RADIOGRAPHIC

ERRORS AND
ARTIFACTS

Dr. Walid Samir Salem

BDS, MS, MHPE
lecturer, Oral Surgery Department
Member, Dental education unit
Films with errors should be avoided due
to the following reasons:
Retake will lead to:
• Expose the patient to unnecessary
radiation.
• Waste film & time (money).
• Interfere with accurate interpretation
and diagnosis.
Causes of faulty
radiograph
The majority of the errors produced
can be categorized into three groups:
I. Technique & Projection
errors.
II.Exposure errors.
III.Processing errors.
 I. Technique & Projection
errors:
a. Patient preparation error:
•Radiopaque artifact •Blurred
image
•Pressure mark
b. Filmimage
•Double placment artifact:
•Reversed film
•Dot artifact •Apices cut off
•Crown not shown •Dropped film corner
•Area of interest not shown •Black line
•Distortion
c. Projection errors:
•Incorrect vertical angulation.
•Incorrect horizontal angulation
•PID alignment artifact
Technique & Projection errors
a. Patient preparation error

Radiopaque artifact
Dental appliances, body piercings,
jewelry & eye glasses left in the mouth
during exposure will appear as
radiopaque artifact superimposed over
the dental image.
Correction: all this items should be
removed before placing of the
film.
Technique & Projection errors
a. Patient preparation error

Blurred image

Movement of the film, patient or X-ray

tube head during exposure will result
in a blurred image.
Correction: the operator should explain
for the patient & remind him to
remain motionless during exposure.
Technique & Projection errors
a. Patient preparation error:

Pressure mark
Pressure from the incisal edge &
cusps of the teeth (mostly in the
pediatric occlusal radiograph).
May appear black or white.
Correction: ask the patient to bite
gently.
Technique & Projection errors
b. Film placment artifact

Double image
When an exposed film is re-exposed the
resulting film will have 2
superimposed images
Technique & Projection errors
b. Film placment artifact

Reversed film
Low density with herring bone, tire-track
or dotted pattern, as a result of directing
the X-ray through the lead foil side of
the film back.
Technique & Projection errors
b. Film placment artifact

Dot artifact
The identification (embossed) dot produce a
circular radiolucent artifact on the final
radiograph. This may interfere with
interpretation of the apical areas of the
teeth.
Technique & Projection errors
b. Film placment artifact

Apices cut off

Occur when the film is not positioned
apically enough to record the entire tooth.
Technique & Projection errors
b. Film placment artifact

Crown not shown

There is no enough film

extending occlusally.
Technique & Projection errors
b. Film placment artifact

Dropped film corner

The film edge is not placed parallel to
the occlusal surface of the teeth.
Technique & Projection errors
b. Film placment artifact

Area of interest not shown

This is the result of not placing the film to
cover all the teeth in the area of interest
and not centralizing the film over the area
of interest.
Technique & Projection errors
b. Film placment artifact

Black line
Due to excessive bending of the film prior
to its placement inside the patient’s
mouth (pressure causes ionization of
silver halide upon processing will be
darker).
Technique & Projection errors
b. Film placment artifact

Distortion
Due to bending of the film to eliminate
the patient’s discomfort specially in
lower premolar area and upper central
incisors.

normal distortion
Technique & Projection errors
c. Projection errors

Incorrect vertical
angulation
It will lead to:
• Elongated image due to insufficient
v. angulation ( too flat), or
• Shortened image due to excessive v.
angulation ( too steep)
Technique & Projection errors
c. Projection errors
Technique & Projection errors
c. Projection errors
Technique & Projection errors
c. Projection errors

Incorrect horizontal
angulation
Is the appearance of the interproximal
surfaces of the adjacent teeth over each
other. This is due to improper H.A. due to
improper alignment of the C.R. through
the contact points i.e. not // to
interproximal surfaces.
Technique & Projection errors
c. Projection errors
Technique & Projection errors
c. Projection errors

PID alignment artifact

If the PID is misaligned and the x-ray is
not centered over the film, a partial image
is seen on the resultant radiograph, this
partial image is called cone-cut.
It appear as a clear area with curved
outline.
Asuan – Egy.
 II. Exposure errors.

Blank image.
Low density image.
High density
image.
Image with high
and low contrast.
Exposure errors

Blank image
A film that didn’t receive radiation
will have no image and will appear
clear.
Exposure errors

Low density (faint) image

Exposure errors

High density image

 III. Processing errors
Chemical errors: Film Handling errors:
•Light image. •Writing lines
•Dark image. •Developer cut off
•Blank image. •Fixer cut off
•Reticulation. •Overlapped film
•Black spot or patch. •Finger nail artifact
•Black line. •Smudge.
•White spot or patch. •Scratched film
• Yellowish brown •Static electricity
discoloration.
Processing errors
Chemical errors

Reticulation
When the film
subjected to a
sudden temperature
changes between the
developer and water.
Appear as cracked
film.
Processing errors
Chemical errors

Black spot or patch

Developer contamination before

immersion into the developer
solution.
Processing errors
Chemical errors

Black line
Developer contamination
processing hanger clips
Dirty roller in automatic processor
Processing errors
Chemical errors

White spot or patch

Contamination with fixer before
processing
Processing errors
Chemical errors

Yellowish brown discoloration

Exhausted solution or insufficient
rinsing
Processing errors
Film Handling errors

Writing lines
Appear on the radiograph due to writing
on the film packet with ballpoint pen or
lead pencil.
It may appear black or white.

Finger nail artifact

Black or whit crescent shape mark due
to rough handling of the film.
Processing errors
Film Handling errors

Developer cut off

A straight blank white border due to
underdeveloped portion. The film
may not be completely immersed in
the developer solution.
Processing errors
Film Handling errors

Fixer cut off

A straight black border. The film may not
be completely immersed in the developer
solution.
Processing errors
Film Handling errors

Overlapped film
Film that overlap in developer are
white, while that overlap in fixer
are black
Processing errors
Film Handling errors

Smudge (finger print)

When the film touched by fingers
contaminated with developer or
fixer
Processing errors
Film Handling errors

Scratched film

White lines appear on

the film due to
careless handling of
the film.
Processing errors
Film Handling errors

Static electricity
Thin black branching lines Occurs when
two surfaces are rubbed together against
each other vigorously, this creates an
electric charges with visible light emitted
which is capable of exposing the x-ray
film, thus leading to ionization of AgBr
crystals at this area.
Occur most frequently during periods of
low humidity
 Metallic partial
denture

Blurred
 Reverse image

Apices cut off

Dropped corner

Distortion
Horizontal overlap

Elongation

Double image
 Static electricity

Low denisty
White spot or patch

Yellowish brown discoloration

 Reverse image

Developer cut off Cone-cut

Thank You