Card Set Information
What is quality assurance in the Dental office?
Special prodedures that are used to ensure the production of high-quality diagnostic radiographs
Who is ultimately responsible for administration of quality assurance?
How can the dental radiographer aid in implementation of administration of quality assurance?
By being knowledgable of the quality assurance plan
Quality control tests
specific tests used to monitor dental radiograph equipment
What do quality control tests monitor?
Dental x-ray machine
Dental x-ray film
Screens and cassettes
Dark room lighting
Describe quality administration procedures
Description of plan
Assignment of duties
evaluation and revision plan
What must you do to care for x-ray machine?
check for calbration, and adjust for accuracy
how often must you test dental x-ray machine?
once a year
What does x-ray machine testing look for?
machine output variations
inaccurate kilovoltage and milliamperage readings
How do you test for freshness of x-ray film?
process one unexposed film
How will a fresh unexposed film appear after testing?
clear with a slight blue tint
How will an unfresh film appear after testing? Why does it appear this way?
expired film, improper storage, exposed to radiation
What are extraoral screens used within a cassette holder examined for? how do you avoid this condition?
dirt or scratches
clean monthly with recommended cleaners
appy astistatic solutions
What are cassette holders examined for?
warping resulting in fogged or blurred radiographs
How do you check for adequate film-screen contact?
flim-screen contact test using wire mesh
How does the film appear if there is adequate film-screen contact?
wire mesh image has uniform density
How does the image appear if there is inadequate film-screen contact?
the film exhibits varying densities
areas of poor contact appear darker
What should you examine on the radiograph viewing equipment?
dirt and discoloration of plexiglass
should emit uniform and subdued light
How do you care for radiograph viewing equipment?
replace discolored plexiglass
replace blackened flourescent bulbs
Why is film processing one of the most critical areas in quality control?
because in can result in a large number of nondiagnostic film
What must the dark room be tested for? and how often?
light-tightness and proper safe-lighting
every 6 months
How do you check for light-tightness in the dark room
turn off all the light including safe-light, and observe room for light leaks
How do you correct light leaks in the dark room?
with weather stripping or black tape
How do you test the safe light?
with the coin test method (after the light leak test has been performed)
How will the film appear if there is proper safe lighting?
no visible image is present on the processed radiograph
How wil the film appear if there is improper safe lighting?
the image of the coin and fogged background appear on the film
how often must the proccessing equipment be monitored?
What do you check in the processing equipment?
water circulation system
How do you test to see if the processing equipment is running properly?
run 2 films, one exposed, one not exposed
How will the films appear if the processing equipment is running properly?
exposed film-pure black
unexposed film- clear bluish tint and dry
How will films appear if the processing equipment is not functioning properly?
exposed flim- not black and dry
unexposed film- not clear and dry
Describe general care for processing solutions
change every 3-4 weeks
evaluate daily before patient films are run
Name 2 methods for checking developer strength
processed under ideal conditions and then used to compare the film densities of radiographs processed daily
What do matched densities in reference radiograph testing indicate?
developer solution strength is adequate
What do unmatched densities on reference radiograph test indicate?
if dinsities on daily radiographs are light-developer is weak or cold
if densities on daily radiographs are dark-developer is too strong or hot
Stepn wedge radiograph
process one of twenty exposed radiographs under ideal conditions
When the fixer solution is at full strength how long should it take the film to clear?
no longer than 2 minutes
Name the 3 types of radiographic examination that use intraoral film
inter proximal exam
Periapical exam purpose
exam entire tooth and supporting bone
periapical film type
PA film-shows root and apex and surrounding bone
technique used for PA exam
interproximal exam purpose
examine crowns of maxillary and mandibular teeth on a single film
examine adjacent tooth surfaces and crestal bone
interproximal exam film type
bite-wing film including bitewing tab
interproximal exam technique used
Occlusal exam purpose
to examine large area of jaw on one film
occlusal exam type
occlusal film-pt bites on film
occlusal exam technique
Complete Mouth Radiographic series
series of intraoral dental radiographs that show all the tooth-bearing areas of the maxilla and mandible
what film types does the CMRS include?
4 maxillary molar-premolar PA's
3 maxillary anterior PA's
4 bitewing films
4 mandibular molar-premolar PA's
3 mandibular anterior PA's
include edentulous areas as well
When is the CMRS appropriate?
new adult pt. presents with clinical evidence of generalized dental diseas, or a history of extensive dental treatment
Diagnostic criteria for intraoral radiographs
images with opyimum density, contrast, definition and detail
images with least amount of distortion as possible-same size and shape as tooth
FMX must show include all tooth-bearing areas
PAX must show entire crown and root of teeth being examined as well as 2-3 mm beyond root apices
BWX must show open contacts or interproximal tooth surfaces- not overlapped
Prescribing of dental radiographs is based on_______. Professional judgement is made by_____________. indentifies what 3 things?
number, type, and frequency
moving or lying in the same plane (railroad tracks)
intersecting or forming a right angle
to cut across or through
angle of 90 degrees formed by 2 perpendicular lines
long axis of tooth
imaginary line that divides tooth longitudinally into 2 equal halves
central portionof the beam of x-radiation
Describe the principles of the paralleling technique
film is placed parallel to the long axis of tooth
central ray of the x-ray beam is directed perpendicular to the film and long axis
film holder must be used
object-film distance must be increased to keep film parallel
target film distance must be increased as a result of object-film distance
What must you increase the target-film distance to to compensate for magnification and loss of definition?
16" using long cone or PID
What does rectangular collimator do?
reduces radiation exposure to pt. by 70%
Name 5 types of film holders
precision film holders (collimator)
Stabe bite block (disposable)
EEZEE-grip film holder (Snap-a-ray)
hemostat with bite-block
Size of film used in anterior regions
Size of film used in posterior regions
positioned to cover teeth examined
positioned parallel to long axis of tooth, and away from tooth
rays must be perpendicular to film and long axis of tooth
central rays must be directed through the contact areas between the teeth
x-ray beam must be centered on the film to ensure that all areas of the film are exposed
Describe pt. preparation for radiographs
explain radiographic procedure
adjust chair to upright and comfortable height
adjust headrest so upper arch is parallel to floor and midline is perpendicular to the floor
place lead apron with thyroid collar
remove all objecs from mouth and glasses
Describeradiographic equipment preparation
set kVp and mA
open sterilized package and assemble
insert film packet into holder
What is the exposure sequence for anterior teeth?
start with maxillary right canine
move to maxillary right lateral and central incisor
move to left maxillary central and lateral incisor
move to left maxillary canine
move to left mandibular canine
move to mandibular incisors
move to right mandibular canine
Describe the sequence for posterior exposure sequence
assemble XCP for maxillary right premolars
then move to maxillary right molars
then mandibular left premolars
then mandibular left molars
then assemble XCP form maxillary left premolars
then move to maxillary left molars
then mandibular left premolars
then mandubular left molars
Maxillary canine exposure
should show center of canine, mesial of 1st premolar, and distal of lateral incisor
Maxillary incisor exposure
centered on contact between lateral and central incisor
mandibular canine exposure
centered on canine, shows mesial of 1st premolar and distal of lateral incisor
mandibular incisor exposure
centered on contact between central incisors- show all lateral and central incisors
maxillary premolar exposure
centered on second premolar, show from canine to 1st molar
maxillary molar exposure
centered on second molar, show from distal of 2nd premolar to 3rd molar
mandibular premolar exposure
center film on second premolar, show from canine to first molar
mandibular molar exposure
center on 2nd molar, show all three molars
What can you do to modify the paralleling technique in case of shallow palate?
Use cotton roll if tilt exceeds 20 degrees
What are the advantages of the parallel technique?
Accuracy-image that has dimensional accuracy and is free of distortion and exhibits maximum detail
simplicity-simple and easy to use and learn
duplication- easy to duplicate and repeat comparisons of series have great validity
What are the disadvantages of the paralleling technique?
film placement is difficult
can be uncomfortable to patients
Film exposure errors
result in nondiagnostic film
additional radiation to the pt. if retake is necessary
How does an unexposed film appear? Why did this happen?
film appears clear
occured becuase the film was not exposed
How does a film exposed to light appear? What caused this
the film was exposed to white light
How does an overexposed film appear? Why did this happen
images are darker
excessive exposure time, kVP, or mA
How does an underexposed film appear? Why did this happen
image is light
inadequate exposure time, kVP, or mA
How might a film appear if incorrect film placement was performed?
absence of apices- film was not positioned into pt. mouth to cover apices
occlusal plane appears tipped or tilted - the edge of the film was not placed parallel to the incisal-occlusal surface of teeth
How does the film appear if incorrect horizontal angulation was used?
contacts on teeth appear overlapped
How do forshortened images appear? Why did this happen?
teeth appear short with blunted roots
verticle angulation was excessive (too steep)
How do elongated images appear? Why did this happen?
long distored teeth appear on film
vertical angulation was insufficient (too flat)
How does a cone cut appear? Why did this happen?
unexposed area appears on film
PID was not aligned with the XCP
name 6 types of miscellaneous technique errors