RADIOGRAPHY Veterinary dental nursing procedures RADIOGRAPHY

5888H - Veterinary Dental Nursing Radiology vs Radiography Radiography –taking and processing pictures Radiology –interpreting pictures

RADIOGRAPHY 5888H - Veterinary Dental Nursing Purpose Diagnosis Planning Post-treatment Prognosis

RADIOGRAPHY 5888H - Veterinary Dental Nursing Radiographs to diagnose Congenital e.g: –Malformations Acquired e.g: –Periodontal disease –Fractured teeth –Discoloured teeth –“Neck lesions” –Jaw lesions

RADIOGRAPHY 5888H - Veterinary Dental Nursing Planning Extractions –Root infections –Impacted teeth –Root fusion (ankylosis) –Feline “neck lesions” Endodontics –Root canal treatment XR v impt for measuring length of drills

RADIOGRAPHY 5888H - Veterinary Dental Nursing Monitoring Lesion progression Post op –Assess treatment success

RADIOGRAPHY 5888H - Veterinary Dental Nursing Film Types Screen Film –Intensifying screens within cassettes permit shorter exposure times –But cassettes don’t fit into mouth Non-Screen Film –Normal Slow & longer exposure but good detail Small & flexible –Dental Small pre-cut sizes Has 2 sides: –One incorporates foil/lead backing –Other with a raised dot – point to the beam

RADIOGRAPHY 5888H - Veterinary Dental Nursing Dental Film

RADIOGRAPHY 5888H - Veterinary Dental Nursing Film positioning Extraoral Intraoral

RADIOGRAPHY 5888H - Veterinary Dental Nursing Film positioning Intraoral –Less superimposition of teeth –Better detail Film closer to tooth Less scattered radiation –Usually need dental film

RADIOGRAPHY 5888H - Veterinary Dental Nursing Patient positioning Mandible- animal in dorsal recumbency Maxilla- animal in ventral recumbency

RADIOGRAPHY 5888H - Veterinary Dental Nursing Full mouth views Would require 6-8 views to evaluate all 4 quadrants

RADIOGRAPHY 5888H - Veterinary Dental Nursing Patient positioning Motionless –Heavy sedation –General anaesthesia Positioning aids –Sandbags, lead sleeves –Troughs, Foam wedges, Syringe cases –Tape –Cardboard or spring loaded devices

RADIOGRAPHY 5888H - Veterinary Dental Nursing X-Ray Machines Normal Dental –Smaller –More manoeuvrable –Safer –Better images

RADIOGRAPHY 5888H - Veterinary Dental Nursing X-Ray Machines General Purpose –Large and difficult to manipulate Ideally would want to get to within 15 cm Dental –Easy to manipulate close in –Safer (less scatter) –Wall or castor mounted –Simple to operate fixed kV and mA Adjust time

RADIOGRAPHY 5888H - Veterinary Dental Nursing Dental X-Ray Machines

RADIOGRAPHY 5888H - Veterinary Dental Nursing Developing Manual –Mini dark room boxes available Automatic –Needs to be able to handle small dental film Within film envelope –Special dental films

RADIOGRAPHY 5888H - Veterinary Dental Nursing Accessories Film positioners Bite blocks (props) Film viewer with magnifier Film marker Film storage envelopes

RADIOGRAPHY 5888H - Veterinary Dental Nursing Accessories Film Viewer Film Positioners

RADIOGRAPHY 5888H - Veterinary Dental Nursing How many views? At least 2 views at right angles –Plus extra obliques to highlight specific problems

RADIOGRAPHY 5888H - Veterinary Dental Nursing Tooth image distortion Size accuracy & fine detail more important than for normal radiographs – Require exact measurements in endodontics- measuring exact length of root canal –Small & subtle lesions may need to be detected

RADIOGRAPHY 5888H - Veterinary Dental Nursing Types of distortion Anatomic –When film cannot be positioned parallel to object being measured (tooth) Beam magnification –Point source effect Blurring –Movement –Aperture effect –Scatter

RADIOGRAPHY 5888H - Veterinary Dental Nursing Anatomic distortion Shortening Lengthening

RADIOGRAPHY 5888H - Veterinary Dental Nursing Beam magnification Point source effect

RADIOGRAPHY 5888H - Veterinary Dental Nursing Blurring distortion Movement Aperture effect (depth of field) Scatter (thickness of tissue)

RADIOGRAPHY 5888H - Veterinary Dental Nursing Reducing distortion Centering Coning down (collimation) Longer anode-film distance –Reduces point source effect If possible –Film parallel to length of tooth Otherwise –Bisecting angle technique

RADIOGRAPHY 5888H - Veterinary Dental Nursing Radiographic Beam Direction 90° Angle (Parallel) Beam technique –Film & Tooth parallel (< 15° separation) Possible for lower PM2-3 M1-3 (film inside mouth) Possible for lower PM1 and all Ms (film outside) –Beam perpendicular Bisecting Angle Beam technique –Film & Tooth not parallel (>15° separation) Required for all Incisors and Cuspids (Canines) –Beam angle is simply averaged to compensate

RADIOGRAPHY 5888H - Veterinary Dental Nursing Parallel technique

RADIOGRAPHY 5888H - Veterinary Dental Nursing Parallel technique

RADIOGRAPHY 5888H - Veterinary Dental Nursing Mandibular molars Can position film parallel Place lingual side Perpendicular beam

RADIOGRAPHY 5888H - Veterinary Dental Nursing Parallel technique

RADIOGRAPHY 5888H - Veterinary Dental Nursing Bisecting Angle

RADIOGRAPHY 5888H - Veterinary Dental Nursing Bisecting angle technique 1.Get Long Axis of tooth 2.Get Long Axis of film 3.Bisecting Axis = half way between 1 and 2 4.Aim beam perpendicular to Bisecting Axis

RADIOGRAPHY 5888H - Veterinary Dental Nursing Bisecting angle technique Use a straight object (e.g. tongue depressor) to help imagine bisecting angle

RADIOGRAPHY 5888H - Veterinary Dental Nursing Mandibular Canine 1. Film 2. Tooth 3. Bisecting Angle X-RAY BEAM

RADIOGRAPHY 5888H - Veterinary Dental Nursing The imaginary bisecting line Is simply ‘eyeballed’

RADIOGRAPHY 5888H - Veterinary Dental Nursing Mandibular Canine

RADIOGRAPHY 5888H - Veterinary Dental Nursing Rostral mandibular PMs Symphysis prevents placing film parallel Bisecting angle

RADIOGRAPHY 5888H - Veterinary Dental Nursing Maxillary Canine - lateral

RADIOGRAPHY 5888H - Veterinary Dental Nursing Maxillary Canine – lat. oblique

RADIOGRAPHY 5888H - Veterinary Dental Nursing Maxillary Canine – lat. oblique

RADIOGRAPHY 5888H - Veterinary Dental Nursing Carnassial

RADIOGRAPHY 5888H - Veterinary Dental Nursing A Near-Parallel technique

RADIOGRAPHY 5888H - Veterinary Dental Nursing A Near-Parallel technique

RADIOGRAPHY 5888H - Veterinary Dental Nursing Ventro-dorsal technique – skull

RADIOGRAPHY 5888H - Veterinary Dental Nursing Dorso-ventral technique – skull

RADIOGRAPHY 5888H - Veterinary Dental Nursing 45° Lateral Oblique technique Mandible

RADIOGRAPHY 5888H - Veterinary Dental Nursing 45° Lateral Oblique technique Maxilla

RADIOGRAPHY 5888H - Veterinary Dental Nursing Mandibular incisors/canines Dorsal recumbency Bisecting angle Center on 1 st Incisors

RADIOGRAPHY 5888H - Veterinary Dental Nursing Any problems? No - normal

RADIOGRAPHY 5888H - Veterinary Dental Nursing Any problems? Periodontal disease

RADIOGRAPHY 5888H - Veterinary Dental Nursing Any problems? Apical lysis (probably apical abscess)

RADIOGRAPHY 5888H - Veterinary Dental Nursing Any problems? Tooth hardening (sclerosis) after pulpitis

RADIOGRAPHY 5888H - Veterinary Dental Nursing Any problems? ‘Root canal’ has been performed

RADIOGRAPHY 5888H - Veterinary Dental Nursing X-Ray Safety Usual precautions Remember: –1 brick = 0.5 mm lead

RADIOGRAPHY 5888H - Veterinary Dental Nursing Digital Imaging Still uses X-Rays Uses a small X-Ray sensor Immediate image obtained –Can easily manipulate image Enlarge Contrast Store & Share

RADIOGRAPHY 5888H - Veterinary Dental Nursing The End