Exposure of extraoral films such as panoramic radiographs requires intensifying screens to minimize radiation exposure to patients. The intensifying screen consists of layers of phosphor crystals that fluoresce when exposed to radiation. In addition to the radiation incident on the film, the film is exposed primarily to the light emitted from the intensifying screen. Previous generations of intensifying screens were composed of phosphors such as calcium tungstate.
Rare-earth film systems, combined with a high-speed film of or greater, can be used for panoramic radiographs. Digital imaging provides an opportunity to further reduce the radiation dose by 40 to 60 percent.
Basic Guide to Dental Radiography (Basic Guide Dentistry Series) [D…
The plate is then scanned and the scanner transmits the image to the computer. Holders that align the receptor precisely with the collimated beam are recommended for periapical and bitewing radiographs. Heat-sterilizable or disposable intraoral radiograph receptor-holding devices are recommended for optimal infection control. Collimation limits the amount of radiation, both primary and scattered, to which the patient is exposed. An added benefit of rectangular collimation is an improvement in contrast as a result of a reduction in fogging caused by secondary and scattered radiation.
The position-indicating device should be open ended and have a metallic lining to restrict the primary beam and reduce the tissue volume exposed to radiation. The operating potential of dental x-ray units affects the radiation dose and backscatter radiation. Lower voltages produce higher-contrast images and higher entrance skin doses, and lower deep-tissue doses and levels of backscatter radiation.
Vital guide to radiography and radiation protection
However, higher voltages produce lower contrast images that enable better separation of objects with differing densities. Thus, the diagnostic purposes of the radiograph should be used to determine the selection of kilovolt setting. A setting above 90 kV p will increase the patient dose and should not be used. Filmless technology is much more forgiving to overexposure often resulting in unnecessary radiation exposure. Facilities should strive to set the x-ray unit exposure timer to the lowest setting providing an image of diagnostic quality.
Imaging plates should be evaluated at least monthly and cleaned as necessary. If all the recommendations for limiting radiation exposure are put into practice, the gonadal radiation dose will not be significantly affected by use of abdominal shielding. All protective shields should be evaluated for damage e. Proper education and training in patient positioning is necessary to ensure that panoramic radiographs are of diagnostic quality. Although dental professionals receive less exposure to ionizing radiation than do other occupationally exposed health care workers, 75,86 operator protection measures are essential to minimize exposure.
Operator protection measures include education, the implementation of a radiation protection program, occupational radiation exposure limits, recommendations for personal dosimeters and the use of barrier shielding. Pregnant dental personnel operating x-ray equipment should use personal dosimeters, regardless of anticipated exposure levels. Operators of radiographic equipment should use barrier protection when possible, and barriers should ideally contain a leaded glass window to enable the operator to view the patient during exposure. The hand-held exposure device is activated by a trigger on the handle of the device.
However, dosimetry studies indicate that these hand-held devices present no greater radiation risk than standard dental radiographic units to the patient or the operator. These include: 1. If the hand-held device is operated without the ring shield in place, it is recommended that the operator wear a lead apron. All operators of hand-held units should be instructed on their proper storage.
Due to the portable nature of these devices, they should be secured properly when not in use to prevent accidental damage, theft, or operation by an unauthorized user. Hand-held units should be stored in locked cabinets, locked storage rooms, or locked work areas when not under the direct supervision of an individual authorized to use them. Units with user-removable batteries should be stored with the batteries removed.
Records listing the names of approved individuals who are granted access and use privileges should be prepared and kept current.
All film should be processed following the film and processer manufacturer recommendations. Once this is achieved, the x-ray operator can adjust the tube current and time and establish a technique that will provide consistent dental radiographs of diagnostic quality. Poor processing technique, including sight-developing, most often results in underdeveloped films, forcing the x-ray operator to increase the dose to compensate, resulting in patient and personnel being exposed to unnecessary radiation.
A safelight does not provide completely safe exposure for an indefinite period of time. Extraoral film is much more sensitive to fogging. Quality assurance protocols for the x-ray unit, imaging receptor, film processing, dark room, and patient shielding should be developed and implemented for each dental health care setting. A qualified expert should survey all x- ray units on their placement and should resurvey the equipment every four years or after any changes that may affect the radiation exposure of the operator and others.
The film processor should be evaluated at its initial installation and on a monthly basis afterward. The processing chemistry should be evaluated daily, and each type of film should be evaluated monthly or when a new box or batch of film is opened. Table 2 lists specific methods of quality assurance procedures, covering not only inspection of the x-ray unit itself but also of the film processor, the image receptor devices, the darkroom and abdominal shielding and collars.
Technique charts should be used for all systems with adjustable settings, such as tube potential, tube current, and time or pulses. The purpose of using the charts is to control the amount of radiation to the patient and receptor. Technique charts are tables that indicate appropriate settings on the x-ray unit for a specific anatomical area and will ensure the least amount of radiation exposure to produce a consistently good-quality radiograph. Technique charts for intraoral and extraoral radiography should list the type of exam, the patient size small, medium, large for adults and a pediatric setting.
The speed of film used, or use of a digital receptor, should also be listed on the technique chart. The chart should be posted near the control panel where the technique is adjusted for each x-ray unit. A technique chart that is regularly updated should be developed for each x-ray unit. The charts will also need to be updated when a different film or sensor, new unit, or new screens are used. Dentists should be prepared to discuss with their patients the benefits and risks of the x-ray exam. Method 1: Sensitometry and Densitometry A sensitometer is used to expose a film, followed by standard processing of the film.
The processed film will have a defined pattern of optical densities. The densities are measured with a densitometer. The densitometer measurements are compared to the densities of films exposed and processed under ideal conditions. A change in densitometer values indicates a problem with either the development time, temperature or the developer solutions.
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Method 2: Reference Film A film exposed and processed under ideal conditions is attached to the corner of a view box as a reference film. Subsequent films are compared with the reference film. Visual inspection of cassette integrity Examination of intensifying screen for scratches Development of an unexposed film that has been in the cassette exposed to normal lighting for one hour or more.
Where permitted by law, auxiliary dental personnel can perform intraoral and extraoral imaging. Practitioners should remain informed about safety updates and the availability of new equipment, supplies and techniques that could further improve the diagnostic quality of radiographs and decrease radiation exposure. Free training materials are available for limiting radiation exposure in dental imaging through the International Atomic Energy Agency.
This information should guide the dentist in the determination of the type of imaging to be used, the frequency of its use, and the number of images to obtain. Radiographs should be taken only when there is an expectation that the diagnostic yield will affect patient care. Dentists should develop and implement a radiation protection program in their offices.
In addition, practitioners should remain informed on safety updates and the availability of new equipment, supplies, and techniques that could further improve the diagnostic ability of radiographs and decrease exposure. The use of cone-beam computed tomography in dentistry.
J Am Dent Assoc ; 8 A comparison of the accuracy of digital and conventional radiography in the diagnosis of recurrent caries. J Contemp Dent Pract ;11 6 :E Diagnostic accuracy of different imaging modalities in detection of proximal caries. Dentomaxillofac Radiol ;39 8 In vitro comparison of digital and conventional bitewing radiographs for the detection of approximal caries in primary teeth exposed and viewed by a new wireless handheld unit. Dentomaxillofac Radiol ;39 2 Utility and effectiveness of computer- aided diagnosis of dental caries.
Gen Dent ;59 2 Assessing the FDA guidelines for ordering dental radiographs.
J Am Dent Assoc ; 10 Efficacy of the FDA selection criteria for radiographic assessment of the periodontium. J Dent Res ;74 7 The prescription and timing of bitewing radiography in the diagnosis and management of dental caries: contemporary recommendations. Br Dent J ; 6 Hintze H. Screening with conventional and digital bite-wing radiography compared to clinical examination alone for caries detection in low-risk children.
Caries Res ;27 6 Hintze H, Wenzel A. Clinically undetected dental caries assessed by bitewing screening in children with little caries experience. Dentomaxillofac Radiol ;23 1 Ferguson F, Festa SA. Radiography for children and adolescents. N Y State Dent J ;59 2 Guidelines for taking radiographs of children. Dent Update ;22 4 Wenzel A. Current trends in radiographic caries imaging. Clinical detection of caries in the primary dentition with and without bitewing radiography.
Aust Dent J ;54 1 A prospective comparison between findings from a clinical examination and results of bitewing and panoramic radiographs for dental caries diagnosis in children. Eur J Paediatr Dent ;5 4 Comparison of radiographic and clinical diagnosis of approximal and occlusal dental caries in a young adult population.
Community Dent Oral Epidemiol ;33 3 Tinanoff N, Douglass JM. Clinical decision-making for caries management in primary teeth. J Dent Educ ;65 10 Arrow P. Incidence and progression of approximal carious lesions among school children in Western Australia. Aust Dent J ;52 3 Lith A. Frequency of radiographic caries examinations and development of dental caries. Swed Dent J Suppl National Institute of Dental Research. The prevalence of dental caries in United States children, The national survey of dental caries in U.
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School Children: Coronal caries in the primary and permanent dentition of children and adolescents years of age: United States, J Dent Res ;75 Spec No Position paper: Periodontal diseases of children and adolescents. J Periodontol ;74 11 Periodontal diseases in the child and adolescent. J Clin Periodontol ;29 5 Radiographs in periodontal disease diagnosis and management. Aust Dent J ;54 Suppl 1:S Hollier LH, Jr.
Facial trauma: general principles of management. J Craniofac Surg ;21 4 Pediatric facial fractures: children are not just small adults. Radiographics ;28 2 ; quiz Assessment of root resorption and root shape: periapical vs panoramic films. Angle Orthod ;71 3 Assessment of the anterior maxilla in orthodontic patients using upper anterior occlusal radiographs and dental panoramic tomography: a comparison. The occlusal radiograph revisited. Oral Health ;84 11 , Are anterior occlusal radiographs indicated to supplement panoramic radiography during an orthodontic assessment?
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Out of stock. Get In-Stock Alert. Delivery not available. Pickup not available. Product Highlights About This Item We aim to show you accurate product information. Manufacturers, suppliers and others provide what you see here, and we have not verified it. See our disclaimer. Basic Guide to Dental Radiography provides an essential introduction to radiography in the dental practice. Illustrated throughout, this guide outlines and explains each topic in a clear and accessible style.
Comprehensive coverage includes general physics, principles of image formation, digital image recording, equipment, biological effects of x-rays and legislation Suitable for the whole dental team Illustrated in full colour throughout Ideal for those completing mandatory CPD in radiography Useful study guide for the NEBDN Certificate in Dental Radiography, the National Certificate in Radiography or the Level 3 Diploma in Dental Nursing. Specifications Series Title Basic Guide. Customer Reviews.
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