DENTAL RADIOGRAPHS

(X-RAY FILMS)
Definition:

It is the image receptors which

receive or record the image of
dental structures after exposure
to x-ray photons as it is sensitive
to ionizing radiation
 Film Types
● Direct exposure film:
Is used for intraoral radiography & it is
sensitive to x-ray.

● Indirect exposure film (Screen film:

Is used for extraoral projection & it is
sensitive to light.
Components of dental x-ray film

s composed of two principle

components:

(1) The film base

(2) The emulsion
Film base:
● It is a transparent blue tinted base (0.18 mm).
● It casts no pattern on the resultant radiograph.
● The slight blue tint improves viewing of the
diagnostic details.
● It is made of cellulose acetate which is less
inflammable & dimensional stable during processing.
● Now, it is made of polyester polyethelene
terephthalate plastic material which is more flexible.
● The film base should withstand exposure to
processing solutions without being distored.
Base Function:
(1) It gives stiffness, flatness &
rigidity to the film.
(2) It is transparent to permit clear
visualization of the image.
(3) It acts as scaffold that supports
the delicate emulsion layer on
both sides.
Emulsion layer:
● It is sensitive to x-ray & light and
record the radiographic image
(photographic suspension).
● It is composed of two components:
1- Silver halide crystals
2- Gelatin matrix
The emulsion is coated on both sides of
the base to increase the film speed &
prevent its curling.
● Silver halide crystals are made up of
approximately 95% silver bromide & 5%
silver iodide crystals embedded in gelatin.

● These crystals are irregular in shape &

responsible for recording the image as
they are sensitive to x-ray photons which
cause depolarization of silver from
bromide forming latent or invisible image.
● Gelatin matrix is a natural material
made of cattle & provides a homogencity
to crystals & prevents its detachment.
● It can withstand temperature of the
processing solution without interfering
the distribution of crystals.
● It also has the property of changing
from gel to sole to allow chemicals to
reach the crystals during developing & can
be harden during fixation.
● Emulsion layer is coated to the base by
a very thin layer of adhesive material
(subcoating layer).
● Emulsion layer is also covered by a thin
layer of gelatin which is clear & protects
the emulsion from mechanical damage
during handling of the film and protect
the recorded image (protective or
supercoating layer).
● X-ray film is sensitive to x-ray, light,
chemicals & mechanical pressure.
 Film Composition

double emulsion adhesive

blue-tinted base
(emusion on both sides)

supercoat
adhesive
emulsion with silver
halide crystals and
supercoat gelatin
●Intraoral films are small in size placed
inside the mouth during exposure, so
they are placed in a packet which is
made of a plastic material or cardboard
pebbled paper.
●The back of the packet has a colored
tap to allow opening of the packet.
●The corners are rounded and smooth
to avoid traumatization of the oral
mucosa.
● One corner of the film has a little
embossed dot which is mechanically
compressed during manufacturing.It has
a convex & concave aspects.
● The convexity is always placed toward
the x-ray tube & the concavity is toward
the patient’s tongue.
● It must be away from any anatomical land
marks (above or below the edges of the lower
or upper teeth, respectively). It is used for film
orientation to know left from right side after
processing.
 Contents of Film Packet
Black paper: surrounds film;
protects it from light.

Film: one or two films (second film serves as a

duplicate record for sending to colleague or
insurance company.
Raised dot in one corner used for film orientation.

Lead foil: placed behind the film.

(1) Provides rigidity of the film.
(2) Protects adjacent tissues from 2ry
radiation comes from the exposed object so
reduces patient exposure.
(3) Shields the film from backscattered
radiation comes from surrounding soft
tissues, so prevents fogging film.
Film Speed or Sensitivity
Represents the amount of radiation required
to produce a radiograph of acceptable density.
It depends on the crystals size & thickness of
emulsion. Film speed increased with larger
silver halide crystals & thicker emulsion.

Too light Proper density Too dark

A-speed(slow, regular) has small sized
crystals & single coated emulsion on one
side of the base.

B-speed(medium, radiatized) has small

sized crystals & double coated emulsion
to reduce the dose to the half.

Both types give more details but also

more hazards as they need more exposure
time & more x-ray (not used now).
C-speed(fast)
has larger sized crystals&double
coated emulsion. It gives less details
& less hazards

D-speed(Ultra-speed)
has globular or rounded crystals
(more larger) & double coated
emulsion so gives less details & less
hazards.
E-speed (Ektaspeed)

has been discontinued by Kodak

F-speed (Insight)
has the largest silver halide crystals.
Tabular crystals (flat) provides 60%
less exposure than D-speed.
 tabular globular

top

side

Tabular (flat) crystals with F-speed film

(Insight)
Globular (rounded) crystals with D-speed
film (Ultraspeed)
The tabular (T) grains are oriented with their relatively large, flat surfaces
facing the radiation source, providing a larger cross-section (target) and
resulting in increased speed without loss of sharpness
Types of intraoral films:
Periapical

Bitewing

Occlusal
 Periapical Film
periapical pathology

It is so called because x-ray

beam passes through the
apex during exposure
internal
showing the entire tooth resorption
length with its apical area &
surrounding structures.

caries
 plastic dot paper

# of films
in packet
#2 #2 #1
tab
D-speed F-speed
(Ultraspeed) (Insight)
It is used in :

●Routine x-ray examination & periodic

follow up.
●Detection of apical pathology.
●Periodontal evaluation.
●Caries detection.
●Endodontic treatment.
●Assessment of root morphology.
 Bitewing Film
● It is so called because
the film packet has a
tab on which the pt. bite
during exposure.
● This tab is either
ready made or made by
adding the wing on the
tube side of the packet .

Bitewing Films – TAB &

LOOP
 Bitewing Film

● It records the
coronal 2/3 of both
upper & lower teeth in
one exposure.
It is used in:
●Detection of initial interproximal caries.
●Detection of initial periodontal dis.
(alveolar bone crest).
●Detection of overhanging restoration.
●Detection of the size of pulp chamber.
●Determine the relationship of deciduous
to permanent teeth.
 Occlusal Film
● It is so called as the film is placed on
occlusal surfaces of teeth.
It is used in:
●Detection of salivary stones (sialolith).
●Detection of foreign bodies & remaining roots.
●Determination of bucco-lingual relations of gross
pathologic lesions, fractures, impacted &
supernumerary teeth.
●Evaluation of developing anterior teeth.
●Examination of patients with trismus
 Film Sizes (Intraoral)
# 0 (22x35 mm): Children (PA & BW); small mouths
# 1 (24x40 mm): Adult anterior (PA) (Paralleling technique)
# 2 (31x41) mm) standard film: Adult anterior (PA)
(Bisecting technique); adult posterior (PA & BW);
pedo-occlusal which is used for children.
# 3: Extra long (BW)
(record 5 teeth used in premolar molar region)
# 4 (57x76 mm): Adult Occlusal
#2 #3

#1
#4
#0
Extraoral Film
Panoramic
Lateral Jaw
Skull films
Cephalometric
TMJ
Panoramic Film
Lateral Jaw Film
Skull Film
Cephalometric Film
 TMJ Films

condyle
 Indications of extraoral films:
●Evaluation of large areas of skull & jaws.
●Evaluation of bony & soft tissues of facial
profile.
●Evaluation of sinuses & TMJ area.
●Evaluation of growth & development.
●Evaluation of impacted,supernumerary &
unerupted teeth.
●Evaluation of trauma, fractures &
loclization of foreign bodies.
●Detection of diseases & lesions of the
jaws.
●Detection of the extent of large lesions.
●In cases of trismus.
 Film Sizes (Extraoral)
•13 x 18 cm (5 x 7 inch):
•lateral oblique jaw

•20 x 25 cm (8 x 10 inch):
Skull, cephalometric

•57 x 76 mm:
•Size 4 occlusal film may be used for some
extraoral exposures as lateral jaw projection
(non-screen film & more exposure time).
 Screen Film
• Used extraorally.

• Sensitive to light.

• Used with intensifying

screens.
 Idea
● These films record hard bony structures, so they
need more x-ray & exposure time.
● This will produce a biologic damaging effect
especially on the brain.
● Therefore, intensifying screens are placed with
the film. These screens are sensitive to x-ray &
emit visible light which expose the film (indirect
action film).
● Intensifying screens are not used intraorally with
periapical or occlusal films because their use
would reduce the resolution of the resulting image
below that necessary for diagnosis of much dental
diseases.
 Intensifying Screen Function
● Converts x-ray energy into light energy
(fluorescence) which in turn exposes film.
● Silver halide crystals are inherently sensitive to
ultraviolet (UV) and blue light (300 to 500 nm) and
thus are sensitive to screens that emit UV and blue
light.
● When films are used with screens that emit green
light (rare earth elements), the silver halide crystals
are coated with sensitizing dyes to increase
absorption of green light.
● Screen/film combination uses 10-60 times less
radiation than direct exposure film.
● Contemporary screen films use
tabular-shaped (flat) grains of silver
halide to capture the image.
● The tabular grains are oriented with
their relatively large flat surfaces
facing the radiation source, providing
a larger cross-section target and
resulting in increased speed without
loss of sharpness.
Two intesifying screens are used:
● One is placed in the front of the film &
absorb low energy x-ray photons (long W.L.).
● The other one is placed behind the film &
absorbs high energy photons (short W.L.) .
 Film Storage
● Store at (dry cool area).
Storage at high temperatures may result in
film fogging.
● Opened boxes of screen (extraoral) film must
be kept in light-tight area (darkroom); (dry cool
area) (orange paper placed between each 2
films to avoid static electricity on rapid
removal of the film).
● Use film before expiration date to avoid film
fogging.
● Do not store film in room where radiographs
are taken (lead-lined container).
● Stored away from chemical fumes.
Careful handling to avoid scratching.
Regular cleaning.
Regular check for film-screen contact.
Thank you