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SHAISTA ZAFAR
BASIC INTRODUCTION TO
RADIOGRAPHS & DIGITAL RADIOGRAPHY
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RADIATIONRadiation is energy that comes from a source and travels through space and may be able to
penetrate various materials
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DENTAL RADIOGRAPHS
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
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MEASURING UNITThe
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
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GOAL
-Diagnostic informationwith minimal exposure
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ARE DENTAL RADIOGRAPHS SAFE?
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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
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ATTRITION
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PROXIMAL CARIES
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BONE LOSS
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IMPLANT
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DENTIGEROUS CYSTC
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04/22/2023 FJDC&H 18
DENTINOGENESIS IMPERFECTA
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04/22/2023 FJDC&H 19
ENDODONTICS
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RECOMMENDATIONS FOR
PRESCRIBING DENTAL
RADIOGRAPHS
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04/22/2023 FJDC&H 22
TYPE OF ENCOUNTER
CHILD (PRIMARY DENTITION)
CHILD (TRANSITIONAL DENTITION)
ADOLESCENT (PERM. DENTITION)
ADULT, DENTATE OR PARTIALLY EDENTULOUS
ADULT EDENTULOUS
NEW PATIENT Periapical/ occlusal or post. bitewing
Post. Bitewing with either OPG or periapical
Post. Bitewing with OPG
(same) Based on clinical signs & symptoms
RECALLED PATIENT (with clinical caries or inc.caries risk)
Post. Bitewing at 6-12mons interval
(same) (same) Post. Bitewing at 6-18mons interval
_
RECALLED PATIENT (with no clinical caries or inc. caries risk
Post. Bitewing at 12-24mon interval
(same) Post. Bitewing at 18-36mon interval
Post. Bitewing at 24-36mon interval
_
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04/22/2023 FJDC&H 23
RECALL ED PATIENT (periodontal disease)
Clinical judgement/ periapical/ bitewing
(same) (same) (same) _
Patient for monitoring dentofacial growth/ dento skeletal relationship
Clinical judgement
(same) Clinical judgement/ panoramic/ periapical
Usually not indicated
(same)
Pt. with implants, other dentofacial pathoses, restorative/endodonticneeds, treated periodontal disease.
Clinical judgement
(same) (same) (same) (same)
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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
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IMAGE RECEPTORS• RADIOGRAPHIC FILM• DIGITAL RECEPTORS
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FILM PACKET CONTENTS
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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
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TYPES
INTRA ORAL RADIOGRAPHSEXTRA ORAL RADIOGRAPHS
TYPES
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INTRA ORAL RADIOGRAPHS
• Bitewing• Occlusal• Peri apical
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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• indications:DC,assessment of fillings &
crown,periodontology
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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
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PERIAPICAL• Shows usually 2-4 teeth,individual teeth &
tissues around apices
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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
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PARALLELING TECHNIQUE
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BISECTED ANGLE TECHNIQUE
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PROBLEMS OF GAGGING
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EXTRA ORAL RADIOGRAPHS
• Oblique lateral Radiography• Cephalometrics• Tomography• Panoramic radiography
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ORTHOPANTOGRAM
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ALTERNATIVE AND SPECIALIZED IMAGING MODALITIES
• Contrast studies• Radioisotope imaging(nuclear
medicine)• Computed tomography• Cone beam CT (CBCT)• Ultrasoud• Magnetic Resonance
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• SIALOGRAPHY
SIALOGRAPHY
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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
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CBCT
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DIGITAL RADIOGRAPHY
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• 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.
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• Accepted?• Radiation Source?• Ordering Dental radiographs?• Operator Location?• Advantages?• Disadvantages?
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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
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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
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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?
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REFERENCES• Essentials of Dental Radiography &
Radiology ERIC WHAITES (by Roderick Cawson)• Images from GOOGLE
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THANKYOU
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? -Paul Merton