dental radiographs

Collimator

  • Definition: A collimator is a device that narrows a beam of particles or waves. In dental x-ray procedures, it is a tube that helps control the size and shape of the x-ray beam.

  • Types:

    • Round Collimator: Circular tube form.

    • Rectangular Collimator: Reduces patient exposure by approximately 40%.

  • Function: Placed on the area of interest on the x-ray film. Reduces patient radiation exposure by filtering out unnecessary x rays.

Intensifying Screen

  • Definition: An intensifying screen is used in conjunction with x-ray films to reduce patient exposure.

  • Usage: Typically utilized during extraoral x-rays, especially with Digital Panoramic Tomography (DPT).

  • Functionality: Enhances the effect of the x-ray beam and allows for lower exposures.

Types of Dental X-rays

  • Intraoral X-rays:

    • IOP (Intraoral Periapical): Focuses on specific teeth, useful for root canal treatment and diagnostic purposes.

    • Bitewing: Shows interproximal caries and helps visualize bone levels between teeth.

    • Anterior Occlusal X-rays: Used to detect supernumerary teeth and evaluate the anterior region of the mouth.

  • Extraoral X-rays:

    • OPG (Orthopantomogram) or Panoramic X-ray: Shows a broad view of the jaws and teeth. Commonly used in orthodontics.

    • Lateral Cephalogram: Orthodontic x-ray used to evaluate the jaw relationship and facial growth patterns.

    • Lateral Oblique: Provides an image of the mandible from an oblique angle.

Dental X-ray Machines

  • OPG Machine: Used to create panoramic images.

  • CT Scanning: Produces cross-sectional images, useful for detailed evaluation.

  • CBCT (Cone Beam Computed Tomography): A specialized CT that provides 3D images with less radiation, suitable for implants and orthodontics.

Regulations and Safety in Radiology

  • IRMER: Ionizing Radiation (Medical Exposure) Regulations. Laws governing x-ray facilities to protect staff and patients.

  • IRR: Ionizing Radiation Regulations. Focus on safe practices in handling radiation.

  • ALARA Principle: "As Low As Reasonably Achievable". Aim to minimize radiation exposure.

Radiographic Errors

  • Types of Errors:

    • Foreign Body Artifact: Caused by forgetting to remove dental appliances, jewelry, etc., before imaging.

    • Blurred Image: Occurs from patient movement or incorrect collimation during the exposure.

    • Reverse Film Error: Occurs when the film is placed backward in the holder; results in low-density images with lead foil markings.

    • Cone Cut: Happens when the collimator isn't aligned with the x-ray film.

    • Incorrect Vertical/Horizontal Angulation: Can lead to overly long or short images and overlapping due to improper positioning of the x-ray beam.

Film Processing Steps

  1. Developer Solution:

    • Temperature: 18-22°C.

    • Time: 4-5 minutes.

    • Reduces silver halide crystals to form a dark image.

  2. Water Bath: 8-10 seconds to rinse excess developer.

  3. Fixer Solution: 8-10 minutes to remove unsensitized crystals, resulting in a clear film.

  4. Final Water Rinse: 10-15 minutes to remove excess chemicals.

Film Composition and Functionality

  • Outer Envelope: Protects the film.

  • Lead Foil: Prevents backscattered radiation which might otherwise create fog on the image.

  • Black Papers: Protect the film from light.

  • Image Formation: Created by the sensitive silver halide crystals inside the film.

Key Concepts in Radiology

  • Optimization: Refers to minimizing radiation exposure while achieving quality diagnostic images.

  • Controlled Zone: Area around the radiation source that should be approximately 2 meters to ensure safety.

Treatment of Radiographic Issues

  • Handling Radiation Contamination: Understanding contamination leads to safety protocols during procedures.

  • Genetic Mutation Risk: Explained due to unnecessary radiation exposure, highlighting patient care importance.

Summary of Important Regulations

  • RPA (Radiation Protection Advisor): Provides advice on safe use of radiography.

  • RPS (Radiation Protection Supervisor): Ensures compliance with safety measures in radiographic imaging.