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Dental Radiography, Basic 1091.e1

Dental Radiography, Basic
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○ Extension arm allowing vertical, hori-
Difficulty level: ♦
zontal, and rotational movement of the also available) with scanning equipment
transferring images to a computer
Overview and Goal tube head without changing the patient’s ○ Less radiation required to produce images
To obtain diagnostic images of the teeth and position ○ Digital image improvable with software
surrounding structures using x-rays ○ Adjusting exposure time based on programs
patient size and tissue thickness to be
Indications imaged (0.1-0.6 seconds for teeth and Anticipated Time
• Diagnosis, treatment planning, and post- jaws when using nonscreen dental films Obtaining a full-mouth dental series:
operative assessment of treatment efficacy and 1 10 of that time when using digital • Cats (8-10 views): 10-15 minutes
for various dental, oral, and maxillofacial systems) • Dogs (10-14 views): 15-20 minutes
conditions • Dental x-ray films Processing a nondigital full-mouth dental series: Procedures and Techniques
• Dental radiographs should be obtained before ○ Nonscreen (providing greater detail than • Cats: 5-10 minutes
tooth extraction to evaluate alveolar bone screened film used with standard x-ray • Dogs: 10-15 minutes
health and variations in root anatomy and machines)
to determine the presence of dentoalveolar ○ Sizes 0, 1, 2, 3, and 4 (0, 2, and 4 most Preparation: Important
ankylosis or root replacement resorption that commonly used). Most jaw lesions can Checkpoints
could potentially complicate the extraction be satisfactorily assessed with size 2 and • Observe radiation safety guidelines.
procedure. They are essential when perform- 4 dental film and intraoral imaging ○ Be protected against three sources of radia-
ing endodontic procedures. techniques. tion: primary beam, secondary radiation
Specifically to diagnose and monitor ○ Dot in corner of packet and on the film: emitted from the patient, and radiation
• Regressive changes of the dentition, including convex (raised) surface facing x-ray beam leakage from the machine housing.
caries, tooth wear, fracture, and resorption during exposure; after developing, dimple ○ Wear film badges that monitor occupa-
• Dental (change in number or shape of is used for distinguishing right side of tional exposure to radiation.
teeth) and jaw size anomalies, including mouth from left. ○ Keep amount of radiation exposure to a
malocclusion, supernumerary teeth, and ○ Contents of moisture-resistant dental film minimum.
developmentally missing teeth packet ○ Have x-ray machine accurately collimated
• Infection and inflammation of teeth, alveolar ■ Outer plastic wrap and equipped with an accurate exposure
bone, and maxillofacial bones, including peri- ■ Black paper on either side of the film timer.
odontitis, endodontic disease (pulp necrosis), ■ Layer of lead foil located at back of ○ Leave the room when radiographs are
periapical disease (apical granuloma, cyst, or packet next to tab opening (protecting obtained.
abscess), condensing osteitis, osteosclerosis, film from secondary radiation, which ○ If leaving the room is not possible, wear
and osteomyelitis may cause fogging) protective lead-lined gear, use a protective
• Oral and maxillofacial cysts and tumors (pp. ■ X-ray film barrier, or stand at least 6 feet from the
711 and 714) ○ Types of film x-ray source and at an angle of 90°-135°
• Oral and maxillofacial trauma ■ Ultra-speed (group D): most commonly to the central ray of the x-ray beam when
• Disorders of joints of the head: mandibular used the exposure is made.
symphysis separation; temporomandibular ■ Ekta-speed (group E): faster (reduc- • Film-processing solutions (rapid developer
joint osteoarthritis, luxation, fracture, and ing patient exposure and radiation) and fixer) should be disposed of properly in
ankylosis; open-mouth jaw locking but image of slightly lesser quality accordance with regional/local law, and lead
• Diseases of bone with manifestation in the than that obtained with ultra-speed foil from film packets should be separated
jaws: craniomandibular osteopathy, calvarial film and stored for recycling.
hyperostosis, secondary hyperparathyroidism, ○ Dental x-ray films can also be used with • Patient positioning varies; lateral recumbency
fibrous osteodystrophy (pp. 697 and 878) standard x-ray machines, using a technique allows easy rotation of the head if needed
• Diseases of the nose, orbit, and ear of 100 mA, a film focal distance of 12-16 and is a good starting position for obtaining
• Partial or full-body imaging studies in small inches, and an exposure time of 1 10 most dental radiographs in cats and dogs.
mammals and exotics second, with a kVp varying from 60-70 • A full-mouth dental series may contain the
depending on patient size. following views:
Contraindications • Other equipment ○ Right maxillary premolars and molars
Contraindicated in patients that cannot undergo ○ Chairside darkroom (or automatic film ○ Right maxillary canine (lateral or lateral
sedation or general anesthesia processor) with small containers for the oblique view)
following solutions (positioned from left to ○ Right and left maxillary canines and
Equipment, Anesthesia right): rapid developer, water, rapid fixer, incisors (occlusal view)
• Sedation or general anesthesia and again water (or fixer, depending on ○ Left maxillary canine (lateral or lateral
• Radiolucent positioning and film-holding number of radiographs obtained) oblique view)
devices (e.g., bite blocks, foam rolls, syringe ○ Film clips and hangers ○ Left maxillary premolars and molars
cases, gauze pads, paper towels, rubber bands) ○ Dental view box ○ Left mandibular premolars and molars
to keep the mouth open and the dental ○ Envelopes or other storage system ○ Left mandibular canine (lateral or lateral
film/sensor pad/phosphor plate in position • Digital imaging oblique view)
without superimposition of maxillary and ○ Most modern dental x-ray machines ○ Right and left mandibular canines and
mandibular dental arches compatible with most digital hardware incisors (occlusal view)
• Dental x-ray machines and software packages ○ Right mandibular canine (lateral or lateral
○ Handheld, stand-supported or (more com- ○ Sensor pads (direct digital; sizes 0 and 2) oblique view)
monly) wall-/ceiling-mounted machine or phosphor plates (indirect digital; size 4 ○ Right mandibular premolars and molars

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