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Films and Screens
The following slides describe the composition and uses of intraoral and extraoral films and intensifying screens.
Intraoral film is used for (1) bitewing films (named for the tab that sticks out from the side of the film which resembles a wing and on which the patient bites); this film shows the crowns of both maxillary and mandibular teeth on one film; (2) periapical films, which show the entire length of the teeth in either the maxillary or mandibular arch and (3) occlusal films, which are usually exposed at approximately right angles (perpendicular) to the occlusal plane and show broad areas of the teeth and bone.
The bitewing film is used to identify interproximal caries (where the teeth contact each other; black arrows) and the appearance of the alveolar bone (red arrows). The white areas on the film are amalgam restorations.
Periapical Film Periapical means ³around the apex´. Normally. and the condition of the bone surrounding the teeth. This film is also used in endodontic treatment of a tooth. the entire tooth is seen. allowing the identification of root problems. interproximal caries. This film is intended to show the area around the root of the tooth. periapical pathology internal resorption caries .
to locate an object in the buccolingual direction. Impacted maxillary canine Anterior dentition .Occlusal Film The occlusal film is used to identify the extent of larger pathological conditions.Child . to show the developing dentition in children and to image patients with trismus (inability to open the mouth).
Lateral oblique jaw film. Cepahalometric and TMJ (temporomandibular joint). Skull film. These will be discussed briefly in the following slides.Extraoral Film Extraoral films used in Dentistry include the Panoramic. .
both maxillary and mandibular.The panoramic film is the most common extraoral film used in dentistry. It is very helpful for third molar extractions . It does not provide the detail that intraoral films do but it gives an overall view of the entire dentition.
The panoramic film is preferred. .The lateral oblique jaw film can be used to image the third molar region in adults and to show the developing posterior dentition in children. It is only used if a panoramic x-ray machine is not available.
Skull films. This patient had external fixation appliances placed to help expand the bone. . such as this PA (postero-anterior) view. are used to evaluate trauma and developmental problems.
It is also used by oral surgeons for evaluating trauma and conditions requiring surgical correction. This film is used routinely by orthodontists in developing treatment plans for their patients. .Ortho-surg. patient ± jaw realignment Surgery patient. such as the lateral cephs above. are used to identify both the bone and the soft tissue outline on the same film.mandibular implant Cephalometric films.
. the glenoid fossa and the articular eminence. including the head of the condyle.Transcranial film Tomogram Temporomandibular joint (TMJ) films provide information on the components of this joint.
this is called a double-emulsion film. (continued on next slide) . and is also clear. similar to that used in desserts. The silver halide crystals are affected by the x-rays and eventually form the image during film processing. The emulsion contains silver halide crystals which are surrounded by gelatin. The gelatin. allowing light to readily pass through when viewing films. is porous.Film Composition An x-ray film is composed of a plastic (polyester) base covered on both sides with an emulsion. allowing processing chemicals to reach the silver halide crystals.
The emulsion is covered with a thin layer of gelatin.´ which helps to protect the film (yellow lines below).Film Composition (continued) The emulsion (gray lines below) is attached to the base with a very thin layer of adhesive (green lines below). Double emulsion (emusion on both sides) blue-tinted base adhesive supercoat emulsion with silver halide crystals and gelatin . The base has a slight bluish tint which makes viewing the films easier on the eye. a ³supercoat.
Globular (rounded) crystals are used in D-speed (Ultraspeed) film. tabular top view globular tabular side view . these crystals are like small pebbles. The crystals are placed in the emulsion so that the flat surface (top view below) is parallel with the surface of the film.Silver Halide Crystals There are two types of silver halide crystals. Tabular (flat) crystals are used in F-speed (Insight) film and in TMat and Ektavision film.
. a type of electromagnetic radiation along with x-rays. It is exposed when x-rays come in contact with it. also called Ultraspeed. will also expose the film. and F-speed. which is called Insight. There are two types of direct exposure film: D-speed. The film is sealed in a light-tight packet because visible light. The first of these. is used intraorally. Direct Exposure Film.Film Types There are two types of film used in Dentistry.
Film Types (continued) The other type of film is Screen Film. . Screen films are used for extraoral radiographs. they emit light which in turn exposes the film. Using the screen-film combination allows a very large reduction in the amount of radiation needed to expose the film (30-60 times less radiation than that required by direct exposure film). Screen film is made to be especially sensitive to the effects of light from an intensifying screen. When these screens. on either side of the film in a cassette. (The x-rays contribute a very small percentage of the actual exposure of the film). are exposed to x-rays.
It is important to make sure that the correct film is used with whichever type screen is selected. The light emission is usually green or blue.) . etc.Intensifying Screen Function One of the properties of x-rays is that they cause certain materials to fluoresce (emit light). (Blue-sensitive film with blue lightemitting screen. depending on the type of phosphor crystal used. The composition of the films used with these screens is adjusted by the manufacturer to be sensitive to either blue light or green light. the phosphor crystals found in intensifying screens are one of these materials.
The phosphor layer (green line) contains the phosphor crystals that emit the light. which is a thin layer of plastic that protects the phosphor layer from damage when the screens are handled. The surface of the phosphor layer is covered with a protecting coat (white line) . . A reflecting layer (silver line) reflects light emitted by the phosphor back toward the film.Intensifying Screen Composition (this side toward film) The base of the screen (yellow line above) is made of plastic and provides support.
(Click to show interaction of x-rays with phosphor crystals) film = phosphor crystal . which emit blue or green light depending on the type of rare earth material being used.Rare Earth Phosphor The most common type of phosphors being used are the rare earth phosphors.
medium sharpness Detail (Slow): produces the sharpest images but requires the most exposure . The three speeds are: Fast (Rapid): requires the least exposure but the images are less sharp Medium (Par): medium speed.Intensifying Screen Speed The speed of the screen depends on crystal size and the thickness of the phosphor layer (larger crystals and thicker layer increase speed). Image quality decreases as the screen speed increases.
Cassette A cassette holds two intensifying screens (one on each side) in tight contact with the film. The rigid cassette has a layer of foam padding under each screen to assure tight contact with the film. depending on the type of panoramic machine. (See next slide) Rigid metal cassette Flexible vinyl cassette . The cassette is either rigid (metal) or soft (vinyl).
Cassette/Screens/Film x-rays cassette front foam (rigid cassettes) screen support phosphor/coating film phosphor/coating screen support foam (rigid cassettes) cassette back .
Any debris in the cassette (between the screen and film) will result in a white spot on the film (red arrow). The other white spots (green arrows) represent tonsillar calcifications.The surface of the screens must be kept very clean. .
This prevents light from one screen affecting both emulsion layers. (See following slides). which is used to provide an extra film for referral purposes (two films are placed in the cassette at the same time). which is used to provide the best contrast. The advantage of Ektavision film over T-Mat film is that it has anti-crossover layers incorporated into the film. which has the widest latitude (long-scale contrast) and is good for soft tissue visualization and H. L.Screen Film (continued) The two types of screen film used with rare earth screens are T-Mat and Ektavision. These films are available in three styles: G. this produces a sharper image on the film. .
T-Mat (crossover) Light produced by the phosphor crystal spreads out as it goes toward the film and with T-Mat film it affects the emulsion on both sides. Since it has spread out more when it reaches the emulsion on the opposite side of the film (crossover). film . the sharpness (edge detail) of the image is decreased.
X-rays easily pass through this anticrossover layer. These layers allow the light from a phosphor crystal to reach the emulsion on the same side as the crystal but prevent the light from reaching the emulsion on the opposite side of the film. film .Ektavision (anti-crossover) Ektavision film has a crossover control layer on each side of the film base.
# 3: Used for extra-long bitewing films. used for small mouths. # 1: Used for adult anterior periapicals with the paralleling technique. # 2: Used for adult posterior periapicals and bitewings and for children with larger mouths. # 4: Used for occlusal films (primarily adults). also used in anterior region of adults for periapical films taken with bisecting-angle technique. one film covers all teeth on one side of the mouth. may also be used for occlusal films in children. (See next slide for comparative sizes) .Film Sizes (Intraoral) # 0: Used in children for both periapical (PA) and bitewing (BW) films.
BW Occlusal in adults #4 #0 . BW Extra-long BW #2 Child occlusal Adult ant.Adult PA. PA #3 #1 Child PA.
It may be used for lateral oblique jaw films or for transcranial films (used for TMJ views). 5´ x 7´: This size is not often used.Film Sizes (Extraoral) 5´ x 12´ and 6´ x 12´: Both of these films are used in panoramic radiography. . Some machines use 5´ x 12´ and others use 6´ x 12´. skull films and tomograms (TMJ). 8´ x 10´: This size is used for cephalometric films.
.Film Speed The speed of a film represents the amount of radiation required to produce a radiograph of acceptable density. As the speed of the film increases. the middle film below has acceptable density. (Density is the degree of darkening of the film. the amount of radiation needed to properly expose it decreases. The one on the left is too light and the one on the right is too dark).
It has globular crystals. resulting in a 60 % reduction in patient exposure when compared to D-speed film. this slower film produces sharper images.Intraoral Film Speed D-speed (Ultraspeed): Once the most common intraoral film speed used. . less radiation is needed to expose these crystals. they are flat tabular crystals. Because of the larger size. F-speed (Insight): this film has larger silver halide crystals. Technically. improving the diagnostic ability of the film. it is now gradually being replaced by F-speed film.
the less sharp the radiographic image will be. . Extraoral film is always used with intensifying screens. In general. the faster the film. The overall speed of an extraoral film system (film plus screen) is determined by the combined speeds of the film and the screen.Extraoral Film Speed The speed of extraoral film is increased with an increase in the size of the silver halide crystals. screens have different speeds. Like films.
Clinasept Barrier Packets Clinasept barriers are sealed plastic covers that protect intraoral film packets from saliva contamination. the barrier is opened at the notch (see below) and dropped into a bag without touching the film (see next slide). front notch back . After exposing the film.
Removing the clinasept barrier from the film packet and dropping it into the film bag. This helps to assure that the film packet is not contaminated when it is taken to the darkroom for processing. The film packet must not be touched with the gloves that have been in the patient¶s mouth. .
depending on film size. The back side identifies the type of film (by color). the number of films in the packet (also by color). and the location of the identifying dot used for film mounting.Film Packet The x-ray film packet is made of plastic or paper. The cover protects the film from light and moisture. dot # of films in packet #2 plastic #2 plastic #1 paper D-speed (Ultraspeed) tab F-speed (Insight) .
Film: one or two films. . Lead foil: protects film from backscatter (see next slide). strengthens packet. pattern on foil identifies when film is placed backwards (back of film faces teeth). reduces patient exposure. raised dot in one corner used for film orientation.Contents of Film Packet Black paper: surrounds film. protects emulsion.
Scatter (secondary) radiation is produced when the primary x-rays from the x-ray tube interact with the patient¶s hard and soft tissues. Backscatter radiation refers to those scattered x-rays that go ³back´ toward the film. Primary x-rays Scatter (secondary) x-rays .
Opened boxes of screen (extraoral) film need to be kept in light-tight area (darkroom).Film Storage Films should be stored at 50±70 degrees F. need to be cool. Use film before expiration date to avoid film fogging. Storage at high temperatures may result in film fogging. Do not store film in room where radiographs are taken .
.This concludes the section on Films and Screens. you may e-mail me at jaynes. If you have any firstname.lastname@example.org.