ROENT Board Review Outline 2022

DR.
CM BELTRAN ROENTGENOLOGY 2022
ROENTGENOLOGY BOARD EXAM REVIEW
INTRODUCTION TO RADIOLOG
Radiology -studies technique and interpretatio
M
4 Main Sections of Radiolog
1. Basic Physics and Equipment - how x-ray is produce
2. Radiation and Protection - Protection of patients and dental staff from the harmful effects of x-ray
D
3. Oral Radiography - Techniques involved in producing the various radiographic image
Intraoral Radiograp
,D
Extraoral Radiograp
4. Oral Radiology - Interpretation of radiographic image
Radiographic Shadows - depend on the number of x-rays reaching lm and also the density of the objec
Radiolucent - white shadows, dens
Radiopaque - black shadows, not so dens AN
Density - in radiography, it is de ned as the degree of darkness of lm. More x-rays reaching the lm, the
R
darker the image
LT
Factors that affects the density of the Fil

1. Exposure factors: mA, kVp, exposure time
2. Subject thicknes
3. object densit
BE
4. Processing of l
Radiographs - 2D representation of 3D object

Contrast - Usual difference between the various black, white, and grey shadow
CM
Factors that affects the contrast of the lm

1. Subject Contrast - characteristics of the subject that in uence radiographic contrast. Determined by
thickness
2. Film Contrast - characteristics of lm that in uence radiographic contras
a. inherent qualities - high or low contrast lm. Controlled by manufacturer
b. Film Processing - development time and temperature of the developing solutio
c. Beam energy and intensity or kVp - inversely related to contras
d. Fog and scattered radiation - presence results into reduced contrast due to undesirable density
Page 1 of 28
.
fi
m
fi
fi
Y
fi
fi
m
fl
s
fl
t
fi
fi
.
fi
t
DR. CM BELTRAN ROENTGENOLOGY 2022
RADIATION PHYSIC
• Atoms - basic building blocks of matter. Consists of nucleus ( protons and neutrons) and surrounded by
electrons
• Isotopes - atoms with the same atomic number (Z) but with different atomic mass numbers (A) and hence
M
different numbers of neutrons (N)
• Radioisotopes - unstable form of an element that emit radiation to transform into a more stable form
• Electrons move in predetermined circular or elliptical shells or orbits around the nucleus
D
• The shell represent different energy levels and are labeled K, L, M, N, O outwards from the nucleus
• The shells can contain up to a maximum number of electrons per shell. K - 2, L - 8, M - 18, N - 32, O - 5
,D
• Electrons can move from shell to shell but cannot exist between shells
• To remove an electron from the atom, additional energy is required to overcome the binding energy of
attraction which keeps the electrons in their shells
AN
• Atoms in the ground state are electrically neutral because the number of positive charges (protons) is
balanced by the number of negative charges (electrons)
• If an electron is removed, the atom is no longer neutral, but becomes positively charged and is referred to as
a positive ion. The process of removing an electron from an tom is called ionization
R
BIOLOGIC EFFECTS OF RADIATIO
Radiation Biology - the branch of biology concerned with the effects of ionizing radiation on living systems
LT
- The biological effects of ionizing radiation originate primarily from damage to the DNA of a cell
or cells
Sources of Radiatio
BE
1. Natura
2. Arti cial (Man-made
3 Major Sources of Naturally Occurring Radiatio

1. Cosmic Radiatio
CM
2. Terrestrial Radiatio
3. Internal Radiatio
Arti cial Sources of Radiatio

1. Dental and other medical x-ray
2. Radiation used to diagnose diseases and for cancer therap
3. Industrial uses of nuclear technique
4. Consumer products such s luminous wrist watches, ionization smoke detector
5. Small amounts released from coal and nuclear power plants
Page 2 of 28
fi
fi
l
Radiation Biology Histor

1895 - Wilhelm Conrad Roentgen announces discovery of X-rays
1896 - (4 months later) Reports of skin effects in x-ray researchers
1902 - First cases of radiation induced skin cancer reported
1906 - Pattern for differential radiosensitivity of tissues was discovered.
M
By 1906, Bergonie and tribondeau realized that cells were most sensitive to radiation when they are
D
• Rapidly dividin
• Undifferentiate
• has greater mitotic activit
,D
Ionizing Radiation - radiation of suf cient energy to disrupt DNA strand
Non-ionizing Radiation
Biologic Effects of Ionizing Radiatio

1. Useful but can be harmful
2. Burns and causes cellular damage
AN
3. Principal hazard is the risk of cancer induction
R
4. Long term epidemiological studies of exposed populations demonstrated potential for delayed induction of
malignancies
LT
Changes in biologic molecule

Proteins - irradiation leads to denaturatio
Nucleic acids - DNA more radiosensitive than RN
BE
Radiosensitive vs Radioresistan
Relative Radiosensitivity of Tissue (Alan Jackson, 2001 from Seibert 1996

Increasing sensitivity to Radiation
• Lymphocyte
CM
• Erythrocytes, Granulocyte
• Epithelial Cell
• Endothelial Cell
• Connective Tissue Cell
• Bone Cell
• Nerve Cell
• Brain Cell
• Muscle cell
Page 3 of 28
s
fi
n
The potential biological effects and damages caused by radiation depend on the conditions of the radiation
exposure. It is determined by
1. Quality of Radiatio
2. Quantity of Radiatio
3. Received dose of radiatio
M
4. Exposure condition
2 Types of Biologic Effects from Radiatio
D
1. Deterministic Effect - dose above the threshold determines occurrenc
- Are the result of various processes, mainly cell death and delayed cell division, caused
,D
by exposure to high levels of radiatio
2. Stochastic Effect - are those that occur by chance, appearing among unexposed people as well. Also
known as Linear or Zero-Threshold Dose-Response Effec
- The main stochastic effects are:
cancer - initiated by damaging chromosomes in a somatic cel

R AN
genetic defects - caused by damage to chromosomes in a germ cel
- Follow ALARA Principle (As Low As Reasonable Achievable
Deterministic Effects Stochastic Effects

LT
Examples Mucositis resulting from radiation Radiation-induced cancer

therapy to oral cavity Heritable Effects
Radiation-induced cataract formation
BE
caused by Killing of many cells sublethal damage to DNA
threshold dose? YES: sufficient cell killing required to NO: even one photon could cause a
cause a clinical response change in DNA that leads to a cancer or
heritable effect
Severity of clinical Severity of clinical effects is directly Severity of clinical effects is independent
CM
effects and dose proportional to dose. of dose. All-or-none response; an

The greater the dose, the greater individual either has effect or does not.
the effect
Probability of having Probability of effect independent of Frequency of effect proportional to dose.
effect and dose dose. All individuals show effect The greater the dose the greater the
when dose is above threshold chance of having the effect
Page 4 of 28
s
Radiation effect on Oral tissu

• Oral mucous membran
• Taste bud
• Salivary gland
M
• Teet
• Radiation Carie
D
• Bon
• Musculatur
,D
THE X-RAY MACHINE
Properties of X-ray
1. Appearanc
2. Mas
3. Charg
4. Spee
AN
5. Wavelengt
R
6. Path of Trave
7. Focusing Capabilit
LT
8. Penetrating Powe
9. Absorptio
10. Ionization Capabilit
BE
11. Fluorescence Capabilit

12. Effect on Fil
13. Effect on living tissue
Component Parts of the X-ray Machin

CM
1. Control Panel - regulate the x-ray bea

2. Extension Arm - Suspends the x-ray tubehea
- Houses the electrical wires that extend from the control panel to the tubehea
- Allows for movement and positioning of the tubehead
3. Tubehead - a tightly sealed, heavy metal housing that contains the x-ray tube that produces dental x-rays
Page 5 of 28
e
Tubehead Component
1. Metal housing - metal body of the tubehead. surrounds the x-ray tube and transformers, lled with oil,
protest the x-ray tube, grounds the high voltage components
2. Insulating Oil - oil that surrounds the x-ray tube and transformers inside the tubehead. Prevents
overheating by absorbing the heat created by the production of x-rays
M
3. Tubehead Seal - Aluminum or leaded glass covering of the tubehead that permits the exit of radiation from
the tubehead. Seals the oil in the tubehead and acts as a lter of the x-ray beam
4. X-ray Tube - Heart of the x-ray generating system
D
Leaded glass housing - leaded glass vacuum tube that prevents x-rays from escaping in all
directions. Has a window that permits the x-ray beam to exit the tube and be directed towards the
aluminum disks, lead collimator and PID
,D
Cathode - Negative electrode. Consists of a focusing cup (Molybdenum) and lament
(Tungsten) that serves as source of electrons
Anode - Positive electrode. Consists of copper stem and target (Tungsten) at which the beam of
high speed electrons is directed
AN
*** TUNGSTEN - high anatomic number, more ef cient for production of x-ray. high melting point
5. Transformers - a device that alters the voltage of incoming electricity. Increase or decrease the voltage in
an electrical circuit
Stepdown transformer - lament circuit. Used to decrease the voltage from the incoming
110-220 line voltage to the 3 to 5 volts require
R
Step up transformer - high voltage circuit. used to increase the voltage from the incoming
110-220 line voltage to the 65,000 to 100,000 volts required.
LT
Autotransformer - serves as a voltage compensator that corrects for minor uctuations in the
current
6. Aluminum Disks - Sheets of 0.5mm thick aluminum placed in the path of the x-ray beam. Filters out the
non-penetrating longer wavelength x-ray
7. Lead Collimator - Lead plate with a central hole that ts directly over the opening of the metal housing
BE
where the x-rays exit. Restricts the size of the x-ray beam
8. Position Indicating Device (PID) - Open-ended, lead lined cylinder that extends from the opening of metal
housing of the tubehead. Aims and shapes the x-ray beam. Sometimes referred to as the cone
Electricity and Electric Curren

CM
1. Electricity- energy that is used to make x-ray

2. Electrical energy – consists of a ow of electrons through a conducto
3. Electric current – ow of electron
4. AMPERAGE – measurement of the number of electrons moving through a conducto
5. Amperes or milliamperes – is the measurement of curren
6. VOLTAGE – measurement of electrical force that causes electrons to move from a negative pole to a
positive one
7. Volts or kilovolts – measurement of voltag
Page 6 of 28
.
fl
.
fl
s
fi
.
fi
fi
t
fi

fl
fi
fi
.

8. Milliamperage (mA) adjustment – controls the amperage or the no. of electrons passing through the
cathode lament by increasing or decreasing it
9. Kilovoltage peak (kVp) adjustment- controls the current passing from the cathode to the anode
10. Circuit - path of electric current. Two electrical circuits are used in the production of x-ray
• Filament circuit ( low voltage) – uses 3 to 5 volts. Controlled by the milliamperag
M
• High voltage circuit –used 65,000 to 100,000 volts controlled by the kilovoltage setting
Types of X-rays Produce
D
• General Radiation - aka Bremsstrahlung Radiatio
- Radiation produced when the speeding electrons slow down because of their interactions with
,D
the tungsten target in the anode
- produced by: Direct Hit - Produced by the sudden stopping or braking of high-speed electrons
at a target
Near Miss - Electron doesn’t hit the nucleus.
AN
-Electron is attracted towards (+) charged nucleus
- The passage of electrons near the nucleus, which results in electrons
being de ected and decelerated
• Characteristics Radiation - Produced when a high speed electron dislodges, an inner shell electron from the
R
tungsten atom and causes ionization of that atom.
- Inner shell electron is replaced by a higher energy level electron
LT
3 Stages of X-ra
• Primary Radiation - Refers to the penetrating x-ray beam that is produced at the target of the anode and
exits the tubehead
BE
• Secondary radiation- Refers to x-ray that is created when the primary beam interacts with matter
• Scattered radiation - form of secondary radiation that de ects after it hits matter
THE X-RAY FIL

CM
Dental Radiograph - Black and white image that includes varying shades of gray
X-ray lm - usual image receptor frequently used in dental radiograph
Composition of an X-ray Fil

1. Film base - exible piece of polyester plastic (polyethylene terapthalate) 0.007 inch or 0.2mm thick
- provides stable support for the delicate emulsio
2. Adhesive Layer - attaches the emulsion to the bas
3. Film Emulsion - coating attached to both sides of the lm bas
- Gives greater sensitivity to x-ra
Page 7 of 28
fi
fi
.
fl
M
fl
.
fi
.
fl
e

- homogenous mixture of gelatin and Ag halide

4. Protective Layer - aka supercoa
- thin transparent coatin
- protects emulsion surface from manipulation as well as mechanical and processing damage
M
Types of dental x-ray l
1. Intraora
D
• Periapical - used to examine the entire tooth and supporting bone and surrounding structures
• Bitewing - used to examine crowns of both maxillary and mandibular teeth
- examination of inter proximal of adjacent tooth surfaces
,D
• Occlusal - used for examination of large areas of maxilla or mandibl
2. Extraora
• Panoramic lm -shows wide view of the upper and the lower jaws in a single radiograp
• Cephalometric lm - exhibits bony and soft tissue areas of the facial pro l
• Transcranial lm - used to examine the TM
Film Packaging of Periapical Film packe

AN
1. Outer package wrapping - soft vinyl or paper wrapper that seals the lm contents. It protects the lm from
R
saliva and exposure to light
Has 2 sides: Tube side - solid white raised bump, the side that faces the teeth and the tubehea
LT
Label side - has a ap that is used to open the lm packet and remove the lm prior to
processing; faces the tongu
2. X-ray lm - May contain one or two lms in one packet (which serves as a duplicate)
BE
- Identi cation dot- one corner of the x-ray has a small raised bump used to determine lm
orientation (right or left); usually faces occlusal
- Also helps in properly mounting the radiograph and interpretatio
3. Paper lm wrapper - Black paper protective sheet that covers the lm and shields the lm from light
CM
4. Lead foil sheet - Located behind the lm to shield the lm from back scattered radiation that results in lm
fog
- Also lessens the patient’s exposure to radiation
Intraoral lm size
• 0 - 22 x 31 mm - for childre
• 1 - 24 x 40 mm - for childre
• 2 - 31 x 41 mm -periapical l
• 3 - 27 x 54 mm - bitewin
• 4 - 48 x 54 mm - occlusal l
Page 8 of 28
.
fi
fi
l
fi
fi
fi
fi
s
fi
fi
m
fi
fi
n
fi
fi
g
fl
J
fi
s
fi
e
fi
fi
fi
.
fi
h
fi
fi
.
fi
d
fi

.

Intraoral lm speed - amount of radiation required to produce a radiograph of standard densit
Film speed/sensitivity is determined by

A. Size of Ag halide crystals - the larger, the faste
- Alphabetical classi cation system A to
M
- Only D and E are used in intraoral radiograph
- ADA and AAOMR recommends the use of E-speed lm, which only requires half the exposure
time of D-speed lm and has comparable image contrast and resolution
D
B. Thickness of emulsion - E-speed has thicker emulsion so there’s increased amount of Ag halide crystal
C. Presence of special radiosensitive dyes - makes lm more sensitiv
,D
Extraoral lms - not enclosed in moisture proof packet
Film Type
• Screen lm - comprises majority of extra oral lm
- requires the use of screen for exposure; the lm is placed between two
special INTENSIFYING SCREENS in cassette holder
- during exposure, screen converts x-ray energy into light, which in turn
exposes the lm (indirect exposure), emulsion is sensitive to uorescent light
AN
• Non screen lm - does not require screen for exposur
R
- primarily used in intraoral radiograph
- lms are directly exposed to x -ray
LT
- used more in dental radiograph

Intensifying Scree
• A plastic sheet with uorescent material called phosphors. Phosphors are materials which convert photon
energy to light
BE
• Used in pairs, one on each side of the lm, and they are positioned inside a cassette
• The purpose of a cassette is to hold each intensifying screen in contact with the X-ray lm to maximize the
sharpness of the image
Speeds of Intensifying Screen

CM
• Fast Screens - thick layer and relatively large crystals used, maximum speed is attained but with some
sacri ce in de nition
• Slow Screens or high de nition screens - a thin layer and relatively small crystals are used; detail is the best,
but speed is slow necessitating a higher dose of ionizing radiation.
• Medium Screens - medium thick layer of medium sized crystals in order t provide compromise between
speed and de nition
Page 9 of 28
fi
fi
fi
fi
s
fi
fi
fi
.
fi
fi
n
fi
.
fl
.
fi
s
fi
y
fi
:
fi
r
fi
s
fi
fl
fi
.
fi
y
Non Screen Fil

• Also known as direct exposure l
• Does not require use of screens for exposur
• Primarily used in Intraoral Radiograph
• Directly exposed to X-ray
• Used more in dental radiograph
M
Direct exposure lm is used for intra-oral examinations because it provides higher-resolution images than
screen- lm combinations
D
Intensifying screens are not used intraorally with periapical or occlusal lms because their use would reduce
the resolution of the resulting image
,D
Film Storage and Protectio
• Film is adversely affected by heat, humidity and radiatio
• Unprocessed lm should be kept in a cool, fry plac
• 50-70 deg
•
•
Lead lined or radiation resistant lm dispenser
Used before expiration date, limited shelf life AN
Density - overall blackness of a radiograph (darker areas represent heavier deposits of black silver particles
R
Factors that affects the density of the l
LT
1. exposure factors: mA, kVp, exposure time. Direct proportional relationship. If kVp is increased , mA must be
reduced to maintain a lm with constant densit
2. Subject thickness- inverse proportional relationshi
3. Object densit
BE
4. Processing of l
Contrast - Difference in degree of blackness (densities) between adjacent areas on a dental radiograp
Factors that affects the contrast of the l

CM
• Subject contrast- characteristics of the subject that in uence radiographic contrast

- Determined by thicknes
• Film contrast- characteristics of lm that in uence radiographic contrast
• Inherent Qualities- high or low contrast lm. Controlled by manufacturer
Page 10 of 28
fi
F
fi
m
fi
fi
m
fi
.
fi
y
fi
fi
m
fi
y
fi
m
fi
s
fl
e
fl
n
fi
.
PROCESSING OF THE X-RAY FIL
Chemical changes produced by x-rays riders the altered crystals sensitive to the chemical reaction of the
developing process that converts the LATENT IMAGE to the VISIBLE IMAGE
Purpose of lm processin
M
To convert the latent image into visible imag
To preserve the image- to harden the lm emulsion so it wont fad
D
Film Processin
• Automatic Film Processing - takes 4-6 minute
- Density and contrast of resultant radiograph tend to be consistent
,D
- Acquisition cost and maintenance is high
• Manual Film Processing - The clinician is the one who processes the x-ray lm
- Clarity of image depends on the clinician
- Rapid processing metho
- Use of developing bo
AN
- Plastic screen on top so you can see what your doing (orange in color
- No uorescent directly over i
- Film clip- used to hold lm as you dip it to different chemical
R
5 Steps in Manual Film Processin
LT
1. Developing - Reduces all Ag ions in the exposed crystals of AgBr (with a latent image) to metallic Ag.
- Areas with more exposed crystals will be more dense (blacker) because of the high
concentration of black metallic Ag granules after development.
- Development of unexposed crystals result in the production of chemical fog in the lm.
BE
- Dark lm are usually the result of overexposure, not underdevelopment.
Constituents Of Developer Solution and their Function

A. Phenidone – brings out the image
CM
B. Hydroquinone- builds contrast

C. Sodium Sulphite- reduces oxidation, help protect developer from being oxidized by atmospheric oxygen
D. Potassium Carbonate- activates developing agents, Softens the gelatin covering the emulsion so
developer will diffuse more to the lm and interact with Ag crystals exposed
E. Benzotriazol- prevents fo
F. Glutaraldehyde- hardens the emulsio
G. Fungicide- prevents bacterial growt
H. Buffer- maintains p
I. Water- solven
Page 11 of 28
fi
t
fi
H
fl
g
fi
h
fi
e
fi
d
fi
.
fi
2. Rinsing - Rinse in water for 15-30 seconds before placing in xer

- To dilute the developer and slow the development process
- Removes the alkali activator, to prevent neutralization of acid xe
3. Fixing - To remove (dissolve) the underdeveloped Ag halide crystals from the emulsio
M
- The presence of unexposed crystals causes the lm to be opaqu
- If not removed, image on the resultant will be dark and non-diagnosti
D
- Secondary function- to harden the lm emulsio
Constituents Of Fixer Solution and their Function
,D
A. Ammonium Thiosulphate- removes unsensitized crystals
B. Sodium Sul te (Na2SO3)- preservative; to prevent the decomposition of the thiosulfate clearing agent,
which is unstable in the acid environment or the xing solution
C. Aluminum chloride- hardener; Prevent damage of the gelatin by subsequent handling. Shortens the
drying time
any carry over of developing agents.

E. Water- solven
R AN
D. Acetic Acid- maintains pH; Functions to neutralize any contaminating alkali from developer and to inhibit
4. Rinsing - to assure removal of all processing chemical

- If Ag compounds or thiosulfate will remain, it will discolor and cause stains
LT
5. Drying - even drying, no water marks because it will affect the radiographic imag
Dark Room Equipmen

• 4ft (1.2m) minimum distance between lamp and counter surface where lm is to be handled
BE
• 7 1/2 or 15 watt white incandescent bulb with safelight lte

• lms should not be subjected to safelight exposure over 2 1/2 minute
Safeligh
X-ray lms are very sensitive to the blue-green region of the spectrum and are less sensitive to yellow and red
wavelengths. The red GBX-2 lter is recommended as a safelight in darkrooms
CM
IMAGING PRINCIPLES AND TECHNIQUES

Criteria of Quality of Radiograph
1. Should record the complete areas of interest in the imag
2. Should have the least amount of distortion. Most distortions result from improper angulation of the x-ray
beam
3. More on processing, should have optimal density and contrast which are essential to interpretatio
4. Right exposure, developing, xing tim
Page 12 of 28
fi
.
fi
t
fi
t
fi
fi
s
fi
fi
s
fi
n
fi
r
fi
s
fi
fi
e
4 Cardinal Rules in Image Formatio

1. Source of radiation: be as small as possibl
2. Focal spot distance object: be as fas as possibl
3. Film to object distance: be as fas as possibl
4. Object and lm: be as parallel as possible. Based on shadow casting
M
*** the rst three affects the sharpness and resolution
D
Paralleling Techniqu
- aka long cone (16 inches) or right angle technique
- lm and long axis of the tooth are paralle
,D
- central ray will hit the lm at a right angl
- This position of the lm, teeth, and central ray minimizes distortio
- Advantages include less magni cation and increased de nitio
size of the afferent focal spot

- In positioning the lm holding device, use the maximum height of the palate AN
- It is important that the x-ray source is located relatively distant to the teeth which reduces the
Bisecting Angle Techniqu

R
-Film is placed as close as possible to the lingual surface of the tooth while resting on the palate.
- Film must not be bent nor deformed.
LT
- The long axis of the tooth and the lm creates an angle, you will bisect this angle and orient the x-ray
tube perpendicular to it
Cienzynski’s rule - the bisecting angle technique is based on this theorem. It states that two (2) triangles are
BE
equal when they share one complete side and have tow (2) equal angles.
Angulation Guidelines for Bisecting-Angle Projection
PROJECTION MAXILLA MANDIBLE

Incisors +40 degrees -15 degrees
CM
Canines +45 degrees -20 degrees

Premolars +30 degrees -10 degrees
Molars +20 degrees - 5 degrees
Page 13 of 28
fi
fi
fi
e
fi
fi
.
fi
n
fi
e
fi
e
fi
.

Bisecting Paralleling
May have correct length but there is distortion at Produce better diagnostic images; no elongation
apical region
Film is manually held in patient’s mouth Use of Paralleling device
M
Tendency of the lm to be deformed No lm deformity but possible problem is the
space inside the patient’s mouth
D
Problem of superimposition of other structures Less exposure to critical organs such as thyroid
gland and eyes
,D
Bitewing Techniqu
used to check the
1. pulp size and pulp change
2. proximal carie
3. overhanging restoration
4. presence of recurrent carie
5. presence of calcular deposit
AN
6. height of the alveolar bon
R
Bitewing (Central Incisors
LT
• Direct the central ray perpendicular to the image receptor through the left and right central incisor
embrasures
• Center the image receptor within the x-ray beam by directing the central ray at the center of the image
receptor at a spot on the incisal plane between the maxillary and mandibular central incisors
BE
• Vertical angulation - +1
Bitewing (Canine
• Direct the central ray perpendicular to the image receptor at the center of the canine
CM
receptor at a spot on the incisal plane between the maxillary and mandibular canines
Bitewing (Premolar
• Direct the central ray perpendicular to the image receptor through the rst and second premolar embrasure
receptor at a spot on the occlusal plane between the maxillary and mandibular second premolars
Page 14 of 28
fi
.
fi
)
fi
.
Bitewing (Molar)
• Direct the central ray perpendicular to the image receptor through the rst and second molar embrasure
receptor at a spot on the occlusal plane between the maxillary and mandibular rst molars
M
Occlusal Projectio
D
Uses of Occlusal Projectio
1. To precisely locate roots and supernumerary, unerupted, and impacted teeth
,D
2. To localize foreign bodies in the jaws and stones in the ducts of sublingual and submandibular glands
3. To demonstrate and evaluate the integrity of the anterior, medial, and lateral outlines of the maxillary sinus
4. To aid in the examination of patients with trismus
5. To obtain information about the location, nature, extent, and displacement of fractures of the mandible and
maxilla
AN
6. To determine the medial and lateral extent of disease and detect disease in the palate or oor of the mouth.
Occlusal Projection - Maxillary Arc

R
1. Anterior Maxillary Occlusal Projectio
- The primary eld of this projection includes the anterior maxillary and its dentition and the
anterior oor of the nasal fossa and teeth from canine to canine
LT
- Orient the central ray through the tip of the nose toward the middle of the receptor with
approximately +45 deg vertical angulation and 0 degrees horizontal angulation
2. Cross Sectional Maxillary Occlusal Projectio

BE
- This projection shows the palate, zygomatic processes of the maxilla, anteroinferior aspects of
each antrum, nasolacrimal canals, teeth from second molar to second molar, and nasal septum
- Direct the central ray at a vertical angulation of +65 degrees and a horizontal angulation of 0
degrees to the bridge of the nose just below the nation, toward the middle of the receptor.
3. Lateral Maxillary Occlusal Projectio
CM
- This projection shows a quadrant of the alveolar ridge of the maxilla, inferolateral aspect of the
antrum, tuberosity, and teeth from the lateral incisor to the contralateral third molar.
- Orient the central ray with a vertical angulation of +60 degrees, to a point 2 cm below the
lateral canthus of the eye, directed toward the center of the receptor
Page 15 of 28
.
fl
n
fi
h
fi
.
fi

fl

Occlusal Projection - Mandibular Arc

1. Anterior Mandibular Occlusal Projectio
- This projection includes the anterior portion of the mandible, the dentition from canine to
canine, and the inferior cortical border of the mandible
- Orient the central ray with -10 degrees angulation through the point of the chin toward the
M
midline of the receptor; this gives the ray -55 degrees of angulation to the plane of the receptor
2. Cross Sectional Mandibular Occlusal Projectio
- This projection includes the soft tissue of the oor of the mouth and reveals the lingual and
buccal plates of the mandible from second molar to second molar
D
- Direct the central ray at the midline through the oor of the mouth approximately 3cm below
the chin, at right angles to the enter of the receptor
,D
3. Lateral Mandibular Occlusal Projectio
- This projection covers the soft tissue of half the oor of the mouth, the buccal and lingual
cortical plates of half of the mandible, and the teeth from the lateral incisor to the contralateral third
molar
AN
- Direct the central ray perpendicular to the center of the receptor through a point
beneath the chin, approximately 3 cm posterior to the point of the chin and 3cm lateral to the midline
EXTRAORAL TECHNIQUE
R
Lateral Obliqu
Area of interest - Body or ramus of mandible; coronoid process; condyl
LT
Purpose - To examine posterior region of the mandible, third molars, especially when panoramic machine not
available; when children or patients who have fractures or swelling are unable to tolerate placement or hold
intraoral image receptor in place
Positionin
Body
BE
- Beam aims at the molar - premolar are

- Film in contact with cheek at molar are
Ramus
- Beam aims at the ramus are
CM
- film in contact with cheek at ramus are
Page 16 of 28
.
fl
fl
fl
.

Lateral Cephalometri
Area of interest - Entire skull from the side (lateral); sinus cavitie
Purpose - Prior to orthodontic intervention, at various stages of treatment, on completion of treatment; to
evaluate growth/development, trauma, pathology, developmental abnormalities; can reveal facial soft tissue
pro le when a lter is placed between the tube and patient to remove some of the x-rays; to establish pre-/
posttreatment records
M
Positionin
• Beam perpendicular to the l
• Film parallel to midsagittal plan
D
,D
Postern-Anterior (PA) Skul
Area of Interest - Entire skull in the posteroanterior plane; orbit; frontal sinu
Purpose - To examine facial growth/development, disease, trauma, developmental abnormalities. Used to
supplement lateral survey because the right and left sides of the facial structures are not superimposed on
each other
Positioning
AN
• Canthomeatal line 10 deg with l
R
LT
Waters View
Area of Interest - Middle third of the face to include zygoma, coronoid process, sinuse
Purpose - To evaluate maxillary, frontal, ethmoid sinuse
BE
Positionin
• Canthomeatal line at 37 degrees with l
CM
Reverse Town
Area of Interest - Condyle
Purpose - To examine fractures of the condylar nec
Positionin
• Canthomeatal line at -30 deg with l
Page 17 of 28
fi
g
fi
e
fi
fi
fi
fi
l
fi
m
fi
m
fi
m
Submento-verte
Area of Interest - Base of the skull; condyles; sphenoid sinus; zygoma
Purpose - To evaluate the position/orientation of the condyles; fractures of the zygomatic arc
Positionin
M
• Canthomeatal Line parallel to the l
D
Transcrania
,D
Area of Interest - Head of condyle; glenoid fossa; temporal bone; temporomandibular joint in open, closed and
at rest positions
Purpose - Aids in diagnosing ankylosis (a stiffening of the temporomandibular joint); malignancies, fractures,
and tissue changes caused by arthriti
Positionin
• Beam at 25 deg to the l
• Film parallel to midsagittal plan
R AN
LT
BE
CM
Page 18 of 28
g
fi
m
fi
m
fi
m
Film Placement Error

• Inadequate Coverage - due to improper placement of the x-ray lm. Can cause missing crowns of the teeth
• Tire Track Marks - Placing the lm backwards in the mouth causes the lead foil inside the packet to face the
radiation source instead of the lm
• Bending - may occur due to the curvature of the palate or lingual arch and/or mishandled receptors/x-ray
M
lms
• Elongation - results when the central ray is perpendicular to the object but not to the lm
• Foreshortening - results when the central ray is perpendicular to the lm but the object is not parallel with the
D
lm
• Horizontal Overlapping - Horizontal alignment errors cause the image to shift right or left, resulting in the
overlapping of the inter proximal surfaces
,D
• Tilted Occlusal Plane - The receptor is not placed perpendicular to the occlusal plane, the occlusal plane will
appear slanted or diagonal
• Beam Centering Errors - The central ray should be aligned over the center of the receptor with the x-ray
beam directed perpendicular to the receptor.
AN
- When this alignment is not observed, a cone-cut occurs. Cone cuts appear as clear zone on
traditional radiographs after processing, due to the lack of x-ray exposure in the area of the cut
COMMON RADIOGRAPHIC ERRORS ENCOUNTERED DURING RADIOGRAPH TAKIN

R
1. Blank Image - A lm that didn’t receive radiation will have no image and will appear clear
2. Underexposure - Results in images of low density (light image). Can also be caused by an increase in the
source-object distance, or not placing the tube head close enough to the patient’s face
LT
3. Overexposure- Results in a high-density or dark image. The causes include improper exposure factors or
improper assessment of patient stature
4. Double exposure - Results when the receptor is exposed twice and two images appear superimposed onto
each other
BE
5. Blurred Image Caused by movement of the patient, lm, or PID during exposure
6. Reticulation - When the lm is subjected to a sudden temperature changes between the developer and
water. Appears as cracked l
7. Black Spot or Patch - Developer contamination before immersion into the developer solution
CM
8. Black Line - Contamination of the hanger clips with the developing solution. Dirty roller in automatic
processor can also cause this
9. White Spot or Patch - Contamination with xer before processing
10. Yellowish brown discoloration - Exhausted solution or insuf cient rinsing
11. Developer cut off - A straight blank white border due to underdeveloped portion. The lm may not be
completely immersed in the developer solution
12. Fixer cut off - A straight black border. The lm may not be completely immersed in the developer solution
13. Overlapped Film - Film that overlap in developer are white, while that overlap in xer are black
14. Smudge ( nger print) - When the lm is touched by ngers that is contaminated with developer or xer
Page 19 of 28
fi
fi
.
fi
.
fi
s
fi
.
fi
m
fi
fi
fi
.
fi
fi
.
fi
fi
fi
fi
.
fi
.
fi

fi
.
fi
.
fi
.

15. Scratched Film - White lines appear on the lm due to careless handling of the lm
16. Static Electricity - Thin black branching lines that occur when two surfaces are rubbed together against
each other vigorously, this creates an electric charges with visible light emitted which is capable of
exposing the x-ray lm, thus leading to ionization of AgBr crystals at this area. Occurs most frequently
during periods of low humidity
M
Miscellaneous Object
• When a removable prosthesis is left in the mouth during exposure, a superimposed image of the appliance
D
will appear over the teeth.
• Prior to radiographic procedures, ask patients to take out all removable items from the mouth, such as
retainers, partial dentures, complete dentures, etc.
,D
• Glasses may appear in radiographs of patients with large eye glasses and/or when extreme vertical
angulation is needed.
• Glasses should be removed prior to radiographic procedures.
• Facial jewelry in the path of the x-ray beam should be removed as well to avoid unwanted artifacts and
unnecessary retakes
LOCALIZATION TECHNIQUE
AN
Used to locate the object of interest (if it is at the buccal, lingual, medial or distal
R
The three primary methods of determining the buccolingual location of objects are
LT
• De nitive Evaluation Metho

• Based on shadow casting principles. An object positioned farther away from the image receptor will be
magni ed and less clear
• Because intraoral image receptor placement positions the receptor close to the lingual surface of the
BE
teeth, those objects on the lingual are more likely to appear distinctly de ned on the resultant radiograph
• Although true in principle, the de nitive method of localization is not consistently reliable
• Right-Angle Technique (Occlusal projection)
Primarily identi es buccolingual location, but may also con rm mesiodistal location seen on periapical.
CM
• Tube-shift Technique (Frank’s shift, Clark’s shift

Utilizes two lms with different horizontal or vertical angulation
Clark’s Shift - Take 2 radiographs at different horizontal angulation while maintaining the same
vertical angulation. Follows SLOB rul
Frank’s shift - Take 2 radiographs at different vertical angulation while maintaining the same
horizontal angulation. Follows DLUB rule
Page 20 of 28

fi
fi
fi
fi
.
fi
.
fi
e
fi

fi
s
fi
fi
:
RADIOGRAPHIC APPEARANCE OF DENTAL MATERIALS
M
D
,D
RADIOGRAPHIC INTERPRETATION OF NORMAL ANATOM
Teet
AN
Enamel - 90% mineral content - appears more radiopaque than other tissues
Dentin - 75% miners content, less radiopaque than ename
R
Cementum - 50% mineral content - usually not apparent radiographicall
Pulp - composed of soft tissues; appears radiolucen
LT
Supporting Structures of the Teet

Lamina Dura - A thin radiopaque layer of dense bone surrounding the tooth socket.
Alveolar Crest - Radiopaque structure found in between the teeth. Considered normal if it is 1.5mm or less
from the CEJ
BE
Periodontal Ligament Space - Radiolucent space between root and lamina dura. Area where the periodontal
ligaments are located
Cancellous Bone - also called trabecular bone or the spongiosa. Lies between the cortical plates in both jaws.
It is composed of thin radiopaque plates and rods surrounding many small radiolucent pockets of marrow
CM
Maxill
• Inter maxillary Suture - aka Median Palatine Sutur
- It appears as a thin radiolucent line in the midline between the two portions of premaxilla
- It extends from the alveolar crest between the central incisors superiorly through the anterior
nasal spine and continues posteriorly between the maxillary palatine process to the posterior aspect of
the hard palate
Page 21 of 28
h

• Anterior Nasal Spine - appears as an inverted radiopaque triangle or V-shaped. It is on the midline and
superior to the apices of the maxillary central incisors
- In the midline; about 1.5 ~ 2 cm above the alveolar crest, at or below the
junction of the inf. end of the nasal septum and inf. outline of the nasal fossa
• Floor of the Nasal Cavity - appears as a radiopaque line extending bilaterally away from the base of the
M
anterior nasal spine
• Nasal Cavity - appears as a radiolucent area superior to the oor of the nasal cavity
D
• Nasal Septum - appears as a radiopaque band going superior from the oor of the nasal cavity. It is on the
midline
,D
• Inferior Nasal Concha - appears as a round to ovoid radiopaque mass superior to the oor of t h e
nasal cavity
• Incisive Foramen - aka Nasopalatine forame

AN
- appears as a round to ovoid radiolucent area between the roots of the maxillary central incisors
• Nasopalatine Canal - two radiolucent areas above the apices of the central incisors in oor of t h e n a s a l
cavity near its anterior border and both the sides of the septum
R
• Lateral Fossa - Appears as a well-localized radiolucent area around the root of the maxillary lateral incisor.
This is due to a decrease in bone thickness in this region
LT
• Nasolacrimal Canal - Appears as a round radiolucent structure located at the palatal area of
maxillary second molars
BE
• Soft Tissue Outline of the Nose - Appears as a radiopaque area superimposed over the maxillary
anterior teeth. The tip of the nose is seen over the maxillary central incisors. The ala of the nose is seen
over the lateral incisors
• Maxillary Sinus - Extends from the distal aspect of the canines to the posterior wall of the maxilla
above the tuberosity
CM
• Maxillary Tuberosity - Rounded eminence especially prominent after the growth of the wisdom tooth
• Coronoid Process - A triangular radiopaque area, with apex directed superiorly & anteriorly
Page 22 of 28
.
fl
.
fl
.
fl
fl

.
MANDIBL
• Mental Ridge - aka Mental triangle. Appears as two oblique thick radiopaque bands that meet in the midline
giving it the appearance of an inverted V or triangle shape
• Mental Fossa - located above the mental ridge. Appears as radiolucent area above the mental ridg
M
• Lingual Foramen and Genial Tubercle - appears as a small radiolucent circle directly inferior to the central
incisors
D
• Nutrient Canal - aka vascular canals. They appear as radiolucent line or bad coursing in a vertical direction.
,D
• Mental Foramen - It appears as a small ovoid radiolucent area located below the apices of the premolars
• External Oblique Ridge - continuation of the anterior border of ramus. A radiopaque line near the alveolar
crest in the mandibular 3rd molar region
AN
• Mylohyoid Ridge - Linear prominence of bone located on the internal surface of the mandible. Appears as
radiopaque band extending downward and forward from molars towards the lower border of the mandibular
symphysis
R
• Mandibular Canal - A tube-like passage extending from the mandibular foramen to the mental foramen and
contains the inferior alveolar nerve and blood vessels. Appears as a radiolucent band outlined by two
radiopaque lines of cortical plate (superior and inferior border)
LT
• Submandibular Gland Fossa - Depressed area of bone located on the internal surface of the mandible.
Submandibular salivary gland lies in this fossa. Appears as a radiolucent area in the molar region below the
mylohyoid ridge
BE
• Inferior Border of the Mandible - Appears as a thick radiopaque band

CM
Page 23 of 28
.
Radiopaque Radiolucent
Bone Canal
Border (wall) Foramen
M
Process Fossa
Ridge Meatus
D
Spine Sinus
Tubercles Space (PDL)
,D
Tuberosity Suture
RADIOGRAPHIC MANIFESTATIONS OF DISEASE
Classi cation of Radiographic Abnormalitie

1. Unilocular Radiolucenc
2. Multilocular Radiolucencie
AN
3. Irregularly-shaped Radiolucencie
R
4. Mixed Radiolucent-Radiopaqu
5. Radiopaqu
LT
How to Interpret a Periapical x-ray

1. Crown- presence of radiolucency (extending upto pulp, dentin, enamel, mesial, distal, occlusal), presence
of radiopacity (suggestive of restoration, crown
BE
2. Root (widened pdl space, intact or discontinuous lamina dura

3. Apex- presence of radiolcency (well circumscribed, diffused
4. Bone- presence of bone loss (horizontal, vertical), amount of bone support (>2/3, 1/2, <1/3, 1/3
5. Proximity to vital structures- with sinus approximation, in close proximity to inferior alveolar canal
6. Others- presence of radiopacity on proximal area suggestive of calcular deposits, presence of radiopacity
CM
on the pulp canal suggestive of endodontic lling material.
Osteomyeliti
Garre’s Osteomyelitis - onion skin appearanc
Diffuse Sclerosing Osteomyelitis - cotton-wool radiopacitie
Chronic Focal Sclerosing Osteomyelitis (Condensing Osteitis) - radiopaque area at the apex of the tooth
Page 24 of 28
fi
e
fi
e
Developmental Disturbances and Anomalies of Teet

Atrophy of the Pulp - Decreased cellular elements (becomes more brotic, so there is decrease in cells and
blood vessels). Degeneration, disappearance of odontoblast
Pulp Stones (denticles) - Localized masses of calci ed tissues. Usually at the coronal pulp
M
External Resorption - can be caused by periapical in ammation, reimplanted teeth, tumors or cysts, excessive
forces, impacted teeth, or idiopathic
Internal Resorption - in ammatory hyperplasia of the pul
D
Hypercementosis - excessive production or deposition of cementum
Major Classi cation of Cyst
,D
Odontogenic Cys
Non-Odontogenic Cys
Pseudocys
Odontogenic Cysts -dental in origi

AN
• Primordial cyst - cyst originating from the enamel organ. Most often seen in the mandibular 3rd molar area or
ascending ramus of the mandible although it may develop in other areas but these are the most frequent
R
• Dentigerous/follicular cyst - Well-de ned, unilocular or occasionally multilocular radiolucency with corticated
LT
margins
• Eruption Cyst - Results from uid accumulation within the follicular space of an erupting tooth
BE
• Radicular/Periapical Cyst - It presents as a well circumscribed radiolucency with radiopaque border located
at the apex of a non vital tooth
• Residual Cyst - A cyst that was left in the socket after tooth extractio
CM
• Lateral Periodontal Cyst - Presents as an asymptomatic, well delineated, round or teardrop-shaped

unilocular (occasionally multilocular) radiolucency with an opaque margin along the lateral surface of a vital
tooth root
• Odontogenic Keratocyst - Presents as a well-circumscribed radiolucency with smooth radiopaque margins.

May be multilocular but most often unilocular
• Calcifying Odontogenic Cyst (COC) - aka Odontogenic Ghost Cell Tumor; salt and pepper patter
Page 25 of 28
.
fi
t
fl
s
fl
.
fi
.
fi
h
fl
p
fi
.
Non-odontogenic Cyst
• Globulomaxillary Cyst - Distinguishing feature is the pear-shaped radiolucency between the maxillary lateral
and cuspid
• Nasolabial Cyst - A large radiolucency at the palatal area enclosing the nasolabial area
• Nasopalatine Canal Cyst - Heart-shaped radiolucency usually above the divergent roots of maxillary central
M
incisors causing separation. Always in the midlin
Pseudocysts - Not a real cyst
D
• Aneurysmal Bone Cyst - may be unilocular or multilocular. Has a slightly irregular margin
• Traumatic Bone Cyst - Area of radiolucency with ill-de ned or no demarcation on borders (might be mistaken
,D
for an abcess or other periapical disease, so a thorough history should be taken
• Static Bone Cyst (Stafne’s bone defect) - Developmental defect. Anatomic indentation or depression at the
posterior border at the lingual surface of the mandible due to entrapment of the salivary gland during
development. Area of radiolucency below IAN near the inferior border of the mandible
Diseases of Bon AN
• Cleidocranial Dysplasia - Aka cleidocranial dysostosis, Marie and Sainton’s Disease, Scheuthauer-Marie-
Sainton Syndrome, Mutational Dysostosi
R
- has underdeveloped or absence or clavicles, underdeveloped sinuses and anomalous cranial sutures
- There is prolonged retention of the deciduous teeth and subsequent delay in eruption of the
succedaneous teeth, as well as presence of numerous supernumerary teeth
LT
• Osteitis Deformans (Paget’s Disease of Bone)- Serum Ca, P are within normal levels but alkaline
phosphatase is elevated. Cotton wool appearanc
• Fibrous Dysplasia - Serum Ca, P, and alkaline phosphatase are still within normal limits. Ground glass
BE
appearanc
• Massive Osteolysis - aka Vanishing bone, disappearing bone, or phantom bone. unknown etiology. Unusual
and uncommon disease characterized by spontaneous, progressive resorption of bone with ultimate total
disappearance of the bone
CM
DENTAL CT SCA
CT Scan - Computerized Tomograph
- Invented by Godfrey Hous eld in 197
- demonstrates differences between various soft tissues that cannot be easily seen in radiographs
Advantages of CT Scan over Conventional Film Radiograph

• CT completely eliminates the superimposition of images of structures super cial or deep to the area of
interest within the patient
• Differences may be distinguished between tissues that differ in physical density
Page 26 of 28
e
fi
y
fi
y
fi
.

• Data from a single CT imaging procedure consisting of multiple continuous scans of a patient may be
viewed as images in the axial, coronal, or sagittal planes depending on the diagnostic task, referred to as
multiplanar imaging
Anatomical Plane
• Sagittal Plane - A vertical plane which passes from ventral (front) to dorsal (rear) dividing the body into right
M
and left halves
• Transverse Plane - aka horizontal plane, axial plane, transaxial plane. An imaginary plane that divides the
body into superior and inferior parts. It is perpendicular to the coronal and sagittal planes
• Coronal Plane - aka frontal plane. It divides the body into dorsal and ventral portions
D
,D
DIGITAL IMAGIN
• Digital imaging is any modality/method of imaging that creates an image that can be viewed or stored on a
computer
• Digital imaging systems used in dentistry replace
AN
lm with image receptors called a sensor or
photostimulatable phosphor (PSP) (a polyester plate covered with phosphor crystals
• Techniques and methods for exposing intra- and extra oral radiographs are the same with traditional lm and
digital image receptor
R
Uses of digital radiograph
• detect, con rm, and classify oral disease and lesion
LT
• Detect and evaluate traum

• Evaluate growth and developmen
• Provide information during dental procedure such as root canal therapy and surger
BE
Advantages of Digital Radiograph

• Less radiation exposur
• Almost instantaneous viewing of the imag
• Elimination of the photographic process and darkroo
• No generation of hazardous wastes such as used xer and lead foils and elimination of cost of disposa
CM
• Elimination of darkroom processing error

• Dark/light images may be improved with software to avoid reexposing the patien
• Effective patient viewing that enhances discussion of treatment plan and oral hygiene educatio
• Long-term costs may be less when compared to costs associated with purchasing lm and processing
chemical
Disadvantages of Digital Radiograph

• The ease of retakes may result in excess radiation exposur
Page 27 of 28
s
fi
.
fi
s
fi
e
fi
n
fi
l

• Bulky, thicker sensor size (CCD and CMOS) and attached wire may elicit patient complaints of discomfort or
excite a gag re ex
• Plastic barrier sheaths placed over the sensor to maintain infection control add additional bulk
• Infection control requires careful adherence to manufacturer’s recommendations to avoid damage to the
sensor. Infection control must be maintained for computer keyboard and/or mouse
• Concern with reliability of digital imaging. Computer crashes, system malfunction, and computer viruses are
M
real risks
2 types of digital imagin
D
• Direct Digital Imaging - use of senso
• Indirect Digital imaging - use of ps
,D
X-ray machin
• Most digital x-ray systems can be used with existing dental x-ray machines that have electronic timers
capable of producing very short exposure times
AN
• An x-ray machine adapted for digital radiography can still be used for conventional lm-based radiography
• Claims for up to 80% radiation reduction are most often accurate when the digital exposure is compared to
slower D-speed l
Storag
R
• Images can be saved in Usb, CD, email, etc
LT
MEDICO-LEGA
• Concerns have been raised in the past about the ability to manipulate the images for fraudulent purposes
• Manufacturers of software programs have installed “audit trails”, which can track down and recover the
original image
BE
Automated diagnostics for X-ray images in dentistr

• Helps the dentist identify and detect any deviations from the norm
• The more users the system has, the better it will “learn” about all sorts of subtleties that no single human
professional can master in full
CM
REFERENCES
White SC., Pharaoh MJ. (2009). Oral Radiology Principles and Interpretation. (6th ed.). Mosby Elsevier Inc
Whaites E., Drage N. (2013). Essentials of Dental Radiography and Radiology (5th ed). Churchill Livingstone,
Elsevie
Page 28 of 28
e
fl
:
fi
m
fi
.

ROENT Board Review Outline 2022

Uploaded by

Copyright:

Available Formats

You might also like

ROENT Board Review Outline 2022

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

ROENT Board Review Outline 2022

Uploaded by

Copyright:

Available Formats

DR.

CM BELTRAN ROENTGENOLOGY 2022

ROENTGENOLOGY BOARD EXAM REVIEW

Factors that affects the density of the Fil

Radiographs - 2D representation of 3D object

Factors that affects the contrast of the lm

DR. CM BELTRAN ROENTGENOLOGY 2022

3 Major Sources of Naturally Occurring Radiatio

Arti cial Sources of Radiatio

DR. CM BELTRAN ROENTGENOLOGY 2022

Radiation Biology Histor

Biologic Effects of Ionizing Radiatio

Changes in biologic molecule

Relative Radiosensitivity of Tissue (Alan Jackson, 2001 from Seibert 1996

DR. CM BELTRAN ROENTGENOLOGY 2022

2 Types of Biologic Effects from Radiatio

cancer - initiated by damaging chromosomes in a somatic cel

Deterministic Effects Stochastic Effects

Examples Mucositis resulting from radiation Radiation-induced cancer

caused by Killing of many cells sublethal damage to DNA

effects and dose proportional to dose. of dose. All-or-none response; an

DR. CM BELTRAN ROENTGENOLOGY 2022

Radiation effect on Oral tissu

11. Fluorescence Capabilit

Component Parts of the X-ray Machin

1. Control Panel - regulate the x-ray bea

DR. CM BELTRAN ROENTGENOLOGY 2022

Electricity and Electric Curren

1. Electricity- energy that is used to make x-ray

Types of X-rays Produce

THE X-RAY FIL

Composition of an X-ray Fil

- homogenous mixture of gelatin and Ag halide

Film Packaging of Periapical Film packe

Intraoral lm speed - amount of radiation required to produce a radiograph of standard densit

Film speed/sensitivity is determined by

- used more in dental radiograph

Speeds of Intensifying Screen

DR. CM BELTRAN ROENTGENOLOGY 2022

Non Screen Fil

Factors that affects the contrast of the l

• Subject contrast- characteristics of the subject that in uence radiographic contrast

DR. CM BELTRAN ROENTGENOLOGY 2022

PROCESSING OF THE X-RAY FIL

- Dark lm are usually the result of overexposure, not underdevelopment.

Constituents Of Developer Solution and their Function

B. Hydroquinone- builds contrast

2. Rinsing - Rinse in water for 15-30 seconds before placing in xer

Constituents Of Fixer Solution and their Function

any carry over of developing agents.

4. Rinsing - to assure removal of all processing chemical

Dark Room Equipmen

• 7 1/2 or 15 watt white incandescent bulb with safelight lte

IMAGING PRINCIPLES AND TECHNIQUES

DR. CM BELTRAN ROENTGENOLOGY 2022

4 Cardinal Rules in Image Formatio

size of the afferent focal spot