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Type of x-ray

-MRI (Magnetic Resonance Imaging): An MRI scan is a powerful diagnostic tool that uses a strong magnetic field to produce high-quality, images in multiple planes or directions. The images are generated using superconducting magnets .and pulsed radio wa es MRI has !een in use since the early "#$%s and has no &nown side-effects. It has !ecome the in estigation of choice for many neurological and musculos&eletal conditions and is used in all .areas of the !ody :It helps identify problems in soft tissue mainly & include "-'pine, (oint or muscle pro!lems. )- A!dominal tumors and disorders. *-+rain tumors and a!normalities. ,- +reast cancer. -eart or !lood essel pro!lems.-5

-CT scan (.omputed Tomography)/ .T is a sensiti e diagnostic tool that uses 0-rays to ta&e a series of two dimensional crosssectional images (1slices1) around an a2is. It is used to image many diseases and in(uries and has !een in widespread use since the early "#3%1s. -It helps identify problems in hard tissue mainly & include: "- Muscle and !one disorders, such as tumors and fractures. )- 4iseases such as cancer or heart disease. *- Tumors, infections, or !lood clots. ,- Internal in(uries. -5ltrasound scan/ 5ltrasound has !een used in a ariety of clinical settings, including o!stetrics and gynecology, cardiology and cancer detection. The main ad antage of ultrasound is that certain structures can !e o!ser ed without using radiation. 5ltrasound can also !e done much faster than 0-rays or other radiographic techniques. -It helps identify cyst mainly & including: the heart and !lood essels, li er, gall!ladder, spleen, pancreas, &idneys, !ladder, uterus, o aries ,eyes , thyroid, testicles , 6regnancy and can help doctors during procedures such as needle !iopsies.

Radiographic images Films are classified into: A - "- Intraoral )- 72traoral - 4epending on location + - "- 4irect e2posure films )- 'creen films - 4epending on type of rays hitting the film -The 2-rays will hit the o!(ect 8pass through it8 hit the film which could !e intraoral or e2traoral film. Intraoral films: - +c9 it is placed inside the pt mouth. -types/ "- +itewing. )- 6eriapical. *- :cclusal.

Bitewing

-'hows/ 6art of the upper and lower teeth ; interpro2imal caries ; al eolar !one in ol ement.

eriapical radiograph

'hows/ periapical area and teeth

-5sed for/ apical pathology, periodontal e aluation, caries detection and endodontic treatment.

!cclusal films

-The orientation of the film in the pt mouth is parallel to the occlusal plane. -It<s a larger film co er a wider area 8 identify larger lesions. -To locate/ !ucco-lingually sides. -=or/ de eloping ant teeth and imaging trismus pt1s (trismus/ persistent contraction of masseter ms).

Extraoral films: - =ilm (receptor) placed outside the mouth. -Types/ "# anoramic. $# %ateral &aw >lateral o!lique>. '# %ateral cephalometric# (# osteroanterior cephalometric or osteroanterior ) *+# ?. @aters (occipitomental). A. Re erse Towne 3. 'u!mento erte2. $. Transcranial. Panoramic

--:,se for
Impacted wisdom teeth diagnosis and treatment planning - the most common use is to determine .the status of wisdom teeth and trauma to the (aw -.6eriodontal !one loss and periapical in ol ement -.=inding the source of dental pain -.Assessment for the placement of dental implants -.:rthodontic assessment. pre and post operati e -.4iagnosis of de elopmental anomalies such as cheru!ism, cleido cranial dysplasia ..arcinoma in relation to the (aws .Temporomandi!ular (oint dysfunctions and an&ylosis 4iagnosis of osteosarcoma, amelo!lastoma, renal osteodystrophy affecting (aws and .hypophosphatemia 4iagnosis, and pre- and post-surgical assessment of oral and ma2illofacial trauma, e.g. .dentoal eolar fractures and mandi!ular fractures

"Lateral jaw "lateral oblique

The purpose of this radiograph is to e2amine the posterior region of the mandi!le, third molars and when children or adults are una!le to tolerate placement of an intraoral image due to fractures or .swelling this is a good alternati e

Lateral cephalometric

The purpose of this radiograph is for use !efore and after ortho T0. It is also used to e aluate trauma, growth, de elopment, de elopmental a!normalities. It can also re eal facial soft tissue .profile when a filter is placed !etween the tu!e and the patient to remo e some of the 2-rays

Posteroanterior (PA) or Cephalometric Posterior

This is used to e2amine facial growth, de elopment, disease, trauma, a!normalities, 5sed to supplement lateral sur eys !ecause the right and left sides are not superimposed on one another .in this method

Waters (occipitomental)

.This method is used to e aluate the ma2illary, frontal and ethmoid sinuses

Reverse owne

This method is used to e aluate and e2amine fractures of the condylar nec& as well as sclera .derma and arthritis !ubmentoverte"

This radiographic method is used to e aluate the positionBorientation of the condylesC or also to .e aluate fractures of the 9ygomatic arch

ranscranial

This radiographic method is used to aid in diagnosing an&ylosis, malignancies, fractures, and .tissues changes cause !y arthritis

Panoramic

"Lateral #aw "lateral oblique

Lateral cephalometric

(Posteroanterior cephalometric or Posteroanterior (PA

Waters (occipitomental)

Reverse owne

!ubmentoverte"

r a n s c r a n i a l

Lateral s$ull

Components o% the %ilm

#lack papers -:Film cover - .It could be a vinyl or a paper Functions: Keeps out light and moisture and to protect.the emulsion Film -:Black paper Surrounds the film from in front and from the back and it protects the emulsion and between them is the film (that is covered by the emulsion (its double emulsion .sometimes there are two films "ead foil -:Lead foil .!o prevent the backscattering

:Clinasept barrier -.$nly available in si%e & films

(&ilm si'e (intraoral films

- :(Film sizes (extra oral 'anoramic( depending on the manufacturer it could be )*+,&* inch or it could be -*+,&* .inch

.+.* !rans cranial( lateral obli/ue 0aw*).+,2* skull( ceph( tomogram*1-

:Cassette

!his is the cassette3s shape and if we open it( there will be & screens and if they are scratched or will be old we can replace them by new screens and between them you replace the film and we call it rigid cassette and it can be soft cassette (like a plastic vinyl envelope4 and there are & screens inside them and we have to be careful .to place the film between the & screens

:!his is how the layers are inside the cassette

Reversed films

If you do a mistake and place the film in backward (it should be placed in the way that the white side to the outside toward the beam4( which means you place the lead foil toward the beam( it will block some +-rays that3s why the film will be lighter and it will have a .pattern 5hen the manufacturer place this lead foil( they will not make it smooth but they make certain pattern on it so if you do a mistake (placed your film backward4( you will know .that it3s due to incorrect placement of the film inside the patient mouth

Direct exposure film:


- +ecause it<s e2posed !y 2-rays directly. -5sed for/ intraoral films.

Screen films:
-'ensiti e to light (indirect) -5sed with/ intensifying screens. -5sed for/ e2traoral films.

-Intensifying screens:
- +c9 the num of 2-ray photons is less than8 out coming light photons. -5sed e2traorally. -.on erts 2-ray energy to light energy !y fluorescence. -0-ray coming to the pt 8 2-ray out of the pt (holds information/ e.g. amalgam may not !e penetrated !y 2-ray !c9 amalgam will a!sor! the rays while soft tissue will !e penetrated) 8will hit the screen 8con erted into light energy 8hit the film to produce the image. -'o it<s indirect (!c9 2-rays won<t hit the film directly, it will !e con erted to light first then it will hit the film). @hy do we use it with e2traoral radiographsD In e2traoral radiographs, there will !e lots of structures (as (aw, chec& and teeth)C it will require more 2-rays so to reduce the e2posure, we use the indirect method. *%-A% times less radiation than the direct method whyD +c9 it<s relying on the intensifying capacity of intensifying screenEE If we use the direct method, we need long e2posure time or more 2-rays.

-Composition of intensifying screen:

#ase: -6ade of plastic. -Function: support. 7eflecting layer: -Function: reflect light back toward the film. 'hosphor layer *fluorescence*: -6ade of rare earth material -Function: active ingredient of the screen( gives fluorescence. ('s: active ingredient of film emulsion4 'rotective coat: -6ade of plastic. -Function: protect phosphor layer.

-$ types of screens .nown now:


"- +lue light emission/ when 2-ray hits it 8 it will emit light8 and produce !lue light. )- Rare earth screen/ color of light they emit is green. -0-rays hit the phosphor layer8 and at this area it will fluoresce 8and gi e light8 that light will go to the film that is !etween ) intensifying screens. - In e2traoral films we ha e ) screens one on each side li&e a sandwich and !etween them is the film. () screens !c9 if the 2-ray didn<t hit the first one, it will hit the second one for sure so we will not waste any ray). -:ne point will !e represented !y a larger area on the film !c9 of the di ergent of the light photons.

-Intensifying screen speed/


-how fast they are in the emission of the light/ -Fast )rapid+: F less e2posure F less details. -0edium )bar+: compromise !etween speed and detail. -1low )fine2 detail+: G more e2posure G more detail.

3ow the speed is increasedD


- (-ow we can decide which is fast, medium or slowD)/ - *nswer: higher absorption phosphor/- More a!sorption more emitting - Hreen emitting rare earth screen faster8 than !lue light emitting screens.

-3igher con4ersion-efficiency phosphor/ - If the screen con erts one 2-ray photon into ? light photons A higher con ersion screen will con ert it to "% light photons.

- G higher con ersion efficiency G faster screen -Rare earth screen ha e higher con ersion efficiency8 it will emit more light photons. -Thic.er phosphor layer/ -Thic&er screens8 more possi!ility into con erting 2-rays into light. - G efficiency of producing light is more G faster screen. :Types of screen film T-Mat and 7&ta ision/ !oth of them has a screen !ut the difference !etween them T-0at: is without anti-crosso er layer and the photons emit light and reach the film and they can also reach to the other side of the film (cross the two emulsion layers). The area will !e larger .!ecause it has to pass through more distance Ektavision: there is an anti-crossover layer which will allow the light to cross only one emulsion layer and not cross over to the other side which means that we will have a .sharper image :Film c oices .8: used form best contrast .": most forgiving9 normally used .:: used for e+tra copy of film :!ntraoral film speed -:5e have .; speed (still used4: the crystals that are inside the emulsion are globular in shape F speed: the newer one that actually used in the dental teaching center and it3s the fastest and it uses larger crystals (the shape of them are tabular4 and they use -2< less e+posure .(than ; speed (e+pose the patient to much less radiation 5hen you talk about e+tra oral speed( you talk about system speed (film speed = screen .(speed 5hen the silver halide crystals are getting enlarge this mean that the film is getting .faster

-:Film storage .('tore at ?%-3% degrees = (refrigerated .'torage at high temperatures may result in film fogging (Temperaturedar&ening of the film dar& radiograph )

:pened !o2es of screen (e2tra oral) film need to !e &ept in light-tight area (dar&room), and need .(to !e cool (only open in a dar& room .5se film !efore e2piration date to a oid film fogging 4o not store film in room where radiographs are ta&en !ecause if you are ta&ing radiographs, .there are scattered 2-rays that may e2pose your film

Done by: Dr. Khalil H. Al-saffar