BASIC

INTRODUCTION
TO RADIOGRAPHS
& DIGITAL
RADIOGRAPHY
SHAISTA ZAFAR

RADIATI
ON

Radiation is energy that comes

from a source and travels through
space and may be able to
penetrate various materials

DENTAL
RADIOGRAPH
S

Type Of An Image Of The Oral Cavity

Which Results From Penetration Of A
High Energy Electromagnetic
Radiation Through Dense Body
Structures To Form An Image On A
Dental Film

MEASURING UNIT
The
scientific unit of measurement for
radiation dose, commonly referred to
as effective dose, is the microsievert
per hour (mSv/hour)
Intraoral x-ray= 0.005 mSv

GOAL
-Diagnostic information
with minimal exposure

ARE DENTAL
RADIOGRAPHS
SAFE?

INDICATIONS!!!

Loss of tooth structure

Caries(occlusal/proximal)
Non-carious(attrition,fracture)
Periodontal disease;
Endodontic disease
Developmental abnormalities;
Tumors
Trauma
Impacted teeth
Unerupted teeth
Other bone pathologies
Implants

ATTRITION

PROXIMAL CARIES

BONE
LOSS

IMPLANT

DEN

TIG
ER O
CYS
US
TC

DENTINOGENESIS IMPERFECTA

11/25/15

FJDC&H

18

ENDODONT
ICS

11/25/15

FJDC&H

19

RECOMMENDATI
ONS FOR
PRESCRIBING
DENTAL
RADIOGRAPHS

TYPE OF
ENCOUNT
ER

CHILD
(PRIMARY
DENTITIO
N)

CHILD
(TRANSITI
ONAL
DENTITIO
N)

ADOLESC
ENT
(PERM.
DENTITIO
N)

NEW
PATIENT

Periapical/
occlusal or
post.
bitewing

Post.
Bitewing
with either
OPG or
periapical

Post.
Bitewing
with OPG

RECALLED
PATIENT
(with
clinical
caries or
inc.caries
risk)

Post.
Bitewing at
6-12mons
interval

(same)

RECALLED
PATIENT
(with no
clinical
caries or
inc. 11/25/15
caries

Post.
Bitewing at
12-24mon
interval

(same)

(same)

Post.
Bitewing at
18-36mon
interval
FJDC&H

ADULT,
ADULT
DENTATE
EDENTUL
OR
OUS
PARTIALLY
EDENTUL
OUS
(same)

Based on
clinical
signs &
symptoms

Post.
Bitewing at
6-18mons
interval

Post.
Bitewing at
24-36mon
interval

22

RECALL ED
PATIENT
(periodonta
l disease)

Clinical
judgement/
periapical/
bitewing

(same)

Patient for
monitoring
dentofacial
growth/
dento
skeletal
relationshi
p

Clinical
judgement

(same)

Pt. with
Clinical
implants,
judgement
other
dentofacial
pathoses,
restorative/
endodontic
11/25/15
needs,

(same)

(same)

(same)

Clinical
Usually not
judgement/ indicated
panoramic/
periapical

(same)

FJDC&H

(same)

(same)

(same)

23

RADIATION PROTECTION
Use of proper
exposure and
processing
techniques
Patients should
be shielded with
lead aprons and
thyroid shields.
These shields
should have at
least 0.5 mm of
lead equivalent.
Film badges

IMAGE RECEPTORS
RADIOGRAPHIC FILM
DIGITAL RECEPTORS

FILM PACKET
CONTENTS

SIZES
Various sizes available, although only
three are usually used routinely:

For periapical & bitewings

31 X 41 mm
22 X 35 mm

For occlusal
57 X 76 mm

TYPES
TYP

ES

INTRA ORAL
RADIOGRAPHS
Bitewing
Occlusal
Peri apical

BITEWING
So called because patient closes
the teeth together biting on a wing
of card projecting from the tube
side of the film
Demonstrates occlusal
surfaces,inter proximal surfaces of
enamel,enamel-dentine junction &
the bone levels surrounding the
tooth
Used for pre-molars,molars

OCCLUSAL
Utilize the largest intra oral film (6 X
8cm)
Various projections
Maxillary occlusal projections
-Upper standard
-Upper oblique standard
Mandibular occlusal projections
-lower 90 degree occlusal
-lower 45 degree occlusal
-lower oblique occlusal

PERIAPICAL
Shows usually 2-4
teeth,individual teeth & tissues
around apices

INDICATIONS
Detection of apical infection
Assessment of periodontal status
After trauma to teeth & associated

alveolar bone
Assessment of root morphology before

extraction
During endodontics
Detailed evaluation of apical cyst & other
lesion within the bone
Evaluation of implants postoperatively

PARALLELING
TECHNIQUE

BISECTED
ANGLE
TECHNIQUE

PROBLEM
S OF
GAGGING

EXTRA ORAL
RADIOGRAPHS
Oblique lateral
Radiography
Cephalometrics
Tomography
Panoramic radiography

ORTHOPANTOGRAM

ALTERNATIVE AND
SPECIALIZED IMAGING
MODALITIES

Contrast studies
Radioisotope
imaging(nuclear medicine)
Computed tomography
Cone beam CT (CBCT)
Ultrasoud
Magnetic Resonance

SIALOGRAPHY

SIALOG
RAPHY

COMPUTED TOMOGRAPHY(CT)
INDICATIONS
Intracranial disease e.g:
tumors,haemorrhage,infarcts
Assessment of fracture involving cranial
base,orbits,naso-ethmoidal complex
Assessment of size & extent of cyst
Tumor staging
Investigation of TMJ,osteomyelitis
Pre-operative assessment of maxillary
and mandibular alveolar height

CBCT

DIGITAL
RADIOGRAPHY

 Dental radiographs produced

with a special computer
create digital images
(computerized dental
radiographs) that can be
displayed and enhanced on
the computer monitor.
It involves the use of a
radiography machine like that
used for conventional xrays.
But instead of using films, the
clinician makes digital images
using a small electronic
sensor or an image receptor
placed in mouth to capture
the image.

Accepted?
Radiation Source?
Ordering Dental radiographs?
Operator Location?
Advantages?
Disadvantages?

ADVANTAGES
requires 50-80% dose reduction
No films,no dark room,no chemical are
needed
No lead foil waste generated
Digital images can be magnified
Friendly

DISADVANTAGES
Cost
Infection control

CORRECT TERMINOLOGY
One examines a radiograph and not
an x-ray, bear in mind that xray
cannot be seen
One does not see infection at the
apex of a tooth
radiolucency/opacity
Periodontal bone loss is not
periodontitis
In radiologic terminology PA is a
postero-anterior view

COMMON QUESTIONS ASKED BY A PT

Are regular scans and xrays

necessary?
If the period of time between
them could be lengthened?
Are dental x-rays safe for a
pregnant women?
Estimated risk for cancer?

REFERENCES
Essentials of Dental
Radiography & Radiology
ERIC WHAITES (by
Roderick Cawson)
Images from GOOGLE

I'm always amazed to hear of air

crash victims so badly mutilated that
they have to be identified by their
dental records. What I can't
understand is, if they don't know
who you are, how do they know who
your dentist is?

THANKYO
U
-Paul Merton