DHE 116 LECTURE 10 CHAPTERS 18,5,

images other than anatomy or pathology that do not contribute to a diagnosis can be avoided with careful patient preparation prior to exposure.

• Dropped film on Floor
• No gloves
• 

• –Low humidity
• –Pulling film out of packet too quickly
• –Use of laytex gloves
• Solution:
• –Increase humidity where the film is stored (50-75%)
• –Place rubber mats on the floor
• 

• 1. patient did not occlude completely on image receptor biteblock
• 2. inadequate vertical angulation, no apical, caused elongation
• 3. incorrect distomesial horizontal angulation, overlapped proximal surfaces

• 1. patient did not occlude completely causing slanting or diagonal occlusal plane 
• 2. excessive vertical angulation, incorrect position of image receptor caused foreshortening
• 3. bent film; artifact

reversed film packet error

conecut error

• radiopaque artifact
• lead thyroid collar

underexposed or underdeveloped; light image

overexposed or overdeveloped; dark image

radiopaque arrtifact; partial denture left in place

• Development error
• Processing and darkroom protocol errors
• Chemical contamination

• film densities compromised
• 

• film takes a longer time to “clear” or become transparent, in unexposed areas
• 

underdevelopment- not left in developer for required time  overdevelopment- left in developer too long

• Too little time
• Too low kVp or mA
• Didn’t adjust exposure for bone density
• Large mass
• Didn’t hold button down full timeUnderdeveloped
• 

• Too much time
• Too high kVp or mA
• Didn’t adjust exposure for bone density
• Child
• Elderly (lean)
• Held button down too long
• Overdeveloped
• 

Premature contact w/ developer

Fixer splatter

• film fog 
• decreased image contrast

double exposed

• Reticulation
• Cracking of film emulsion = due to warm chemicals & cold water

amalgam tattoo

• Purposefully done to make film /PSP more comfortable
• Bent film/PSP can jam automatic processors

• restorations absorb x-rays
• Very little radiation comes in contact with the receptor [film]
• area of receptor remains unexposed
• metallic restorations appear completely radiopaque on a dental image

• vary in appearance from radiolucent to slightly radiopaque
• depending on the density of the material
• Gold is the most dense and least radiolucent
• acrylic the least dense and most radiolucent

• One-surface amalgam restorations
• Amalgam overhangs
• Amalgam fragments

• 2 surface metal fillings
• Overhang
• fragments

• Gold restorations appear completely radiopaque and exhibit a smooth marginal outline [contours]
• Amalgam restorations less contoured and more varied

• Appear radiopaque, but not as densely radiopaque as amalgam or gold
• Outlines and margins appear smooth and regular
• Some areas may appear “see-through” on a radiograph

retention pins

stainless steel crown

• Usually seen in endodontically treated teeth
• Appears radiopaque
• The core portion resembles the prepared portion of a tooth crown
• The post portion extends into the pulp canal

• (1) Post and core within the root canals
• (2) Gutta percha

• Porcelain restorations is slightly radiopaque and resembles the radiopacity of dentin
• All-porcelain crowns
• thin radiopaque line outlining the prepared tooth and then cement may be evident through the slightly radiopaque porcelain crown

The metal component appears completely radiopaque, and the porcelain component appear slightly radiopaque.

• Vary in appearance from radiolucent to slightly radiopaque
• Depending on the composition of the composite material

• These are often used as an interim or temporary crown or filling
• Least dense of all nonmetallic restorations
• Appears radiolucent or barely visible on a dental image

• cavity liners placed on the floor of a cavity preparation to protect the pulp
• appear radiopaque, less radiodense than amalgam

• used to enhance retention of amalgam or composite
• cylindrical or screw-shaped radiopacities

• are used when there are adjacent teeth on only one side of the missing tooth 
• 

consists of a pontic with one or two metal clasps or wings on one or both sides that are cemented or bonded to adjacent natural teeth

• used to fill pulp canals
• They are very radiopaque, similar to other metallic materials, appear more radiodense than gutta percha
• 

• claylike material used to fill pulp canals.
• Appears radiopaque, similar to base materials, is less radiodense than metallic restorations
• 

• Patients should be instructed to remove all complete and partial dentures before dental images are taken **
• Complete dentures
• ives the illusion of rootless, or “floating” teeth
• Removable partial dentures [RPD ]
• metal base with acrylic saddles appears densely radiopaque where metal is present and slightly radiopaque in the areas of acrylic
• 

• 
• Orthodontic bands, brackets, and wires may be observed on dental images.
• They have a characteristic appearance

• Implants
• The appearance varies based on the shape and design of the implant used.
• Suture wires, metallic splints and plates, bone screws, and stabilizing arches are used in oral surgery to stabilize fractures of the maxilla and mandible
• 

abrasion

attrition

• (1)Amalgam
• (2) Porcelain fused- to-metal crown
• (3) Post and core
• (4) Gutta percha
• (5) Base material
• (6) Full metal crown
• (7) Retention pin
• (8) Metal pontic

• (1)Radiopaque composite
• (2) Radiolucent composite (or acrylic resin or silicate)
• (3) Porcelainfused-to-metal crowns
• (4) cement under this crown
• (5) Silver point endodontic filler

• Radiation exposure
• Patient protection
• Value and uses of dental radiographs.
• Education can achieved though oral presentation, printed literature or a combination of both

• Is 80% of communication.
• Smiling
• Eye contact
• Posture
• Sitting down when talking to patients.

Early disease detection can only be done using dental x-rays

X-ray needs are based on your individual needs

• No. In most cases patient can’t be treated without x-rays. Treatment without necessary x-rays is negligent.
• No document can be signed to release the dentist from liability.

Yes if the x-rays are recent and they are diagnostic

Lead apron protects you from unnecessary radiation

With a lead apron no detectable radiation reaches the child. ADA & FDA guidelines regarding x-rays “do not need to be altered because of pregnancy”. Many dentist elect to postpone x-rays, because of patient concerns; **double up on lead apron**

Dental x-rays are safe when taken as recommended. They have a very small amount of exposure and are only taken when their benefit outweighs the risk

Not recommended because: A panoramic x-ray only shows general condition of mouth, it does not show the detail needed to diagnose many conditions.

cannot

pose a risk

harmful

• disruption of cellular metabolism
• Produce biologic changes in living tissues
• The amount of x-radiation used in dental radiography is small, but biologic changes do occur

• –how the harmful effects can occur
• –how to discuss the risks of radiation with patients
• Exercising safety precautions
• Minimize radiation exposure
• Radiograph retakes
• –contribute to unnecessary exposureare preventable when proper protocol

true

its ability to deposit its energy into things

modern version of the metric system ***ADA Requires SI terminology to be used on national board exams

is the amount of ionizing radiation that is absorbed into a substance