Dental radiology by Andreas Fuhrmann

www.pdflobby.com www.pdflobby.com www.pdflobby.com www.pdflobby.com Dental Radiology An d reas Fu h r m an n , DDS Foren sic Odon tologist Depar t m en t of Legal Medicin e Cen ter for Diagn ost ics Un iversit y Medical Cen ter Ham bu rg-Eppen dorf Ham bu rg, Germ any 304 illu st rat ion s Th iem e St u t tgar t • New York • Delh i • Rio de Jan eiro www.pdflobby.com Librar y of Congress Cataloging-in -Pu blicat ion Dat a Fuh rm an n , An dreas, auth or [Zah närztlich e Radiologie English ] Den t al radiology / An dreas Fuh rm ann p ; cm In cludes bibliograph ical referen ces an d in dex ISBN 978-3-13-200421-4 (alk paper) – ISBN 978-3-13-200431-3 (e-book) I Title [DNLM: Diagn ost ic Im aging Radiography, Den tal—m ethods W N 230] RK309 617.6’07572—dc23 2014047560 Th is book is an auth orized t ran slat ion of th e 1st Germ an edit ion p ub lish ed an d copyrigh ted 2013 by Georg Th iem e Verlag, St u t tgar t Tit le of th e Germ an edit ion : Zah n ärztlich e Radiologie Tran slator: Su zyon O’Neal Wan drey, Berlin , Germ any Illust rators: Angelika Brann er, Hoh enpeissen berg, Germ any; Joach im Horm an n , St ut tgart , Germ any Eugen Roth poem t ran slated an d reprodu ced w ith kin d p erm ission of Carl Han ser Verlag, Mun ich , Germ any © 2015 by Georg Th iem e Verlag KG Im p or t an t n ote: Medicin e is an ever-ch anging scien ce u n d ergoing t in u al develop m en t Research an d clin ical experien ce are t in ually expan d ing ou r kn ow ledge, in p art icu lar ou r kn ow ledge of prop er t reatm ent an d drug th erapy In sofar as th is book m en t ions any dosage or app lication , read ers m ay rest assu red th at th e au th ors, editors, an d p u blish ers h ave m ade ever y e or t to en su re t h at su ch referen ces are in accordan ce w it h t h e st ate of k n ow ledge at t h e t im e of p rod u ct ion of t h e b ook Never th eless, th is d oes n ot involve, im p ly, or exp ress any gu aran tee or responsibilit y on th e part of th e publish ers in respect to any dosage in st ruction s an d form s of applicat ion s stated in th e book Ever y u ser is requ ested to exam in e carefu lly th e m an u fact u rers’ lea et s accom panying each drug an d to ch eck, if n ecessar y in su lt at ion w ith a p hysician or sp ecialist, w h eth er th e d osage sch edu les m en tion ed th erein or the t raindicat ion s st ated by th e m an ufact urers di er from th e statem en ts m ade in the presen t book Such exam in at ion is part icu larly im p ort an t w ith d rugs th at are eith er rarely u sed or h ave been n ew ly released on th e m arket Ever y dosage sch edu le or ever y form of app licat ion u sed is en t irely at th e u ser’s ow n risk an d respon sibilit y Th e au th ors an d p u blish ers requ est ever y u ser to rep or t to th e p u blish ers any discrepan cies or in accuracies not iced If errors in th is w ork are fou n d after p u blicat ion , errat a w ill be p osted at w w w.th iem e.com on th e produ ct descript ion page Som e of th e produ ct n am es, p aten ts, an d registered d esign s referred to in th is book are in fact registered t rad em arks or prop rietar y n am es even th ough sp eci c referen ce to th is fact is n ot alw ays m ade in th e text Th erefore, th e ap p earan ce of a n am e w ith ou t design ation as p rop riet ar y is n ot to be st ru ed as a rep resen t at ion by t h e p u blish er th at it is in th e p u blic dom ain Th iem e Publish ers St ut tgar t Rü digerst rasse 14, 70469 St u t tgart , Germ any +49 [0]711 8931 421, cu stom erser vice@th iem e.de Th iem e Publish ers New York 333 Seven th Aven ue, New York, NY 10001 USA +1 800 782 3488, custom erser vice@th iem e.com Th iem e Publish ers Delh i A-12, Second Floor, Sector-2, Noida-201301 Ut tar Pradesh , In dia +91 120 45 566 00, cu stom erser vice@t h iem e.in Th iem e Publish ers Rio, Th iem e Pu blicaỗừes Ltda Argen t in a Bu ilding 16th oor, Ala A, 228 Praia d o Bot afogo Rio de Jan eiro 22250-040 Brazil +55 21 3736-3631 Cover design : Th iem e Publish ing Grou p Typeset t ing by L42 Media Solu tion s, Berlin , Germ any Prin ted in Germ any by Aprin ta, Wem ding ISBN 978-3-13200-421-4 Also available as an e-book: eISBN 978-3-13200-431-3 54321 Th is book, in clu d ing all par ts th ereof, is legally p rotected by copyrigh t Any u se, exp loit at ion , or com m ercializat ion ou t sid e th e n arrow lim its set by copyrigh t legislation w ith ou t th e pu blish er’s sen t is illegal an d liable to p rosecu t ion Th is ap p lies in p art icu lar to p h otostat rep rodu ct ion , copying, m im eograph ing or du p lication of any kin d, tran slat ing, p rep arat ion of m icro lm s, an d elect ron ic dat a p rocessing an d storage www.pdflobby.com To Chrissi and Kat i A m aster advised h is devotees To on ly believe in w h at on e sees An d yet – th is w e sh ou ld recon ceive, Som e only see w h at th ey believe Eugen Roth www.pdflobby.com www.pdflobby.com Contents Preface Acknow ledgments x xi History and Development of Dental Radiography Radiation Physics 2.1 Types of Radiation 2.5.2 Ion izat ion 10 2.2 Direct and Indirect Ionization 2.6 Interactions betw een X-rays and Matter 10 2.3 Corpuscular and Photon Radiation 2.3.1 2.3.2 Corpu scu lar Radiat ion Ph oton Rad iat ion 8 2.6.1 2.6.2 Absorpt ion —Ph otoelect ric E ect 10 Scat tered Radiat ion —Com pton E ect 11 2.7 Radioactivity 11 2.8 Production of X-rays 12 2.8.1 2.8.2 Den t al X-ray Equ ipm en t 12 Addit ion al Equ ip m en t Needed for Dose Lim it at ion an d Im provem en t of X-ray Im age Qu alit y 17 2.4 Interactions betw een Radiation and Matter 2.5 Fundamental Physical Processes Involved in the Transfer of Photon Energy to Matter 10 2.5.1 Excit at ion 10 Dose Terms and Dose Units Used for Ionizing Radiation The Biology of Radiation E ects 4.1 Fundamentals 26 4.4 Repair Mechanisms for the Restoration of DNA 27 4.2 Direct and Indirect E ects of Radiation 27 4.5 Biological E ects of Radiation Damage 27 22 26 4.3 E ects of Ionizing Radiation on DNA 27 Radiation Pathology 5.1 Natural Radiation Exposure 30 5.1.1 5.1.2 Cosm ic Radiat ion 30 Terrest rial Radion uclides 30 5.2 Arti cial Radiation Exposure 30 Image Formation and Image Processing 6.1 Fundamentals 34 6.1.1 6.1.2 Su m m at ion E ect 34 Tangen t ial E ect 35 6.2 Image Receptor-Independent Factors In uencing Image Formation 35 30 5.3 Stochastic and Deterministic E ects of Ionizing Radiation 31 5.3.1 5.3.2 Stoch ast ic E ect s 31 Determ in ist ic E ects 31 34 6.2.1 6.2.2 6.2.3 6.2.4 6.2.5 Object Con t rast Curren t In ten sit y an d Exposure Tim e Inverse Squ are Law High Volt age Scat tered Rad iat ion 36 36 36 36 37 vii www.pdflobby.com Content s 6.3 Radiographic Film and Intensifying Screen-Dependent Factors that In uence Image Formation 37 6.3.1 Screen less Film s 37 Digital Dental Radiography 7.1 Sensors 47 7.1.1 Sp at ial Resolut ion 48 6.3.2 Radiographic Film w ith In ten sifying Screens 6.4 Processing of Radiographic Films 42 46 7.2 Storage Phosphor Imaging Plates 48 7.3 Advantages of Digital Radiography 50 Radiation Protection and Quality Assurance in Dental Radiology 8.1 History of Radiation Protection 54 8.1.1 St ru ct u re of th e In tern at ion al Com m ission on Radiological Protect ion 54 Tasks an d Con ten t of th e Variou s Act ivit ies of th e In tern at ion al Com m ission on Radiological Protect ion 54 8.1.2 41 54 8.4.2 Preven t ion of Acciden t s an d Protect ion again st Exist ing or Un regulated Radiat ion Risks 55 8.5 Implementation of Recommendations by the International Commission on Radiological Protection 55 8.2 Responsibility for Radiation Protection 55 8.2.1 8.2.2 Su per visor y Du t y of the Govern m en t 55 Adm in ist rat ion an d Man agem en t of Safet y 55 8.6 Quality Assurance in Dental Radiology 56 8.6.1 St an dards 56 8.3 Need and Justi cation 55 8.7 8.4 Optimization of Radiation Protection 55 Procedures to Ensure Compliance w ith Basic Principles of Radiation Protection 56 8.4.1 Lim it at ion an d Mon itoring of In dividu al Dose Lim its 55 Practical Dental Radiography 9.1 Intraoral Radiography 58 9.1.1 9.1.2 9.1.3 9.1.4 9.1.5 9.1.6 9.1.7 9.1.8 Qu alit y Criteria for In t raoral Radiography Prin cip les of Project ion Geom et r y Paralleling Tech n ique Bisect ing-angle Tech n ique Righ t-angle Tech n ique Bitew ing Radiography Radiograp h ic Measurem en t Tech niques Occlu sal Radiography 58 58 59 61 67 72 73 74 74 9.3.1 9.3.2 9.3.3 Pan oram ic Radiography w ith a Slit Collim ator 79 Pan oram ic Radiograp hy w ith an In t raoral Source 80 Rot at ion al Pan oram ic Radiography 80 9.4 Cone Beam Computed Tomography 109 9.4.1 Tech n ique an d Im age Form at ion in Con e Beam Com pu ted Tom ography Lim itat ion s of Com puted Tom ography an d Con e Beam Com pu ted Tom ography Volum e Size Clin ical In dicat ion s for Con e Beam Com pu ted Tom ography 9.4.2 9.2 Conventional Tomography 77 9.3 Panoramic Tomography 79 10 Anatomy and Topography of the Facial Skeleton 10.1 The Teeth and Tooth-supporting Structures 121 10.2 The Mandible 123 9.4.3 9.4.4 109 112 114 114 120 10.3 The Maxilla 124 10.4 Panoramic Radiographic Anatomy 125 10.4.1 Th e Man dible 125 10.4.2 Th e Maxilla an d Midface 128 viii www.pdflobby.com Radiographic Findings and Diagnosis Fig 11.35 Cementom a (cem entoblastom a): The radiograph reveals a radiopaque m ass that is closely connected to the apex of tooth 43 and surrounded by a radiolucent m argin 11 Fig 11.36 Cemento-osseous dysplasia: edentulous spaces 37 and 46 show the t ypical radiographic features of cem ento-osseous dysplasia; cem enticles are deposited in the connective tissue strom a 154 www.pdflobby.com 11.2 Assessm ent and Diagnosis of the Most Com m on Pathological Changes 11.2.6 Bone Diseases of the Jaw In addit ion to in flam m at ion s, cysts, an d t u m ors of th e jaw, bon e diseases of th e jaw s are oth er t yp ical p ath ologies th at d o n ot fit in to th e above categories Many are n ot detected in rou t in e X-ray exam in at ion s Im p ort an t bon e lesion s of th e jaw s in clu de osteom yelit is, ossifying brom a, brous dysplasia, cen t ral gian t cell gran ulom a, an eu r ysm al bon e cyst , an d p seu docyst Osteom a falls in to a special categor y Osteom a is den ed as a ben ign n eoplasm of m at ure com pact or can cellous bon e bu t is n ot listed as a t u m or in th e W HO classi cat ion Osteomyelitis Osteom yelit is is an in fect ion of th e bon e In p at ien t s w ith a w eak im m un e system , it can occur as a com plicat ion of periapical in fect ion , acute n ecrot izing gingivit is, an d u n t reated op en fract u res Radioth erapy of th e jaw is also associated w ith a h igh risk of osteom yelit is Acute osteo m yelit is is ch aracterized by n ecrosis an d th e form at ion of sequest rum (dead bon e) in th e area of in fect ion ( Fig 11.37) Ossifying Fibroma Ossifying fibrom a is classified as a ben ign bon e lesion an d a t ru e n eoplasm It is m ost com m on ly foun d in th e m an dibu lar m olar region Radiograph ically, th e ossifying fibrom a appears as m ixed radiolucen t-radiopaque, tain ing variably calciu m -den se st ruct u res w ith t rabecu lae ( Fig 11.38) It h as a t ypical groun d-glass appearan ce an d is w ell dem arcated from th e surroun dings Fig 11.37 Osteomyelitis with the formation of sequestrum (dead bone) as a complication of open fracture 11 Fig 11.38 Osteolysis: note the well-de ned expansile lytic lesion in the right mandible (edentulous spaces 47–48) containing trabecula-like structures 155 www.pdflobby.com Radiographic Findings and Diagnosis Fibrous Dysplasia Central Giant Cell Granuloma Fibrou s dysp lasia (McCu n e–Albrigh t syn drom e) is a rare, gen et ically determ in ed bon e disease th at m ost com m on ly involves th e m axilla Fibrou s dysplasia is a slow ly progressive, episodic disease w ith sym ptom -free in ter vals On ce th e jaw lesion reach es a cer tain size, it cau ses facial asym m et r y Adjacen t teeth in th e m axilla are som et im es disp laced Obliterat ion of th e m axillar y sin us m ay also be obser ved ( Fig 11.39) Cen t ral gian t cell gran ulom a is a ben ign , gen erally localized but som et im es aggressive proliferat ing osteolyt ic lesion ( Fig 11.40) React ive bon e form at ion is a t ypical radiograph ic feat u re Cen t ral gian t cell gran ulom a is an exp an sile an d often m ult icyst ic bon e disease Adjacen t teeth are often displaced, an d root resorpt ion is p ossible Fig 11.39 Fibrous dysplasia: the radiograph reveals a homogeneous, hyperdense, sharply demarcated shadow in the left maxillary arch, narrowing of the maxillary sinus, and caudal displacement of m olar teeth 26 and 28 11 Fig 11.40 Central giant cell granulom a: note the discernible but not sharply dem arcated round radiolucency in the anterior mandibular region, which appears oval as a result of distortion related to the radiographic technique 156 www.pdflobby.com 11.2 Assessm ent and Diagnosis of the Most Com m on Pathological Changes 11.2.7 Sialolithiasis Fun ct ion al in tegrit y of th e salivar y glan ds an d proper saliva secret ion are crucial for a w ide range of differen t physiological p rocesses occurring in th e oral cavit y Abn orm ally red u ced or in creased saliva flow can result in dehydrat ion of th e oral m u cosa, w h ich can lead to in fect ion s an d oth er p ain fu l dit ion s Diagn ost ic im aging of th e salivar y glan ds does n ot act ually fall in to th e eld of den t ist r y How ever, sialolith s (salivar y ston es) are frequen tly detected as in ciden t al or secon dar y n dings on den tal pan oram ic radiograph s in th e d en t al p ract ice ( Fig 11.41) Shadow s from salivar y stones often project onto the m andible Therefore, if a radiopaque w hite zone is detected in the lower jaw, the exam iner m ust rst decide if it is located w ithin the bone or on the oor of the m outh A second radiograph is then needed for localization Previously, a survey of the oor of the m outh w as used as the second plane to im age the oor of the m outh How ever, CBCT is now able to provide high -qualit y im ages and exact localization of salivary stones ( Fig 11.42 and Fig 11.43) Fig 11.41 Sialolithiasis: a salivary stone in the right duct appears as a large, inhom ogeneously radiopaque lesion on the right side of the m andible 11 Fig 11.42 This panoram ic CBCT image shows a large sialolith in the bend of the right submandibular gland 157 www.pdflobby.com Radiographic Findings and Diagnosis Fig 11.43a, b Salivary stones in the subm andibular gland a Axial view b Coronal view 11.2.8 Tooth Fractures 11 Radiograp h ic exam in at ion of th e m an dible, m axilla, an d m idface for fract u res is n ot n orm ally perform ed in a den tal pract ice If su ch st udies are n ecessar y, CBCT can provide com preh en sive im ages of difficult-to-detect m an dibu lar fract u res in m ult iple plan es ( Fig 11.44) Most of th e fract u res d iagn osed in n orm al den t al pract ice are associated w ith t rau m at ic den t al injuries—in m ost cases, an terior tooth t raum a, w h ich m u st be adequ ately visualized an d diagn osed Th ree m ain t yp es of t rau m at ic den tal inju ries are tooth lu xat ion , in t ru sion , an d fract ure Th e rad iograp h ic exam in at ion procedure for each t ype is th e sam e In t raoral radiograph ic tech n iques are u sually recom m en ded for opt im al visualizat ion of t raum at ic den tal inju ries Note In patients presenting with tooth luxation, careful examination of the alveolar sockets is recommended, to rule out the possible presence of a fracture in this region Fract ure diagn osis is gen erally st raigh tfor w ard in singlerooted an terior teeth Conversely, fract ures in th e m olar region can cause diagn ost ic difficult ies, regardless of w h eth er th ey are of t raum at ic or idiopath ic origin Again , CBCT can provide precise an sw ers to th ese clin ical quest ion s ( Fig 11.45) Root fract u res can involve all segm en t s of th e root Differen t radiograph ic tech n iques an d project ion s are recom m en ded, depen ding on th e t ype of fract ure an d th e angle of th e exposure If th e pat ien t’s dit ion allow s, th e paralleling tech n ique sh ou ld alw ays be used for radiograph ic exam in at ion an d diagn osis of tooth fract u res Th is is th e on ly w ay to en sure th e reproducibilit y of radiograph ic exam in at ion s, w h ich is especially im port an t for fract u re follow -u p ( Fig 11.46) Tooth fract ures can occur in associat ion w ith fract ures of th e m an dible Den tal fract ures (usually longit udin al) can also occur as a com plicat ion of den t al in ter ven t ion s Root resorpt ion often occurs as a com plicat ion of tooth fract ures ( Fig 11.47, Fig 11.48, Fig 11.49) 158 www.pdflobby.com 11.2 Assessm ent and Diagnosis of the Most Com m on Pathological Changes a b c Fig 11.44a–c Median m andibular fracture a This CBCT panoram ic reconstruction shows a thin vertical fracture line on tooth 31, with no signs of dislocation b The axial view rm s the diagnosis of mandibular fracture without dislocation at edentulous space 32, as well as a second fracture without dislocation on the right side of the m andible The second fracture line extends diagonally c This three-dimensional view obtained by volume rendering also shows only the fracture in the anterior region Fig 11.45a, b Crown fractures a Crown fracture of tooth 21 b Crown fracture of tooth 42 a 11 b 159 www.pdflobby.com Radiographic Findings and Diagnosis a b c d e f Fig 11.46a–f Multiple transverse root fractures in the maxillary anterior teeth 11 Fig 11.47 Mandibular fracture with tooth involvem ent Fig 11.48 Longitudinal fracture caused by a screw root 160 www.pdflobby.com Fig 11.49 Root resorption in teeth 21 and 22, induced by anterior tooth trauma References Arai Y, Tam m isalo E, Iw K, Hash im oto K, Sh inoda K Developm ent of a com pact com puted tom ographic apparat u s for dent 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Oral Su rg Oral Med Oral Path ol 1951;4(10):1250–1261 Up d egrave W J Sim plifying an d im proving in t raoral den tal roen tgen ography Oral Surg Oral Med Oral Path ol 1959;12(6):704–716 Up d egrave W J High er delit y in in t raoral roen tgen ography J Am Dent Assoc 1961;62:1–8 van Aken J Lim it at ion s in clin ical diagnosis of den t al caries of approxim al surfaces Adv Fluorine Res 1966;4:89–92 van Aken J Opt im um dit ion s for in t raoral roentgen ogram s Oral Surg 1969;27:475–481 van Aken J, Verh oeven JW Factors in uen cing th e design of aim ing devices for int raoral radiography an d th eir pract ical applicat ion Oral Su rg Oral Med Oral Pathol 1979;47(4):378–388 van St raaten FJ, van Aken J Th e opt im um circular eld size for den t al radiography w ith in traoral lm s Oral Surg Oral Med Oral Pathol 1982;54(3):347–359 Visser H, Herm an n KP, Bredem eier S, Köhler B Dose m easurem en ts com paring convent ion al and digit al pan oram ic radiography [in Germ an ] Mun d Kiefer Gesich tsch ir 2000;4(4):213–216 Waggen er DT Th e righ t-angle tech n ique using th e exten sion e Den t Clin North Am 1960;11:783–788 Wall BF, Ken dall GM Collect ive doses an d risks from dent al radiology in Great Britain Br J Radiol 1983;56(668):511–516 Wen zel A, Møyst ad A Work ow w ith digital in t raoral radiography: a system at ic review Acta Odon tol Scand 2010;68(2):106–114 W h aites E Essent ials of Den tal Radiography and Radiology 4th ed Ph iladelph ia: Elsevier; 2007 W h ite SC Assessm en t of radiat ion risk from den tal radiography Den tom axillofac Radiol 1992;21(3):118–126 W h ite SC, Ph aroah MJ Oral Radiology 5th ed St Louis: Mosby; 2004 Zabel H Kurzleh rbu ch Physik St ut tgart: Thiem e; 2011 Zu lau f AF Pan oram ic X-Ray apparat us US paten t 1408 March 7, 1922 162 www.pdflobby.com Index Note: Page num bers follow ed by f an d t in dicate gures an d t ables, respect ively A Accept able level [term ], 55 Accept ance test s, 56 Accident(s), preven t ion of, 55 Act ive pixel sensors (APS), 47 Addit ion, 35–36, 138 Age (pat ien t), and X-ray im age form at ion, 36 Alph a part icles, 8, 11 – ion izat ion den sit y of, 22 – radiat ion w eigh t ing factor for, 22 Alveolar crest , age-related changes in , 139 Alveolar recess, radiograph ic ap pearance of, 125, 127f, 129, 131 Alveolar ridge, 121, 122f Alveolus, 121, 121f Am eloblastom a(s), 147, 147f – m ult icyst ic, 147 – varian ts of, 147–148, 148f Am erican Den tal Associat ion (ADA), St an dards Com m it tee on Den t al Product s, 56 Angle of jaw, 128f Angle of rotat ion (φ ), in tom ography, 78 An ode(s) – angulat ion of, 14, 14f – rotat ing, 13, 14f – st at ion ar y, 13, 13f – of X-ray t ube, 12, 13–14, 13f, 14f – – interact ion s of elect ron s w ith , 15 An terior n asal spin e, 124, 124f An t i-scat ter grids, 36–37, 37f Apoptosis, 27–28 Art icular t ubercle, 127f As low as reasonably ach ievable (ALARA) principle, 134 Atlan to-axial join t , lateral, 127f Atom (s), – elect ron sh ells, 9, 10 Atom ic n um ber, 9, 34 At tenu at ion , 10, 16, 34 Auger e ects, 26f Autom at ic lm processor(s), 42, 43f – w ith dayligh t loader, 42, 43f Axial project ion techn ique, for occlusal radiography, 76, 76f B Backgroun d fog, 41 Beam -indicat ing device (BID), 17–18 Beta part icles, 8, 11 Beta rays, radiat ion w eigh t ing factor for, 22 Bisect ing-angle tech n ique, 2, 3f, 61, 63, 67–72, 67f, 68f – disadvan tages of, 68–71, 68f–70f – im age distort ion in , 67–71, 68f, 69f, 70f – m eth odology, 71–72, 72f – for occlusal radiography, 75, 75f – an d paralleling tech n ique, com parison of, 67, 67f, 70f – an d radiat ion protect ion , 70 – an d reproducibilit y, 71 – vert ical angulat ion and, 71, 71f Bite block, an d paralleling tech nique, 62, 62f Bitew ing radiography, 73–74, 73f, 121, 122f – of caries, 136 – m eth odology, 74, 74f, 136 – vert ical, 139f, 140 Blackm an , Sydn ey, Bloom ing, 47 Blurring, in tom ography, 78 – exten t of, 78 – pat tern s of, 78, 78f – t ype of, 78 Blurring out , 77, 77f Bocage, An dré, 2, 77 Boh r, Niels, Bon e, X-ray appearan ce of, 34 Bon e defect s, vert ical, 139–140, 140f, 141f Bon e diseases, of jaw, 155–156 Bon e loss, h orizon t al, 139–140, 140f, 145, 146f Bouch acourt , Léon , 80 Braking radiat ion See Brem sst rah lu ng Brem sst rah lung, 15–16, 16f, 26f Broadben t , B Holly, C Calcium t ungst ate cr yst als, 41, 41f Can cer, radiat ion -in duced, 31, 32f Caries – approxim al, 136 – assessm en t and diagn osis of, 136–139 – C1 (super cial), 137, 137f – C2 (m oderate), 137, 138f – C3 (deep), 137, 138f, 139 – C4 (deep com plicated), 137, 138f – cem en t um , 136 – an d cer vical burn out , di eren t iat ion of, 122, 122f – an d developm ent al defect s, different iat ion of, 139 – di erent ial diagn osis, 139 – early ch ildh ood, 139, 139f – en am el, 137, 137f – ssure, 136 – in terproxim al, 136 – occlusal, 137, 138f – predilect ion sites for, 136 – prim ar y (in it ial), 136, 137f – – t ypes of, 137, 137f – progression , st ages of, 137, 137f – radiograph ic appearan ce of, 136 – recurren t , 137, 139 – secon dar y, 136, 137 Cath ode, of X-ray t ube, 12–13, 13f CCD sensors, 47 CdTe sen sors, 48 Cell death , program m ed, 27–28 Cell fun ct ion , im pairm en t of, 27 Cem entoblastom a, 153, 154f Cem entom a, 153, 154f Cem ento-osseous dysplasia, 153, 154f – orid, 153 Cen t ral gian t cell gran ulom a, 156, 156f Cen t ral project ion , 34, 121 Cephalom et ric radiograph, e ect ive dose for, 114 Cer vical burn out , 122, 122f Cer vical spin e, 128f Cesium iodide cr yst als, 48 Ch aracterist ic cur ve(s) – for digital radiography, 51, 52f – of radiograph ic lm , 40f, 41, 50–51 – – sh ou lder of, 40f, 41 – – toe of, 40f, 41 – for storage ph osph or im aging plates, 51, 52f Ch em ical t rap(s), 48 Cieszyn ski, A., Clin ical in dicat ion s, for radiological exam inat ion , 56 Close-up im aging, 77, 77f CMOS sen sors, 47 Collim ator(s), 17–18, 18f, 19f, 37 – geom et r y of, an d radiograph ic tech niqu e, 18, 19f Collim ator h older, 18 Com parabilit y, of radiograph s, 134 Com pton e ect (Com pton scat tering), 11, 11f, 26, 26f Com puted tom ography (CT) – art ifacts, 112–113 – e ect ive dose for, 113–114 – h istorical perspect ive on , 109–110 – lim itat ion s of, 112–114 – prin ciples of, 109 – radiat ion exposure in , 113–114 – spiral, 110, 110f Cone beam com puted tom ography (CBCT), 5, 5f, 47, 85, 87, 109–117 – art ifacts, 113 – basic rules for, 114 – of bone dit ion s, 140 – clin ical applicat ion s of, 114– 117, 115f–117f, 121, 122f – data recon st ruct ion , 110–111 – developm ent of, 109–110 – e ect ive dose for, 113–114 – at panel detectors for, 111 – – – – im age form at ion , 110–111 im age in ten si ers for, 111 of n asopalat in e duct cyst , 143 prim ar y recon st ruct ion, 111, 111f – radiat ion exposure in , 113–114 – secon dar y reconst ruct ion, 111, 111f, 112f, 113f – of sialolith iasis, 157, 157f, 158f – slice posit ion, 114, 116f – slice th ickn ess, 114, 116f – system s, cost of, 114 – of tooth fract ures, 158, 159f, 160f – volum e size for, 114, 115f Con t in uing educat ion , an d radiat ion protect ion, 56 Con t rast See Film , t rast; Object cont rast Coolidge, William , 13 Corpuscular radiat ion , Cosm ic rays, 30 Coulom b per kilogram (C/kg), 22 Cribriform plate, 121, 121f Crossover, 42, 42f Curren t in ten sit y, and im age form at ion , 36 Cyst(s), 120, 120f – de n it ion of, 143 – follicu lar (dent igerous), 143, 143f, 144f, 147 – nasopalat in e duct , 124, 143, 144f – non odon togen ic epith elial, 143 – odon togenic epith elial, 143 – radicular (periapical), 143–144, 145f – radiograph ic appearance of, 135 – W HO classi cat ion of, 143 D Dent al radiography, h istorical perspect ive on, 2–5 Dent al X-ray h ead, 3, 3f Dent al X-ray t ube, 12, 12f – design of, 12, 12f, 13f – kilovolt age and, 11, 15 Dent ures, and panoram ic radiography, 101, 101f Derm at it is, radiat ion -in duced, 54 Detect ive quan t um e cien cy (DQE), 50 Determ in ist ic e ect s, 28, 31, 32f Diagn osis, radiographic n dings an d, 135 Diagn ost ic radiology, physics of, 10–11, 11f Digital dent al radiography – advant ages of, 50–51 – dat a storage in , 51 – de n it ion of, 47 – edit ing of, 51 163 www.pdflobby.com Index – en h an cem en t of, 51 – equipm ent for, 46f, 47 – at pan el detectors for, 46f, 47 – h istorical perspect ive on , 46 – im age acquisit ion in , 47 – im age inten si er for, 46f, 47 – im aging plate for, 46f, 47, 48–50 – rapid availabilit y of im age in , 51 – sen sors for, 46f, 47–48, 47f – spat ial resolut ion in, 48 Digit al radiography, h istorical perspect ive on , Digit al volum e tom ography See Cone beam com puted tom ography (CBCT) Distort ion, im aging free of, in int raoral radiography, 59, 60f DNA (deoxyribon ucleic acid) – base dam age, 27, 27f – double-st ran d breaks, 27, 27f – radiat ion dam age to, 27, 27f, 31 – – biological e ects of, 27–28 – repair m ech anism s, 27 – single-st ran d breaks, 27, 27f Dose–area product , 23, 23f Dose lim it(s), 55 – m on itoring of, 55 Dose lim itat ion , 17–18 Dose units, 22 Dosim et r y, un it s an d term s for, 22–23 Dynam ic range, 50–51 E Ear lobe, sh adow, on pan oram ic radiography, 105, 126, 127f Edison , Th om as, E ect ive dose, 23 – for CBCT, 113–114 – for ceph alom et ric radiograph , 114 – for CT, 113–114 – for digital pan oram ic radiograph, 114 – for in t raoral radiograph, 114 E ect s of radiat ion See Radiat ion e ect s Elect ric eld st rength , 8f, Elect rom agn et ic spect ru m , 9, 9f Elect rom agn et ic w aves, 8–9, 8f Elect ron (s), – in teract ions w ith an ode m aterial, 15 – release of, 26, 26f – sh ell-to-sh ell t ran sit ion s, 10 Elect ron beam (s), radiat ion w eigh t ing factor for, 22 Elect ron shell(s), 9, 10 Elect ron t rap(s), 48, 49 En do-Holder, 74, 74f Epith elial cell rest s of Malassez, 143 Equipm en t (den t al X-ray), radiat ion -proof h ousing, 12, 12f Equivalen t dose, 22 Er ythem a, radiat ion -in duced, 31 European Atom ic En ergy Com m unit y (EURATOM), 55 European Com m it tee for St andard izat ion , 56 Excit at ion , 10 Exposure See Radiat ion exposure Exposure t im e, an d im age form at ion , 36 External acou st ic m eat us, 127f F Feldkam p algorith m , 111 Fibroden t inom a, 147 Fibrom a – am eloblast ic, 147–148, 149f – ossifying, 155, 155f Fibro-odontom a, am eloblast ic, 147–148, 149f Fibrous dysplasia, 156, 156f Film – bending of, errors cau sed by, 65f, 70, 70f – ch aracterist ic cur ves, 40f, 41, 50–51, 52f – cont rast , 37, 50–51 – – an d ch aracterist ic cur ve, 40f – cross-sect ion al st ruct ure of, 39, 39f – for dent al X-ray, ch aracterist ics of, 37–38, 37f – developm ent of, disadvan t ages of, 51 – D-speed, 38 – em ulsion layer, 39, 39f – E-speed, 38 – F-speed, 38 – w ith in ten sifying screens, 41–42, 41f – – disadvant ages of, 42 – – sen sit ivit y of, 41 – norm al exposure of, 40f – for occlusal radiography, 74, 75f – over-exposure of, 40f – packaging of, 39, 39f – processing of, 42, 43f – screen less, 37–38 – – for occlusal radiography, 74 – sh arpn ess (resolut ion ), 37–38, 37f – silver tent of, 39 – speed (sen sit ivit y), 37–38 – un der-exposu re of, 40f – view ing, dit ion s for, 134 – w rong-side exposure of, 39f, 41 Film holder – an terior, for paralleling tech niqu e, 65, 65f – for bitew ing radiography, 74, 74f – in sert ion in to m outh , 64–67, 64f–66f – an d orth ogon al project ion geom et r y, 63, 63f – for paralleling tech n ique, 61, 61f – w ith posit ion -in dicat ing device, 136 Filter(s), alum inum , 17 Filtered back project ion, 111 Filt rat ion – by alu m in um lters, 17 – in h eren t , 17 – tot al t ube, 17 – of X-rays, 17 Fin dings (radiograph ic) – challenging an d/or un com m on , 135–136 – den sit y of, 135 – descript ion of, 135 – an d diagn osis, 135 – e ect on adjacen t st ru ct ures, 135 – evaluat ion of, 135 – in tern al st ruct u re of, 135 – locat ion /site of, 135 – m argins of, 135 – an d n orm al varian t s, 135–136 – relat ionsh ip to adjacen t st ru ct ures, 135 – sh ape of, 135 – suggest ive of lesion s/path ological changes, 135 – w rit ten report of, 135 Fit zgerald, F G., 61 Fluorescence, 41 Focal spot , 13–14, 14f – act u al, 14, 14f – apparent (e ect ive), 14, 14f – size of, 13–14 Focus-to-object dist ance (FOD), for or th odon t ic radiography, 61–62 Food an d Drug Adm in ist rat ion (FDA), and radiat ion protect ion , 56 Fract ure(s) See also Tooth fract ures – m an dibular, 158, 159f, 160f – radiograph ic appearan ce of, 135 Fran kfort h orizon t al plan e, 89f, 91, 91f Free radicals, 27 G Gadolin iu m cr ystals, 41, 41f Galileos digit al e beam com puted tom ography system , 5, 5f Gam m a rays, 8, 9, 9f, 11 – radiat ion w eigh t ing factor for, 22 Garret son , J L., Geh ler in tensifying screen , Gen erator(s), m ult i-pulse, 14, 15f Gen et ic defect s, radiat ion -in duced, 31, 32f See also Mut at ion (s) Geom et ric u nsh arpness, 48 Gh ost im ages, in panoram ic radiography – of an atom ical st ruct ures, 102, 102f – of cer vical spin e, 98–99, 98f, 99f – de nit ion of, 97 – of earrings and other ear jew elr y, 103, 103f – of m etallic object s, 100, 100f – of m olar/prem olar crow n s, 104, 104f 164 www.pdflobby.com – of object s in rot at ion cen ter, 103–104, 103f, 104f – t ypes of, 97 Gran ulom a, 141 See also Cen t ral gian t cell gran ulom a Gray (Gy), 22 Gray-scale range, 34, 35–36 H Hard palate, radiograph ic appearan ce of, 125, 125f, 127f, 129f Heckm an n , K., 80 Hofrath , H., Holzknech t , Guido, 35 Houn s eld, Godfrey N., 109 Hyoid bon e, 127f, 128f I Im age an alysis, system at ic, 134 Im age form at ion , 34 – factors a ect ing – – lm -related, 37–42 – – im age receptor-in dependent , 35–37 Im age in terpret at ion, system at ic, 134 Im age noise, 48 Im age qualit y, 17–18 – assessm en t of, 134 Im aging plate(s) See also Storage ph osphor im aging plates – for digital radiography, 46f, 47 – dyn am ic range of, 51, 52f Incisive can al, 124 Incisive foram en , 124f In am m at ion See also Periodon t it is – of en dodon t ically t reated tooth , CBCT of, 116, 116f – radiograph ic appearan ce of, 135 Infraorbital can al, 128f, 130 Infraorbital foram en , 130 Inten sifying screen(s), 2, 41–42, 41f – disadvan tages of, 42 – speed classes of, 41–42 Interden tal bon e sept u m , 121 Interm axillar y sut ure, 124f Intern at ional Atom ic Energy Agen cy (IAEA), 54, 55 Intern at ional Basic Safet y St an dards (BSS), 56 In tern at ion al Com m ission on Radiological Protect ion (ICRP) – act ivit ies of, 54–55 – collaborators w ith , 54 – goals of, 54 – h istorical perspect ive on , 54 – recom m endat ion s form u lated by, im plem ent at ion of, 55–56 – st an ding com m it tees of, 54 – st ruct ure of, 54 In tern at ion al Organ izat ion for Stan dardizat ion (ISO), Tech n ical Com m it tee 106 Den t ist r y, 56 Index In terradicular bon e sept um , 121, 122f In t raoral radiography – of bon e dit ion s, 140, 141f – clin ical applicat ions of, 58 – com pleten ess of visualizat ion in , 58, 58f – diagnost ic im age qualit y of, 58, 138 – distor t ion -free im aging, 59, 60f – e ect ive dose for, 114 – full-m outh series, 63, 63f – im age receptor posit ion ing for, 134 – orth ogon al im aging – – project ion geom et r y for, 58–59, 59f – – superim posit ion -free, 58–59, 58f – periapical, 61, 61f – prin ciples of, 58 – qualit y criteria for, 58–59 – reproducibilit y, 59, 60f – st an dards for, 58 – superim posit ion s in , 138 Inverse square law, 36, 36f Ion dose, 22 Ion izat ion, 9–10, 10, 16 – de nit ion of, – direct , – in direct , Ion izing radiat ion, – e ect s of See also Radiat ion e ect s (biological e ects/e ects in t issu e) – – direct , 27 – – on DNA, 27–28, 27f – – indirect , 27 Isotope(s), radioact ive, 11 J Jaw s See also Man dible; Maxilla – bone diseases of, 155–156 K Kalen der, Willi, 110 Kells, C Edm und, 2, 61 Keratocyst s, 143 See also Tum or(s), odon togen ic Kilovoltage, of den tal X-ray m ach in es, 11, 15 Koch an d Sterzel, 80 Kön ig, Walter, L Lam ina dura, 121, 121f Laten t period, 31 Lead lin e grid, 36–37, 37f, 38 Le Master, Collins, Leukem ia(s), radiat ion -in duced, 32f Ligh t – u lt raviolet See Radiat ion , ult raviolet – visible, 9f, 10 Lin ea obliqua See Oblique lin e Linear energy t ransfer (LET), 22, 22f Line pairs per m illim eter (lp/m m ), 48 Lum inescen ce, 16, 17f – ph oto-st im u lated, for im aging plate readout , 48, 48f, 49, 50f M Magn et ic u x den sit y, 8f, Malign ant lesion s, 145–154 Malign ant t ran sform at ion , 31 Man dible – an atom ical variat ion s, 123f, 124 – bone dit ion s in, assessm en t of, 140, 140f – collum , 126, 127f – com pact bon e of, 128f – dyle, 128f – coron oid process, radiograph ic appearan ce, 125, 126f, 129f – radiograph ic an atom y of, 123–124, 123f – – panoram ic, 125–126, 126f, 127f, 128f Man dibular (n er ve) can al, 123, 124, 125, 128f, 143 Man dibular foram en , 125 Man dibular fract ure(s), 76, 76f Maxilla – bone dit ion s in, assessm en t of, 140, 140f – radiograph ic an atom y of, 124– 125, 124f, 128–131, 129f–130f Maxillar y sinus – diagnost ic evaluat ion of, 131 – lateral w all, on pan oram ic radiography, 129f, 130f, 131 – m ucocele in, 130f – posterior w all, on pan oram ic radiography, 129f, 131 – radiograph ic appearan ce of, 124–125, 125f, 126, 129f, 130 – residual root in , 4f – sh adow, on pan oram ic radiography, 106, 106f Maxillar y t uberosit y, radiograph ic appearan ce of, 126, 128f McCorm ack, Allan , 109 McCune-Albright syn drom e, 156 Median palat in e sut ure, 124 Men tal foram en , 123, 125, 128f Met al art ifact s – on CBCT, 113 – on CT, 112 – in pan oram ic radiography, 100, 100f Midface – pan oram ic radiography of, 87, 87f – radiograph ic an atom y of, 128–131, 129f–130f Mon itor view ing, dit ion s for, 134 Mot ion art ifact s – on CBCT, 113, 113f – on CT, 113 Mou th , oor of, can cer of, 145– 146, 146f Mozzo, P., 110 Mucocele, in m axillar y sinu s, 130f Muller, H J., 54 Mutat ion (s), 28, 31, 32f, 54 Myxo brom a, odontogen ic, 153, 153f Myxom a, odon togen ic, 153, 153f N Nasal cavit y, 128f, 129f Nasal conch ae, sh adow s, on pan oram ic radiography, 105–106, 105f, 106f, 128f Nasal oor, radiograph ic appearan ce of, 125, 125f, 127f Nasal sept um , 128f Nat ional Coun cil on Radiat ion Protect ion and Measurem en ts (NCRP), 55, 56 Neut ron (s), 11 – ion izat ion den sit y of, 22 New Tom e beam com pu ted tom ography system , 5f, 109 Nose, shadow – on intraoral radiograph, 124, 124f – on pan oram ic radiography, 106, 106f, 126, 127f – on radiograph , 124, 124f, 125f Nuclei – st able, 8, 11 – unst able, 8, 11 Nuclide(s), radioact ive, 11 See also Radion uclides Num ata, H., 3, 4f, 79–80 O Object t rast , 36 Object-to- lm distan ce, and paralleling tech n ique, 62 Oblique lin e, of m an dible, 123, 123f, 127f Occlusal radiography, 74–76 – axial project ion tech n ique for, 76, 76f – bisect ing-angle tech n ique for, 75, 75f – lm for, 74, 75f Odontom a, 151 – com plex, 151, 151f – com pou nd, 151, 152f Opt im izat ion procedures, 56 Oral cavit y, can cer of, 145–146 Orbit , 127f, 129f, 130 Oro-an t ral com m unicat ion , CBCT of, 117, 117f Orth odon t ic radiography, 61–62 Orth ogon al im aging, 81–83 Orth ogon al project ion geom et r y, 58–59, 59f – lm h olders an d, 63, 63f – for m olars, 63, 63f – for prem olars, 63, 63f Or th opan tom ography, 3, 81–83, 84–85, 88f, 89, 112f Orth ophos XG 3D e beam m ach ine, 110f Osteom a, 155 Osteom yelit is, 155, 155f Ot t , Walter, 3, 80 P Paatero, Y V., 3, 4f, 79–80, 82 Pair product ion, 11 Panoram ic radiography, 79–108, 121, 122f, 139–140 – air sh adow s in , 126 – of alveolar crest , 86 – an atom y, 87f, 88f, 88t, 89, 125–131 – of an terior tooth region, 86, 86f – bitew ing view s, 86f, 87 – of bone dit ion s, 139–140, 140f – of cyst s, 120, 120f, 143, 143f– 145f, 144 – in den tate pat ien ts, bite-rod posit ioning device for, 93 – dent ures an d, 101, 101f – in eden t ulou s pat ient s, posit ion ing for, 93–95, 94f, 95f – e ect ive dose for, 114 – errors in – – an terior displacem ent of an terior teeth , 96, 96f – – h ead displacem en t or rot at ion, 92–97 – – h ead posit ion ing, 90–97 – – h ead rot at ion out of m edian plan e, 97, 97f – – h ead t ilt , 90–92, 90f–92f – – posterior displacem en t of anterior teeth , 92, 93f – w ith ext raoral lm , 80 – focal t rough adjust m en t to den tal arch in , 81, 81f, 82f – gh ost im ages in , 97 – – of anatom ical st ruct ures, 102, 102f – – of cer vical spin e, 98–99, 98f, 99f – – of earrings an d oth er ear jew elr y, 103, 103f – – of m etallic objects, 100, 100f – – of m olar/prem olar crow n s, 104, 104f – – of object s in rotat ion cen ter, 103–104, 103f, 104f – h ead posit ion ing for, 89–90, 89f – – errors in , 90–97 – h istorical perspect ive on , 3–5, 4f, 5f, 79–80 – w ith in t raoral source, 80, 80f – m ethodology, 89–108 – of m idface, 87, 87f – of part ial-arch segm ent s, 85–86, 85f – pat ient posit ion ing for, 84, 84f, 134 – rotat ion al, 80–81, 80f – – advan ces in , 84–85 – – angle of in ciden ce in , 82, 82f 165 www.pdflobby.com Index – – h ead posit ion ing in, 83, 84f – – im age layer th ickness in , 83, 83f – – an d orth ogon al im aging, 81–83 – – pat ien t posit ion ing in, 84, 84f – – principle of, 81, 81f – – projection geom etry, 83–84, 84f – – project ion in h orizon tal plan e, 83, 84f – – project ion in vert ical plan e, 83, 84f – – project ion radiu s in , 83, 83f – – rot at ion cen ters in, 82–83, 82f, 83–84, 84f – – slit collim ator w idths in , 82f, 83, 83f – w ith slit collim ator, 79–80, 79f – soft-t issue sh adow s in , 97, 104–109, 126 – special program s, 85–88 – superim posit ion s in , 97, 104–109 – of tem porom an dibular joint , 86f, 87, 87f Pan oram ic tom ography, 79–108 See also Pan tom ography Pan orex X-ray m ach in e, Pan tom ography, 3, 4f Paralleling techn ique, 18, 61–67, 136 – advan t ages of, 62, 63 – an d bisect ing-angle tech n ique, com parison of, 67, 67f, 70f – bite block an d, 62, 62f – lm h older for, 61, 61f – – an terior, 65, 65f – – insert ion in to m outh, 64–67, 64f–66f – lm posit ion ing in, 63–64, 65f – im age receptor placem ent in, 62, 62f – long-cone tech nique for, 61–62 – m ethodology, 63–67 – – for m andibular in cisors and can ines, 66f, 67 – – for m andibular m olars an d prem olars, 66–67, 66f – – for m axillar y in cisors an d can ines, 65, 65f, 66f – – for m axillar y prem olars an d m olars, 64, 64f, 65f – object-to- lm distan ce an d, 62 – prin ciples of, 61–62 Par t ial volum e art ifacts, on CT, 112–113 Path ology – iden t i cat ion of, on radiograph s, 134–135 – versus n orm al varian ts, 135–136 – an d X-ray im age form at ion, 36 Periapical cem en t al dysplasia, 153 Periapical radiography, 61, 61f See also Bisect ing-angle tech n ique; Paralleling tech n ique Periodon t it is, apical – acute, 141 – – radiograph ic feat ures of, 141, 141f – ch ron ic, 141 – – radiograph ic feat ures of, 141, 142f – ch ron ic granu lom atou s, radiograph ic feat ures of, 141, 142f – radiograph ic feat u res of, 141, 141f, 142f Ph ar yn x, 128f Ph otoelect ric e ect , 10–11, 11f, 16, 17f, 26, 26f Ph oton(s), scat tering of, 11, 11f, 26, 26f Ph oton en ergy, t ran sfer to m at ter, 10, 26, 26f See also Excitat ion; Ion izat ion Ph oton radiat ion, 8–9 Ph oto-st im ulated lum in escen ce (PSL), for im aging plate readout , 48, 48f, 49, 50f Pixel bin ning, 48 Pot assium , 30 Price, W A., Project ion geom et r y – im plem ent at ion of, 59–61, 60f – prin ciples of, 59–61, 60f Proton (s), 8, 9, 11 – ion izat ion den sit y of, 22 Pter ygopalat in e fossa, 126, 128f Q Qualit y assuran ce, 56 – st an dards for, 56 R Radiat ion See also Ion izing radiat ion – absorpt ion of, 10, 22 See also X-ray(s), absorpt ion of – alph a, – art i cial, 12 – beta, – cosm ic, 12, 30, 31f – de nit ion of, – elect rom agn et ic, 8–9, 8f – in frared, 8, 9f – an d m at ter, interact ion s bet w een , 9–10, 26, 26f – n at urally occurring (backgrou nd), 8, 30 – scat tered, 37, 37f See also Scattering – secon dar y, 37, 37f – solar, 30 – terrest rial, 12, 30, 31f – t ypes of, – u lt raviolet , 8, 9f Radiat ion absorbed dose, 22 Radiat ion e ects (biological effect s/e ect s in t issue), 26, 26f – biological ph ase, 26–28, 26f, 27f – ch em ical ph ase, 26, 26f – determ in ist ic, 28, 31, 32f – direct , 27 – in direct , 27 – physical ph ase, 26, 26f – stoch ast ic, 31, 32f Radiat ion exposu re – art i cial, 30, 31f – nat ural, 30, 30f, 31f – occupat ion al, 30, 31f Radiat ion protect ion , 17–18 – adm in ist rat ion of, 55 – bisect ing-angle tech n ique an d, 70 – historical perspect ive on , 54 – legal an d regulator y fram ew ork for, 55 – m an agem en t of, 55 – an d need/just i cat ion , 55 – opt im izat ion of, 55 – procedures for, 56 – respon sibilit y for, 55 Radiat ion qualit y, 22 Radiat ion risk(s) – an d need/just i cat ion , 55 – reduct ion of, 55 Radiat ion sickness, acute, 31 Radiat ion w eigh t ing factor (W R), 22 Radioact ivit y, 8, 11–12 Radiograph ic m easurem ent, 74, 74f Radioisotopes, 11 Radion uclides, 11 – terrest rial, 30 Radiosen sit ivit y, 23 RadioVisioGraphy system , 46 Radon , Joh an n , 111 Radon gas, 30, 30f, 31f Raper, How ard R., 2, 73, 136 Rare-earth screens, 41, 41f Report , radiological, 135 Reproducibilit y – of im ages in in t raoral radiography, 59, 60f, 71 – of radiograph s, 134 Right-angle techn ique, 72–73, 72f, 73f Risk/ben e t assessm ent , 56 Roen tgenogram , rst , Roen tgen rays, Roller t ran sport system , of autom at ic lm processor, 42, 43f Rön tgen , Wilh elm Con rad, discover y of X-rays, Root canal, w orking length of, radiograph ic m easu rem en t of, 74, 74f Root resorpt ion – w ith am eloblastom a, 147, 147f, 148f – t raum a-in duced, 158, 160f Rutherford, Ern est , S Scanora, 5, 85 Scat tering, 11, 11f, 26, 26f, 37, 37f – in ten sifying screen s and, 42 Sem icon ductor e ect , 16 Sem ilun ar n otch , 128f Sen sor(s), for digital radiography, 46f, 47–48, 47f – act ive pixel, 47 – CCD, 47 166 www.pdflobby.com – CdTe, 48 – CMOS, 47 – sign al processing w ith , 47, 47f – spat ial resolut ion of, 48 – t ypes of, 47 Sh ell capacit y, Sialolith iasis, 76, 76f, 157, 157f, 158f Siem ens X-ray sph ere, 3, 3f Sievert (Sv), 22, 23 Silver brom ide cr ystals, 38–39, 38f – conven t ion al, 38, 38f – T-grain (t abular), 38, 38f Single-t ank design , 12 Skin cancer, radiat ion -induced, 54 Slit-beam tech niqu e, 3, 4f Slit collim ator – pan oram ic radiography w ith, 79–80, 79f – in rotat ional pan oram ic radiography, 82f, 83, 83f Soft palate, 127f – radiographic appearance of, 129f – shadow, on panoram ic radiography, 107, 107f, 126 Soft rays, 11 Spacer e(s), 17–18, 18f, 19f Sphen oid sin us, 127f St andard radiograph ic project ion s, 35 St andards – for in t raoral radiography, 58 – for radiat ion protect ion , 56 St at us-X pan oram ic X-ray ap parat us, 4f Stochast ic e ect s, 31, 32f Storage ph osphor im aging plates, 48–50 – characterist ic cur ve for, 51, 52f – dam age-related m arks on , 50, 51f – form ats for, 49, 49f – laten t im age on , 49 – readout , 48, 48f, 49, 50f – scan ners for, 49, 49f – st ruct ure of, 48, 48f St yloid process, 126, 127f Subt ract ion , 35–36, 138 Sum m at ion e ect , 34, 34f, 121, 138 T Tangen t ial e ect , 35, 35f Teeth See also Tooth – radiograph ic an atom y of, 121–122, 121f, 122f Tem porom an dibular joint (TMJ) – close-u p view of, 77f – pan oram ic im aging of, 86f, 87, 87f Th erm ion ic em ission, 13 Th orium , 30 Th resh old dose, 31, 32f Tissu e(s) – e ect s of radiat ion in See Radiat ion e ects Index – radiat ion -induced ch anges in , 31 – X-ray appearance of, 35 Tissue w eigh t ing factor (W T), 23, 23t Tom ography – blurring in, 78, 78f – conven t ion al, 77–78, 77f, 78f – – principles of, 77f, 78, 78f – digital volu m e See Con e beam com pu ted tom ography (CBCT) – pan oram ic, 79–108 See also Pan tom ography Tongue – posit ion, for pan oram ic radiography, 107, 107f, 109 – sh adow, on pan oram ic radiography, 107–108, 108f–109f, 126 Tongue piercing, an d rotat ion cen ter of pan oram ic radiography, 103–104, 103f, 104f Tooth fract ures, 158, 159f, 160f Tooth lu xat ion, 158 Tooth -support ing st ru ct ures, radiograph ic an atom y of, 121, 121f, 122f Training, and radiat ion protect ion , 56 Tran sverse pan oram ic tom ography, Traum at ic den tal inju ries, 158, 159f, 160f Tum or(s) – odontogen ic, 147–153 – – ben ign m ixed, 147 – – keratocyst ic, 143, 147, 148, 150f, 151f – – W HO classi cat ion of, 147 – radiograph ic appearan ce of, 135 Turbinates, in ferior, radiograph ic appearan ce of, 129 Type tests, 56 V Vascular system , radiat ion -induced ch anges in , 31 Voltage, an d im age form at ion , 36–37 Volum e art ifact s, on CBCT, 113 Voxels, 111 W Waggener, D T., 61 Walkh o , Friedrich Ot to, Water, radiolysis of, 27 Weh n elt cylin der, 13, 13f, 14 X U Ulcer(s), radiat ion -induced, 31 Un ited St ates, organ izat ion s in, respon sible for radiat ion protect ion , 55–56 Updegrave, W J., 61 Uranium , 30 X-ray(s), 8, 9f – absorpt ion of, 10, 22, 34 – – factors a ect ing, 35–36 – ch aracterist ic, 10, 15, 16f – discover y of, – lt rat ion of, 17 – ion izat ion den sit y of, 22 – an d m at ter, in teract ion s bet w een , 9–10, 26, 26f – product ion of, 10 – – in den tal X-ray equipm en t , 12–16 – propert ies of, 16 – radiat ion w eigh t ing factor for, 22 – of teeth , rst , X-ray beam (s), at ten uat ion of, 10, 16, 34 X-ray m ach in e, den tal, rst , Z Zon arc pan oram ic X-ray m ach ine, 3, 5f Zon arc rotat ion al panoram ic radiography m achin e, 85f Zon ography, 83 Zulauf, A F., 79–80 Zygom at ic arch , 128f Zygom at ic bon e, radiographic appearan ce of, 125, 125f, 128, 128f, 129f 167 www.pdflobby.com www.pdflobby.com ...www.pdflobby.com www.pdflobby.com www.pdflobby.com Dental Radiology An d reas Fu h r m an n , DDS Foren sic Odon tologist Depar t... w h o tran slated the poem by Eugen Roth w ith w it and skill xi www.pdflobby.com www.pdflobby.com Chapter History and Development of Dental Radiography www.pdflobby.com History and Developm... been no English edition The English version has again show n that dental radiology is a ver y special and challenging eld of radiology that dem ands a high level of expertise an d a deep understanding