Dental Radiographic Image

This document provides information about dental radiographic image, including a case study on preparing a patient for x-rays and the necessary safety precautions. It also explains how to ensure quality x-rays and correctly label, mount, and store them.

Running head: DENTAL RADIOGRAPHIC IMAGE
DENTAL RADIOGRAPHIC IMAGE
Name of the Student:
Name of the University:
Author note:

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Case Study 1:
Q1) Explain how you would prepare Mr. White for his x-rays, any safety precautions you
take, your choice of x-ray equipment, accessories such as locating devices or guides, and
technique for the x-rays including positioning of film or film plate or sensors.
Mr. White was new patient and his initial appointment was for bitewing X-rays.
Bitewing X-rays are the most common type of X-rays taken up by the patient during regular
dental check-ups. Bitewing X-ray displays the upper and lower premolars and molars in a
solitary view. This X-ray is used to discover for decay, detection of infection leading to bone
loss and to evaluate severe gum diseases (Nwpgmd.nhs.uk 2019). Mr White was prepared to
position properly before taking up the X-ray. He has to be informed in detail about the X-ray
and the outcome of the test. He was asked to sit on the chair and to remove any orthodontic
appliances ion case he used any; the chair was adjusted with the headrest to support his head
while taking up the X-ray. Once he was positioned properly, the operator made sure that lead
aprons and the thyroid collar was given to him as a safety precaution.
The major safety precaution taken into consideration was to cover the patient with
lead aprons and thyroid collar, which will protect his exposed body parts from radiation
including his neck and reproductive organs. The radiation level in bitewing X-ray method is
very less when compared to other radiation approach still the safety measures were
considered to avoid any future risk (Dianati et al. 2014). Except the operator and the
specialist, nobody else was allowed in the X-ray room. Film holders were used so that the
patient do not have to hold the film or nay kind of exposure takes place.
For bitewing X-ray, Rinn bitewing instrument was used where patient has to bite a
wing, which will be placed on the X-ray film to examine the problem. There are three
different types of film, which can be used for this process such as interproximal caries,

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restorations contours and Crestal bone levels. The film was placed in the instrument. The
premolar and molar bitewing film was placed in the second premolars and second molars
respectively. It is always recommended to start the process by placing the film first in second
premolars, so that the patient is adjusted with the film. Once X-ray is done for both
premolars, the operator should move the film to second molars. In case of Mr White, film
size of 31*41 mm was used with a longer film packet of size 53*26 mm (Training.gov.au
2019). The film is placed inside the mouth parallel to the crown with the X-ray beam directed
in contact with the teeth or over the connection areas, with right angles of the teeth and the
film packet. In this method of X-ray film holders are used to eliminate the traditional method
of bitewing X-ray were detachable tabs were used instead of film holders. Each bitewing X-
ray expose the upper as well as lower part of the teeth with a detail view of the roots and the
supportive bone.
Q2) What precautions do you take to ensure quality x-rays and how do you label, mount and
store the x-rays correctly?
X-ray technicians are used to operate and to maintain the X-ray with quality. In order
to get supreme quality of X-rays, the technicians are firstly required to manipulate or operate
the equipment properly with prior knowledge of the machine (Zenobio et al. 2018). After
every X-ray conducted, it is necessary to wash or clean up the equipment to ensure the best
quality of the X-ray because the correct calibration of the equipment is necessary to avoid
any kind of error. The second most important aspect of maintaining supreme quality of X-ray
is the perfect patient alignment. The proper positioning of patient is the only important
criteria while taking up the X-ray as the Film needs to be placed correctly with minimum
possibility of error. In case of movable x-ray equipment, good ergonomic methods need to be
used (Zenobio et al. 2018). Precautions has to be taken while developing the X-ray film too.

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Different chemicals or compounds with film processing equipment is required for developing
X-ray film. The material safety data sheets (MSDS) should be considered in case of using
chemicals for developing the X-ray so that the operator know how to exactly function the
equipment. Chemical resistant gloves and splash goggles need to be used while functioning
with wet chemicals for developing the X-ray.
Once the X-ray has been taken, it is labelled and mounted properly with correct
patient information and stored (Claudia et al. 2018). The patient data is entered into the cut
tape and labelled in bold. The label is removed through crack and peel backing paper and is
adhered to the required X-ray. All the X-ray films must be stored in a vented cab inets or
vented storage room in hospitals.
Case Study 2:
Q1) Explain how you operate the necessary equipment for this exposure.
An Orthopantogram (OPG) provides a panoramic outlook in a sole film, which
includes lower face covering all the teeth of the upper and lower jaw. This method gives an
overview of the teeth, which is still not surfaced or erupted. OPG also reveals the problem of
jawbone and the joint fixing the jawbone with the head of the patient (Walshaw and Mannion
2018). Radiographic imaging equipment is used in case of OPG, which is operated by the
technician. This equipment is operated when the patient is standing and relaxing his face on a
trifling shelf. A sterilized mouthpiece is provided to the patient to help him stand steadily and
firmly. The accurate and firm positioning of the patient is considered as the most essential
criteria for operating the radiographic imaging in OPG. The head and neck of the patient
needs to be straight and firm. Three different rays of light is essential for this exposure
process, which comprises of mid saggital, canine position and Frankfort (Claudia et al. 2018).

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Once the patient is positioned properly, the operators starts the procedure by placing the X-
ray film in the mouth of the patient with all safety measures and then mount and label the
film to analyse the result.
Q2) Once the image has been produced, you notice it is blurred. How do you prevent blurred
images occurring?
Steps taken to prevent occurrence of blurred images are as follows (Rockenbach,
Morosolli and Dias 2018):
 Patient should be positioned properly while taking up the radiography. If the patient
was not positioned properly then the X-ray will have a blur image and to overcome
that a retake radiography is conducted.
 The size of the image plane or focal trough must be adjusted properly according to the
patient to overcome any kind of blur images.
 The latest radiographic machines are fully automated as compared to the older ones
hence, the specialist should use the automatic radiographic machine with all the facilities
and no prior adjustments.
 The light alignment of the X-ray must be accurate and precise.
 The radiation dosage must be kept in mind while performing the X-ray as for older people
the amount of radiation is different from younger people with high-resolution sensors.
 Image enhancement like local equalization, colorization and embossing must be done to
obtain a proper and correct X-ray with no errors or blur images.

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References:
Claudia, A., Barbu, H.M., Adi, L., Gultekin, A., Reiser, V., Gultekin, P. and Mijiritsky, E.,
2018. Relationship between third mandibular molar angulation and distal cervical caries in
the second molar. Journal of Craniofacial Surgery, 29(8), pp.2267-2271.
Dianati, M., Zaheri, A., Talari, H.R., Deris, F. and Rezaei, S., 2014. Intensive care nurses’
knowledge of radiation safety and their behaviors towards portable radiological
examinations. Nursing and midwifery studies, 3(4).
Nwpgmd.nhs.uk 2019. [online] Nwpgmd.nhs.uk. Available at:
https://www.nwpgmd.nhs.uk/dentistry/courses/docs/Bitewing%20Radiography.pdf
[Accessed 25 Feb. 2019].
Rockenbach, M.I.B., Morosolli, A.R.C. and Dias, V.S.C., 2018. Periapical radiographic
technique errors made with digital sensors. Journal of Pharmaceutical and Biological
Sciences.
Training.gov.au 2019. [online] Training.gov.au. Available at:
https://training.gov.au/TrainingComponentFiles/HLT07/HLTDA304D_R1.pdf [Accessed 25
Feb. 2019].
Walshaw, E.G. and Mannion, C.J., 2018. A systematic approach. British Dental Journal,
224(8), p.560.
Zenóbio, E.G., Zenóbio, M.A., Azevedo, C.D., Nogueira, M.D.S., Almeida, C.D. and Manzi,
F.R., 2018. Assessment of image quality and exposure parameters of an intraoral portable X-
rays device. Dentomaxillofacial Radiology, 47(xxxx), p.20180329.