ROENT LAB diagnostically acceptable x-ray images, as

well as for the care and maintenance of the

Roentgenology (Lab)-JMMACAPAGAL equipment used to obtain patients x-ray
images. Learning about the machine will
Introduction also help everyone in communicating with
X-ray technology today is a culmination of others regarding safety and improve
more than a century of innovation technique and outcome of exposures.

and experimentation. Oral radiology is one Objectives:

of the most important fields of dentistry 1. Describe all the parts of the dental x-
because the resulting images can reveal ray machine and discuss the
non-clinically visible structures, which would function of each
help in treatment planning. Being aware of 2. Demonstrate the proper way of
the conditions in the oral cavity the dentist handling the x-ray machine safely
and patient may discuss treatment options
to make informed decisions together. Oral M1 Lesson 1: The X-ray Machine
radiographs serve as an adjunct to the
The x-ray machine is an
dentist’s professional judgment so he may
indispensable tool in a dental office.
give the best possible care and treatment
Dentists use it to find hidden dental
for the patient. Learning to use on x-ray
structures, bone loss and cavities. It is one
machine properly and safely is the first step
of the tool used in diagnosing a variety of
in guaranteeing proper care for your
dental problems. Continue learning about
patients.
the x-ray machine by studying - xray
Module 1 machine.pdf

Module 1: Introduction to Oral X-ray Machine

Radiology-2
● Vertical adjustment indicator
X-ray machines are complex devices that scale
are designed to emit radiation on demand. ● Horizontal adjustment/pivot
Understanding the way x-rays are created ● Control panel
and properly utilizing the tools used to ● Support arm
create images will help in the care of ● Focal spot
patients as well as improve their quality of ● Tubehead
life. All of the disciplines of dentistry would ● PID/BID
require proper imaging, may it be film based ● Yoke
or digital. Learning about the machine will
help everyone in communicating with others
to improve technique and outcome of
exposures.
M1 Lesson 1: X-ray Machine Introduction
& Objectives
The X-ray Machine
It is crucial that a clinician be aware and has
knowledge of components of a dental x-ray
machine. It is their responsibility to obtain
PID = position indicating device
BID = beam indicating device

Vertical angulation indicator scale 00 -

±900

Digital type Control Panel

● Exposure time is preselected per
tooth into the control panel
● Exposure time for children may also
be selected using the control panel
● Exposure time may also be selected
dependent on what type of film
exposure is needed
 mobile Dental X-rayX-ray machines are very
inefficient machines in creating x-rays. Even
though inefficient it is the only safe way we
can create a usable x-ray beam that can be
used for diagnostic purposes. It is important
for a clinician to understand how x-rays are
generated so they may appreciate the
● Custom exposure times may also be
complexity of the equipment them are
selected in the control panel as the
employing.
need arises
Objectives:
1. Understand how the x-ray machine
generates energy
2. Understand the conditions necessary
for x-ray production
M1 Lesson 2: X-Ray Generation Pre-task
READING ASSIGNMENT
Read chapter one of Oral radiology
Principles and Interpretation by Stuart C.
White, Michael J. Pharoah 7th edition
Take note of the objectives of this lesson
when you read the assigned chapter.
M1 Lesson 2: X-Ray Generation

X-rays are produced within the X-ray

machine, also known as an X-ray tube. No
external radioactive material is involved.
          Radiographers can change the
current and voltage settings on the X-ray
machine in order to manipulate the
properties of the X-ray beam produced.
Different X-ray beam spectra are applied to
different body parts.  Read the lecture abou

M1 Lesson 2: X-ray generation tthe X-RAY PRODUCTION .pdf,     

Download X-RAY PRODUCTION .pdf,  Also
Introduction & Objectives-2
read the article about the Basics of X-ray
Physics (Links to an external site.) to further
understand the lesson.

X-RAY PRODUCTION (pdf)

● The safest means of generating

x-rays is in an x-ray tube, and the
simplest form of an x-ray tube is
a sealed leaded glass envelope
from which air has been evacuated

XRAY TUBE
ANODE - Dental x-ray machines have
stationary anode limiting their size

Tubehead

Schematics of a dental x-ray machine

circuitry and x-ray tube
CATHODE
 ● Production of high-speed electrons
● Focusing of electrons
● Stopping of high-speed electrons at
the target
■ End

Article about the Basics of X-ray Physics

Basics of X-ray Physics (Links to an
external site.) 

Basics of X-ray Physics

TWO PROCESSES OF X-RAY
PRODUCTION X-ray production
● When the fast-moving electron X-rays are produced within the X-ray
stream strikes the tube target, the machine, also known as an X-ray tube. No
cathode electrons interact with target external radioactive material is involved.
atoms producing x-rays by the Radiographers can change the current and
following two processes: voltage settings on the X-ray machine in
o GENERAL RADIATION order to manipulate the properties of the X-
o CHARACTERISTIC ray beam produced. Different X-ray beam
RADIATION spectra are applied to different body parts.

GENERAL RADIATION Key points

(BERMSSTRAHLUNG)
● Most of the x-rays produced by the ● X-rays are produced by interaction of
dental x-ray machines are called accelerated electrons with tungsten
Bremsstrahlung, Brems, White, or nuclei within the tube anode
General Radiation ● Two types of radiation are generated:
characteristic radiation and
bremsstrahlung (braking) radiation
● Changing the X-ray machine current or
voltage settings alters the properties of
the X-ray beam
The X-ray tube

CHARACTERISTIC RADIATION A small increase in the filament voltage (1)

results in a large increase in tube current
(2), which accelerates high speed electrons
from the very high temperature filament
negative cathode (3) within a vacuum,
towards a positive tungsten target anode
(4). This anode rotates to dissipate heat
generated. X-rays are generated within the
FOUR CONDITIONS NECESSARY FOR tungsten anode and an X-ray beam (5) is
THE directed towards the patient.
PRODUCTION OF X-RAYS
● Generation of electrons
 ● Approximately 80% of the population
of X-rays within the X-ray beam
consists of X-rays generated in this
way.

X-rays are generated via interactions of the

accelerated electrons with electrons of
tungsten nuclei within the tube anode.
There are two types of X-ray generated:
characteristic radiation and bremsstrahlung
radiation.
The X-ray spectrum
Characteristic X-ray generation
● As a result of characteristic and
bremsstrahlung radiation generation
a spectrum of X-ray energy is
produced within the X-ray beam.
● This spectrum can be manipulated
by changing the X-ray tube current
or voltage settings, or by adding
filters to select out low energy X-
rays. In these ways radiographers
are able to apply different spectra of
X-ray beams to different body parts.

Characteristic X-ray generation

When a high energy electron (1) collides
with an inner shell electron (2) both are
ejected from the tungsten atom leaving a
'hole' in the inner layer. This is filled by an
outer shell electron (3) with a loss of energy
emitted as an X-ray photon (4).
Bremsstrahlung/Braking X-ray generation
● When an electron passes near the The X-ray beam
nucleus it is slowed and its path is
deflected. Energy lost is emitted as a X-rays travel in straight lines and a beam of
bremsstrahlung X-ray photon. X-rays diverges from its source. Structures
● Bremsstrahlung = Braking radiation the beam hits first will be magnified in
relation to those which are nearer the
detector. To reduce magnification the X-ray
source can be moved further away from the
subject. Structures that need to be
measured accurately should be placed
closer to the detector.
Key points
● X-rays travel in straight lines
● Body parts further away from the Helpful magnification
detector are magnified compared
with those that are closer ● Knowledge of the magnifying
● Occasionally magnification can be properties of an X-ray beam is
helpful in localising abnormalities sometimes helpful.
● In this image there is a simulated
AP v PA magnification abnormality (arrow) located in the
posterior part of the chest, not visible
Anterior-Posterior (AP) magnification
on a PA view as it lies below the top
The X-ray beam for an anterior-posterior of the diaphragm (green line).
(AP) view of the chest exaggerates heart ● This is a LEFT lateral image, that is,
size as the heart is relatively near to the the LEFT side of the body is closest
beam source. to the detector and the X-ray beam
has passed from RIGHT to LEFT.
Body structures such as the RIGHT
ribs therefore appear bigger and are
more posteriorly placed in relation to
their counterparts on the LEFT
which are less magnified.
Near beam magnification ● It is possible to locate this abnormal
shadow (arrow) on this lateral view
A source that is too near the patient will because it extends behind the line
further exaggerate the size of structures formed by the LEFT ribs. Assuming
nearest to that source. it lies within the rib cage at all, it
must be located on the RIGHT.

Posterior-Anterior (PA) projection

A posterior-anterior(PA) beam view of the
chest allows more accurate representation
of heart size as the heart is positioned
closer to the detector and is therefore less
magnified.
 in either density or thickness of two adjacent
structures leads to greater contrast between
those structures within the image.
For descriptive purposes there are five
different densities that can be useful to
determine the nature of an abnormality. If
there is an unexpected increase or
decrease in the density of a known
anatomical structure then this may help
determine the tissue structure of the
abnormality.
The 5 X-ray densities
Low density material such as air is
represented as black on the final
radiograph. Very dense material such as
metal or contrast material is represented as
white. Bodily tissues are varying degrees of
Tissue densities grey, depending on density, and thickness.

A radiographic image is composed of a

'map' of X-rays that have either passed
freely through the body or have been
variably attenuated (absorbed or scattered)
by anatomical structures. The denser the
tissue, the more X-rays are attenuated. For
example, X-rays are attenuated more by
X-ray tissue densities
bone than by lung tissue.
Here are the four natural tissue densities
seen on a chest radiograph. Note there is a
Key points range of greyness, depending on the
thickness of each tissue.
● An X-ray image is a map of X-ray
attenuation Natural tissue densities
● Attenuation of X-rays is variable
1 - Air/Lung
depending on density and thickness
2 - Fat (layer between soft tissues)
of tissues
3 - Soft tissue
● Describing X-ray abnormalities in
4 – Bones
terms of density may help in
determining the tissue involved
Describing densities X-ray tissue densities
The greatest contrast is found in areas of
Contrast within the overall image depends greatest difference in density of adjacent
on differences in both the density of structures (red circle).
structures in the body and the thickness of
those structures. The greater the difference
If you think there is an abnormal structure in
an X-ray, try describing it in terms of X-ray safety
density. Ask yourself if density is abnormally It's the law!
increased, or decreased. Ask yourself how
dense it is in relation to adjacent normal Referrers for radiological investigations are
structures. required to provide sound clinical reasons to
justify exposing patients to radiation. Local
Abnormal X-ray densities rules of the X-ray department must be
There is a large area of increased density adhered to, as ignoring them may result in
on the left side of the chest. This has breaking the law.
increased the density (increased whiteness)
of this area (green circle). This is a soft All X-rays may cause alteration of cellular
division and other intracellular processes
tissue density mass that has destroyed a rib
and are therefore potentially harmful to the
which is missing. The posterior rib has lost
human body. For this reason all medical
density and therefore this area appears exposure to radiation should be justified in
blacker than normal (red circle). terms of risk to benefit ratio.

Key points
● X-rays are potentially harmful to both
patients and hospital staff
● Requests for radiological
examinations should be clinically
justified

Biological effects of X-ray exposure

Some biological effects such as skin

damage are dose dependent, whereas
others, such as development of cancer, are
random.
 small. However, local rules are enforced to
Dose dependent biological effects become ensure that dosimetry badges and
measurable above 50mSv (millisieverts) protective clothing such as lead aprons are
and a whole body dose of greater than 10Sv worn, in order to monitor and reduce staff
(sieverts) is universally lethal. The average radiation dose.
radiation dose per person in the UK is
2.6mSv per year, 2.2mSv of which is Knowledge of the 'inverse square law' helps
background and 0.4mSv relates to medical in reducing dose. This states that the dose
exposure. Diagnostic investigations typically to a given area is quadrupled be halving the
involve doses between 0.02mSV (chest X- distance from the radiation source. Simply
ray) to 10mSv (CT abdomen). This means put, standing back from a source of
that a chest X-ray amounts to 3 days of radiation reduces dose to staff. This is
background radiation and a CT abdomen is particularly important during interventional
equivalent to 4.5 years! radiology cases when radiologists or
radiographers are working close to the X-
Some body parts are more susceptible to ray beam.
the random damaging effects of radiation.
These are generally tissues with rapidly The inverse square law
dividing cells, for example, radiation dose to ● The strength of the X-ray beam is
the stomach is over 20 times more likely to inversely proportional to the square
result in a fatal cancer than the same dose of distance from the source (X).
to bone. ● Standing back by double the
distance from a source of radiation
Radiation exposure to reproductive organs (d to 2d) will quarter the dose to the
carries further potential risk to future radiologist or radiographer.
generations. Children are more
radiosensitive than adults and irradiation of
a fetus should be avoided wherever
possible.

Safety principles
Several principles should be adhered to in
order to reduce risk to patients.
JUSTIFICATION - Potential benefit of
radiation exposure should outweigh risk.
OPTIMIZATION - Measures should be in
Radiation safety should be taken
place to reduce dose to patients and staff.
seriously by all referring doctors. If
LOCAL RULES - Measures to ensure wider
you are in doubt about justifying a
regulations are enforced, for example that
procedure or investigation you
X-ray machines are correctly installed and
should discuss it with a radiologist.
used, and that referrals are justified.
For more information please use
the 'iRefer' guidelines available
Risks to staff
online from the Royal College of
Radiologists.
Staff are also at potential risk from radiation
exposure. The doses that radiologists and
radiographers are exposed to are generally
Tutorial conclusion

Key points
● X-rays are produced de novo when
needed
● No radioactive substance is used
● X-rays travel in straight lines and are
attenuated by body tissues
according to density and thickness
of those tissues
● X-rays are potentially hazardous
● Hospital staff have a duty to use X-
rays responsibly

Having a basic knowledge of radiation M1 Lesson 3: Types of X-Ray Film Pre-

physics and safety is helpful in appreciating task
some of the limitations of X-ray
investigations. The science of radiographics Read Chapter 5: Film Imaging of our
deal with understanding and overcoming textbook Oral Radiology Principles and
some of these difficulties. Interpretation by Stuart C. White, Micheal
J. Pharoah (7th Edition).
■ End
Take note of the answers to the objectives
M1 Lesson 3: Types of dental x-ray film of this lesson when you read the assigned
Introduction & Objectives-2 chapters.

The most utilized recording media or image

receptor for diagnosis is dental radiographic M1 Lesson 3: Types of X-ray Film
film. It is of utmost importance that
radiographs be properly produced to aid in There are various types of Dental X-rays
proper decision making in diagnosis and which are used according to the
treatment, thus adding care and value in requirement starting from a Periapical X-ray
management our patients. which is the smallest and most commonly
used Dental x-ray film available in almost all
Objectives: Dental clinics used to capture an x-ray of
1. Differentiate the various types of one to three teeth at a time in a single arch.
intraoral films The comes the Bitewing radiograph which
2. Evaluate the ways of using the accommodates two to three in opposing
different types of intraoral film. arches at the same time.  Occlusal Films
are another Intra Oral radiographs which
show the radiographic image of the occlusal
aspect. Continue reading about the
article Different Types & Sizes of X-Ray
films - DentistryLinks to an external site. by
JuniorDentist.com.  Also, study the

provided X-ray film.pdf     Download X-

ray film.pdf  for further understanding of the radiographic appearance of a specific
lesson region or segment of the oral cavity where
the infection is suspected or restricted to.
Article: Different Types & Sizes of X-Ray
films – Dentistry PERIAPICAL:

Dental Xrays are one of the most important This type of radiograph helps in recording
part of a successful dental treatment, any the structures surrounding the Apical region
dental treatment starts from Diagnosis of of the tooth hence the name Periapical
the present problem or condition. As a which means around the Apex of the tooth
Dentist after hearing the chief complaint of (root)". There are three types of Periapical
the patient we get a minimum of two to X-rays based on the size of the film.
three conditions in mind leading to
Differential Diagnosis. To come to a proper
diagnosis Dental Radiograph plays a major
role.

There are various types of Dental Xrays

which are used according to the
requirement starting from a Periapical Xray
which is the smallest and most commonly Intra Oral Peri Apical Radiograph
used Dental Xray film available in almost all
Dental clinics used to capture an Xray of o Size 0: 22×35 mm Children
one to three teeth at a time in a single arch. o Size 1: 24×40 mm Anterior, Adults
Then comes the Bitewing radiograph which o Size 2: 31×41 mm Standard size (Ant, &
accommodates two to three teeth in
Post) Adults
opposing arches at the same time. Occlusal
Films are another Intra Oral radiographs
The size of the Size 0 film is apt for children
which show the radiographic image of the
being small in size it can fit into the
occlusal aspect.
children's oral cavity. The other two sizes
are for adults and are used in the Anterior or
The other types of Dental Radiographs are
Posterior region.
Extra Oral Radiographs like the
Cephalogram- mostly used for Orthodontic
BITEWING FILMS:
assessment of the Skeletal deformity and
the other one is Orthopantomogram (OPG)
This film is slightly bigger in size when
which is used to get a complete
compared to the regular Periapical
radiographic picture of the complete set of
radiographic film and it helps in recording
teeth.
both the upper and lower teeth in a bite
position and hence the name - Bitewing
INTRAORAL X-RAY FILMS:
radiograph.
These Films are used to record or capture
Bitewing radiograph helps in identifying any
the dental structures and anatomy from
Interdental caries, caries under existing
inside the mouth or oral cavity and hence
restorations or crowns, bone loss between
the name Intraoral. The size of the Films is
teeth etc.
usually small and are used to record the
 Occlusal Radiograph

o Size: 57x 76 mm

This film is 4 times the number of layers

o Size 0: 22 x 35 mm Ant. Children
when compared to a standard periapical
o Size 1: 24 x 40 mm Posterior, Children
film. The presence of foreign bodies and
Anterior, Adults
their location can be identified using these
o Size 2: 31 x 41 mm Posterior, Adults
X-rays such as stones in salivary ducts etc.
(Standard size)
o Size 3: 27 x 54 mm Posterior, Adults (All EXTRAORAL X-RAY FILMS:
posterior teeth are seen in 1 film) These are comparatively larger size X-ray
films which are used to record the Oral
There are four sizes of Bitewing cavity and its surrounding structures in a
radiographic films based on the position and single film. The surrounding structures
the age of the patient it is used in. include - parts of the Skull, jaw, etc. The
Image and structures recorded are large but
OCCLUSAL FILM: the detail is not similar to Intraoral
radiographs. These types of radiographs
As the name suggests, this films is used to are used in patients undergoing Orthodontic
record the Maxilla or Mandible from the treatment or TMJ problems or to identify any
occlusal surface showing all the teeth fractures and the location of the fracture and
Oclussaly. This type of Radiographic its extent. The positioning of the Wisdom
technique is used in recording the position tooth and the type of Impaction it is in.
and number of Supernumerary or Impacted
teeth in relation to the Buccal or Lingual Panoramic film: Size - 5 x 12 inch, 6 x 12
walls of the Mandible and Maxilla. inch. This type of X-ray film is used in
recording a two-dimensional scan of the
To record or the extent of displacement of upper (maxilla) and lower (mandible) jaws
the broken fragments in case of Mandibular which include the teeth, jaws, surrounding
or Maxillary Fractures. To determine the structures, maxillary sinus and even the
amount of bone left on the buccal or lingual Vertebrae. It shows a two dimensional view
aspect of a Cyst or Abscess in the Mandible of the patient starting from one ear to the
or Maxilla. other in a half circle form.
 of the structures and tissues of the oral
cavity mainly used while planning for Dental
Implants or in case of Fractures and any
lesions to get to know the extent of their
spread and surrounding structures.

X-ray film (pdf)

PARTS OF DENTAL X-RAY FILM

Panoramic Radiograph ● The beam of X-ray traversing an object
is reduced in intensity by absorption and
OPG of Panoramic Radiograph is used in scattering of the photons out of the
determining the position of Wisdom tooth in primary beam
relation to the Inferior Alveolar nerve canal. ● The pattern of the photons that exit the
presence of any fractures in the mandible object carries information pertaining to
and their location, TMJ problems etc. the structure and composition of the
absorber
Cephalometric films: Size - 5 x 7 inch, 8 x ● For this information to be diagnostically
10 inch, It is used in Orthodontic treatment useful it must be recorded on an image
planning, in some cases, a Cephalogram is receptor
taken before and after the completion of ● Image receptor most frequently used in
Orthodontic treatment to access the dental radiography is x-ray film
progress and changes in the occlusion and
relation of the maxilla to the mandible. INTRAORAL DENTAL X-RAY FILM

Two principal components:

● Emulsion
- Sensitive to x-rays and visible light
and records the radiographic image
● Base
Cephalogram - Supporting material onto which the
emulsion is coated
It is up to the Dental Practioner to decide,
which Radiograph is needed in the SCANNING ELECTRON MICROGRAPH
particular patient. There are other newer OF DENTAL X-RAY FILM
and more diagnostic procedures like CBCT
or "Cone Beam Computed tomography"
which gives you a three-dimensional image
 HOW TO HOLD X-RAY FILM PROPERLY

CONTENTS OF A INTRAORAL
DENTAL X-RAY FILM PACKET

■ end

EMBOSSED DOT

M1 Lesson 4: Parts of dental x-ray film

Introduction & Objectives-2
Being knowledgeable with the different parts
of dental x-ray film would aid in processing
of exposed film creating quality images as
well as reducing errors. This knowledge
would translate to more precise exposures
expediting rapid interpretation and
treatment.

Objectives:
 1. Distinguish the different parts of dental
x-ray film film.pdf  Download Parts of x-ray
2. Demonstrate the proper way of film.pdf
handling dental x-ray film
Parts of x-ray film (pdf)
TYPES OF X-RAY FILM
● DIRECT EXPOSURE FILM
● INTRAORAL FILM
● PEDO FILM

● ANTERIOR ADULT FILM

● POSTERIOR ADULT FILM

M1 Lesson 4: Parts of the x-ray film Pre-

task ● BITEWING FILM
READING ASSIGNMENT
Continue reading Chapter 5:  Film
Imaging of our textbook Oral Radiology
Principles and Interpretation by Stuart C. ● OCCLUSAL FILM
White, Micheal J. Pharoah (7th Edition). 
As you read, take note of the answers to the
objectives of this lesson.
Take note of the answers to the
objectives of this lesson when you read
the assigned chapter. ● INDIRECT EXPOSURE FILM
● EXTRAORAL FILM
M1 Lesson 4: Parts of the Dental X-ray ● SCREEN FILM
Film
● CASSETTE FILM or SCREEN FILM
It is important to know the parts and the
corresponding function of the dental x-ray
film. Knowing will decrease the possibility of
committing errors in taking radiographs. 
Continue learning about the parts of the
dental x-ray film by reading - Parts of x-ray
 radiography. With panoramic units, it is very
These are different from dental film in important to explain and illustrate how the
that they are designed to be parts work, and with cephalometry, it is
particularly sensitive to visible light helpful to briefly illustrate why and how the
rather than x-radiation positioning rods work. To put the patient at
The intensifying screens absorb x-rays ease, make sure you explain exactly what is
and emit visible light that exposes the being done throughout.
screen film
■ END
Cephalometric Tomographic Skull
Radiographs FILM

Screen film is used in combination

with intensifying screens

Intensifying screens are used

because
they decrease the x-ray dose to the
patient and still result in a properly
exposed film
● EXTRAORAL X-RAY MACHINE

EXTRA PATIENT CARE

Patients are sometimes intimidated by the
unfamiliar equipment in extraoral
ROENT LEC Roentgen. He was a professor of
physics at the Physical Institute of
Roentgenology LEC -JMMACAPAGAL
the Julius Maximilian University at
Introduction Wurzburg. During the summer of
1894, Roentgen repeated all of
Dental radiology is the core Lenard's published work,
diagnostic modality of dentistry. Dental familiarizing himself with the
radiographs assist in detecting hidden equipment. By the fall of that year
painful pathology, estimating the severity of the press of administrative duties
dental conditions, assessing treatment forced him to discontinue his
options, providing intraoperative guidance, research. However, the following
and also serve to monitor success of prior autumn of 1895 he was back at work
treatments. in his laboratory, but because of
obligations of the rectorship he could
Module 1 Radiation Basics only devote his evening hours to the
study of cathode rays. It was on a
M1 Introduction Friday evening that he had darkened
his laboratory to obscure the
Knowledge of the history of x-radiation is an
fluorescence produced by a Hittorf-
important aspect in Oral Radiology.
Crookes tube.
For us to understand x-radiation better we ● He covered the tube with black
have to know its background, why and how cardboard and applied power to the
was it discovered. electrodes with a Ruhmkorff
induction coil. To his surprise, he
Through history we can discover the nature noticed a faint glow on a table some
of this x-radiation, its effects and its distance from the tube. The source
importance in the practice of Dentistry. of the glimmering was another
It is in this module that topics about the fluorescent screen covered with
production of x-radiation and its hazardous barium platinocyanide. As a result of
effects to human system. his experience with cathode rays,
Roentgen realized that the distance
If we are aware of the hazardous effects, we between the Hittorf-crookes tube
can highly appreciate the significance of the and glowing screen was well beyond
different measures that will protect us from the distance, 6 to 8 cm., that
its untoward effects. cathode rays from a Lenard tube
could be detected. He quickly
Methods of protection will be tackled in this
realized that he was observing a
module which I deemed necessary for the
new form of energy. He discovered
end user of the x-radiation.
x-radiation which penetrate to a
certain extent some radiopaque
M1 Lesson 1 Radiation History structures. With his discovery, he
brought change to the practice of
● In a darkened room on the night of Medicine and Dentistry. They were
November 8, 1895, a tiny bit of able to utilize x-radiation in both
fluorescence, which was to enlighten
the entire medical world, was
noticed by Wilhelm Conrad
 Medical and Dental Practice. necessary to establish high potentials
across the tube for accelerating the
electrons to very high speeds. Control over
tube performance is maintained through
various circuits that control the conduction
of electrons. The cathode consists of
focusing cup and the filament.
The filament, the source of electrons within
the x-ray tube, is a coil of tungsten wire
about 0.2 cm in diameter and 1 cm or less
Powerpoint presentation slides are in length. The anode is consist of copper
available at the end of Lesson 3 stem and the target. The purpose of the
target in an x-ray into convert the kinetic
energy of the electrons generated from the
M1 Lesson 2 Radiation Physics filament into x-ray photons.
Knowledge of the different parts of an x-ray
machine is of great advantage for the
clinicians/students. It will be easier to
manipulate an x-ray machine if we are
familiar with different parts of the machine
as well as the parts of the x-ray tube called
Coolidge tube.
The basic apparatus for generating x-rays,
the x-ray tube, consist of (1) cathode, a
component of which is the filament that
The kinetic energy of electrons in the tube
serves as a source of electrons, and (2) an
current is converted in x-ray photons at the
anode or target, at which the beam of high-
focal spot of an x-ray tube by two
speed electrons is directed. The filament
mechanisms: bremsstrahlung radiation and
and target are encased within an evacuated
characteristic radiation. Bremsstrahlung
glass envelope or tube.
radiation, the primary source of x-ray
photons from the x-ray tube, is produced by
the sudden stopping or breaking of high-
speed electrons at the target. This process
is accomplished by first accelerating
electrons to a high velocity by the high
voltage applied across the gap between the
filament and target of the x-ray tube, and
altering their direction of travel by interacting
with the electrostatic field of the nucleus or
by direct interaction or collision with the
nucleus. This process of rapidly
decelerating the high-speed electron gives
X-rays are produced when the electrons rise to bremsstrahlung or breaking,
strike the target. In order for the x-ray tube radiation.
to function, an electrical power supply is
 predominant molecule in biologic
systems, which is 75% of body
Characteristic radiation occurs when
weight, it participates in the greatest
bombarding electron of the tube current
number of the interactions between
displaces an electron from a shell of a target
x-ray photons and the system’s
(tungsten) atom, thereby ionizing the atom.
constituent molecules.
Another electron in outer shell of the
Consequently, water plays a major
tungsten atom and at a higher energy level
role in the transfer of energy from
is quickly attracted to the void in the
photons to biologic molecules by the
deficient inner shell. When the displaced
indirect effect. The effects of
electro is replaced, a photon is emitted with
radiation on cellular structures result
an energy equivalent to the difference in the
from radiation-induced changes in
two orbital binding energies. Characteristic
their macromolecules. Although the
radiation from the K orbit/shell only occurs
initial molecular changes are
above 70 kvp with a tungsten target and is
produced within a fraction of a
seen as discrete increments of
second after exposure, cellular
bremsstrahlung radiation. Characteristic
changes resulting from moderate
radiation is only a minor source of radiation
exposures usually require hours or
from an x-ray tube.
longer to become apparent. This
The intensity of an x-ray beam is reduced changes manifest themselves
by interaction with the matter it encounters. initially as structural and functional
This attenuation of the x-ray beam results changes in cellular organelles. Later,
from interactions of individual photons in the cell death may occur. The radio
x-ray beam with the atom of the absorbers. sensitivity of a tissue or organ is
As a result of their interaction with matter, x- measured by its response to
ray photons are attenuated by absorption irradiation. The criterion usually
and scattering of x-ray photons out of the employed is tissue hypoplasia.
absorber as aresult of interactions with the ● The decision to use diagnostic
orbital electrons of component atm. radiography rest on professional
judgment of its necessity for the
benefit of the total health of the
M1 Lesson 3 Radiation Biology patient. This decision having been
made, it then becomes the
● The primary actions of radiation on responsibility and duty of the dental
living systems are mediated through professional to produce a maximum
direct and indirect effects. When the yield of information per unit of x-ray
energy of a photon or secondary exposure. Becoming aware of the
electron is transferred directly to potential risks associated with the
biologic macromolecules, the effect use of ionizing radiation and its
is termed direct. Alternatively, when contribution to rising health care
the photon is absorbed by water in a costs is the first step toward
biologic system and the water exposure and dose reduction in
molecules are ionized, they form diagnostic radiography. Once this
free radicals that in turn interact with awareness has been developed, the
and produce changes in the biologic second step is the utilization of
molecules, the effect is termed techniques, materials, and
indirect. Because water is the equipment that optimize the
 radiologic process. Optimizing the
radiologic process is the best way to
ensure the maximum patient benefit
with a minimum of patient and
operator exposure. There are
several ways to protect ourselves
from unnecessary exposure to x-
radiation which may lead to
hazardous effects.
Additional Reading: Powerpoint

Presentation Slides  Download

Powerpoint Presentation Slides
Oral Radiology Prelim (PPT)
History of x-radiation
Dr. C. Edmund Kells
 Discovery of x-radiation - First Intraoral Radiograph 1896
Wilhelm Conrad Roentgen
- Discovered x-rays on Nov. 8, 1895 Terminology
● Voltage
- is the term use to describe electric
pressure or force
● Ampere
- is the standard unit used in
measuring the amount of an electric
that is flowing through a circuit.
● Transformer
- use to raise(step-up) or lower(step-
down) the voltage of an AC electric
current by a high factor.
● Autotransformer
- makes one coil do the work of two. It
can be used only for making minor
changes in voltage.
● Rheostat
- is the device that increase the
resistance to the passage of an
electric current through a wire. It
reduces or controls the amount of
current that flows through a circuit
and thus controls the amperage or
amount of the flow of electricity.
 Dental x-ray machine circuitry
with the major components Radiation Biology
labeled. Radiation Chemistry
A, Filament step-down transformer; Primary actions of radiation on
B, filament current control (mA living systems maybe:
switch); C, 1. Direct effect
autotransformer, D, kVp selector dial 2. Indirect effect
(switch); E, high-voltage transformer; Water Radiolysis
F, x-ray timer (switch); G, tube Initially : Photon +H2O e- +
voltage indicator (volt-meter); H, H2O+
tube current indicator Or : e- + H2O 2e-
(ammeter); I, x-ray tube. + H2O+
Then : e- + H2O
H2O-
H2O+ H+
+ OH’
H2O- OH-
+ H’
On balance : Photon + H2O
H’ + OH’
H’ + OH-
H2O
H’ + O2 HO2’ - Lungs
HO2’ + H’ H2O2 - Kidneys
Radiation effects - Liver
1. Cellular level - Optic lens
Cell RADIATION SAFETY AND PROTECTION
Nucleus
Two general sources of radiation:
Chromosomes Aberrations
2. Tissue and organs level 1. Natural radiation
a. High sensitivity a. cosmic radiation
- Lymphoid organs b. terrestrial radiation
- Bone marrow c. internal sources
- Testes 2. Man-made radiation or artificial
- Intestines. radiation
a. radiation in the healing art
b. consumer, and industrial product
and sources
METHODS OF EXPOSURE AND DOSE
REDUCTION
Patient selection
Conduct of examination
1. choice of equipment
a. receptor selection
- intraoral image receptor
- intensifying screen
b. focal spot-to-film distance
c. collimation
d. filtration
e. leaded aprons and collars

b. Intermediate sensitivity
- Fine vasculature
- Growing cartilage
- Growing bone
c. Low sensitivity
- Salivary glands
2. choice of intraoral technique
a. paralleling technique
b. bisecting angle technique
3. operation equipment
a. kilovoltage
b. milliamperage
4. film processing
5. interpretation of image

PROTECTION OF PERSONNEL JO GMEET NOTES

1. Operator can leave the room or take

ROENTGENOLOGY
a suitable barrier or wall.
2. Operator should stand at least 6 feet ● Radiograph as primary diagnostic tool
from the patient at an angle of from
90 degrees to 135 degrees to the
central ray of the x-ray beam.
Radiolucency – dark
3. Film should never be held in place
by the operator. Radiopacity – light
4. Radiographic tube housing should
never be stabilized by the operator
or patient during the exposure. Through history, we can discover how X-RAY
5. Use badge with a piece of sensitive
works
film or radiosensitive crystal called
thermoluminiscent dosimeter. Radiation Basics

● Testing cathode rays if it can pass

through a glass
● There is a faint light that is projected on
the screen
● The hand is his wife’s hand
● He named the X-ray as “X” unknown
rays
● Within a year, the medical community
used x-rays to find fractures and objects

Crooke’s Tube

● glass bulb containing positive and

negative electrodes
● he first used this to observe light

Edward
 ● 1896 Filament transformer – this hit the cathode
● Dentist and Inventor inside the x-ray tube
● Father of dental radiograph
Electricity will come out from the socket, there
● First intraoral radiography (x-ray film is
will be high electricity and high-voltage
inserted in the oral cavity)
transformer activated, there is a time/duration,
● During those times, the x-ray machines
milliampere selector, filament transformer and
were not safe compared to what we’re
then hits the cathode
using now
● Edward ended up with skin cancer

X-RAY MACHINE AND FILMS (Periapical x-ray

machine)
Terms:
X-ray – high energy electromagnetic
VOLTAGE – describes electric pressure/force
We need radiographic images when patient
AMPERE – amount of electricity that is flowing
needs diagnostic images to see what’s beyond
in the circuit
clinical examination
TRANSFORMER – to lower or raise the voltage,
Importance of having a complete diagnostic tool
can change the voltage (step up or step down)
is important in diagnosing in our practice of
AUTOTRANSFORMER – only for automatic dentistry
changes (minor changes in the voltage)
XRAY is any machine that involves the
RHEOSTAT – device that increases the generation of x rays directed towards the
resistance to the current electricity the flows to patient for diagnostic screening
circuit (controls amperes)
MAJOR PARTS OF XRAY MACHINE

● Control panel – use for operational

Standard electricity format control, this enables energizing the
other parts, where electricity enters
AC – alternating current (power supply)
● Extension arm – it enables the tube
Dentist will pick a Kilovoltage peak and then head to be position, passing of electric
high-voltage transformer wires/electricity
● Tube head – there is an x-ray tube
In an X-ray machine you need to increase the inside, where x-ray is generated
speed of electrons inside the x-ray machine so
that we can have a high voltage transformer
(electrical pressure high)
MINOR PARTS OF XRAY (varies in x-ray
Exposure timer – it regulates the duration or machines, not all follow a certain format)
interval when the electrical current can pass
● Line switch – on/off switch, turning on
through
and off
Milliampere selector – measures the current ● Milliampere selector – determines the
flow of electricity number of free electrons in the
cathode, allows measure to the number
of electrons, available number of
 electrons, measure the number of ● PID – positioning indicating device
electrons in the cathode filament (serves as a guide to aim)
● Kilovolt peak selector – predetermined, ● You must give careful attention to the
determines the speed of electrons vertical angles before you hit the
● Exposure timer/timer – exposure exposure switch
duration, serves to regulate the ● Can be move up and down, left and
duration of the travel of electricity in right (please be careful in handling this)
the tube, the longer it is activated, the
longer the x-ray is produced
● Exposure switch/button – activates the
machine, in order to finish the timer
(hold this button)

X-ray photon’s -carries information regarding its

structure

● Must be recorded in an image receptor

(x-ray film)

Adult PA (Periapical), BW (Bite wing) – Type #2

#1 – smaller

#0 – Child (pediatric patient)

#3 - Extra-long BW

#4 – occlusal in adults

X-ray beam – collimator (circle/rectangular)

Some x-ray tube head has an angulator

Periapical radiograph – shows the crown to the

apical portion of the tooth

Bitewing radiograph - occluded teeth, crown

and 2/3 of the tooth, focused on the
● Always has a vertical and horizontal interproximal
angulation
Occlusal radiograph – shows the occlusal view, You will only take out everything inside a dark
half (maxillary or mandibular) room/developing box

#SLAY

The faster the speed, the less exposure

Dental film – composed of emulsion and base

Xray’s are developed in a dark room

Emulsion - records the information coming from

the xray, records radiographic image, one that
absorbs the light
You do it a dark room, inside a developing box,
Base – supporting material to which the inside a developing film
emulsion is coated
A – slowest
Emulsion components
F – fastest
● Silver halide grains – composition:
E and F are the most recommended
crystals of silver bromides
● Matrix – where the crystals are Monobat / E-speed
suspended, vehicle matrix absorbs the
solution so that it can react with the
crystals
● If an x-ray film has image already, it’s
called a radiograph
● Embossed dot / Identification – a bump,
always facing PID (Positioning indicating
device)
Aluminum filter
Black Inner paper and inner paper wrap –
connected to one another, protects the x-ray Collimator – restricts the size
film, it’s easier to pull out the x-ray film
Cathode filament it will be heated to generate
Lead foil backing – protects the dental film from the electrons and then kVP (speed) it will hit the
the back, protect from tattered radiation focal spot, it will produce a kinetic energy
(radiation)

In order to heat up this cathode filament, we

need electricity
Tungsten wire – mounted by 2 hard support
wires When it hits or displaces an orbiting electron, it
will create characteristic radiation. There will
Vacuum – oxidation of filament (there is no be VACANCY, it will require the outer electrons
oxygen dapat here) to go in. (Low energy)
Focusing cup – made up of molybdenum When the electrons go in from the outer orbit
(composition)

Bremsstrahlung radiation means breaking

Quantity of radiation produced
electrons

Most of the time radiation doesn’t hit (near

miss) the nucleus directly to create low energy
Clinical examination -> radiation exposure > x-
ray film processing -> radiographic
interpretation

Grays – measuring unit for radiation

Usually, in the periapical teeth

Ionizing radiation – changes in anatomic level

Inverse Square Law – the intensity of the x-ray

beam depends on the focal spot

The intensity is inversely proportional to the

square of the distance

As the x-ray beam spreads out, it weakens

Biological levels dependent on these factors

Minimize time

Maximize time – increase the distance,

decrease the dose

Use Shielding – put something between you and

the source
Reduce radiation exposure for the gonads and - The light can pass through
thyroid gland ^^ anything
- X-rays- unknown

Milliampere

- Crooke’s Tube - Glass bulb

with the capacity containing
positive and negative electrons
- He first uses these glass tube
to observed light phenomenon

Position distance rule

Patient should stand at least 2 meters

JANE GMEET NOTES -V2 MEETING - Guide of Dr. C. Edmund Kells

- dentist
Wilhelm Conrad Roentgen's - First Intraoral Radiograph 1896
- Who discovered X-ray on - He was a dentist and
November 8, 1895 inventor
- Paint like that project on - Father of dental radiography
screen
- Wife’s hand (1st artifact)
 - Intraoral radiography – the x- Electricity will come out on the socket of
ray film is inserted to the oral plug of x-ray machine because namili ng
cavity kvp selector, magkakaroon ng high
electricity and the high voltage
transformer activates and have
exposure time that will pass through X-
Happening inside of Xray machine ray tube. You will select Ma selector –
measure the current flow of electricity
- AC current - standard electricity because of that the filament transformer
format that comes out on the socket will heat so that the cadote? Will
of plug of x-ray machine produce electrons

- when the electricity starts to pass

it can cause alternating current
power supply X-ray Machine and Films

- when the clinician selects a - X-rays are high energy

kilovoltage, one button in the picture electromagnetic radiation
of x-ray machine (kilo), the electricity
will increase do higher voltage. The - We need radiographic images
clinician will choose of kilovoltage, it and the px need diagnosis. Any
will greatly increase due to the high machines that involve the generation
voltage transformer. of patient directed.

- In X-ray machine you need to - Clinical examination (seen on the

increase the speed of electrons. You naked eye) what you seen on visual
need high voltage transformer. eye and with radiographic
Voltage means mataaas ung
- Visual (seen) Clinical = Proper
electrical pressure.
history of px you will have diagnosis
- Exposure timer – part of machine
that regulates the duration of the
interval of electrical current that pass The important of having a complete
through the x-ray tube. When it diagnostic tool is very important in our
already stop, the electricity will shut practice
down pass the timer area.
- Clinical exam
- Ma selector – measure the
current flow of electricity. - Radiographic exam
- Filament transformer – heat the Xray machine - Any machines that
chadote in x-ray tube. The purpose involves the generation of x-rays
for the filament cut is to guide the directed towards the px or the diagnostic
electron stream to the target area on screening (primary and supplementary)
the anode.
MAJOR PARTS OF X-RAY MACHINE
Summary:
 1. CONTROL PANEL – it is use for
operational control and allow to pass
electricity

2. EXTENSION ARM – it enables

the tube head to be positioned and
permits the passage of electrical
wires.

3. tube head – contains xray tube

CATHODE FILAMENT – electrons need
(xray generated)
to produce

4. Exposure timer it serves to

regulate the duration of travel of
electricity on x-ray tube. The longer it
is activated, the longer duration of
producing x-ray.

5. Exposure button – if you hold it

long enough, you will be finish the
seconds all required that indicated in
MINOR PARTS varies IN x-ray the time
machine

CONTROL PANEL

- modern control interface

1. line switch – on/off switch,

enables the machine to utilize
electricity

2. mill amperage selector – number

of free electrons cathode
filament(electrons will be produce),
allows input number of electrons

3. Kilo voltage pit selectors –

determines the speed of electrons
inside xray tube PID (positioning indicating device) guide
in aiming the tube head kung san
pupunta yung tube head

Collimator - Tube head is rectangular -

unnecessary exposure
Proper angulation – prescribed angle in Pediatric px
certain technique
Type 1 – mas maliit

Type 0 – use in pediatric px – n

Portable xray
- Hold in steady (cannot move ur
hand)
- Advantage - position instability
Different types of Xray film Periapical Radiograph
Film of the x-ray
- Heat an object or body part - Shows tooth from the crown
- Absorbed x-ray up to apical portion

Bitewing Radiograph

- Shows the crown 2/3rd of the

tooth

Use in dentistry

4 types

Type 2 – xray film need ftf (periapical

adult )
Inner part of machine Xray tube -production of xray in atomic
level
Electricity will come in extension arm
and the power supply conducts the Cathode – negative electrons
whole tube
Anode – positive electrons,
Oil – conducts the heat away from xray
tube tungsten target (convert electric
energy) , - produce kinetic energy
Aluminum filter - Reduces the low and (radiation), embedded in the copper
high collimator stem – labas sa PID

Every xray tubes composed of glass

envelope : vacuum (prevent polition? of
past electrons)