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Professor Nancy Rivaldo
Monroe Community College
O  
 „efine extraoral
 Indications for use of extraoral
 „efine cassette
 What is an intensifying screen?
 Advantage and disadvantage of
intensifying screens
 What is screen film?
 How is speed/intensification
determined?
O
 What is a grid?
 What are the 7 common extraoral
exposures?
 What is a cephalometric
radiograph?
 What are two extraoral exposures
commonly used in cephalometrics?
 What is the best extraoral
exposure for maxillary sinus?
O

 What is sialography?
 What techniques are used to
examine the TMJ?
| 
 Æilm packet or cassette placed
outside oral cavity
 Advantages
--usually easier than intraoral
--minimal equipment needed
 Indications for use
--patient has limited opening
--area to be viewed is larger then
can be seen on intraoral
radiograph
O
 ight-tight container in which film
placed
 Rigid or flexible
 Ælat or curved
 Varying sizes
 Should have ³ or ³R
identification for orientation of
images in relation to patient
O

 Tubeside of cassette placed


toward head

 Radiation enters film from opposite


side
›  

 Intensify or increase radiation
 „ecrease exposure time
 Coated with a fluorescence
substance
 Material responsible for
fluorescence called phosphors
 Phosphors emit light when
irradiated
2  
 Type of phosphor plays role in
speed or intensification
 Calcium tungstate produces blue
light
 Rare earth elements sensitive to
light in green portion of light
spectrum
 Rare earth elements more efficient
in converting x-ray energy into light
O   
 •ASE

 PHOSPHOR AYER

 REÆ ECTIVE AYER

 PROTECTIVE COATING
• |

 Structural component upon which


other screen elements are applied

 Made of polyester

 Provides rigidity to the screen


||O›| |

 Coating of white titanium dioxide

 Reflects stray light back to x-ray


film

 Increases efficiency and sensitivity

 Contributes to dose reduction


22 |

 Contains phosphor materials that


fluoresce

 Emit visible light when irradiated


 
 ñsed with intensifying screen (film
placed between two intensifying
screens in cassette holder)
 Cassette irradiated, screens
convert x-ray energy into light,
which in turn exposes screen film
 This additional mean of exposing
film = intensifying =decrease
radiation to patient
 Indirect imaging
Ú 
 ñsed to prevent scattered radiation
from reaching film

 Series of narrow lead strips


separated by spaces of low-density
material

 Act as cleaning device to improve


image contrast
 

 Æilm positioned lateral to jaw on
side of patient¶s face to be
examined
 ñsed with children and patients
with limited jaw opening
 Examines posterior region of
mandible
 View fractures, impactions, salivary
stones in floor of mouth

 ateral view of entire skull
 Primary use = cephalometrics:
--assess patient profile
--assist in predicting jaw growth
pattern
--used for measuring arch size
changes
 Can also view fractures and
pathologic conditions
 

 Modification of lateral skull

 ñsed to examine growths,


infections or foreign bodies in
maxillary sinus
2 
 Shows entire skull in posterior-
anterior plane
 Primary use = cephalometrics
--measure skull growth
--observe growth abnormalities
 ñsed to view fractures and
pathologic conditions of skull in
frontal plane
2 
 
 Shows entire mandible in frontal
plane

 ñsed to localize impactions,


fractures and pathologic conditions
2  

 Referred to as Waters View

 •est projection for maxillary sinus

 ñsed to view fractures of maxilla,


malar bone and zygomatic arch

 See structures as if viewer looking
upward from under patient¶s chin

 Can view condylar heads, base of


skull and sphenoid sinus

 ñsed to view fractures and


displacements of zygomatic arch
O 
 Extraoral radiographs of head used
for making skull measurements

 Purpose is to correlate skeletal


growth with tooth development and
position

 ateral skull and posteroanterior


projection of skull most commonly
used in ortho surveys
!  
 ñsed to correlate chronologic age
with:
--skeletal age and development
--dental aged and development
 •ased on principle that these

bones are good indications of


skeletal maturation due to the
many centers of ossification in this
area
 "
 TMJ tomography = radiographic
technique to examine joint

 Other radiographs (pan) will show


the bone and relationship of joint
components only (erosions, bony
deposits)
 

 ñsed for imaging soft tissue
components of TMJ

 Radiopaque die injected into joint


space

 View condyle, glenoid fossa and


joint space
  

 Radiograph taken through or


across the skull or cranium

 indblom technique most common

 Shows glenoid fossa and


relationship to condyle
 


 Examination of salivary gland

 ñses radiopaque dye injected into


ducts

 Initial radiograph taken followed by


successive radiographs to
visualize draining of gland

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