x-rayfilms-1202140-phpapp01 (1) (3).pptx

x ray film

1. X- ray Films February 14, 2012 Dr Saad Wahby Al Bayatti 1 Dr, Surabhi tomar B.D.S., M. D.S . JR2 DEPT. OF PEDODONTICS & PREVENTIVE DENTISTY

2. X- ray Films February 14, 2012 Dr Saad Wahby Al Bayatti 2 The media on which the radiographic images of objects are recorded Images are stored as an unseen (latent) image that will be changed to a seen image by processing the film

3. N o n - s c r e e n f i l m I n t r a o r a l S c r e e n f i l m E x t r a o r a l T y p e s o f X - r a y f i l m s February 14, 2012 Dr Saad Wahby Al Bayatti 3

4. Intra oral x-ray films (non-screen films) Types / Sizes February 14, 2012 Dr Saad Wahby Al Bayatti 4 2 2 x 3 5 m m P e d o 3 1 x 4 1 m m A d u l t P e r i a p i c a l T y p e 1 2 2 x 3 5 m m P e d o 3 1 x 4 1 m m A d u l t B i t e w i n g T y p e 2 5 7 x 7 6 m m O c c l u s a l T y p e 3 I n t r a o r a l f i l m s C l a s s i f i e d a c c o r d i n g t o u s e a n d s i z e

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7. Intra Oral x- ray Film Composition Film Base February 14, 2012 Dr Saad Wahby Al Bayatti 7 Film base; clear transparent sheet of cellulose acetate with a bluish tint. Adhesive; connects the emulsion to the base. Emulsion; on both sides of the base where silver bromide(AgBr) crystals are distributed in an the gelatin emulsion Protective layer; protects the emulsion from mechanical damage

8. Intra oral x- ray film composition Film base February 14, 2012 Dr Saad Wahby Al Bayatti 8 Protective gelatin layer Adhesive Emulsion ( silver halide) Film base Cross sectional structure of double emulsion film

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10. Intra oral x- ray film composition Film Packet February 14, 2012 Dr Saad Wahby Al Bayatti 10 Outer plastic wrapper; protects the film from light, saliva and mechanical damage, has two sides: *Front; faces the x- ray tube, single color (white) *Back; opposite side to x-ray tube, two colors (white and green). It has an opening tab to open the film during processibg Black paper wrapper; protects the film base from light, saliva and damage during opening

11. February 14, 2012 Dr Saad Wahby Al Bayatti 11 Lead foil; thin sheet of lead present at the back of the film, has certain shapes on its surface, it: *prevents x –rays from going to deeper tissues after passing through the film *prevents scattered radiation from deeper tissues to come back to the film Raised dot; an elevation embossed on each component of the film,has two surfaces Convex; indicates front of the film (facing x- ray) Concave; indicates back of film (facing lead foil)

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15. Intra oral x- ray film composition Film Packet February 14, 2012 Dr Saad Wahby Al Bayatti 15 Outer plastic cover Front Back Film Lead foil Protective black paper

16. Front Back February 14, 2012 Dr Saad Wahby Al Bayatti 16 Film base Lead foil Black paper cover Dot Back Front Outer plastic cover Intra oral x- ray film composition Film Packet

17. Intra oral x- ray film composition Film Packet Dr Saad Wahby Al Bayatti February 14, 2012 17 Front Back

18. Deep Tissues Behind film Incident x- rays February 14, 2012 Dr Saad Wahby Al Bayatti 18 Object (Tooth ) Film packet without a lead foil Scattered x-rays Back-scatter

19. Deep Tissues Behind film No x- rays behind the film Film packet with a lead foil Incident x-rays Object (Tooth ) February 14, 2012 Dr Saad Wahby Al Bayatti 19

20. Latent image formation February 14, 2012 Dr Saad Wahby Al Bayatti 20 Radiolucent object Thick Radiolucent object Radioopaque object Incident x- ray photons Incident x- ray photons Incident x- ray photons Emerging x- ray photons Emerging x- ray photons Emerging x- ray photons Max.Ag ppt Less Ag ppt No Ag ppt Latent image in the x- ray film Metals Enamel Dentin Cementum Bone Muscle Fat Air

21. Latent image formation Dr Saad Wahby Al Bayatti February 14, 2012 21 AgBr AgBr Ag + Ag ppt in emulsion precipitate precipitate Ag + Br gas Ag + Br gas = latent image Molecule split by ionization Molecule split by ionization X –ray photon

22. Latent image formation February 14, 2012 Dr Saad Wahby Al Bayatti 22 Br gas Br gas X- ray photons Ag ppt

23. Processing of the x-ray films February 14, 2012 Dr Saad Wahby Al Bayatti 23 The sequence of events by which the unseen latent image is changed to a seen image. Steps of processing are; Developing : alkaline solution, it acts on the Ag atoms initially separated by the x- ray photons and are further precipitated and increased in size by Oxidization Washing : Water removes the alkaline developer and prevents the contamination of the acidic fixer.

24. Processing of the x-ray films, cont’d February 14, 2012 Dr Saad Wahby Al Bayatti 24 Fixing : acidic solution, it acts on the AgBr crystals not affected by the x- ray photons, all crystals are removed from the gelatin emulsion into the fixer solution Washing : water removes fixer solution from the film to prevent oxidization of the remaining fixer and future contamination of the final radiograph Drying : air drying to remove water from the processed radiograph

25. Ag ppt Ag ppt Ag ppt Exposed film Steps of processing February 14, 2012 Dr Saad Wahby Al Bayatti 25 Developing Continuation of exposed silver precipitation (oxidation) Washing Fixation Washing & drying Removal of unexposed AgBr Final radiograph

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27. Processing of the x-ray films February 14, 2012 Dr Saad Wahby Al Bayatti 27 D e v e lo p in g W a s h in g F ix in g W a s h in g D r y in g F ilm p r o c e s s in g

28. Processing of the x-ray films February 14, 2012 Dr Saad Wahby Al Bayatti 28 M a n u a l A u t o m a t i c F i l m p r o c e s s i n g

29. Dark Room February 14, 2012 Dr Saad Wahby Al Bayatti 29 Light tight room to allow opining the x- ray films safely without exposure to light Supplied with a safe light (red or orange > 600 nm wavelength) to permit unwrapping the films in otherwise total darkness Should be covered with acid resistant, washable benches Well ventilated, convenient,and clean. Supplied with disinfectants to disinfect films and other materials

30. Manual Film Processing February 14, 2012 Dr Saad Wahby Al Bayatti 30 Wash Dry Change exhausted solutions !! Unwrap the exposed film (in the dark room) Clip to a hanger Immerse the film in the developer for 4.5 min at 20 C. Agitate W a o s h Immerse film in the fixer for 8 minutes at 20 C o

31. Automatic Film Processing February 14, 2012 Dr Saad Wahby Al Bayatti 31 Unwrap the exposed film (in the dark room) or in a day light loader Insert the film in the loading slot Receive the film dry from the film exit slot Change exhausted solutions !!

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34. GBX- 2 safe light 15 watt bulb February 14, 2012 Dr Saad Wahby Al Bayatti 34

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41. Automatic processor February 14, 2012 Dr Saad Wahby Al Bayatti 41

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46. Dark Room February 14, 2012 Dr Saad Wahby Al Bayatti 46 Light tight room to allow opining the x- ray films safely without exposure to light Supplied with a safe light (red or orange) to permit unwrapping the films in otherwise total darkness Should be covered with acid resistant, washable benches Well ventilated, convenient,and clean. Supplied with disinfectants to disinfect films and other materials

47. February 14, 2012 Dr Saad Wahby Al Bayatti 47 Manual Film Processing Unwrap the exposed film (in the dark room) Clip to a hanger Immerse the film in the developer for 4.5 min at 20 o C. Agitate Wash Immerse film in the fixer for 8 minutes at 20 o C Wash Dry

48. Automatic Film Processing February 14, 2012 Dr Saad Wahby Al Bayatti 48 Unwrap the exposed film (in the dark room) or in a day light loader Insert the film in the loading slot Receive the film dry from the film exit slot

49. Develop Wash Fix Wash Dry Safe light Processing solutions February 14, 2012 Dr Saad Wahby Al Bayatti 49

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59. Checking the light leaks in the dark room ( light tightness) February 14, 2012 Dr Saad Wahby Al Bayatti 59 Turn all lights off Close door(s) Wait for 10 minutes Check light leaks by eye (door hinges, ceilings and other possible light leaks) Correct Check again Perform coin test

60. Checking the safe light February 14, 2012 Dr Saad Wahby Al Bayatti 60 Check light tightness in the dark room If OK then, Turn the safe light ON Open an unexposed film under the light Put a metal coin on the film Wait for 5 minutes Process the film Clear film, light OK Dark film with clear image of the coin, improper safe light/light leak

61. Safe light February 14, 2012 Dr Saad Wahby Al Bayatti 61 Coin Film Light tight dark room Proper safe light Light leaks in dark room Improper safe light Dark room

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64. Radiographic Image Quality February 14, 2012 Dr Saad Wahby Al Bayatti 64

65. D e n s i ty C o n tr a s t S h a r p n e s s I m a g e Q u a l i ty February 14, 2012 Dr Saad Wahby Al Bayatti 65

66. Density The degree of blackness of the processed radiograph It is measured by the density meter which gives a Log scale of the transmitted light through the radiograph. Density can either be ; High (dark radiograph) Medium Low (light radiograph) February 14, 2012 Dr Saad Wahby Al Bayatti 66

67. Contrast February 14, 2012 Dr Saad Wahby Al Bayatti 67 Is the differences between black, grey and white shadow in the radiograph Contrast can either be; low when the difference between the shades is gradual High when the difference between the shades is sharp

68. Sharpness February 14, 2012 Dr Saad Wahby Al Bayatti 68 The ability of the radiograph to produce sharp outlines of the borders of the object

69. Factors that affect the radiographic image quality Dr Saad Wahby Al Bayatti February 14, 2012 69 Object factors ; object density (w/v) object thickness Exposure factors kVp mA exposure time tube-film distance Film factors film speed lead foil storage Processing solutions temperature. concentration. time

70. Density increases when February 14, 2012 Dr Saad Wahby Al Bayatti 70 Object factors; * object density (w/v) - - - - -- - - - -- - decreases * object thickness Exposure factors kVp mA exposure time tube-film distance - - - -- - - - -- - - decreases - - - - -- - - - -- - increases - - - - -- - - - -- - increases - - - - -- - - - -- - increases - - - -- - - - -- - - decreases

71. Density increases when Film factors film speed lead foil (Opposite side) lead foil (If not used) *storage (at high Temp.) Processing solutions temperature concentration time Dr Saad Wahby Al Bayatti February 14, 2012 71 -- - - - -- - - - - - increases -- - - - -- - - - - - decreases - -- - - - -- - - - - increases - - -- - - - -- - - - increases - -- - - - -- - - - - increases -- - - - -- - - - - - increases - - - -- - - - -- - - increases

72. Contrast increases(HIGH) when February 14, 2012 Dr Saad Wahby Al Bayatti 72 Object factors; * object density (w/v) - - - - -- - - - -- - increases * object thickness Exposure factors kVp mA exposure time tube-film distance - - - -- - - - -- - - increases - - - - -- - - - -- - decreases - - - - -- - - - -- - decreases - - - - -- - - - -- - decrease - - - -- - - - -- - - increases

73. Contrast increases(HIGH) when Film factors film speed lead foil (Opposite side) lead foil (If not used) *storage (at high Temp.) Processing solutions temperature concentration time Dr Saad Wahby Al Bayatti February 14, 2012 73 -- - - - -- - - - - - decreases -- - - - -- - - - - - decreases - -- - - - -- - - - - decreases - - -- - - - -- - - - decreases - -- - - - -- - - - - decreases -- - - - -- - - - - - decreases - - - -- - - - -- - - decreases

74. February 14, 2012 Dr Saad Wahby Al Bayatti 74 Sharpness increases when Object factors; patient stability - - - - -- - - - -- - decreases object density (w/v) - -- - - - -- - - - - NIL * object thickness Exposure factors x- ray head stability kVp mA exposure time tube- film distance - - - -- - - - -- - - decreases - - - - -- - - - -- - NIL - - - - -- - - - -- - NIL - -- - - - -- - - - - NIL - - - -- - - - -- - - increases

75. Sharpness increases when Film factors film movement film speed lead foil (Opposite side) lead foil (If not used) *storage (at high Temp.) Processing solutions temperature concentration time - - - -- - - - -- - - decreases -- - - - -- - - - - - decreases -- - - - -- - - - - - NIL - -- - - - -- - - - - NIL - - -- - - - -- - - - NIL - -- - - - -- - - - - NIL -- - - - -- - - - - - NIL - - - -- - - - -- - - NIL Dr Saad Wahby Al Bayatti February 14, 2012 75

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77. Radiographic Artifacts ( Errors) February 14, 2012 Dr Saad Wahby Al Bayatti 77

78. Radiographic Artifacts ( Errors) Films Dr Saad Wahby Al Bayatti February 14, 2012 78 Cause(s) Storing film at high Temp./Humidity Storing film in a radiation area Films without lead foil Light leaks Improper safe light Severe bending of the film Error Fog: an increase in radiographic density that result from deposition of silver ion from reasons not caused by the primary beam Black line on radiograph

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80. Radiographs of an aluminum step wedge taken at different kVp February 14, 2012 Dr Saad Wahby Al Bayatti 80

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83. Errors in Image Quality Density February 14, 2012 Dr Saad Wahby Al Bayatti 83 Error High density (dark film) Cause(s) Film opened in light Fog High speed film High kV High mA Incorrect safe light

84. Errors in Image Quality Density Dr Saad Wahby Al Bayatti February 14, 2012 84 Error High density (dark film) High exposure time High developing Temp High developing Time High developer Conc.

85. Errors in Image Quality Density February 14, 2012 Dr Saad Wahby Al Bayatti 85 Error Low density (light film) Cause(s) Opposite side of film(zigzag/tire tracks) Low speed film Low kV Low mA Low exposure time

86. Errors in Image Quality Density Dr Saad Wahby Al Bayatti February 14, 2012 86 Error Low density (light film) Old developer solution Low developer Temp Low developing Time Low developer Conc. Incomplete fixation

87. Errors in Image Quality Density February 14, 2012 Dr Saad Wahby Al Bayatti 87 Error No image (clear film) Cause(s) No exposure Old developer solution Film fixed directly

88. Errors in Image Quality Sharpness Dr Saad Wahby Al Bayatti February 14, 2012 88 Error Image unsharpness Cause(s) Curved film Film moved Patient moved Tube moved

89. Errors in Image Quality Dr Saad Wahby Al Bayatti February 14, 2012 89 Error Double image Images of Foreign objects Cause(s) Film exposed twice Failure to remove; Eye glasses Partial dentures Ear/nose rings

90. Errors in Image Quality Exposure Techniques Dr Saad Wahby Al Bayatti February 14, 2012 90 Error Elongated image Shortened image Cause(s) Cone directed perpendicular to object Bent film Cone directed perpendicular to film

91. Errors in Image Quality Exposure Techniques Dr Saad Wahby Al Bayatti February 14, 2012 91 Error Overlapping contacts Cause(s) Cone not parallel to buccal surfaces of teeth (incorrect horizontal angulation)

92. Errors in Image Quality Exposure Techniques Dr Saad Wahby Al Bayatti February 14, 2012 92 Error Tooth incompletely seen(apex cut off) Cause(s) Free margin of film extending more that 2 mm Bent film Elongated image

93. Errors in Image February 14, 2012 Dr Saad Wahby Al Bayatti 93 Error Part of film exposed Cause(s) Incomplete coverage of beam to film(cone cutting) Film partially immersed in developer Part of film immersed in fixer prior to developer

94. Errors in dark room Dr Saad Wahby Al Bayatti February 14, 2012 94 Error Tree like black lines Clear spots on radiograph Brown spots Two film stuck Finger prints Cause(s) Static electricity Fixer drops Failure to wash film Dirty rollers Film held from center

95. Errors in dark room Dr Saad Wahby Al Bayatti February 14, 2012 95 Error Cracked emulsion Scratches Cause(s) Difference in solution temperatures Wet film Cut your finger nails!

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103. Processing of the x-ray films February 14, 2012 Dr Saad Wahby Al Bayatti 103 The sequence of events by which the (unseen) latent image is changed to a seen image. Steps of processing are; Developing : alkaline solution, it acts on the Ag atoms initially separated by the x-ray photons and are further precipitated and increased in size by Oxidization The developing solution is composed of; Developer:Phenidone, hydroquinine Activator: sodium (potassium) hydrozide. Buffers are added, e.g. sodium carbonate, sodium hydroxide, sodium metaborate or tetraborate (Preservative (antioxidant): sodium sulfite Restrainer: potassium or sodium bromide Developer replenisher

104. Processing of the x- ray films Washing : Water removes the alkaline developer and prevents the contamination of the acidic fixer. February 14, 2012 Dr Saad Wahby Al Bayatti 104

105. Processing of the x-ray films, cont’d February 14, 2012 Dr Saad Wahby Al Bayatti 105 Fixing : acidic solution, it dissolves and removes unexposed AgBr crystals not affected by the x- ray photons, all crystals are removed from the gelatin emulsion into the fixer solution The fixing solution is composed of; Clearing agent: ammonium thiosulfate (hypo) Acidifier: acetic acid Preservative: sodium or ammonium sulfite Hardener: ammonium salts

106. February 14, 2012 Dr Saad Wahby Al Bayatti 106 Washing : water removes fixer solution from the film to prevent oxidization of the remaining fixer and future contamination of the final radiograph due to silver thiosulfate reaction Drying : air drying to remove water from the processed radiograph

107. Waste disposal February 14, 2012 Dr Saad Wahby Al Bayatti 107 Dissolved silver Electroplating Metallic replacement Lead foil Collected to be disposed separately

108. Radiographic Image Quality February 14, 2012 Dr Saad Wahby Al Bayatti 108

109. D e n s i ty C o n tr a s t S h a r p n e s s I m a g e Q u a l i ty February 14, 2012 Dr Saad Wahby Al Bayatti 109

110. Density The degree of blackness of the processed radiograph It is measured by the density meter which gives a Log scale of the transmitted light through the radiograph. Density can either be ; High (dark radiograph) Medium Low (light radiograph) February 14, 2012 Dr Saad Wahby Al Bayatti 110

111. Contrast February 14, 2012 Dr Saad Wahby Al Bayatti 111 Is the differences between black, grey and white shadow in the radiograph Contrast can either be; low when the difference between the shades is gradual High when the difference between the shades is sharp

112. Sharpness February 14, 2012 Dr Saad Wahby Al Bayatti 112 The ability of the radiograph to produce sharp outlines of the borders of the object

113. Resolution The ability of the radiograph to record separate structures that are close together, e.g. enamel and dentin February 14, 2012 Dr Saad Wahby Al Bayatti 113

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115. Factors that affect the radiographic image quality Dr Saad Wahby Al Bayatti February 14, 2012 115 Object factors ; object density (w/v) object thickness Exposure factors kVp mA exposure time tube-film distance Film factors film speed lead foil storage Processing solutions temperature. concentration. time

116. Density increases when February 14, 2012 Dr Saad Wahby Al Bayatti 116 Object factors; * object density (w/v) - - - - -- - - - -- - decreases * object thickness Exposure factors kVp mA exposure time tube-film distance - - - -- - - - -- - - decreases - - - - -- - - - -- - increases - - - - -- - - - -- - increases - - - - -- - - - -- - increases - - - -- - - - -- - - decreases

117. Density increases when Film factors film speed lead foil (Opposite side) lead foil (If not used) *storage (at high Temp.) Processing solutions temperature concentration time Dr Saad Wahby Al Bayatti February 14, 2012 117 -- - - - -- - - - - - increases -- - - - -- - - - - - decreases - -- - - - -- - - - - increases - - -- - - - -- - - - increases - -- - - - -- - - - - increases -- - - - -- - - - - - increases - - - -- - - - -- - - increases

118. Contrast increases(HIGH) when February 14, 2012 Dr Saad Wahby Al Bayatti 118 Object factors; * object density (w/v) - - - - -- - - - -- - increases * object thickness Exposure factors kVp mA exposure time tube-film distance - - - -- - - - -- - - increases - - - - -- - - - -- - decreases - - - - -- - - - -- - decreases - - - - -- - - - -- - decrease - - - -- - - - -- - - increases

119. Contrast increases(HIGH) when Film factors film speed lead foil (Opposite side) lead foil (If not used) *storage (at high Temp.) Processing solutions temperature concentration time Dr Saad Wahby Al Bayatti February 14, 2012 119 -- - - - -- - - - - - decreases -- - - - -- - - - - - decreases - -- - - - -- - - - - decreases - - -- - - - -- - - - decreases - -- - - - -- - - - - decreases -- - - - -- - - - - - decreases - - - -- - - - -- - - decreases

120. February 14, 2012 Dr Saad Wahby Al Bayatti 120 Sharpness increases when Object factors; patient stability - - - - -- - - - -- - decreases object density (w/v) - -- - - - -- - - - - NIL * object thickness Exposure factors x- ray head stability kVp mA exposure time tube- film distance - - - -- - - - -- - - decreases - - - - -- - - - -- - NIL - - - - -- - - - -- - NIL - -- - - - -- - - - - NIL - - - -- - - - -- - - increases

121. Sharpness increases when Film factors film movement film speed lead foil (Opposite side) lead foil (If not used) *storage (at high Temp.) Processing solutions temperature concentration time - - - -- - - - -- - - decreases -- - - - -- - - - - - decreases -- - - - -- - - - - - NIL - -- - - - -- - - - - NIL - - -- - - - -- - - - NIL - -- - - - -- - - - - NIL -- - - - -- - - - - - NIL - - - -- - - - -- - - NIL Dr Saad Wahby Al Bayatti February 14, 2012 121

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123. Radiographic Artifacts ( Errors) February 14, 2012 Dr Saad Wahby Al Bayatti 123

124. Radiographic Artifacts ( Errors) Films Dr Saad Wahby Al Bayatti February 14, 2012 124 Cause(s) Storing film at high Temp./Humidity Storing film in a radiation area Films without lead foil Severe bending of the film Error Fog Black line on radiograph

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126. Light radiograph (low density) Dr Saad Wahby Al Bayatti February 14, 2012 126 Processing errors Underdevelopment Low temperature Short time Thermometer incorrect Depleted (exhausted) developer solution Diluted developer Contaminated developer Excessive fixation Under exposure Insufficient mA Low kVp Insufficient time Tube- film distance long Film reversed

127. Light film (low density) February 14, 2012 Dr Saad Wahby Al Bayatti 127 Film placed on reverse side

128. Film fog Dark film Low contrast February 14, 2012 Dr Saad Wahby Al Bayatti 128

129. Dark Radiographs February 14, 2012 Dr Saad Wahby Al Bayatti 129 Processing errors Overdevelopment high temp Increased developing time Developer concentration high Inadequate fixation Accidental exposure to light Improper safe lighting

130. Dark Radiographs Over exposure February 14, 2012 Dr Saad Wahby Al Bayatti 130 High mA High kVp Excessive exposure time Tube- film distance short

131. Insufficient contrast February 14, 2012 Dr Saad Wahby Al Bayatti 131 Underdevelopment Underexposure High kVp Excessive Film fog

132. Film fog February 14, 2012 Dr Saad Wahby Al Bayatti 132 Improper safe lighting Improper filter Excessive bulb wattage Inadequate distance between safe light and working bench Prolonged exposure to safe light

133. Film fog cont’d February 14, 2012 Dr Saad Wahby Al Bayatti 133 Light leaks Cracked safe light Light from doors Light from vents Overdevelopment Contaminated solutions Outdated film Films stored at high temperatures Films stored at high humidity Films stored in a radiation area

134. Dark spots or lines February 14, 2012 Dr Saad Wahby Al Bayatti 134 Fingerprint contamination Back wrapping paper sticking to film surface Film contact with tank or wit another film during processing Film contaminated with developer before processing Excessive bending of the film Static discharge to film before processing Excessive roller pressure during automatic processing Dirty rollers in automatic processor

135. February 14, 2012 Dr Saad Wahby Al Bayatti 135 Light spots Film contaminated with fixer before processing Film in contact with tank or another film during development Excessive bending of film

136. Yellow or brown stains February 14, 2012 Dr Saad Wahby Al Bayatti 136 Depleted developer Depleted fixer Insufficient washing Contaminated solutions

137. Blurring February 14, 2012 Dr Saad Wahby Al Bayatti 137 Movement of patient Movement of X- ray tube head Double exposure

138. Partial images February 14, 2012 Dr Saad Wahby Al Bayatti 138 Top of film not immersed in developing solution Misalignment of X- ray tube head (cone cut)

139. Stuck films February 14, 2012 Dr Saad Wahby Al Bayatti 139 Blurred image

140. Fixer drops February 14, 2012 Dr Saad Wahby Al Bayatti 140 Cone cutting