LO 4 Flashcards
All _______ radiations are harmful and cause _________
Ionizing; biologic changes in living tissue
Although the amount of x-radiation used in dental radiography is small
biologic damage does occur
What are the 2 mechanisms of radiation injury?
- Ionization
- Free radical formation
Describe ionization in relation to radiation
- Results when x-ray strikes patient’s tissue
- Produced through photoelectric effect or Compton scatter
- Results in formation of positive atom and dislodged electron
- Electron interacts with other atoms within absorbing tissue - chemical change in cell = damage
- Can have little effect if sensitive molecules not altered or can have profound effect on cell function (e.g. DNA)
X-radiation causes cell damage primarily through the formation of ________
Free radicals
What causes free radicals to form?
- X-ray photon ionizes water, the primary component of a living cell
- Results in the production of hydroxyl and hydrogen free radicals
- They are highly reactive and unstable
What 3 things may free radicals do to achieve stability?
- Recombine without causing changes in the molecule
- Combine with other free radicals and cause changes
- Combine with ordinary molecules to form a toxin (hydrogen peroxide H2O2) capable of producing wide spread cellular changes
What 2 theories describe how radiation damages biologic tissue?
- Direct theory
- Indirect theory
What is the direct theory of biologic damage?
- Cell damage results when ionizing radiation directly hits critical areas within a cell
- Occurs infrequently
- Most x-ray photons pass through the cell and cause little to no damage
What is the indirect theory of biologic damage?
- X-ray photons absorbed withing cell and cause formation of toxins, which in turn damage the cell
- When x-ray photons are absorbed by water in the cell, they form free radicals
- Free radicals combine to form H2O2
What is a dose response curve?
Correlates/plots the response/damage of tissue with the dose or amount of radiation recieved
What does it mean that when dose and damage of radiation are plotted a linear, nonthreshold relationship is seen?
- Leanear indicated response of tissue is directly proportional to dose
- Nonthreshold means there is no certain level where damage does not exist - it starts immediately
Describe stochastic radiation effects
- It’s a direct function of the dose
- PROBABILITY of occurrence increases with dose, but SEVERITY is not dependent on the magnitude of absorbed dose
- No dose threshold
- Examples are cancer and genetic mutations
Describe nonstochastic radiation effects
- These are somatic effects that have a threshold - they DO increase in severity with absorbed dose
- Require larger radiation doses to cause serious health impacts
- E.g. erythema, hair loss cataracts, decreased fertility
What is the sequence of radiation injury?
- Chemical reactions (ionization/free radical formation) happen rapidly - observable effects not visible immediately after exposure
- A latent period elapses between exposure of ionizing radiation and observable clinical signs
- After the latent period, a period of injury occurs
- Recover period begins - not all injuries are permanent, but each exposure causes cellular damage which is followed by repair
The more radiation recieved and the faster the dose rate, the _______ the latent period
Shorter
What types of cellular injuries may occur as a result of radiation exposure?
- Cell death
- Changes in cell function
- Breaking or clumping of chromosomes
- Abnormal mitotic activity