Chapter1 FOUNDATIONS

Matter
• is anything that has mass and occupies space.
Atom
• is the basic unit of all matter.

consists of a nucleus containing

1. protons and
2. neutrons, and
3. electrons that are bound to the nucleus by electrostatic forces.
Schematic View of an Oxygen Atom

A. Bohr Model
B. quantum mechanical model (3D)
Ionization
-process of forming an ion pair is termed ionization
ionizing radiations.

• High-energy particles, x-rays, and ultraviolet

• radiation have sufficient energy to displace electrons from their orbitals and ionize atoms.

nonionizing radiations.
• visible light, infrared and microwave radiations, and radio waves
• do not have sufficient energy to remove bound electrons from their orbitals
Radiation is the
transmission of may occur in
energy through two forms:
space and •electromagnetic
matter.
•particulate
• Quantum Theory = considers electromagnetic radiation as small
discrete bundles of energy called photons.

•
>travels at the speed of light and
>specific amount of energy,

unit electron volt (eV).

Wave theory - propagated in the form of waves
All electromagnetic waves travel at
the velocity of light (c = 3.0 × 108
m/s) in a vacuum.

Waves are described in terms of

their
1. wavelength (λ, meters) and
2. frequency (ν, cycles per second,
hertz).

• Radiation in bulk
Photons with shorter wavelengths have higher energy.
Small atom
Large atom

Break > RELEASE :

alpha, beta = another element
gamma rays = gamma decay

RADIOACTIVITY
Xray machine
X-ray machines produce x-rays that pass through a patient's
tissues and strike a digital receptor or film to make a
radiographic image

The primary components

• x-ray tube and its
• power supply, positioned within the tube head.

For intraoral x-ray units, the tube head is typically supported by

an arm that is usually mounted on a wall

A control panel :
1. duration of the exposure
2. the energy and exposure rate of the x-ray beam.
An x-ray tube is composed of a cathode and an anode situated within an evacuated glass envelope or tube

The Anode is the negative or reducing electrode that releases electrons to

ANODE – negative the external circuit and oxidizes during and electrochemical reaction.
The Cathode is the positive or oxidizing electrode that acquires electrons
Cathode -positive from the external circuit and is reduced during the electrochemical
reaction
The cathode in an x-ray tube consists of a
1. filament and a
2. focusing cup.

The filament
• source of electrons
• a coil of tungsten wire > 2 mm in diameter
and 1 cm or less in length.
• contain approximately 1% thorium > release
of electrons from the heated wire.
• heated to incandescence with a low-voltage
source and emits electrons at a rate
proportional to the temperature of the
filament.
Anode
The anode in an x-ray tube consists of a
tungsten target embedded in a copper stem

The purpose of the target in an x-ray tube is

to convert the kinetic energy of the colliding
electrons into x-ray photons.

The conversion of the kinetic energy of the

electrons into x-ray photons is an inefficient
process, with more than 99% of the electron
kinetic energy converted
to heat.
 Why TUNGSTEN?
High atomic number (74), allows for efficient xray production
High melting point (3422°C) to withstand heat produced during x-
ray production.
High thermal conductivity to dissipate the heat produced away
(173 W m−1 K−1) from the target.
Low vapor pressure at the working temperatures of an x-
ray tube, to help maintain vacuum in
the tube at
high operating temperatures.

The tungsten target is typically embedded in a large block of copper which functions as a thermal conductor to
remove heat from the tungsten, reducing the risk of the target melting.
Power Supply
The x-ray tube and two transformers lie within an electrically grounded metal
housing called the head of the x-ray machine.

Functions:
1. Provide a low-voltage current to heat the x-ray tube Filament

2. Generate a high potential difference to accelerate electrons from the

cathode to the focal spot on the anode
Timer
A timer is built into the high-voltage circuit to control the
duration of the x-ray exposure).

The electronic timer controls the length of time that

high voltage is applied to the tube and thus the time
during which x-rays are produced.
Xray protection : ALARA [ As Low As Reasonably Achievable]
t protection Staff protection
Patient Protection:
1- Radiographs are only taken when necessary [ there should be a clinical indication]
2- Use high output DC x- ray generators
3- Minimum kilovoltage = 60kV
4- Minimum milliamperage = 8 mA
5- Minimum filtration = 1.5 mm Al
6- Maximum Beam diameter should be 7 cm + Use rectangular collimation for intra oral films
7- Minimum target – skin distance should be 20 cm
9- Use film holders and beam-aiming devices
10- Avoid retakes, master radiographic techniques
11- Use lead aprons + thyroid collars

Staff Protection
1- Never hold the x- ray head / film during exposure
2- Never stand in the path of the primary beam
3- Stand behind a lead barrier (2 mm thickness)
4- Stand minimum 2 M from the x-ray beam behind the patient’s head
Production of X Rays
Most high-speed electrons traveling from the filament to the target interact with target electrons and
release their energy as heat.

Occasionally, the electron’s kinetic energy is converted into x-ray photons by the formation of
bremsstrahlung radiation and characteristic radiation.

Bremsstrahlung photons
• primary source of radiation from an x-ray tube.
• Bremsstrahlung means “braking radiation”

Characteristic radiation
• contributes only a small fraction of the photons in an xray beam.
• It is made when an incident electron ejects an inner electron from the
tungsten atom.
Factors Controlling the X-Ray Beam
Exposure Time
Milliamperage Setting (mA, Tube Current)
Tube Voltage Peak (kVp)
Filtration
• measured in fractions of a second.
• modifies the duration of the exposure and thus the
number of photons generated
• directly proportional to the milliamperage setting.
• As the mA setting is increased, more power is applied
to the filament, which heats up and releases more
electrons that collide with the target to produce
radiation.
• Increasing the kVp increases the potential difference
between the cathode and the anode, increasing the
kinetic energy of the electrons as they move toward
the target.
• The greater the energy of an electron, the greater the
probability it will be converted into x-ray photons at
the target.
• removes low-energy photons from the beam but
allows high-energy photons that contribute to making
an image to pass through.
Factors Controlling the X-Ray Beam
Collimation • metallic barrier with an aperture in the middle used
to shape and restrict the size of the x-ray beam and
the volume of tissue irradiated.
• Collimators also improve image quality.
Inverse Square Law • The intensity of an x-ray beam varies with distance
from the focal spot.
• The reason for this decrease in intensity is that an x-
ray beam spreads out as it moves from its source.
Practical Applications
• distance between the x-ray tube and the patient,
• switching from a machine with a short aiming tube to one with a long aiming tube,
• has a marked effect on beam intensity.
• Such a change requires a corresponding modification of the kVp or mA to maintain the same intensity
at the image receptor.
• Increasing operator distance from the x-ray source is an effective method to minimize operator dose
Biologic Effects of Ionizing
Radiation
Biologic effects of ionizing radiation occur through direct
and indirect actions
Direct Effects
• Biologic molecules absorbs energy from ionizing radiation
and form unstable free radicals

Indirect effects
• Are effects in which hydrogen and hydroxyl free radicals,
produced by the action of radiation on water interact
with organic molecules. Reactions results to formation of
organic free radicals.
Deoxyribonucleic Acid and Chromosomal
Damage and Damage Response

Damage to a cell's deoxyribonucleic acid (DNA) is the primary cause of

radiation-induced cell death, heritable mutations, and carcinogenesis.

Ionizing radiations, via production of free radicals, produce many different types
of alterations in DNA, including:
• Base damage
• Single-strand breaks
• Double-strand breaks
• DNA-DNA and DNA-protein cross-links
 Cell Killing

MITOTIC DEATH
• The predominant mode of radiation-induced cell killing is
mitotic death (or mitotic catastrophe), resulting from
lethal chromosomal and chromatid aberrations

• A cell's sensitivity to this mode of death is determined

by its mitotic rate and degree of differentiation
***rapidly dividing cells will be more radiosensitive and postmitotic specialized cells will be
most radioresistant; it holds true for most cell types.
APOPTOSIS
-self destruction
is the predominant mode of radiation-
induced death.

-In this mechanism, radiation damage

induces a programmed cascade of events
that rapidly causes cell death within hours
after radiation exposure.

Unlike mitotic death, apoptotic death does not require the cell to undergo mitosis, and the cell
dies in interphase.
Radiotherapy Involving the Oral Cavity
Oral Mucusa
Taste Buds
Salivary Glands
Radiation Caries
Teeth
Bone
Musculature
 ORAL
COMPLICATIONS