1. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Extraoral and Digital Radiography Chapter 23

2. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Extraoral Radiographs Panoramic –Common in general and specialty offices Cephalometric –Common with orthodontists Digital –Becoming standard –Easier for staff

3. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Panoramic Radiography Tomography –One layer shown Rotational centers –Tubehead –Cassette Focal trough –Image layer or sharpness

4. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Panoramic Unit Exposure controls Head positioner X-ray tubehead Cassette holder © Cengage Learning 2013

5. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Panoramic Techniques Lead apron without thyroid collar Bite block barrier Cassette preparation in dark room Explanation of procedure –Patient must be still

6. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Common Errors Preparation –Ghost image –Lead apron artifact Positioning –Too far forward or too far back –Patient’s head tilted down or up –Patient’s tongue not against roof of mouth –Patient not standing up straight

7. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Check What can be visualized on a panoramic radiograph? –Entire dentition, nasal and orbital areas, alveolar bone, carious lesions, fractures, cysts, tumors, malocclusion, maxilla, mandible, sinuses, unerupted teeth, dental appliances, restorations, periodontal disease, and TMJ

8. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Cephalometric Radiographs Patient’s skeletal structure and profile Orthodontists mainly use Lateral jaw radiograph Transcranial TMJ radiograph © Cengage Learning 2013

9. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Radiographic Interpretation Terminology –Anatomical landmarks –Radiopaque –Radiolucent –Diagnosis –Interpretation –Superimposition

10. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Tooth and Surrounding Tissues © Cengage Learning 2013

11. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Mandibular Landmarks © Cengage Learning 2013

12. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Maxillary Landmarks © Cengage Learning 2013

13. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Imaging Systems and Digital Radiology Computed tomography (CT) Magnetic resonance imaging (MRI) Digital radiography –New technology becoming common –Dental film not needed

14. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Digital Radiography Analog image –No limits Intraoral and extraoral possible Pixels and gray scale

15. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Digital Radiography Direct digital imaging –X-ray machine –Sensor –Computer monitor and software

16. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Digital Radiology Indirect digital imaging –Converts traditional X-rays to images –Scanner –Computer monitor and software Storage phosphor imaging

17. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Advantages of Digital Radiology Less radiation to patient Quick results Image alterations possible Storage Darkroom, equipment, and solutions eliminated Data files can be attached

18. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Disadvantages of Digital Radiology Initial expense Proficiency training Uncomfortable sensors System failures

19. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. 3-Dimensional (3-D) Imaging in Dentistry Shows immediate 3D reconstruction of patient’s mouth, face, and jaw areas Lowest possible radiation levels “Cone beam” shaped to cover image in single scan

20. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Uses and Benefits of 3-D Imaging Locate detailed anatomy Evaluate deformities Locate pathology –E.g., cysts, bone lesions Show miniscule detail Determine bone quality Evaluate temporomandibular disorders (TMD) and TMJ diagnosis

21. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Patient Preparation Patient may stand or sit comfortably in open scanner Scans can be done in dental office Scans are quick –8 to 20 seconds Information is processed in less than one minute and ready to be examined by dentist to discuss diagnosis with patient

22. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Hand-Held Intraoral Radiography Battery-operated and portable Low radiation dose Digital control panel –Adult-Child –Anterior, posterior, and bitewings –Expose film, digital sensors, or phosphor plates

23. ©2013 Delmar, Cengage Learning. All Rights Reserved. May not be scanned, copied, duplicated, or posted to a publicly accessible website, in whole or in part. Dental Check Discuss what makes digital imaging more efficient. –Is immediate – no processing involved –Patient can view at the same time as the dentist –Can easily be e-mailed to third parties when necessary