1. SHAISTA ZAFAR
BASIC
INTRODUCTION TO
RADIOGRAPHS & DIGITAL
RADIOGRAPHY

2. RADIATION
Radiation is energy that comes from a source
and travels through space and may be able to
penetrate various materials

3. 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

4. MEASURING UNIT
The
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

7. GOAL
-Diagnostic information
with minimal exposure

8. ARE DENTAL
RADIOGRAPHS SAFE?

9. 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

11. ATTRITION

12. PROXIMAL CARIES

14. IMPLANT

18. 9/29/2013 FJDC&H 18
DENTINOGENESIS IMPERFECTA

19. 9/29/2013 FJDC&H 19
ENDODONTICS

21. RECOMMENDATIONS
FOR
PRESCRIBING
DENTAL
RADIOGRAPHS

22. 9/29/2013 FJDC&H 22
TYPE OF
ENCOUNTER
CHILD
(PRIMARY
DENTITION)
CHILD
(TRANSITION
AL
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
_

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/en
dodontic
needs,
Clinical
judgement
(same) (same) (same) (same)
9/29/2013 FJDC&H 23

24. 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

25. IMAGE RECEPTORS
• RADIOGRAPHIC FILM
• DIGITAL RECEPTORS

26. FILM PACKET
CONTENTS

27. 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

28. TYPES
INTRA ORAL
RADIOGRAPHS EXTRA ORAL
RADIOGRAPHS
TYPES

29. INTRAORAL RADIOGRAPHS
• Bitewing
• Occlusal
• Peri apical

30. 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

33. 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

35. PERIAPICAL
• Shows usually 2-4 teeth,individual teeth &
tissues around apices

36. 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

37. PARALLELING
TECHNIQUE

38. BISECTED ANGLE
TECHNIQUE

42. PROBLEMS
OF GAGGING

43. EXTRA ORAL RADIOGRAPHS
• Oblique lateral Radiography
• Cephalometrics
• Tomography
• Panoramic radiography

44. ORTHOPANTOGRAM

46. ALTERNATIVE AND SPECIALIZED
IMAGING MODALITIES
• Contrast studies
• Radioisotope imaging(nuclear
medicine)
• Computed tomography
• Cone beam CT (CBCT)
• Ultrasoud
• Magnetic Resonance

47. • SIALOGRA
PHY
SIALOGRAPHY

48. 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

50. CBCT

52. DIGITAL
RADIOGRAPHY

53. • 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.

55. • Accepted?
• Radiation Source?
• Ordering Dental radiographs?
• Operator Location?
• Advantages?
• Disadvantages?

57. 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

58. 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

59. 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?

60. REFERENCES
• Essentials of Dental Radiography &
Radiology ERIC WHAITES (by
Roderick Cawson)
• Images from GOOGLE

61. 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