Dental Film and Processing Procedures Flashcards
Dental Film Holders
Types of intraoral film holders are available on market today.
- Disposable styrofam bite black: backinh plate and slot for film retention. Its advantage is that it is disposable and doesnot need to be sterilized.
-Snap A-RavC(formerly the Eezee-Grip): is a double eneded instruments that holds the film between serrated plastic grips that can be locked into place. it has advantage of being albe to be adjusted for patient with jaws too shallow to accommodate the full depth of film.
Endoray Device: is designed foe use in radiographs of eeth involving endonotic instruments in the cancal. If an endoray device is not available, it is not uncommon to have patients use finger or a hemostat to hold the film in place.
Uni-bite device: beam alignment device.
Introduction to dental film and processing
film-processing have a direct effect on the quility of a radiograph. The dental assistant must be knowledgeable about the types of dental film and film holding device and must also thought understand the processing procedure to produce high quality diagnostic dental radiographs.
Film: term for medium that x-ray rays will be exposed to. The film is in the packet; the film is placed in the bite block; and the film is exposed and processed. After the film has been processed, it becomes a radiography.
radiography: term for the film after the film has been exposed to x-rays and processed.
Dental X-ray Film
Film used radiography s similar to photographic film with some adaptation. A photographic image is produced on dental x-ray film when it is exposed to x-ray that have passed through teeth and adjacent tissues. The dental assistant must understandd the composition of x-ray film and latent image formation that result in increased patient exposure to x-rays.
Intraoral dental film is made of a clear semiflexible, cellulose actate film base that is coated on both sides with emulsion of sliver bromide, sliver halide, and sliver iodide that sensitive to radiation.
The emulsion layers on film allow an image to be produced with the use of less radiation.
Three types of r-ray film in dental radiography:
- Intraoral is the most common used.
- Extraoral
-Duplicating
Latent Image Formation
when the radiation interacts with the sliver halide crystals in film emulsion, the image on the film is produced. Te image, which is not visible before processing, is called latent image. fingerprint are anther type of latent image : image on film that is no visible until the film is processed. When you leave fingerprint on item after you have touched it. Even through you might not able to see them, fingerprint become visible when the items is treated.
produced. The image which is not visible before
Intraoral film
Intraoral film:is placed inside the mouth during x-ray exposure. The intraoral x-ray film has empulsion on both side of the film instead of just one because it require less radiation to produce an image. Light cannot pass through the packet but x-rays can.
Intraoral film packed typically are availbe in boxes of 25,100, or 150 film. The film can contain one film or two film packet.
Boxes of film are labeled with the following:
- Type of film
- film speed
- # of film per individual packet
- total number of films per individual packet
- Total # of films in the box
-expiration #.
Identification Dot: a small raised bump on one corner of film packet that help with the orientation of the radiograph.
Intraoral film packets
A thin back scattered lead foil sheet is positioned behind the film to shield from back-scatted radiation: secondary.
Intraoral film packets comes in five basic size:
- Child(size 0)
- narrow anterior (size 1)
- Adult size (size 2)
- preformed bite wing size 3-rarely
- occlusal size 4
Bite-wing x-ray usually are taken with size film and a bite tab or red XCP
extraoral film
extraoral film: placed ouside of the mouth during the x-ray exposure. extraoral film is used to examine large area of the head or jaws.
extraoral film is more common used specially practice. such as pediatric and oral surgery and orthodontic.
extraoral radiography uses a film screen system (combination with intensifying screens).
extraoral film use in dental radiography is avaliver in 5x7 inch and 8x20 inch size and is supplied in boxes of 50 or 100 films. Not supplied in film packets.
Cassette is a plastic or metal case used in extraoral radiography to hold the film and protect it from exposure to light.
The front side of the cassette must always face the patient during exposure.
panoramic film: view of the upper and lower jaw on a single radiograph. (pediatric dentists use panoramic film to see a developing a teeth becuase it difficult to have a child sit through a full mouth series of radiographs. It also exposes the child to less radiation than a full mouth series.
Cephalometric film shows the bony and soft tissue area of the facial profile. (orthodontist often use cephalometric film to view the relationship of the jaw to the skull).
Duplicating radiographs
Duplicating machine and special Duplicating film ( is used only ina darkroom setting and never exposed to x-rays.
Duplicating film are necessary to Duplicate machine produce white light exposes is performed in a darkroom under a safelight. the longer the Duplication film is exposed to light the lighter will become. This is the opposite of the x-ray which become taker when exposed to light. only light. duplicating film can never be exposed to x-rays.
Film speed
Film speed refers to the amount of radiation reqired to produce a radiograph of standard density.
density the darkness.
Film speed is determine by the following factors:
- Size of sliver halide crystals
- thickness of the emulsion
- presence of special radiosensitive dyes.
Facts: larger crystals increase film speed but reduce image resolution slightly/
F speed film, the newest and fastest film on the market today, reduce radiation exposure to the patients by 20-60% compared with E speed and D.
E speed and D: commonly used by cost conscious dentists because the relative decrease in radiation exposure from F speed is small when only a few exposure are involved.
Dental X ray film processing
Processing a series of steps that changes the latent image on the exposed film into a radiograph by producing a visible image on the film.
Radiographs that are nondiagnostic because of poor processing techniques must be retake, exposing the patient to necessary radiation.
Intraoral film is processed in an automatic process. However, it is still necessary to know to process the film manually:
- to identify and correct errors is processing
- to develop a film more quickly as with endodontics.
Steps to dental radiograph processing
- step1: development
-step2: rinsing
-step3: fixation
-step4: wa: washing
-step5: drying
Flim processing solutions
Flim processing solutions are available in following forms:
- Powder
- ready to use liquid
- liquid concentrate-most commonly used solution. powder and concentrate require mixing that most practice choose not to take the time to do.
Darkroom requirements
Darkroom mist be clean and organized at all times, properly developing x-ray film requires a light darkroom. The darkroom should be equipped with items listed here
- Gloved, disinfectant spray, and paper towels
- container, labeled with biohazard label
- Recycling container for lead foil pieces
- processing tanks for the developer and fixer solution, and a circulating water bath
- Running water with mixing valves to adjust the temperature
- Both safelight and source of white normal light
- Accurate timer
- Accurate floating thermomeer
- stirring rods or paddles to mix the chemicals and equalize the temperature of solutions
- soft storage space for chemicals
- film hangers
- film dryer rack and film dryer.
Processing tank
manual processing is a method that is used to develop, rinse, fix and wash dental x-ray film without an automate machine.
Processing tank a piece of equipment used in the manual processing of film. it is divided into compartment to hold the developer solution, water bath and fixer solution.
The solution should be chanaged every three to four weeks.
Automatic film processing
Never open the automatic processor with the overhead light when film is being processed. If a film gets stuck. If a film gets stuck, open the automatic processor with the safelight on and dry to locate the film.
Automatic film processing is fast and simple method used too process dental x-ray film. It requies only 4-6 min for development, fixing, washing and drying of film.
Automatic film advantages:
- less processing time is required. 4-6 min
- time and temperature and automatically controlled
- less equipment is used.
- less space is required.
Automatic processor components
Automatic processor components have components
- Processor housing: covers all the component parts
- Film feed slot: used to insert unwrapped film into the automatic processor
- Roller film transporter: system of rollers that rapidly moves the film through the compartments.
- Developer and fixer compartments: hold the solutions
- Water compartment: holds circulating water
- Drying chamber: holds heated air and dries the wet film.
Processing errors
proper maintenance of the processor reduce the chance of errors during film processing.
The dental assistant must be able to recognize the appearance of common processing errors and know what to do to prevent such problem from reoccurring.
Errors result in radiographs that are not diagnostics. They require retakes and additional exposure to the patient.
processing errors can occur for a vanity of reasons including the following:
- Time and temperature errors
- chemical contamination errors
- film-handling erros
-lighting errors
Time and temperature with solutions
Problem/appearance are
-Underdeveloped film/L light
Issues
* developing time too short
* solution too cold or depleted
* inaccurate timer or thermometer
Fixes
* check and adjust development time
* check developer fluid temp and levels
* replace timer or thermometer
-Overdeveloped Film/Dark
Issues
* developing time too short
* solution too cold or depleted
* inaccurate timer or thermometer
Fixes
* check and adjust development time
* check developer fluid temp and levels
* replace timer or thermometer.
Reticulation of Emulsion/Cracked
Issues
* Drastic temp changes occurred between developer and water bath
Fixes
* check the temp of the developer and water bath.
chemical contamination problem and solutions
Problem:
- Developer spots/Dark spots
Issues
* Developer touches the film prior to processing
Fixes
* clean the work area in the darkroom between processing
- Fixer spots/white spots
Issues
* fixer touches to film prior to processing
Fixes
** clean the work area in the darkroom between processing
- Yellow-brown stains/yellowish-brown color
Issues
* fixing time is too short
* the fixer is no longer longer good
Fixes
* correct the fixing time.
* monitor and chanage the chemicals as needed.
Film Handling problem and solution
Problem
-Developer cutoff/straight/ white border
Issues
* a part of the film was above the low level of the developing solution.
Fixes
* check and adjust the fluid level prior the processing.
-Developer cutoff/straight/ black border
Issues
* a part of the film was above the low level of the fixer solution.
Fixes
* check and adjust the fluid level prior the processing.
- Film overlap/light or dark areas
Issues
- Two films contacted one another during processing
Fixes
- Ensure films are separated prior to processing.
Film Handling problem and solutions
Problem
-air bubbles/white spot
Issues
* air contacted film surface during processing
Fixes
* gently agitate the film racks when placing film into the solution
- Fingermail mark/black crescent-shaped marks
issues
* fingernail contracts the film emulsion during processing
Fixes
* handle only the film edges in a gently manner
-Fingerprint mark/black fingerprint
Issues
* contaminated finger contacted the film surface.
Fixes
* clean hands and touch only film edges.
Film Handling problem and solutions will reduce errors while processing
- static electricity/black thin branching lines
Issues
* dilm packet was opened too quickly
Fixes
* slowly open film packets.
-Scratched film/white lines
Issue
* soft film emulsion contracted a sharp object
Fixes
* handle film and film on racks very carefully.
Lighting problem an ssolutions
- Light leak/black exposed area
Issue
& film was exposed to light
Fixes:
*inspect the film packets for any defects prior to use.
* do not expose unopened packets to light.
-Fogged Film over grayness with little to no contrast:
Issue
* safeliht malfunction
* darkroom mmight have a light leak
* old film
* flim was stored
Fixes
* ckecl the safelight filter and bulb
inspect the sarkrrom for light keaks
* cjeck flim expiration sate
* store film in cool, dry
Legal consideration to x-ray
dental assistant responsibility to understand the law when exposing to radiography.
-Federal and state regulation regarding x-ray equipment and its use
-Licensure for individuals exposing radiographs.
- Risk management for avoiding potential lawsuits.
States and federal regulation
- All dental x-ray machines manufactued or sold in the USA adter 1974 must meet federal regulation that include safety for filtration and accuracy of miliamperage time and kilovoltage settings.
- Many states require x-ray machines to be registered and charge a fee for this registration.
-Most states have laws taht require inspection of dental x-ray equipment on a regular basis, for instance every 5 years.
Quality Assurance
Quality Assurance: is that everything possible is being done to prodce quality diagnostic radiography. Ensire minimum standards are met.
Tests designed to diagnose the prolems:
- Variation in radiation output
- Inadequate collimation
- Tube head drifting
- Inaccurate kilovoltage and milliamperage reading.
Proper Quality Assurance Administrative procedures
Description: written description of the quality assurance plan
Monitoring: A written monitoring schedule, which should be posted in office.
Evaluation : A written evaluation plan
- staff training: a key to proper x-ray procedures
Proper Quality Assurance procedures involves action
- Inspecting the dental x-ray machine periodically
- storing dental x-ray film properly and ensuring that it does not become outdated
- checking screens and cassettes for direct and scratches
-cleaning view-boxes so that the operator can iterpret the x-ray
- Checking darkrrom lighting for leaks every 6 months.
Film processing Quality Assurance
Darkroom must ckeck every 6 months.
Reference radiography: tool for training in which an ideal radiograph is used to compare against recently taken radiography to help improve the quality.
Step wedge radiograph: an aluminum device that is used to display a range of exposure intensities on a radiography.
Infection control in dental radiography
x-ray procedures include:
- x-ray tube head
-position indicating device (PID) - x-ray control panel
- exposure button
- lead apron
-digital sensor
Radio
graphy operatory prepartion
-x-ray machine: tube head, OID, control panel, exposure button, must all be covered or carefully disinfected.
-Lead Apron: should considered considered contaminated and wiped down with a disinfectant after each use.
-dental chair: back and arms of the chair, the headrest and headrest adjustment control must all be covered or disinfected.
-Work area: x-ray film and film holding device are placed during expoure should be disinfected after which barrier should be placed.this barrier can be a paper sheet a paper towel or plastic cover
operator prepartion
dental assistance must wear gloves and protective clothing while expoing radiography and contaminated film.
After each exposed film is removed from patient’s mouth. it must be wiped with a paper towel to remove excess saliva.
