Dental Radiograph 1 (Review: Outcomes 1-10) Flashcards

Question

How are patients protected from x-radiation?

Answer 1

1. Proper prescribing or order of dental images by dentist - dentist uses professional judgement to make decision about the number, type, and frequency of dental images 2. Use of proper equipment - Dental x-ray tube head must be equipped with appropriate aluminum filters, a lead collimator, and a position-indicating device (PID) - longer (16-inch) PID is preferred vs. short (8-inch) because it produces less divergence of the x-ray beam During exposure: 3. Patient protection measures are used before and during x-ray exposure i. Thyroid collar ii. Lead apron iii. Digital Sensors or fast film iv. Beam alignment devices 4. Exposure Factor Selection - Adjustment of kVp, milliamperage, and time settings on the control panel to limit the amount of x-radiation exposure received by the patient - on most units, kilovolt peak and milliamperage are preset by manufacturer and cannot be adjusted 5. Proper Technique - helps create a diagnostic image and reduce amount of exposure a patient receives - Nondiagnostic images must be retaken = additional exposure of patient to radiation *RE-EXPOSURE OF AN IMAGE, OR RETAKE MUST BE AVOIDED AT ALL TIMES* - To produce diagnostic images, the radiographer must have a thorough knowledge of techniques used in dental imaging After exposure: 6. Proper receptor handling - Artifacts caused by improper film handling result in nondiagnostic films 7. Proper film processing/image retrieval - Improper film processing may require retakes, needlessly exposing the patient to excess x-radiation *Proper selection of exposure factors and good technique further protect the patient from excessive exposure to x-radiation

Answer 2

A flexible lead shield that is placed securely around the patient's neck to protect the thyroid gland from scattered radiation - the lead prevents radiation from reaching the gland and protects the highly radiosensitive tissues of the thyroid - Recommended for all intraoral exposures - NOT recommended for extraoral exposures

Answer 3

A flexible shield placed over the patient's chest and lap to protect the reproductive and blood-forming tissues from scatter radiation - the lead prevents the radiation from reaching these radiosensitive organs - Recommended for both intraoral and extraoral exposures

Answer 4

Stabilizes the receptor in the mouth and reduces the change for movement - eliminates the need for the patient to hold the receptor in position with a finger, recuing unnecessary exposure

Answer 5

- Compared with traditional film radiography, digital image receptors require less radiation exposure to patient - Digital receptor is the most effective method of reducing a patient's radiation exposure - the lower absorbed dose is significant with regard to patient protection from excessive radiation

Answer 6

1. Must use proper protection measures to avoid occupational exposure to x-radiation (e.g. primary radiation, leakage radiation, scatter radiation) 2. The use of proper operator protection techniques can minimize the amount of radiation 3. Operator protection measures include following protection guidelines and using radiation-monitoring devices

Answer 7

1. Must stand at least 6 feet (2 meters) away from x-ray tube head during x-ray exposure 2. Must never hold a receptor in place for a patient 3. Must never hold or stabilize the x-ray tube head

Answer 8

Whenever possible, stand behind a protective barrier (e.g. a wall) during x-ray exposure - most dental offices incorporate adequate shielding in walls through the use of several thicknesses of common construction materials (drywall) - A leaded glass window or use of a mirror is beneficial to monitor the patient during exposure - At SAIT, we stand behind a glass window

Answer 9

1. Radiation Safety Legislation 2. Maximum Permissible Dose 3. Cumulative Occupational Dose 4. ALARA Concept

Answer 10

The maximum dose equivalent that a body is permitted to receive in a specific period - For occupationally exposed persons: 50 mSv/year (0.05 Sv/year or 5.0 rem/year) - For non-occupationally exposed persons: 1 mSv/year (0.1 rem/year) - For occupationally exposed pregnant women: 0.5 mSv per month during pregnancy months

Answer 11

The dose accumulated over a lifetime - An individual's COD should not exceed the worker's age multiplied by 10 mSv

Answer 12

An understanding of dental radiography equipment will permit the DA to practice safely, produce diagnostically acceptable radiographs, and troubleshoot as needed - Dental radiographer must be familiar with dental x-ray equipment and x-ray receptor holders and beam alignment devices used in digital and film-based imaging

Answer 13

i. Tube head - where x-rays are generated ii. Position indicator device (PID) - reduces exposure to the patient iii. Extension arm - allows positioning of tube head *See image in lecture slide - Outcome 3*

Answer 14

*NEGATIVE CHARGE* - Consists of a tungsten filament - Purpose: supply electrons necessary to generate x-rays - Electrons are generated in x-ray tube at the cathode - The hotter the filament becomes, the more elections that are produced *See diagram in lecture slide - Outcome 3* *Electrons travel from cathode to anode* CAT-->NAP CAT = cathode N = negative A = anode P = positive

Answer 15

*POSITIVE CHARGE* - It is the target for the electrons - Composed of tungsten target - Purpose of tungsten target: serve as a focal spot and convert the bombarding electrons into x-ray photons *Electrons travel from cathode to anode* CAT-->NAP CAT = cathode N = negative A = anode P = positive

Answer 16

1. Electricity - energy used to make x-rays 2. Amperage - measurement of the number of electrons moving through a conductor 3. Voltage - measurement of electrical force that causes electrons to move from a negative pole to a positive one

Answer 17

A device that is used to either increase or decrease the voltage in an electrical circuit - Higher penetration = shorter wavelength - Lower penetration = longer wavelength

Answer 18

1. Wavelength: - shorter wavelengths = greater energy = greater penetrating power 2. Distance: - from source to object - shorter distance = greater penetrating power 3. Density: - of object to be penetrated - less dense object = greater penetrating power

Answer 19

Used to adjust the: i. milliamperage (mA): the amount of electrical current coming out of the cathode - usually 10-15mA ii. kilovoltage (kV): the amount of current passing from anode to cathode - longer exposure (@ 70kV) = high contrast (fewer shades of gray - darker) - less exposure (@90kV) = low contrast (more shades of gray - lighter)

Answer 20

1. Primary - useful rays are produced from the x-ray tube 2. Stray - rays that flow out from parts of the x-ray tube other than the window (faulty tube) 3. Scatter or Secondary - reflected rays that have been reflected by objects in its path (patient or dental unit) - less penetrating than primary radiation

Answer 21

Different tissue types absorb different amounts of radiation There are two different types: i. Radiopaque (white on x-ray) ii. Radiolucent (black on x-ray)

Answer 22

Tissue with high absorption of x-radiation, appears white in a finished radiograph ex. enamel, dentin, bone

Answer 23

Tissue with low absorption of x-radiation, appear dark on the finished radiograph ex. pulp

Answer 24

1. Film base - polyester plastic, provides support and strength 2. Adhesive layer - attaches emulsion to base 3. Film emulsion - a mixture of gelatin and silver halide crystals (sensitive to radiation) 4. Protective layer - protects emulsion from damage *Halide is a chemical compound that is sensitive to radiation. Silver halide is used in dental radiographs

Answer 25

1. Intral Oral - placed inside the mouth 2. Extra Oral - taken on the outside of the mouth 3. Duplicating - produces 2 copies of the same image (special film)

Answer 26

Composed of: - paper wrapper - lead foil - outer package wrapping (has 2 sides) i, Tube side = solid white (raised dot) ii. Label side = colored, contains flap to open packaging (inverted dot) *Remember: WHITE in sight and DOT in the slot* - Tube side = dot is a bump - Label side = dot is flat

Answer 27

Film that has been exposed to radiation and has not yet been developed - Silver halide crystals (coating on film) contain various levels of stored energy, depending on the density of the objects in the area exposed - the stored energy forms a pattern known as LATENT IMAGE *The latent image cannot be seen until chemical processing occurs to produce a visible image*

Answer 28

Film speed = sensitivity Determined by: 1. Size of the silver halide crystals 2. Thickness of the emulsion 3. Presence of radiosensitive dyes Speed ratings are from A-F A (slowest), F (Fastest) *** ONLY D, E, F, speed film used for intraoral radiology ***

Answer 29

2 types of extraoral films that are placed outside the mouth for x-ray exposure: 1. Screen - film placed between 2 intensifying screens for exposure 2. Non-screen - film is exposed directly to x-rays, requires longer exposure time, NOT recommended for use in dentistry

Answer 30

Photographic film used to make an identical copy of an intraoral or extraoral radiograph *Used only in a darkroom setting and is NOT exposed to raadiation*

Answer 31

Film must be kept in a cool, dry place (At SAIT, keep film in the fridge) - Must be stored in an area adequately shielded from radiation - Film MUST be used before expiration date (can cause fogged films)

Answer 32

Digital imaging eliminates chemical processing and hazardous waters (lead foil, chemicals) - Require less radiation to expose - Allows for digital enhancements, measurements and corrections - Images can be electronically transferred to other health care providers - Sensors are VERY expensive

Answer 33

1. Direct digital imaging 2. Indirect digital imaging

Answer 34

Solid-state sensor that contains an x-ray sensitive silicon chip with an electronic circuit embedded in the silicon - most commonly used - instantly transmits image to computer screen

Answer 35

Phosphor Storage Imaging (PSP) - Thin, flexible plate that is covered in phosphor crystals - Plates are the same size as conventional x-ray film - Phosphor layer stores energy of x-ray photons - After exposure, plates are placed into a scanner - Scanner laser reads the latent image and converts it to digital image - Films are exposed to a bright light to "erase" the image

Answer 36

1. Periapical (PA) - used to view entire tooth (root and crown) - Size #2 are used for posterior - Size #1 for anterior 2. Interproximal (Bitewings) - used to detect interproximal (between the teeth) caries and bone loss - can be taken vertically and horizontally 3. Occlusal - used to determine tooth development - can determine if patients are missing teeth - film is placed in mouth horizontally and the patient down bites on film like a cookie

Answer 37

Periapical radiographs show the entire tooth from occlusal surface or incisal edge to about 2-3mm beyond apex - used to diagnose pathologic conditions of the tooth, root, and bone - shows tooth formation and eruption - essential in endodontics and oral surgery

Answer 38

Image shows the upper and lower teeth in occlusion - only crowns and small portion of root are seen Used for detecting: - interproximal decay - early periodontal disease - recurrent decay under restorations - fit of metallic fillings or crowns

Answer 39

1. All required anatomy must be present 2. Contrast (also referred to as grey scale) 3. Density (also referred to as darkness) 4. Sharpness 5. Magnification 6. Distortion

Answer 40

Moving or lying in the same plane - never intersecting paths

Answer 41

To cut across or through

Answer 42

Intersecting at, or forming, a right angle

Answer 43

An angle of 90 degrees formed by two lines

Answer 44

An imaginary line that divides the tooth longitudinally into 2 equal halves

Answer 45

The central portion of the primary beam of radiation

Answer 46

1. Paralleling technique - extension cone paralleling technique (XCP) *ALARA* 2. Bisecting Angle Technique - Uses a Snap-A-Ray - not as frequently used

Answer 47

- Receptor is parallel to long axis of tooth - X-ray beam is perpendicular to the long axis of the tooth - Face of cone is parallel with the face of the film - Common errors: incorrect placement and alignment

Answer 48

1. Explain procedure to patient 2. Position receptor close to midline for a maxillary PA and between tongue and teeth for mandibular exposure 3. Position receptor centered on the required anatomy/teeth 4. Position receptor parallel to the long axis of the teeth 5. Seat bite block on the incisal edge or occlusal surface for support 6. Ask patient to relax and slowly close down to support the XCP holder, and breath slowly through their nose - Position the face of the open cone/PID parallel to the ring - To do this, you will be adjusting the horizontal and vertical angulation of the PID

Answer 49

Advantages: 1. Accurate - produces an image that has dimensional accuracy - the image represents the actual tooth - image exhibits maximum detail and definition 2. Simple - simple to use and easy to learn - because it uses a beam alignment device, the radiographer doesn't need to determine horizontal and vertical angulation - reduces dimensional distortion 3. Least amount of radiation - minimizes exposures and having to re-take images Disadvantages: 1. Uncomfortable - may impinge on oral tissue and cause discomfort for patient 2. More limited - film placement may be difficult in child patient or adult patient with small mouth or shallow palate 3. XCP Kit has to be sterilized - they are not disposable and must be sterilized

Answer 50

The paralleling technique requires the use of a beam alignment instrument or receptor holding device to position the receptor parallel to the long axis of the tooth

Answer 51

When lining the PID up to expose, the central ray of the x-ray beam must be directed through the contacts. - When it is not, this creates "overlap"

Answer 52

The Bisecting Angle Technique is another method that can be used to expose periapical films - Major disadvantage: image is dimensionally distorted - This technique should used only as an alternative method in special circumstances, when it is not possible to use the paralleling technique

Answer 53

1. Position the occlusal plane parallel to the floor and the midsagittal plane perpendicular to the floor 2. Place film against the lingual (backside) of the tooth 3. Visualize an imaginary line that bisects (divides in half) the angle formed by the film and the tooth 4. Center the PID over the film and position the opening of the PID parallel to this imaginary line. - This will direct central ray of x-ray beam perpendicular to the imaginary line

Answer 54

Available types of film/sensor holders for bisecting technique include: - EeZee-Grip Holder - Snap-A-Ray - Stabe Disposable holder

Answer 55

Plan dental radiographic procedures carefully and avoid unnecessary retakes - every image that must be repeated results in excess patient radiation exposure - retakes represent one of the greatest cause of excessive radiation exposure in dental radiography - obtaining a quality dental radiographic image is a complex process demanding careful attention to many details

Answer 56

Avoid taking x-rays on pregnant patients unless it is an emergency - the benefits should always out weight the risks

Answer 57

Interproximal radiographs are commonly used to assess and/or confirm general defects in teeth and/or surrounding tissues - they are commonly requisitioned during recall/check up appointments - they can be taken both vertically and horizontally

Answer 58

- Detects interproximal decay - Detect loss of alveolar bone - Changes in the pulp - Overhanging restorations - Poor margins on crowns - Recurrent decay beneath restorations

Answer 59

- Can be taken using a beam alignment device (e.g. RINN XCP) or bitewing tab - When exposing a BW, the angulation of the PID is critical - Both vertical angulation (up & down) and horizontal angulation (side to side) must be correct to expose a proper BW

Answer 60

- Vertical angulation of the PID must be at +10 degrees - If vertical angulation is incorrect, it will lead to a distorted image

Answer 61

- To maintain the correct horizontal angulation, the central ray must be directed perpendicular to the curvature of the arch through the contact areas of the teeth

Answer 62

Typically on adults, 4 bitewings are taken - 1 premolar and 1 more BW on each side Premolar BW: must include edges of canines, premolars visible, open contacts Molar BW: must include entire lower second molar, open molar contacts, no cone-cuts

Answer 63

i. Size 0 = primary dentition - posterior teeth - one on each side ii. Size 1 = mixed dentition - posterior teeth - one on each side iii. Size 2 = permanent dentition - premolar teeth and molar teeth - two on each side

Answer 64

- The PID is not covering the entire film (PID is not align with the target) - The PID is covering the target and should be close to patient's face

Answer 65

- Ensure sensor is lined up properly inside ring of XCP positioning device BEFORE exposure - Ensure PID is steady and ask patient to not move once it's placed - When not using a positioning device, ensure entire film is covered by PID

Answer 66

- Front edge in middle of lower mandibular canine - Premolars visible - Occlusal plane in middle of receptor - Occlusal plane parallel with bottom receptor edge - Correct horizontal = open premolar contacts - Correct vertical angulation of +10 degrees - No cone-cuts *Make sure the receptor is covering the distal surface of the canines*

Answer 67

- Front edge in middle of lower mandibular 2nd premolar - Molars visible - Occlusal plane in middle of receptor - Occlusal plane parallel with bottom receptor edge - Correct horizontal = open molar contacts - Correct vertical angulation of +10 degrees - No cone-cuts *Make sire the receptor covers the distal of the second molar*

Answer 68

1. Position patient's head parallel to the floor 2. Ensure that the film or sensor is placed in the correct position for the BW being exposed 3. Stand directly behind the tube-head and look along the side of the PID, no portion of the receptor should be visible

Answer 69

1. Process films/image 2. Keep records of processed films/image 3. Maintain darkroom 4. Maintain processing equipment

Answer 70

- Use of traditional film is still currently being used in dental practices (although increasing numbers of dentists have transitioned to digital imaging, many offices still rely on film and processing) - Film processing procedures directly affect the quality of a dental radiograph - it is important to have a working knowledge of film processing procedures, problems, and solutions

Answer 71

A series of steps that produce a visible permanent image on a dental radiograph Purpose of film processing: 1. Convert latent (invisible) image on the film into a visible image 2. Preserve the visible image so that it is permanent and does not disappear from the dental radiograph

Answer 72

1. Manual (hand processing) - requires a dark room and processing solution - not recommended as it is very technique sensitive 2. Automatic processing - automatic film processing machine or automatic processor

Answer 73

1. Development 2. Rinsing 3. Fixing 4. Washing 5. Drying

Answer 74

- Must be completed in a darkroom - Any white light that "leaks" into the darkroom (e.g. from around a door or through vent) is termed a light leak - In a dark room, when all lights are turned off and the door is closed, no white light should be seen - Any light leak must be immediately corrected with weather stripping or black tape (white light affects the film)

Answer 75

A special type of lighting used to provide illumination in the darkroom - it is a low-intensity light (15 watts or less) composed of long wavelengths in the red-orange portion of the visible light spectrum - provides sufficient illumination in the darkroom to carry out processing activities safely without exposing or damaging film - Under safelight conditions, it is necessary to maintain an adequate safelight illumination distance of min. 4 feet - a film exposed to safelight for more than 2-3 minutes will appear fogged

Answer 76

1. Film feed slot - where the film is inserted 2. Roller film transporter - primary function: transport the film through the processor and helps to remove excess solutions on the film 3. Developer compartment - holds the developer solution (a special chemical solution for high temp. processing between 80-95F) 4. Fixer compartment - holds the fixer solution which has chemical hardening agents that fix and harden 5. Water compartment - holds circulating water that washes the film after the fixer to remove all excess solutions 6. Drying chamber - holds heated air and is used to dry the wet film 7. Film recovery slot - an opening on the outside of the processor housing where the dry processed radiograph emerges from the automatic processor 8. Processor housing 9. Replenisher pump 10. Replenisher solutions - the pump and solutions are required to maintain proper solution concentration and levels automatically in some automatic processors, whereas other processors require the operator to add the necessary replenishing solutions

Answer 77

Many dental personnel prefers automatic processing as a method of film processing for the following reasons: 1. Less processing time is required 2. Time and temperatures are automatically controlled 3. Less equipment is used 4. Less space is required

Answer 78

No, the solutions are different in both

Answer 79

4 to 5 minutes

Answer 80

1. Processor chemicals should be checked and topped up daily 2. Processing solutions should be replaced every 2-6 weeks (this can depend on the number of films being processed) 3. The rollers within the processor should also be cleaned weekly (dependent on manufacturer instructions) - to do this, the rollers are removed and rinsed in warm running water and then soaked for 10-20 minutes - cleaning film can be used at the beginning of each day to remove any residual gelatin or dirt on the rollers

Answer 81

An identical copy of an intraoral or extraoral radiograph - may be used when referring patients to specialists, for insurance claims, and as teaching aids - before duplication occurs, the films are to be duplicated, the duplicating film, and the film duplicator must be present in the darkroom - similar to film processing = light-tight darkroom

Answer 82

1. Time and temperature errors 2. Chemical contamination errors 3. Film handling errors 4. Lighting errors *As a DA, it is important that we understand what actions are needed to prevent these errors

Answer 83

1. Underdeveloped film - Appearance: light - Problems: i. inadequate film time ii. developer solution too cool iii. inaccurate timer or thermometer iv. depleted or contaminated developer solution 2. Overdeveloped film - Appearance: dark - Problems: i. excessive developing time ii. developer solution too hot iii. inaccurate timer or thermometer iv. concentrated developer solution 3. Reticulation of emulsion - Appearance: cracked - Problem: i. sudden temperature change between developer and water bath

Answer 84

1. Developer spots - Appearance: dark or black spots - Problem: i. developer comes in contact with film before processing 2. Fixer spots - Appearance: white or light spots - Problem: i. fixer comes in contact with film before processing 3. Yellow-brown stains - Appearance: yellow-brown stains - Problem: i. exhausted developer or fixer ii. insufficient fixing time iii. insufficient rinsing

Answer 85

1. Developer cutoff - Appearance: straight white border - Problem: i. undeveloped portion of film caused by low level of developer 2. Fixer cutoff - Appearance: straight black border - Problem: i, unfixed portion of film caused by low level of fixer 3. Overlapped films - Appearance: white or dark areas appear on film where overlapped - Problem: i. two films contacting each other during processing 4. Air bubbles - Appearance: white spots - Problem: i. air trapped on film surface after being placed in the processing solutions 5. Fingernail artifact - Appearance: black crescent-shaped marks - Problem: i. film emulsion damaged by operator's fingernail during rough handling 6. Fingerprint artifact - Appearance: black fingerprint - Problem: i. film touched by fingers that are contaminated with fluoride or developer 7. Static electricity - Appearance: thin, black, branching lines - Problem: i. occurs when a film packet is opened quickly ii. occurs when film pack is opened before radiographer touches a conductive object 8. Scratched film - Appearance: white lines - Problem: i. soft emulsion removed from film by a sharp object

Answer 86

1. Light leak - Appearance: exposed area appears black - Problem: i. accidental exposure of film to white light 2. Fogged film - Appearance: gray; lack of detail and contrast - Problem: i. improper safelighting ii. light leaks in darkroom iii. outdated films iv. contaminated solutions v. developer solution too hot

Answer 87

- Must be labeled once they have been developed on the film mount as well as documented in patient chart 1. Record patient's first and last name 2. Date they were taken 3. Type of radiograph(s) and how many 4. Name of the Dentist or Hygienist who prescribed

Answer 88

- Used to examine large areas of the maxilla or the mandible - technique is named so because the patient bites or "occludes" on the entire receptor 1. Size 4 receptors: traditionally used for adults 2. Size 2 receptors: traditionally used for children

Answer 89

A supplementary imaging technique used in conjunction with periapical or bite-wing images 1. Used when large areas of the maxilla or mandible must be visualized 2. Preferred when area of interest is larger than a periapical receptor or when placement of periapical receptors is too difficult for the patient

Answer 90

1. The receptor is placed with the tube side facing the arch that is being exposed 2. The receptor is placed in the mouth between the occlusal surfaces of maxillary and mandibular teeth 3. The receptor is stabilized when the patient bites on the surface of the receptor **It is important to stress to the patient to gently bite on the receptor to avoid seeing permanent bite marks on the surface of the sensor**

Answer 91

1. Patient preparation 2. Equipment preparation 3. Maxillary occlusal projections 4. Mandibular occlusal projections 5. Vertical angulations

Answer 92

1. Explain the imaging procedure to the patient 2. Adjust the chair so that the patient is positioned upright and level of the chair is at a comfortable working height 3. Adjust the headrest to support and position the patient's head 4. Place the lead apron with thyroid collar on the patient and secure it 5. Request that the patient remove eyeglasses and any objects in the mouth 6. Be sure the occlusal plane is parallel to the floor and patient is in an upright position 7. Patient should gently bite down; otherwise the patient can damage the receptor

Answer 93

Set the exposure control factors on the x-ray unit according to the recommendations of the receptor manufacturer - Either a short (8-inch) or a long (16-inch) PID may be used

Answer 94

1. Topographic projection - used to examine the palate and the anterior teeth of the maxilla 2. Lateral (left or right) projection - used to examine the palatal roots of the molar teeth - may also be used to locate foreign bodies or lesions in the posterior maxilla 3. Pediatric projection - used to examine the anterior teeth of the maxilla - recommended for use in children 5 years old or younger **The central ray (CR) is directed at +65 degrees vertical angulation to the plane of the receptor**

Answer 95

1. Topographic projection - used to examine the anterior teeth of the mandible 2. Cross-sectional projection - used to examine the buccal and lingual aspects of the mandible - used to locate foreign bodies or salivary stones in the region of the floor of the mouth 3. Pediatric projection - used to examine anterior teeth of the mandible - recommended for use in children 5 years old or younger **Central ray (CR) is directed at -55 degrees vertical angulation to the plane of the receptor

Answer 96

1. A method used to locate the position of a tooth or object in the jaws - a thorough understanding of basic concepts is necessary - a knowledge of step-by-step procedures is required 2. The dental image is a 2-dimensional picture of a 3-dimensional object - it does not depict the depth of the object 3. Can be used to locate the object

Answer 97

May be used to locate: 1. Foreign bodies 2. Impacted teeth 3. Unerupted teeth 4. Retained roots 5. Root positions 6. Salivary stones 7. Jaw fractures 8. Broken needles and instruments 9. Dental restorative materials

Answer 98

A lot of info. about teeth and supporting bone is obtained from image interpretation 1. All dental images must be carefully reviewed and interpreted 2. Paramount importance to dental professional and plays a vital role in the detection of diseases, lesions, and conditions of the teeth and jaws that cannot be identified clinically

Answer 99

Any dental professional with training in interpretation can examine images Identification of: 1. Normal anatomy 2. Dental restorations, dental materials, and foreign objects 3. Dental caries 4. Periodontal disease 5. Traumatic injuries and periapical lesions 6. Common artifacts and errors

Answer 100

Interpretation = an explanation of what is viewed on an image Diagnosis = the identification of disease by examination or analysis - The final interpretation and diagnosis are the responsibilities of the dentist - Dental hygienist and DA are restricted by law from rendering a diagnosis

Answer 101

1. Best to have images taken at the beginning of the appointment and interpreted immediately after mounting in the presence of the patient 2. Suspicious or questionable areas can be examined by dentist or dental hygienist to obtain additional info. or confirm a suspected problem

Answer 102

1, All dental images must be reviewed and interpreted 2. Interpretation must be documented and include: - date of exposure - number/type of images - evaluation of diagnostic quality - list of limiting factors, retakes, or additional images needed - description of teeth Must also include: i. description of bone and supporting structures of the teeth ii. description of artifacts iii. indication of any areas that require additional images or clinical evaluation/confirmation

Answer 103

Images may be an educational tool in the dental setting 1. Patient may be educated through discussion of normal findings on dental images 2. Specific problems and areas of concern may be identified

Answer 104

The dental radiographer must be able to recognize the normal anatomic landmarks on intraoral images in order to mount and interpret intraoral films accurately

Answer 105

1. Cortical bone - dense outer layer of bone - appears radiopaque on an image 2. Cancellous bone - soft, spongy bone located between 2 layers of dense cortical bone - appears primarily radiolucent (Trabeculae appear radiopaque, marrow spaces appear radiolucent)

Answer 106

1. Process - marked prominence or projection - ex. Coronoid process 2. Ridge - linear prominence or projection - ex. Mental ridge 3. Spine - sharp, thornlike projection - V-shaped radiopaque area located at the intersection of the floor of the nasal cavity and the nasal septum - ex. Anterior nasal spine 4. Tubercle - small bump or nodule - ex. Genial tubercles 5. Tuberosity - rounded prominence - radiopaque bulge distal to the third molar region - ex. Maxillary Tuberosity

Answer 107

1. Canal - tube-like passageway through bone that contains nerves and blood vessels - narrow radiolucent band bounded by 2 thin radiopaque lines - ex. incisive canal 2. Foramen - opening or hole that permits the passage of nerves and blood vessels - radiolucent area between maxillary canine and lateral incisors - ex. incisive foramen 3. Fossa - broad, shallow, scooped-out, or depressed area - ex. Lateral fossa 4. Sinus - hollow space, cavity, or recess - ex. Maxillary sinus 5. Septum - bony wall or partition that divides 2 spaces or cavities - radiopaque - ex. vertical radiopaque partition that divides the nasal cavity 6. Suture - immovable joint representing a line of union between adjoining bones of the skull - ex. median palatal suture. Thin radiolucent line between the maxillary central incisors

Answer 108

Anatomy of the alveolar bone: 1. Lamina dura - appears as a dense, thin radiopaque line around the root of a tooth 2. Alveolar crest - typically appears 1.5 to 2.0mm below the cemento-enamel junction 3. Periodontal ligament space - appears as a thin radiolucent line around the root of the tooth Shape and density of alveolar bone: 4. Anterior regions - anterior alveolar crest normally appears pointed and sharp 5. Posterior regions - posterior alveolar crests normally appears flat and smooth

Answer 109

Dental professional should interpret all dental images while the patient is present - when dental images are interpreted with the patient present, some important clinical info. is not available

Answer 110

1. Amalgam restorations 2. Gold restorations 3. Stainless steel and chrome crowns restoration 4. Post and core restorations 5. Porcelain restorations 6. Composite restorations 7. Acrylic restorations

Answer 111

1. One-surface amalgam restorations - appear as distinct, small, round or void radiopacities - may be seen on buccal, lingual, or occlusal surfaces 2. Larger two-surface and multi-surface amalgam restorations - appear radiopaque and are characterized by irregular outlines or borders 3. Amalgam overhangs - extensions of amalgam seen beyond the crown portion of tooth in the interproximal region 4. Amalgam fragments - fragments of amalgam may be inadvertently embedded in adjacent soft tissue during restoration of a tooth

Answer 112

1. Gold crowns and bridges - appear completely radiopaque and unlike amalgam, exhibit a smooth marginal outline 2. Gold onlays - seen on maxillary premolars

Answer 113

1. Stainless Steel and Chrome Crowns - appear radiopaque, but not as dense as amalgam or gold 2. Post and core restorations - can be seen in endodontically treated teeth 3. Porcelain Restorations; All-porcelain crowns and bridges - appearance is slightly radiopaque and resembles the radiopacity of dentin 4. Porcelain-fused-to-metal crown - metal component appears completely radiopaque; porcelain component appear slightly radiopaque 5. Composite restorations - may vary in appearance from radiolucent to slightly radiopaque depending on composition of composite material 6. Acrylic restorations - least dense of all nonmetallic restoration - appear radiopaque or barely visible on dental image

Answer 114

1. Restorative dentistry (Base materials) - used as cavity liners placed on the floor of a cavity preparation to protect pulp - appear radiopaque, less radiodense than amalgam 2. Restorative dentistry (Metallic pins) - used to enhance retention of amalgam or composite - appear as cylindrical or screw-shaped radiopacities 3. Endodontics (Gutta percha) - a claylike material used to fill pulp canals - appears radiopaque, similar to base materials, is less radiodense than metallic restorations 5. Endodontics (Silver points) - used to fill pulp canals - very radiopaque, similar to other metallic materials, appear more radiodense than gutta percha 6. Prosthodontics (complete dentures) - patients should be instructed to remove all complete and partial dentures before dental images are taken - a complete denture that is not removed gives the illusion of rootless, or "floating" teeth 7. Prosthodontics (Removable partial dentures) - RPD with a metal base with acrylic saddles appears densely radiopaque where metal is present and slightly radiopaque in the areas of acrylic 8. Orthodontics (orthodontic bands, brackets and wires) - have a characteristic appearance

Answer 115

1. Implants are being used with increased frequency - appearance varies based on shape and design of implant used 2. Suture wires, metallic splints and plates, bone screws, and stabilizing arches - used in oral surgery to stabilize fractures of the maxilla and mandible

Answer 116

1. Jewelry i. Earrings - ghost images seen on panoramic image ii. Necklaces - metallic necklace appear radiopaque loop in the region of the mandible iii. Nose jewelry - maxillary anterior PA 2. Eyeglasses - metal framework of sides of eyeglasses - appear radiopacity 3. Hearing aids 4. Shrapnel - or small metal fragments that scatter outward from an exploding device

Dental Radiograph 1 (Review: Outcomes 1-10) Flashcards

(140 cards)