Xray - Week 6 PP

Question 1

X-Ray Unit

Answer 1

• Source of radiation when you take an xray
  -Most digital imaging systems use a conventional
  dental x-ray unit as the x-radiation source
  -The x-ray unit timer must be adapted to allow
  exposures in a time frame of 1/100 of a second

Question 2

Intraoral Radiography - 3 types

Answer 2

There are three different types of intra-oral
radiographs, that can be taken to asses the
patients dentition.
-Periapical
-Interproximal
-Occlusal

Question 3

X-Ray receptors

Answer 3

Dental x-ray film serves as a recording
medium or image receptor
-Traditional Film
-Phosphor Storage Plates (PSP)
-direct digital

Question 4

Digital Sensor

Answer 4

A small detector that is placed in the mouth of the patient and used to capture the dental image

◦ Wired
▪ The imaging sensor is linked by a fiber optic cable to a computer (direct digital)

◦ Wireless
▪ The imaging sensor is not linked by a cable (indirect digital)

Question 5

Film Sizes Range

Answer 5

Size 0 to Size 4 (Largest)

Most common is Size 2
0 or 1 is typically used for children

Size 4 is for occlusal xrays (PSP plates usually only - digital not typical in this size)

Question 6

Direct Digital Imaging

Answer 6

Components include an intraoral dental x-ray
unit, a sensor, and a computer with imaging
software
◦ A sensor is placed into the mouth of the patient and
exposed
◦ The sensor captures the image and transmits it to
the computer monitor
◦ Software is used to enhance and store the image

Question 7

Computer - for Xrays

Answer 7

Used to store the incoming electronic signal
◦ Converts the electronic signal from the sensor into a shade of gray that is viewed on the computer monitor
The computer digitizes, processes, and stores information received from
the sensor
◦ An image is recorded on a
computer monitor in 0.5 to 120 seconds
Has a split screen and magnification
capability

Question 8

Indirect Digital Imaging

Answer 8

Components include a CCD camera and a computer
◦ An existing x-ray film is digitized using a CCD
camera
◦ The image is displayed on a computer monitor

Question 9

Storage Phosphor Imaging

Answer 9

A wireless digital imaging system
◦ This is a reusable imaging plate coated with phosphors instead of a sensor with a fiber optic cable
◦ The phosphor-coated plates are flexible and fit into the mouth
◦ A high-speed scanner (electronic/computer) is used to convert the information into electronic files
◦ This type of digital imaging is less rapid than direct
digital imaging

• advantage: These are thinner/flexible - easier to fit into a patient’s mouth.
  -downside: you don’t know how image looks immediately, have to scan into computer first - takes more time to find out if your xray is shite

Question 10

Description of PSP / Indirect digital

Answer 10

• Thin, flexible plate that is covered in phosphor crystals
• Plates are the same size as conventional x-ray film
• Phosphor layer stores energy of x-ray photons
• Thin, flexible plate that is covered in phosphor crystals
• Plates are the same size as conventional x-ray film
• Phosphor layer stores energy of x-ray photons

Question 11

Advantages of Digital Imaging

Answer 11

1. Superior gray-scale resolution
2. Reduced exposure to x-radiation
3. Increased speed of image viewing
4. Lower equipment and film cost
5. Increased efficiency
6. Enhancement of diagnostic image
7. Effective patient education tool
8. Eco-friendly tool

Question 12

Disadvantage of Digital Imaging

Answer 12

1. Initial set-up costs
2. Image quality
3. Sensor size and thickness
4. Infection control
5. Wear and tear
6. Legal issues

Question 13

Digital Imaging Software Programs

Answer 13

Most computer software programs that are used
in digital imaging can perform electronic image
enhancement.
The operator can change the following image
variables either together or separately:
▪ Contrast
▪ Brightness
▪ Image size (zoom)
▪ Sharpness
▪ Inversion (white to black and black to white)
▪ color alteration

Question 14

Digital Image Storage

Answer 14

Dental radiographs are part of the patients dental record.
In Alberta, through the HPA, patients have the right to reasonable access to their records, and may request a copy of their radiographs. Original radiographs should never be sent, once radiographs are requested a note should be made documenting the request in the patient file and digital copies are provided.

Question 15

Digital File Security

Answer 15

An advantage of digital files is that they can be sent over a computer network, however all federal privacy regulations must be followed. This includes using VPNs or encrypted files. Sait provides Xray files on a USB stick.

Question 16

Occlusal Technique

Answer 16

The occlusal technique is used to examine large areas of the maxilla or mandible
It is named the occlusal technique because the patient bites or occludes on the film

Question 17

Occlusal Technique

Answer 17

The occlusal technique is used when a large area of the maxilla or mandible must be visualized.

to locate retained roots of extracted teeth
to examen the area of a cleft palate
to locate supernumeray unerupted or impacted teeth

Question 18

Maxillary Occlusal projection

Answer 18

1. Position the patients max arch parallel to the floor
2. Place size 4 receptor (tube side up) into patient’s mouth
3. instruct the patient to bite gently on the film
4. Position the PID with the central ray directed through the midline of the arch
5. Position the PID and 65+ degrees*. PID should sit between patient’s eyebrows on the bridge of the lose

Question 19

Maxillary Pediatric Occlusal Projection

Answer 19

For pediatric exposure, a size 2 film is used. Placement technique is the same however the angulation is decreased to +60 degrees

Question 20

Mandibular Occlusal Projection

Answer 20

1. Position the patients mandible parallel to the floor
2. place size 4 receptor in the patients mouth with the tube side facing down
3. instruct patient to gently bite
4. Position tube head under chin at -55 degrees

Question 21

Mandibular Pediatric Occlusal Projection

Answer 21

** -55 degrees the same as adult

Question 22

PSP Xray Instruction

Answer 22

1. Remove cart from op
2. Organize unexposed plates on top of the cart.
3. After you expose an image place plate in the
   contaminated cup.
4. Once all images are exposed take off gloves and
   sanitize hands.
5. Put on new gloves
6. Wipe PSP plates and place them on the top of the
   cart.
7. Second wipe, new gloves.
8. Once plates are dry, remove gloves and sanitize.
9. Remove the barrier and place plates in transfer
   box - BLUE Side down to avoid light
10. Bring it to the viewing room
11. Make sure the scanner power is on
12. Use the computer to set up the software to process the image
13. Select your patients chart
14. Set up scanning component - Green lights will come on
    when the scanner is
    ready
15. Remove PSP from the transfer box.
16. Place it against the tube with the black non phosphor side facing OUT
17. Slide it into the appropriate slot.
18. Guide it in a downward direction.
19. When the scanning is complete, the PSP will drop onto the lower platform.
20. Place PSP back into the transfer box & take it back to the barrier station.
21. Sanitize handles and replace barrier on PSP.