Radiographic Examinations in Dentistry

This document discusses the main considerations taken by dental operators before conducting radiographic examinations, including age, gender, and evaluation of dento-alveolar trauma. It also explains the types of intra-oral X-rays and the use of magnetic resonance imaging in dental imaging. Additionally, it covers different types of dental images, such as binary, grayscale, and color images. The document concludes with a discussion on the importance of informed consent in dental procedures.

Running head: MEDICAL
Medical
Name of the Student
Name of the University
Author Note

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Answer: 1
The main consideration taken by the dental operator before the conduction of the
radiographic examinations include the age and gender (Jansson et al. 2014). Other factors
taken under consideration include evaluation of the dento-alveolar trauma in case of the intra-
oral radiographic examination. If the main zone of interest extends beyond the dento-alveolar
complex then extra-oral imaging is recommended. In case of bone-loss due to peri-dontal
disease, development of the anomalies along with occult disease is also considered. However,
it is not recommended to conduct radiographic screening for the purpose of detecting the
disease before conduction of the clinical examination (Jansson et al. 2014). In case of a child
with transitional dentition, individualised radiographic exam is considered done in the
posterior bitewings with the help of the panoramic exam and periapical images. 6-12 months
of interval is taken under consideration if the proximal surfaces cannot be examined visually
or by the use of the probe (Jansson et al. 2014).
Answer: 2
Artefacts in the image of the dental X-ray can occur as a result of the improper
handling of the packet of the film or improper process of the films, excessive moment of
tube. Thus in order to avoid the formation of artefacts over the X-ray film, proper handling of
the radiographic film and image processing technique must be undertaken like use of gloves
and controlling the exposure of the film during the developing phase. Tan et al. (2013) are of
the opinion that in order to control the distorted images, proper alignment of the tube is
important like vertical elongation at an optimum level. In order to avoid the finger marks
proper handling of hands is important like avoidance to contact of fluoride particles (grease)
over the finger tips. In order to control the blurred images proper movement of hands is
important during the tubing exposure. The duplicating image must be free from dirt and

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radiolucent spots (powder from the gloves, developer drops and spilling of developing
chemicals) thus developing stage must be done under utter sincerity (Tan et al. 2013).
Answer: 3
The bitewing film refers to little piece or tab of plastic or paper situated at the centre
of the X-ray film. The tab when bitten enables the film to hover so that it can capture an even
amount of the dental information. The bitewing portion of the film packet must be positioned
along the long axis either horizontally or vertically (Herman and Ashkenazi 2013). According
to Herman and Ashkenazi (2013), bitewing of the X-ray film is done in order to hold the teeth
of the patient in place that in between the film attached and on the side of their tongue. The
X-ray beam is directed outside of the cheek of the patient in order to make equitable
exposure. This particular design helps to get a clearer image as the bite of the patient helps to
keep the film still and free from distortion thereby making it easier in order to view the signs
of the early decay of teeth.
Answer: 4
There are three types of intra-oral X-rays
(i) Bite-wing X-rays: It helps to highlight the lower and the upper part of the teeth in one area
of the mouth. After each bite-wing the teeth is exposed from its crown (the exposed surface)
to the base level of the supporting bone. It used to detect the thickness of the gum disease
(Ludwig et al. 2016)
(ii) Peri-apical X-rays: It is done to show whole portion of the mouth starting crown area to
beyond the root where the tooth is attached within the haw. Entire portion of the teeth is
exposed in exposed thus helping to detect unusual changes in the root and the surrounding

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bone structures. This approach is used in case of the detection of the cavity for the paediatric
gum and teeth care (Ludwig et al. 2016)
(iii) Occlusal X-rays: It is used to track the development and placement of the overall arch of
the teeth either in the upper or the lower jaw portion of the teeth (Ludwig et al. 2016)
Answer: 5
Magnetic resonance is most comprehensive radiological imaging technique which
helps in accurate evaluation of the joint structures of the bone and the soft tissue of the gum.
This imaging technique helps in the detection of the acute and sub-acute images of the tooth
decay and the problem in gum under the application of the "light bulb effect" over the fat-
suppressed sequences done under long-repetition time. Magnetic resonance imaging is known
for their excellent spatial resolution and is thus helpful in highlighting the complex bone
structures of the bones. The magnetic resonance imaging are at times manipulated in the form
of the cone beam computerised tomography in order to evaluate more intricate imaging of the
teeth (Tan et al. 2013)
Apart from this, two dimensional, peri-apical and panoramic radiographs are
frequently used in the dental practice. However, these two-dimensional imaging techniques
are associated with sudden limitations which can be over-come under the application of the
one-dimensional imaging technique (Tan et al. 2013)
Answer: 6
1. Binary image: It is the simplest form of image and can record two values like white and
black under the parameter of 0 or 1. It is referred as 1-bit image as it takes only 1 binary digit
in order to represent each pixel. It is frequently used to outline the basic shape of teeth (Rad,
Rahim and Norouzi 2013)

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2. Gray-scale image: It is also known as monochrome image or one-colour image and they
contain gray-level information and no specific information about the colour, the total number
of bits used for each pixel determinants is regarded as the number of different gray level
present within the image. Mainly it contains 8 bits/pixel data (Rad, Rahim and Norouzi 2013)
3. Colour image: it is modelled as three-band monochrome image where each of the band
correspond to different colours. The main information stored within the digital data is known
as gray-level information. It is 24 bits/pixel image where 8-bits is considered for each for the
colour bands like red, green and blue (Rad, Rahim and Norouzi 2013)
Answer: 7
Giving informed consent means given consent to conduct a therapy plan or undertake
a biochemical imaging technique under consent of the patient or his or her family members
(in case of minor patient). Here the term informed signifies that patient is well-aware about
the intended outcome of the technique along with the prognosis of the therapy. The informed
consent is taken in pen and paper. Here the patient is asked to sign a document before the
initiation of the tests or the therapy plan. If the patient is unable to understand the therapy
informed consent then it is duty of the nursing professional to make the patient understand
the entire therapy plan by the use of the effective communication skills. Abiding by the
informed consent helps to align with the ethical principal of autonomy which states that it is
the right of the patient to have comprehensive right to provide consent before the initiation of
the therapy plan (Kakar et al. 2014).

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References
Herman, H.D. and Ashkenazi, M., 2013. Quality of bitewing radiographs in children in
relation to the type of film holder used. European Archives of Paediatric Dentistry, 14(3),
pp.141-146.
Jansson, H., Wahlin, Å., Johansson, V., Åkerman, S., Lundegren, N., Isberg, P.E. and
Norderyd, O., 2014. Impact of periodontal disease experience on oral health–related quality
of life. Journal of periodontology, 85(3), pp.438-445.
Kakar, H., Gambhir, R.S., Singh, S., Kaur, A. and Nanda, T., 2014. Informed consent: Corner
stone in ethical medical and dental practice. Journal of family medicine and primary
care, 3(1), p.68.
Ludwig, U., Eisenbeiss, A.K., Scheifele, C., Nelson, K., Bock, M., Hennig, J., Von
Elverfeldt, D., Herdt, O., Flügge, T. and Hövener, J.B., 2016. Dental MRI using wireless
intraoral coils. Scientific reports, 6, p.23301.
Rad, A.E., Rahim, M.S.M. and Norouzi, A., 2013. Digital dental X-ray image segmentation
and feature extraction. TELKOMNIKA Indonesian Journal of Electrical Engineering, 11(6),
pp.3109-3114.
Tan, J.H., Chao, C., Zawaideh, M., Roberts, A.C. and Kinney, T.B., 2013. Informatics in
radiology: Developing a touchless user interface for intraoperative image control during
interventional radiology procedures. Radiographics, 33(2), pp.E61-E70.