging are _____% to _____% less than those required for conventional radiography
256
Digital radiography uses up to ______ colors of gray compared with the 16 to 25 shades of gray differentiated on a conventional film.
Intraoral
Dental receptors placed inside the mouth are termed as
Extraoral
Dental receptors placed outside the mouth
straight white border
Developer cutoff
dark spots
Developer spots
Stepwedge
Device used to demonstrate short-scale contrast and long-scale contrast.
Transformers
Device used to either increase or decrease voltage in an electrical current
RAD
Dose measurement (amount of energy absorbed)
Statute of Limitations
Duration of time during which a patient may bring a malpractice action against a dentist or the auxiliary.
Snap-a-ray (BAD)
EEZEE Grip Film Holder
1st step in x-ray production.
Electricity from the wall outlet supplies the power to generate x-rays. When machine is turned on, the electrical current enters the control panel through the cord plugged into the wall outlet.
Electromagnetic spectrum
Electromagnetic radiations are arranged according to their energies.
Terrestrial Radiation
Emitted from radioactive materials present in earth and air
straight black border
Fixer cutoff
white spots
Fixer spots
Molybdenum Cup (cathode)
Focuses the electrons into a narrow beam and directs the beam across the tube toward the tungsten target of the anode
middle of the oral cavity
For paralleling, the film is placed towards
roentgen
How are x-rays measured?
Amount of Tissue Irradiated
How large an area of the body is exposed to radiation
6
How many anterior PAs are in a FMX
4
How many bitewings are in a FMX
8
How many posterior PAs are in a FMX
150-300 mrads per year
How much background radiation on average does an individual received yearly in the US
Varies depending on the film speed, the technique used, and the exposure factors.
How much radiation will I receive from the dental x-rays?
Based on individual needs because every patient's dental condition is different.
How often should adults have dental x-rays?
Lead Apron (infection control)
If contaminated, must be wiped with a disinfectant between patients.
buccal side
If object moves in opposite direction of tube
lingual side
If object moves in same direction of tube
Increase kV, mA, or time
If patient is large
decrease kV, mA, or time
If patient is small
concentrated or warm
If the densities on the daily radiographs appear darker than those on the reference radiograph, the developer solution is too
adequate
If the densities on the reference radiograph match the densities on daily radiographs, the developer solution strength is
weak or cold
If the densities seen on the daily radiograph appear lighter than those on the reference radiograph the developer solution is too
depleted
If the density on the daily radiograph differs from that one the standard radiograph by more than two steps on the stepwedge, the developer solution is
3 to 4
If the film does not completely clear in _ to _ minutes, the fixer solution is deplete
Patient can legally claim malpractice or negligence
If written consent not obtained from patient before exposing radiographs
Disclosure
Informing the patient about particulars of exposing dental radiographs
Film viewing
In dental radiography, the examining of dental radiographs on a light source
Patient and Equipment Preparations
In the patient with a hypersensitive gag reflex, every effort should be made to limit the amount of time that a receptor remains in the mouth. The longer a receptor stays in the mouth, the more likely the patient is to gag.
decrease exposure time
Increase mA
Visual characteristics
Influence the diagnostic quality of a dental radiograph 1. Contrast 2. Density
Geometric characteristics
Influence the quality of a dental radiograph 1. Sharpness 2. Magnification 3. Distortion
Minors under 18
Informed consent must be obtained by legal guardian when
Barrier envelope
Intraoral films may be inserted and sealed in plastic barriers
W.A. Price (1904)
Introduction of bisecting techniques
Operator Attitude
It the dental radiographer does not appear to be in complete control the patient interprets this as a lack of confidence and can act as a a psychogenic stimulus and elicit the gag reflex
High kVp
Low contrast (many grays) will have
2.5 mm aluminum
Machines operating above 70 kVp require
1.5 mm aluminum
Machines operating at 70 kVp or lower require
Current
Measured in amperes (A) or milliamperes (mA)
Exposure
Measurement of ionization in the AIR produced by x-rays
Amperage (A)
Measurement of number of electrons moving through a conductor
Line Pairs/millimeter
Measurement used to evaluate the ability of the computer to capture the resolution of a radiographic image
Indirect Digital Imaging
Method in which an existing radiograph is scanned and converted into a digital form by using a CCD camera
Direct Digital Imaging
Method in which an intraoral sensor is exposed to xradiation to capture a radiographic image that can be viewed on a computer monitor
Occlusal technique
Method used to expose a receptor in occlusal examination
Information found on Dental Radiographs
Missing, Extra, Impacted teeth, Dental caries, Periodontal disease, Tooth abnormalities, Retained roots, Cysts and tumors.
Cell Sensitivity
More damage occurs to specific cells sensitive to radiation
Children
Most Susceptible to Radiation Damage
prevent errors in interpretation
Mounted radiographs must be viewed in sequential order to
1974
No federal standards existed for dental x ray machines manufactured before
Radioresistant Cells
Not easily affected by radiation
Mass number/atomic weight
Number of PROTONS and NEUTRONS in the nucleus
Atomic number
Number of protons inside the nucleus is equal to the number of electrons outside the nucleus
Frequency
Number of wavelengths that pass a given point in a certain amount of time
Inherent Filtration
Occurs when the primary beam passes through the glass window of the X-ray tube, the insulating oil, and the tubehead seal.
the maxillary molar receptor
Of all receptor placements, this the most likely to elicit the gag reflex
ion pairs
One positive and one negative that results when an electron is removed from an atom.
Anode
Positive electrode
Horizontally
Posterior PAs are arranged
Size 0 film (bite-wing)
Primary dentition, always horizontal
Heat production
Primary factor that limits the size of the tungsten target
Radioactivity
Process which certain unable atoms or elements undergo spontaneous disintegration or decay in an effort to attain a more balanced nuclear state (not used in dental)
Characteristic Radiation
Produced when a high speed electron dislodges an inner shell electron from the tungsten atom and causes ionization of that atom.
Adults (occlusal)
Size four film
Children (occlusal )
Size two film
heat sterilization
Some digital sensors cannot withstand ________ _________, therefore sensors require complete coverage with plastic sleeves that must be changed with each patient.
Premolar (gag)
Start after anterior exposures with a gag patient
Anterior (gag)
Start with these exposures with a gag patient
Rule of isometry (bisecting )
States that 2 triangles are equal if they have 2 equal angles and share a common side.
Tactile Stimuli
Stimuli originating from touch
Psychogenic Stimuli
Stimuli originating in the mind
Rinsing
Stops the development process
PSP (Photo-Stimuable Phosphor)
Storage phosphor imaging
latent image
Stored energy within the silver halide crystals forms a pattern, and creates an invisible image
Contact areas
The area of a tooth that touches an adjacent tooth; the area where adjacent tooth surfaces contact each other
Work area
The area where x-ray supplies, or film sensors, are placed during exposure must be covered or disinfected
Radiography
The art and science of making radiographs by the exposure of film to x-rays
Horizontal Bite-wing
The bite-wing receptor is placed in the mouth with the long portion of the receptor in a horizontal direction
Vertical Bite-wing
The bite-wing receptor is placed in the mouth with the long portion of the receptor in a vertical direction
Vertical angulation ( bisecting)
The central ray of the x-ray beam must be directed perpendicular (at a right angle) to the imaginary bisector that divides the angle formed by the receptor and the long axis of the tooth
Horizontal angulation (bisecting)
The central ray of the x-ray beam must be directed through the contact areas between teeth.
secondary radiation
The closed-end pointed cone should not be used as a PID because it creates:
Total Filtration
The combination of the inherent and the added filtration in an x-ray machine.
3rd step in x-ray production
The filament uses the 3-5 volts to heat the tungsten filament in the cathode portion of the x-ray tube.
Target-surface distance
The distance from the source of radiation to the patient's skin
Target-receptor distance
The distance from the source of radiation to the receptor
Target-object distance
The distance from the source of radiation to the tooth
5th step in x-ray production
The electrons travel from the cathode to the anode. When the electrons strike the target, their energy is converted to x-ray energy and heat. 1% energy 99% lost as heat.
Imaging, dental
The creation of digital, print, or film representations of anatomic structures for the purpose of diagnosis.
2nd step in x-ray production
The current is directed to the filament circuit and step down transformer. The transformer reduces the 110 or 220 volts entering-line voltage to 3 to 5 volts.
month and six months
The darkroom must be checked for light-tightness every _ and proper safelighting every _
to stabilize receptor placement
The dental radiographer may ask the caregiver to assist with the holding of the receptor while wearing a lead apron and thyroid collar during exposure
6 feet
The dental radiographer should stand away from primary beam.
Dental Chair
The headrest as well as the headrest adjustment and chair adjustment controls must be covered or disinfected
6th step in x-ray production
The heat produced is carried away from the copper stem and absorbed by the insulating oil in the tube head. A small number of x-rays are able to exit the tube through the unleaded glass portion of the tube.
32
The human eye can appreciate _____ shades of gray.
fiber optic
The imaging sensor with a _________ cable linked to the computer is placed into the mouth of the patient and exposed to x-radiation
Maximum Accumulated Dose (MAD)
The maximum accumulated lifetime radiation dose that may be received by persons who are occupationally exposed to radiation.
to minimize distortion
The object and receptor must be parallel to each other and the beam perpendicular to the receptor
buccal and lingual and anterior and posterior
The occlusal relationship for right angle technique
anterior-posterior and superior and inferior
The periapical relationship for right angle technique
Rotation center
The pivotal point, or axis, around which the receptor and the x-ray tubehead rotate is termed this.
Film mounting
The placement of radiographs in a supporting structure or holder
Milliampere-seconds (mAs)
The product of milliamperes and exposure time
Dental Radiography
The production of the radiographs of the teeth and adjacent structures by the exposure of an image receptor to x-rays
Lateral cephalometric projection
The purpose of this is to evaluate facial growth and development, trauma, and disease and developmental abnormalities.
Posteroanterior projection
The purpose of this is to evaluate facial growth and development, trauma, and disease and developmental abnormalities.
Lateral jaw projection (body of mandible)
The purpose of this is to evaluate impacted teeth, fractures, and lesions located in the body of the mandible.
Lateral jaw projection (ramus of mandible)
The purpose of this is to evaluate impacted third molars, large lesions, and fractures that extend into the ramus of the mandible .
Waters projection
The purpose of this is to evaluate the maxillary sinus area.
Transcranial projection
The purpose of this is to evaluate the superior surface of the condyle and the articular eminence
Reverse towne projection
The purpose of this is to identify fractures of the condylar neck and ramus area
Submentovertex projection
The purpose of this is to identify the position of the condyles, demonstrate the base of the skull, and evaluate fractures of the zygomatic arch.
the standard of care
The quality of care that is provided by dental practitioners in a similar locality under the same or similar conditions.
Receptor placement (bisecting)
The receptor must be positioned to cover the prescribed area of the tooth to be examined. Specific placements are described in the procedures.
Latent Period
The time between exposure to ionizing radiation and the appearance of first symptoms or damage
X-ray machine
The tubehead, PID, control panel, and exposure button must al be covered or disinfected
Penumbra
The unsharpness, or blurring, of the edges of a radiographic image.
Filtration
The use of absorbing materials ( aluminum) for removing the low-energy x-rays from the primary beam.
Receptor exposure (bisecting)
The x-ray beam must be centered on the receptor to ensure that all areas of the receptor are exposed.
7th step in x-ray production
The x-rays travel through the unleaded glass window, the tube head seal and the aluminum disks
Head positioner
This consists of a chin rest, notched bite-block, forehead rest, and lateral head supports or guides
Interpretation
This is the explanation of what is viewed on a dental radiograph
Temporomandibular joint (TMJ)
This is the jaw joint
Screen film
This is used in panoramic imaging; this film is sensitive to the light emitted from intensifying screens.
Tomogram
This is used to estimate joint space and evaluate the extend of movement of the condyle when the mouth is open
Temporomandibular joint tomography
This technique is used to examine the TMJ
Bisect (B)
To dived into 2 equal parts
to minimize magnification
Tooth and receptor should always be placed as close together as possible
Caries
Tooth decay
Dentulous
Tooth-bearing areas that exhibit teeth
Edentulous
Tooth-bearing areas that no don't exhibit teeth
The Dose Equivalent Measurement
Used to compare biological effects of different types of radiation 1 rem= 0.01 SV 1 SV= 100 rems
Step down transformer
Used to decrease the voltage from the incoming 110-220 line voltage to the 3 to 5 Volts used by the filament circuit.
Mandibular topographic occlusal projection
Used to examine the anterior teeth of the mandible
Mandibular pediatric occlusal projection
Used to examine the anterior teeth of the mandible and is recommended for use in children 5 years or younger.
Maxillary pediatric occlusal projection
Used to examine the anterior teeth of the maxilla and is recommended for use in children 5 years or younger
Maxillary topographic occlusal projection
Used to examine the palate and the anterior teeth of the maxilla
Step up transformer
Used to increase the voltage from the incoming 110-220 line voltage to the 65,000 to 100,000 volts used by the high voltage circuit.
Film Holders
Used to keep film parallel with long axis of tooth
appears yellowish brown
Yellow-brown films
Glenoid Fossa (RO)
a concave, depressed area of the temporal bone
Infraorbital Foramen (RL)
a hole or opening in bone inferior to the border of the orbit
External Auditory Meatus (RL)
a hole or opening in the temporal bone located superior and anterior to the mastoid process
Inferior Border of the Mandible (RO)
a linear prominence of cortical bone that defines the lower border of the mandible
Styloid Process (RO)
a long, pointed, and sharp projection of bone that extends downward from the inferior surface of the temporal bone
Coronoid Process (RO)
a marked prominence of bone found on the anterior-superior ramus
Tongue (RO)
a movable muscular organ attached to the floor of the mouth
Pterygomaxillary Fissure (RL)
a narrow space or cleft that separates the lateral pterygoid plate and the maxilla
Mandibular Foramen (RL)
a round or ovoid hole in bone on the lingual aspect of the ramus
Mandibular Condyle (RO)
a rounded projection of bone extending from the posterior superior border of the ramus
Articular Eminence (RO)
a rounded projection of the temporal bone located anterior to the glenoid fossa
Mental Fossa (RL)
a scooped-out depressed area of bone located on the external surface of the anterior mandible above the mental ridge in the mandibular incisor region
Lingula (RL)
a small, tongue-shaped projection of bone seen adjacent to the mandibular foramen
Lingual Foramen (RL)
a tiny opening or hole in bone located on the internal surface of the mandible near the midline
Lateral Pyerygoid Plate (RO)
a wing-shaped bony projection of the sphenoid bone located distal to the maxillary tuberosity region
Silver halide crystals
absorbs radiation during exposure and stores the energy from radiation
exposure button
activates the machine to produce x-rays
control panal
allows the dental radiographer to regulate the x-ray beam
matter
anything that occupies space and has mass
Dentinoenamel junction-DEJ
appear as a line where enamel ( very radiopaque) meets the dentin( less radiopaque)
Ear (RO)
appears as a radiopaque shadow that projects anteriorly and inferiorly from the mastoid process
Fogged film
appears gray and lacks image detail
yes. Many diseases and conditions such as tooth decay gum disease and tumors cannot be detected simply by looking into the mouth.
are dental x-rays really necessary?
Fingernail artifact
black, crescent-shaped mark due to rough handling of film
Cancellous Bone
bone "arranged like lattice" spongy bone
Intensifying screen
calcium tungstate and rare earth
Pre- Molar Placement
center the film on the 2nd pre- molar-- the front edge of film should at least be at the distal of the mandibular canine
Central Ray
central portion of primary beam.
Vertical Angulation (paralleling)
central ray of x-ray beam must be directed perpendicular to the film and the long axis
Horizontal Angulation (paralleling)
central ray of x-ray beam must be directed through the contact areas between the teeth (inter proximal space)
Particle concept (electromagnetic radiation)
characterizes electromagnetic radiation as discrete bundles of energy called photons.
F Film
fastest film and intraoral film available
Dentin
comprises most of the tooth structure, not as radiopaque as enamel
Amount of tissue irradiated, cell sensitivity, and age
damage to occur due to
decrease density (exposure time)
decrease exposure time
less magnification
decrease in object-receptor distance
decrease density (kVp)
decrease kVp
decrease density (mA)
decrease mA
increase exposure time
decrease mA
An image with high contrast
dental caries
Transformer (tube head)
device that alters the voltage of incoming electricity
Stabe Bite Block (BAD)
disposable one time film holder
Copper stem (anode)
dissipate the heat away from the tungsten target
dose/time
dose rate equals
Light leak
exposed area appears black
Beta particles (particulate radiation)
fast moving emitting into nucleus
Milliamperes and exposure time
have a direct influence on the number of electrons produced by the cathode filament.
low kVp
high contrast (black and white) will have
cathode ray
high speed electrons originating in tube
Critical organ
if damaged, significantly diminishes the quality of a person's life
indicator light
illuminated when the equipment is turned on
ala-tragus line
imaginary line from lower border of nostril to upper border of ear
Sensor
in digital imaging, a small detector that is placed intraorally to capture a radiographic image.
Patients with Specific Dental Needs
includes pediatric, endodontic, and edentulous patients where examination techniques must often be modified
increase density (exposure time)
increase exposure time
greater magnification
increase in object-receptor distance
increase density (kVp)
increase kVP
increase density (mA)
increase mA
Intraoral Radiographic Examination
inspection of the teeth and intraoral adjacent structures.
Occlusal Examination
inspects large areas of the mandibular or maxilla on one image
Extraoral Radiographic Examination
inspects large areas of the skull or jaw
Interproximal Examination
inspects the crowns of both maxillary and mandibular teeth on a single image
Periapical Examination
inspects the entire tooth and supporting bone 2. must show 2-3 mm beyond apices.
Pulp Cavity (RL)
it contains blood vessels, nerves, and lymphatics, appears relatively radiolucent on a dental image
high kVp (scale)
long scale contrast
Volt (V)
measurement used to describe the potential that drives an electrical current through a circuit.
Precision Film Holder
metal collimating shields with film holding devices
Rapidly dividing, blood, reproductive, and young
most susceptible cells to radiation damage
Cathode
negative electrode
high does rate
no time for cells to repair themselves because
Bit-depth Image
number of possible gray-scale combinations for each pixel
Radiation Biology
the study of the effects of ionizing radiation on living tissues
Insulting oil (tube head)
prevents overheating by absorbing the heat created by the production of X-ray
reference radiograph
processed under ideal conditions and then used to compare the film densities of radiographs that are processed daily
Metal housing (tube head)
protects the X-ray tube and grounds the high voltage components
alpha particles
protons and neutrons emitting from Nuclei
safelight
provides low-light intensity light made of long wavelengths in the red-orange portion of the visible light spectrum safelighting
Analog Image
radiographic image produced by conventional film
Lead apron artifact
radiopaque cone shaped artifact
Reversed intensifying screen
radiopaque due to screen being flipped; more likely with flexible cassette
2.75 inches
recommended size of the beam at the patients face
Contrast
refers to how sharply dark and light areas are differentiated or separated on an image.
quality administration
refers to management of the quality assurance plan in the dental office
Nasopharyngeal Air Space (RL)
refers to the portion of the pharynx that is located posterior to the nasal cavity
Glossopharyngeal Air Space (RL)
refers to the portion of the pharynx that is located posterior to the tongue and the oral cavity
Palatoglossal Air Space (RL)
refers to the space between the palate and the tongue
State and local governments
regulate how dental X-ray equipment is being used and dictate codes that pertain to the use of X-radiation
Lead Collimator (tube head)
restricts the size of the X-ray beam
Polychromatic x-ray beam
result of varying kilovoltages occurring in the tube current, or a beam that contains many different wavelengths of varying intensities is produced
selective reduction
results in the crystals becoming totally black while the unexposed (unenergized) silver halide crystals are removed from film
the coin test
safelighting test where a coin is placed on unexposed film under safelight. developed film showing outline of coin indicates that the safelight intensity is too great and not safe
monthly
screens should be cleaned
Somatic effects
seen in the person irradiated.
Tungsten target (anode)
serves as a FOCAL SPOT and converts bombarding electrons into X-ray photons
Rectangular PID
shape of the position-indicating devices that is most effective in reducing patient exposure
low kVp (scale)
short scale contrast
More radiation and faster dose rate
shorter latent period occurs
Radiation Monitoring Badge
should be worn at waist level whenever the dental radiographer is exposing x-ray film or digital sensors.
calcium tungstate
slow screen (blue light )
D film
slowest intraoral film
dark image
small patient decrease thickens will result in
Velocity
speed of a wave
ALARA concept
states that all exposure to radiation must be kept to a minimum, or "as low as reasonably achievable".
Inverse square law
states that the intensity of radiation is inversely proportional to the square of the distance from the source of radiation.
general/breaking radiation
stopping or slowing of the electrons of the cathode stream as they collide with the nuclei of the target atoms.
Gagging
strong, involuntary effort to vomit.
extension arm
suspends the x-ray tube head
small crystals
the sharper the image
Field of View
the area that can be captured when performing imaging procedures
Orbit (RL)
the bony cavity that contains the eyeball
Hard Palate (RO)
the bony wall that separates the nasal cavity from the oral cavity
reduction
the chemical reaction that occurs when the halide portion of the exposed, energized silver halide crystals are removed
Benefits of Dental Radiographs
the clinician can minimize and prevent problems, such as tooth-related pain or the need for surgical procedures.
6 months
the darkroom should be checked for light-tightness and proper safelighting every
Extreme Cases of Gag reflex
the dental radiographer must resort to extra oral images such as panoramic or lateral jaw images to obtain diagnostic information.
Patient in a wheelchair
the dental radiographer should initially ask the patient how he or she would prefer to transfer to the dental chair.
90-135 degrees
the dental radiographer should stand to the primary beam.
Wavelength
the distance between the crest of one wave and the crest of the next.
MAD=(N-18)X 5 rems/year MAD=(N-18) X 0.05 SV/year
the formula for maximum accumulated dose:
Xray tube (tube head)
the heart of the X-ray generating system
Storage Phosphor Imaging
the image is recorded on phosphor-coated plates and then placed into an electronic processor, where a laser scans the plate and produces an image on a computer screen
Big crystals
the less sharp the image
movement
the less sharp the image
5.0 rems/year (0.05 SV/year)
the maximum permissible dose for occupationally exposed people
Enamel
the outermost radiopaque layer of the crown of a tooth
Density
the overall darkness or blackness of an image
Thermionic emission
the release of electrons from the tungsten filament when the electrical current passes through it and heats the filament.
no movement
the sharper the image
small Focal spot
the sharper the image
Static electricity
thin, black branching lines appear on the film
Digitize
to convert an image into a digital form that, in turn, can be processed by a computer
the purpose of dental radiography
to provide the oral health care team with radiographic images for the best diagnostic quality.
use long PID
to reduce skin exposure
appears light
underdeveloped film
DICOM data
universal format of handling, storing and transmitting 3D images
the fresh film test
unwrapping one exposed film from a newly opened box and using fresh chemicals to process the unexposed film is known as
Lead plate
used as a collimator
normalizing device
used to monitor developer strength and film density
Protective Barrier
used to protect the operator from primary and scatter radiation.
energy results
when mass is altered