Xray - Outcome 5

Question 1

Automatic Processor - for Film

Answer 1

Automatic processor units can improve the efficiency and consistency of resulting radiographic images on traditional x-ray film. The radiographic images are transported through solutions, to a wash, and then finished at a dryer. A series of rollers are used to carry the films along and squeegee the solutions from the films between solutions. This reduces the contamination of one solution with anothe

Question 2

How long does an automatic processor take?

Answer 2

Using an automatic unit, the total processing time, from developing to receiving the dried films, usually takes from 4 to 6 minutes depending on the manufacturer. This is achieved by using special processing chemistry at a higher temperature (80° to 95° F) and an internal dryer

Question 3

Daylight loader - Automatic Processing

Answer 3

The automatic processing unit may be used in a traditional darkroom setting or in daylight if a daylight loader is attached to the unit. The daylight loader allows the films to be unwrapped and fed into the processor outside of a darkroom

Question 4

Maintanence of Automatic Processors

Answer 4

If maintained according to the manufacturer’s instructions, automatic processors will produce consistent, quality radiographs. Maintenance includes checking solution levels, replenishment of solutions, thorough cleaning of tanks and rollers on a regular maintenance schedule as well as the replacement of solutions on a regular basis. Cleaning films should be run through the processor at the beginning of each day to remove any contaminants on the rollers. The chemistry used in automatic processors is different from manual processing solutions. Only chemistry specifically designed for automatic processors can be used because it is manufactured to perform at high temperatures. A care and maintenance schedule for developing equipment is one of the contributors to quality assurance

Question 5

There are two processing solutions involved in processing conventional dental x-ray films. They are:

Answer 5

1. Developer
2. Fixer

Question 6

When a conventional X-ray film enters an automatic processor it will go through the following stages:

Answer 6

1. Developing the developer solution
2. Fixing the fixer solution
3. Washing in the water bath
4. Drying

Question 7

2 Types of Silver Haide used in the emulsion of dental film

Answer 7

1. Silver Bromide
2. Silver Iodide

Question 8

When silver halide grains are exposed to light or xrays they…

Answer 8

..they store energy from the radiation. Various areas on the film receive more or less radiation depending on the density of the tissue being exposed (differential absorption) and therefore, exposed films have areas in which silver halide crystals contain various levels of stored energy. The pattern formed by the energized and non-energized crystals creates the latent image within the emulsion

Question 9

The developer permeates the..

Answer 9

…the gelatin and reacts with all the silver halide crystals . The energized crystals are easily excited and react quickly with the developing chemicals.

Question 10

The silver halide separates into..

Answer 10

….into bromide (or iodide) and metallic silver

Question 11

Metallic Silver produces what on a developed radiograph?

Answer 11

Black areas on a developed radiograph. This black metallic silver is deposited on the film.

Question 12

Silver halide crystals that did not receive x-radiation gives us…

Answer 12

Silver halide crystals that did not receive x- x-radiation and are not energized, do not react with the developer and are washed away. The corresponding area on the film will be white

Question 13

Density of a radiograph

Answer 13

The number of X-rays used to expose the film determines the overall darkness of the processed radiograph. This degree of blackness is referred to as the density of the radiograph. An over-exposed film will appear to be too dark while an under-exposed film will appear too light.

Question 14

Contrast of a radiograph

Answer 14

Contrast is the difference in densities of adjacent shadows recorded on the film. The greater the difference in densities between two adjacent structures, the greater the image contrast.

Question 15

Long-Scale Contrast

Answer 15

An increased range of grays between the blacks and whites on a radiograph. Higher kilovoltage increases this range.

Question 16

Short-Scale Contrast

Answer 16

A reduced range of grays between the blacks and whites on a radiograph.

Question 17

Fixing in the Fixer Solution

Answer 17

The fixer dissolves and removes the unexposed silver halide crystals from the film emulsion which clears the film so that the black or darker images become more perceptible. The fixer also hardens the emulsion, allowing you to handle the film.

Question 18

Washing in the Water Bath

Answer 18

After the fixer, the film is fed into the water bath to remove all the agents used to process the film.

Question 19

Drying

Answer 19

An internal dryer found in the automatic processor dries the films after the washing stage before the films are expelled out of the automatic processor and ready for viewing

Question 20

In the past, radiographs could be processed in two ways:

Answer 20

1. Time-temperature method in a darkroom (manual)
2. Automatic processing unit (automatic/mechanical)

However, as times change, techniques change. The manual method of processing conventional X-ray film has become obsolete. However, the use of automatic processing units, whether in a dark room or as day-light loaders, is still common.

Question 21

The Dark Room

Answer 21

Dark rooms are designed to filter out visible light, except for safelights. The room must be completely dark because conventional x-ray films are sensitive to light

Question 22

Errors in the Darkroom

Answer 22

Errors in the darkroom can easily ruin a good film, making it necessary to retake the films resulting in loss of time and increased radiation exposure to the patient and loss of tim

Question 23

Darkroom Responsibility

Answer 23

The darkroom is one of the areas in a dental office for which the dental auxiliary has complete responsibility. In addition to processing films, the auxiliary must keep the darkroom clean, change solutions regularly, and keep accurate records of the radiographs processed. Only through meticulous attention to detail can proper dark room technique be maintained. It is important to realize that the processing of film is a vital link in the production of the diagnostic radiograph.

Question 24

Latent Image

Answer 24

Radiographs, having been exposed in the patient’s mouth, contain a “latent image”. Processing the film makes this latent (or invisible) image visible and permanent

Question 25

The steps in the processing procedure of traditional film are...

Answer 25

developing, rinsing, fixing, washing and drying

Question 26

Copies or duplicates of radiographs may be required for:

Answer 26

1. Sending to insurance companies for pre-authorization of treatment 2. Referring the patient to a specialist for treatment 3. Transferring records for patients who are changing dentists

Question 27

How to make duplicate films

Answer 27

This can be accomplished either by using a film packet containing two films instead of one or by duplicating the radiographs. Duplicating radiographs requires a film duplicator and duplicating film. The duplicator provides a light source (usually ultraviolet) to expose the film. Duplicating film only has emulsion on one side. In addition, the concept of exposure is different. The longer the film is exposed to the light source, the lighter (less dense) the duplicate radiograph will appear Duplicating films take place in a darkroom under safelight conditions. The films are placed on the duplicator and the duplicating film is placed over the radiographs with the emulsion side contacting the radiographs. The radiographs and the duplicating film must lie flush against one another. The duplicator is then activated for the time specified in the manufacturer’s directions. The duplicating film is then removed and processed in the normal procedure

Question 28

Advantages of PSP

Answer 28

The processing of PSP plates requires only an electronic processor and a computer – no chemicals. This reduces the need to purchase and store materials as the plates may be reused, the images on the plates are erased after processing, and the images are recorded and saved onto a computer

Question 29

The procedure for processing a phosphor plate is as follows:

Answer 29

1. An image is recorded by exposing the phosphor-coating on the phosphor plates. 2. The phosphor plates are fed through an electronic processor (scanner) where a laser will scan the plate and transfer the image onto a computer screen. 3. The processor can be set to save or erase the image. 4. The image can be manipulated and viewed.

Question 30

As a Registered Dental Assistant, you will be required to assess your films for quality and problem-solve any errors. Areas to be assessed are specific to:

Answer 30

Film placement Horizontal/vertical angulation Density/contrast Operator errors Handling/mounting

Question 31

Errors in Processing: Stained Film

Answer 31

Any fluid can stain a dental X-ray film.

Question 32

Errors in Processing: Stained Film - Clear Spots

Answer 32

a. Clear Spots - If drops of water are left in contact with the film, the emulsion will dissolve and leave a clear spot.

Question 33

Errors in Processing: Stained Film - White Spots

Answer 33

b. White Spots - Usually caused by allowing the film to come into contact with the fixing solution before developing. These areas are lighter in appearance because the silver halide reduction to black metallic silver was blocked by the fixing solution.

Question 34

Errors in Processing: Stained Film - Black Spots

Answer 34

c. Black Spots - Caused by premature contact with the developing solution. When the film is placed in the developer for normal development, the area that has already contacted the developing solution becomes over-developed causing a dark spot or streak.

Question 35

Errors in Processing: Stained Film - Opaque Spots

Answer 35

d. Opaque Spots - These areas are caused by one film clinging to another or the side of the tank during the fixing process. To prevent this, always agitate the films when placing them in the solution and make sure that they are not touching another film or the side of the tank. This can also result when films are processed too close together in an automatic processing unit.

Question 36

Errors in Processing: Stained Film - Brown Stain

Answer 36

e. Brown Stain - Usually caused by “old” developer or insufficient time in fixer and wash baths.

Question 37

Errors in Processing: Stained Film - Gray Image

Answer 37

f. Gray Image - The image appears grey or washed out. This is usually caused by contaminated solutions or lack of replenishment.

Question 38

Errors in Processing: Stained Film - Fluoride Artifact

Answer 38

g. Fluoride Artifact -Fingers contaminated with fluoride solution will leave black fingerprint stains on the film.

Question 39

Errors in Processing: Dark Films

Answer 39

There are many causes of dark films: exposure to light overdevelopment (too long) overly high developer concentration temperature too high

Question 40

Errors in Processing: Light Films

Answer 40

A radiograph that is too light and lacks density may be caused by: underdevelopment (not long enough) cold processing solution weak processing solution (too old, under replenishment) solutions not being stirred

Question 41

Errors in Processing: Partial Image

Answer 41

The film will have a straight, clear portion. This is caused by the failure of the processing solutions to cover the film. Check the level of the solutions before beginning to process.

Question 42

Errors in Processing: Scratched Film

Answer 42

Scratches are caused by sharp or pointed objects and fingernails (crescent-shaped marks).

Question 43

Errors in Processing: Static

Answer 43

A “tree-like” artifact appears on the film. This is caused by the production of static electricity while processing.

Question 44

Errors in Processing: Torn Film

Answer 44

Usually results from removing the film from the packet too hastily.

Question 45

Errors in Processing: Reticulation

Answer 45

The film appears "pitted." This is caused by sudden temperature changes between processing solutions and wash water.

Question 46

Errors in Processing: Cathedral Effect

Answer 46

The film has a mottled appearance caused by a very short development time (30 seconds).

Question 47

Errors in Processing: Fogged Films

Answer 47

The overall appearance of a fogged film is also dark. The film lacks density, and the images lack definition and appear as though they are being viewed through fog. Fogging is usually due to an excessive amount of light reaching the film from an improper safe light, from light leaks around the dark room door, or from turning on a white light before the film is adequately fixed. The out-dated film has a degree of fog imparted to it.

Question 48

Film Errors can be reduced by..

Answer 48

Film errors can be reduced by establishing a quality assurance program and by carefully monitoring image production. Unusual artifacts or problems should be documented as a guide for correction and improvement