Dental Radiology Text Problem

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13 .NUTTTPN OFX.RAYS

Ionization occurs:A. lfhen atoms lose electrons; hey becomedefi-cient in negative charges and therefore behaveas positively charged atoms.B. I7hen atoms gain electrons; hey becomeposi-tively charged.C. 'Whenan atom loses ts nucleus.D. Only when a K orbit electron s ejectedandreplacedby an L orbit electron.\fhich electron has the greatest binding energy tothe nucleus?A. J shell electron.B. K shell electron.C. L shell electron.D. Q shell electron.Select he correct statement:A. X-rays cannot be focused o a point.B. X-rays can be focused o a point.C. X-rays cannot increase he electricalconduc-tivity of a gas.D. X-rays do not always travel in a straight line.The mean penetrability of an x-ray beam is not re-lated ro which of the following?A. kVp.B. Filtration.C. \Tavelength.D. Frequency.E. mA.

BIBLIOGRAPHYAlpen E. Radiation Biophysics. Englewood Cliffs, NJ: Prentice HalL1990.

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Bushberg T, Seibert A, Leidholdt EM Jr, BooneJM. The Essenti,Physics f Medical maging.Baltimore:Williams&'V7ilkins,1994.BushongSC.RadiologicScienceor Technologists: hysics,Biolog,and Protection.5th ed. St.Louis:Mosby-YearBook. 1993.CemberH. Introduction to Heabh Physics.New York: McGraw-Hill1.996.Curry TS III, DowdeyJE,Murry RC Jr. Christensen' s hysics f Diag-nosticRadiology.4th d.PhiladelphiazLea Febiger, 990.GlasserO. The Science f Radiology.Springfield:CharlesC. Thomas.1.933:1-1.4.Hendee W, Ritenour F.E.Medical Imaging Physics.3rded. St. LouisMosby-Year ook,1992.LanglaisRP, KasleMJ. BasicPrinciples f Oral Radiography. hiladel-phia:'WBSaunders,,98t.LanglandOE, SippyFH, LanglaisRP. Textbookof DentalRadiolog'-2nd ed.Springfield:CharlesC. Thomas,L984.RezaiRF, \Talkhoff O. Renaissance an of dentistry.Bull Hist Dent1.986;34:L1.5-1.2L.

Roentgen'$7C. n a new kind of r ays.Nature 1896;53:274-276.RohrmeirG, 'WalkhoffFO. Leben und werk. \Turzburg,Germanr':'WurzburgUniversity, anuary1895.Dissertation.Sellman . The Fwndamentalsf X-Ray and RadiumPhysics.Tth Ed-Springfield: harles . Thomas, 985.SprawlsP Jr.PhysicalPrinciples f Medical maging.2nded.Gaithers-burg:Aspen,t993.SquireLF, Novelline RA. Fundamentals f Radiology.4th ed. Cam-bridge:HarvardUniversityPress, 988.Ter-PogossianMM. The PbysicalAspectsof DiagnosticRadiologt'.New York: Harper& Row, HoeberMedical Division,1967.'Vfolbarst AT. Physicsof Radiology. East Norwalk, CT: Appleton-Lange,1.993.

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DIAGNOSTIC UALITY F DENTALMDIOGMPHS

3. \fhich of the following would minimize the sizeofthe penumbra?A. Large focal spot.B. Long source-film distance.C. Short source-filmdistance.D. Long object-film distance.

4. lf by mistake you used the exposure time for theshort-BlD technique (8-inch source-film distance)while using the long-BID technique (L6-inchsource-film distance),what would be the densitv ofthe film?A. Too light.B. No visible change n density.C. Too dark.D. Altered from long-scale to short-scale.

5. \fhat is the primary factor in controlling density?A. kVp.B. Source-film distance.C. mAs.D. Collimarion.E. Film development.

6. '$7hat is the primary factor in conrrolling contrast?A. Film speed.B. Source-filmdistance.C. kVp.D. Exposure time.E. mA.

7. \7hich of the following properties of x-rays is thebasis for the rules of geometric projection?A. X-rays travel at rhe speedof light.B. X-rays travel in diverging straight lines from apoint source.C. The course of an x-ray photon can be divertedwith an electromagnetic source.D. X-rays can form a latent image on photo-graphic film.

8. Regardlessof the target-film distance, incorrecrhorizontal angulation will cause:A. Elongation of the x-ray image.B. Foreshortening of the x-ray image.C. No significant change in the x-ray image.D. Overlapping of teeth in the x-ray image.

9. The size of the x-ray tube focal spot influences ra-diographic:A. Density.B. Contrast.C. Definition.D. Distorrion.

Which of the following doesnot control magnifi-cationof the radiographed bject?A. Focalspor-filmdistance.B. Alignmentof film, objects,and radiation BID.C. Object-filmdistance.D. Cathode ize.I7hich of the following doesnot consritutean ad-vantageof the smallest ossibleocalspot?A. Decreasedeometric nsharpness.B. Increasedmagnification.C. Increased efinition.D. Decreasedenumbra.

12. The densityof an intraoral film indicates he:A. Degree f darkness.B. Differencebetween ensities.C. Speed f the screens.D. Kilovoltage sed.E. Noneof theabove.

13. Fog affects he contrast of a:n ntraoral film be-causet:A. Decreasesilm density.B. Increasesilm density.C. Produceswhite specks n rhe ilm.D. Produces hosphorus rystalson rhe ilm.

14. Adequatecoverageof the areaof intereston theradiographdepends n which of these actors?A. Properalignmentof film and the radiationbeam o the arcaof. nterest.B. Properselection f film types.C. Properselection f film-projection echniques.D. All of theabove.

15. \7hich of the following facrorsminimizepenum-bra formation andmagnificationon a radiograph?1.. LongBID.2. Short arget-filmdistance.3. Film ascloseaspossibleo theteeth.4. Large ocalspor.5. ShortBID.A. 2 and5.B. 5 only.C. L and3.D. 3 and4.E. 1 and4.

BIBLIOGRAPHYBloom_ J, HollenbachJL, Morgan JA.Medical RadiographicTechnic.3rd ed.Springfield:CharlesC. Thomas,1969.Bushongsc. Radiologicscience or Tecbnologists.Sth d. st. Louis:Mosby-Year ook,1993.

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RADIOGRAPHICNFECTION ONTROLPROCEDURES

C. Gowns.D. Resuscitation bags, pocket masks, other venti-lation devices.E. All of the above.5. You are about to perform a full-mouth survey ona patient who has no medical conditions as indi-cated by the medical history and interview. Forthis appointment the dental professional shouldwear:

A. Gloves only.B. Glasses and a face mask.C. Glasses nd gloves.D. Glasses, loves,and a face mask.

6. \7hich of the following statements s/are correct?A.. Taking sterilized x-ray instruments out of apackage and placing them in clean drawers isrecommended.B. Hands should be washed thoroughly beforeand after taking intraoral radiographs.C. The risk of contracting acquired immune defi-ciency syndrome (AIDS) during x-ray proce-dures is greater than the occupational risk forhepatitisB.D. Both A and C are correct.E. Both A and B are correct.

7. The most commonly usedglove type for x-ray pro-cedures s what kind of gloves?A. Medical grade vinyl.B. Sterile vinyl.C. Unsterile atex.D. Sterile atex.E. Medical grade latex.

8. The class of chemical that is leasteffective as a sur-face disinfecting agent is:A. Hypochlorite.B. Iodophor.C. Complex phenol.D. Synthetic phenol.E. 70% isopropyl alcohol.

9. \7ith respect to x-ray instruments, which of thefollowing statements s most appropriate?A. Sterilize everything.B. Be certain to sterilize hands before x-ray pro-cedures.C. Dark drawer sterilization can work under cer-tain conditions.D. Do not worry about sterilization for most x-

ray instruments.E. Do not disinfect when you can sterilize.

10. Which of the following s not a virus?A. Epstein-Barr.B. Pneumococci.C. Herpes implex.D. HepatitisB.

11,. Glove powder can affect some film emulsithus, powder-free gloves are recommended. Glpowder may also be responsible or :A. Allergic reactions.B. Dirty uniforms.C. Nonallergic kin reactions.D. All of the above.

t2. TheOSHABloodborne athogen ule senforbytA. Federalnspections.B. State nspections.C. Employees.D. All of the above.Using the recommended infection control methfor processing films, as stated by the authorsthis chapter, how many pairs of gloves are actuused from the beginning to the end of the pdure?A. One glove and an overglove.B. Two latex or vinyl gloves.C. Three latex or vinyl gloves.D. Two latex gloves only.

L4. Is it true thatbacteria from dirtv films can surviin the processingsolutions?A. Yes.B. No.

15. Is t true hat microbialcontamination f an xfilm can survive he processingycle?A. Yes.B. No.

BIBLIOGRAPHYAmerican Academy of Oral and Maxillofacial Radiology. Infectiontrol guidelines for dental radiographic procedures. Oral SurgMed Oral Pathol L992;73:248-249.American Dental Association. Infection controlthe dental office and dental laboratory.1.996;1.27:672-680. I Am DentBachman CE,'White JM, Goodis HE, et al. Bacterial adherenceandtamination during radiologic processing. Oral Surg Oral MedPath ol 799 0 76 112-1,1,9Bajuscak RE, Hall EH, Giumbarresi LI. Bacterial contamination oftal radiographic fi lm [abstract].J Dent Res 991;70:1.439.Bajuscak RE, Hall EH, \Teaver T, et al. Sporicidin and chlorine bdisinfectant of dental radiographic fi lm [abstract]. J Dent

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recommendations

1.991;70:1.439.


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TNTRAORAL ADTOGRAPHTCECHNTQUES

11. Why is the extension or long BID a necessaryad-junct to the paralleling technique?A. To avoid magnification of the image.B. To avoid shape distortion of the image.C. To reducesecondary adiation.D. To facilitate correct vertical angulation of theBID.E. To avoid superimpositionof structures.

L2. Compared with the short BID (bisecting angle)technique, the right angle (paralleling) techniqueusing the extension BID involves:L. Greater vertical angulations.2. Greater object-film distances.3. Shorter developing times.4. Greater anode-film distances.A. 'l..and 2.B. L and 3.C. 2 and 3.D. 2 and 4.E. 3 and 4.

13. \hich statement is most correcr?A. The long BID can be used correctly with ei-ther the paralleling or the bisecting angle tech-nique.B. The long BID is used with the parallelingtechnique only.C. The short BID is used correctly with either theparalleling or the bisecting angle technique.D. Film-holders are not necessarywith the paral-leling technique.

t4. In order to increase he periapical coverage n themandibular premolar arca the:A. Positive (+ ) vertical angulation should be in-creased.B. Negative (- ) vertical angulation should be in-creased.C. Positive (+) vertical angulation should be de-creased.D. Negative (- ) vertical angulation should be de-creased.

15. As used n intraoral radiograpiry, the bisecting an-gle technique is one in which the central x-raybeam is directed:A.B.C.D.

Perpendicular to the long axis of the object.Parallel to the long axis of the object.Perpendicular to a line bisecting the angleformed by the object and the film packet.Perpendicular to the long plane of the filmpacket.

CASE-BASEDUESTIONScAsE 5.1The patient is a 3S-five-yearold woman and a long-stand-ing, usually cooperative patient. She complained of dis-comfort when the film was being placed. This is amandibular premolar radiograph.

QUESTTONSL. Forgetting or now that the apices renot showimesiodistallvhe film is:A. Poorly placed becausepart of the canine ismissing.B. Poorly placed because he second premolar isnot centered on the biteblock.C. \fell placed because he second premolar is inthe middle of the film.D. \7ell placed because he distal of the canineand first molar are in the image.

2. \7ith respect to the apices, the problem couldbest corrected by:A. Increasing the negative vertical angulation,because his will also align the lingual andbuccal cusp tips.B. Asking the patient to raise the tongueter film placement.C. Asking the patient to bite down more

for bet-firmlyon the biteblock.D. Positioning he film more ingually o avoidtraumatizing he lingual torus.

3. Match the columnsby identifying he following.Arrow LArrow 2Arrow 3Arrow 4

A. Mandibular torus.B. Buccalcusp ip.C. Lingualcusp ip.D. Laminadura.


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ANALYSIS F ERRORSND ARTIFACTS

7. What is the function of the raised dot on the film?A. It identifies the side of the film toward the lineof occlusion.B. It identifies the side of the film toward the

tongue.C. It identifies the side of the film toward thebeam of radiation.D. It identifies the maxillary or mandibularteeth, depending on how the film is placed inthe mouth.E. It identifies Ef type of film.8. If an unexposed film is stripped from its filmpacket, exposed to light, and then processed, twill:

A. Be unaffected.B. Turn white.C. Turn black.D. Be translucent.E. Be streaked.9. lf an exposed film is stripped from its packet, pro-cessedproperly in dark conditions, and then ex-posedto light, it will:

A. Be unaffected.B. Turn white.C. Turn black. .D. Be translucent.E. Be streaked.10. \7hich of the following will not produce fog?

A. Films left unprotected in the operarory wherex-rays are taken.B. Films stored for many years.C. Light leaks in the dark room.D. Films stored in lead containers.E. Films stored near source of heat.11. tilflhich of the following will produce fog?

A. Light leaks in the darkroom.B. Films stored for many years in an unsafeplace.C. Films left unprotected where x-rays are taken.D. Unsafe safelight.E. All of the above.

12. In the paralleling technique, what is the cause offoreshortening of the image?A. "Too much" vertical angulation of BID.B. "Too flat" a vertical angulation of BID.C. Improper horizontal angulation of BID.D. Movement of BID.E. Placing film parallel to long axis of the teeth.

L3. In the paralleling technique, what is the cause ofelongation of the image?A. "Too much" vertical angulation of BID.B. "Too flat" a vertical angulation of BID.C. Improper horizontal angulation of BID.D. Movement of BID.E. Placing film parallel to long axis of the teeth.

14. In the paralleling technique, what is the causeoverlapping of images?A. "Too much" vertical angulation of BID.B. "Too fIat" a vertical angulation of BID.C. Improper horizontal angulation of BID.D. Movement of BID.E. Placing film parallel to long axis of the teeth.Black marks or streaks n the image of a procesfilm are causedby:A. Bending of corners of film.B. Incidental crimping of film.C. Saliva contamination.D. Static electricity.E. All of the above.

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CASE-BASEDQUESTIONScAsE 7.

QUESTTON1. Identify theerror in this radiograph: Disregardrows)A. Film conraminated y fixer beforedevelopment.B. The film packet was reversed.C. Excessiveexposure to thermal changesdevelopment.D. Improper use of Styrofoam biteblock.E. Use of outdated film.

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ANALYSISOF ERRORSND ARTIFACTS

cAsE 7.5After taking a maxillary pfemolar radiograph using theDentsply/Rinn instruments and manual processing, a fel'low worker tells you that there were common efrors onthe radiograph, and You agree.

QUESTION1. How would you correct or theseerrors?1. Leave ilm in the water bath longerafter ftxa-tion.Leave ilm in the developeronger.Decreaseerticalangulation.Placedot in the slot of the film-holder.Position he film moremesiallY.Position he film moredistallY.tr 3, and6.

L, 4, and5.3, 4, and5.2 and4.1.r , and6.cAsE7.6A loyal patienrof your dentalclinic comes o you for herL-year heckup andthis radiographwastaken.

QUESTIONL. 'What caused he common errors in this radiograph

L. Too flat a verticalangulationof the BID'2. Too steepa verticalangulationof the BID'3. Fixer aftlfact.4. Developer tain.5. Air on emulsion6. Roughhandlingof film.A. 1 and3.B. 2 and4.C. 2 and6.D. 3 and6.E. t and5.cAsE 7.7Your office has purchased a new automatic proceThe first time you use t, two films come out stuck toother, with the resultant film.

QUESTION1. \fhat causeshiserror?A. Processingemperatures re oo high.B. The rollersareset oo slow.C. Filmswere nserted oo fast n the sameD. Filmshavebentedges.E. Dryer not working ProPerlY.

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QUALITY SSURANCEND LEGAL SPECTS

4. Vhich of the following is not considered an ad-vantage of keeping a retake log?A. Provides clues for the source of most retakes.B. Servesas a guide for continuing educationtopics.C. Provides some measure of the operator's com-petence.D. Reduces he amount of paperwork.The half-value layer test is used to evaluate whichof the following?A. Filtration.B. Collimation.C. kVp.D. mA.E. Beam alignment.'V7henusing a radiographic normalizing and mon-itoring device, there is a difference of two or moresteps noted for a monitoring film when comparedwith a baseline density number determined previ-ously under ideal conditions. What should you do?1,. Take a preexisting reference ilm from the re-frigerator and develop it.2. Take a reference ilm from the refrigerator,expose t with standard exposure factors, anddevelop t.3. If the reference ilm matches within two steps,the problem is most likely a processing prob-lem.4. If the reference ilm matches within two steps,the problem is most likely in the x-ray equip-ment or technique.5. If the reference ilm does not match withintwo steps, he problem is a processing prob-lem.A. 1 and 3.B. l. and 5.C. 2 and 5.D. 2 and 4.E. 2 and 3.\7hich of the following are true statements egard-ing the lega l aspectsof dental radiography?L. The patient's radiographs rightfully belong tothe patient.2. The patient's radiographs are legal propertyof the dentist.3. The dentist should not give original radio-graphs to the patient.4. Radiographs should always be taken beforeand after each tooth extraction.

5. One of themostcommoncauses f dentalmalpractice uits s the useof radiographsbythe dentistwhen they are not necessaryo ren-der a diagnosis.A. 2,4, and5.B. 1 and5.C. 2 ,3 , and5 .D. 1 and4.E. 2 and 3.

8. A patient is moving to another city. He stopsbyyour dentaloffice before eavingand asksyou forthe radiographshat you took previously.'Sfhatsthe correctmethod o handle his situation?Give the radiographs to the patient. After all,they legally belong to the patient because hepatient paid for them.Give the radiographs to the patient and tellthe patient to give them to his dentist in theother city.Tell the patient he cannot have the radio-graphs because he radiographs legally belongto the dentist.D. Tell the patient that after he has found a newdentist in the other city, the new dentistshould send a written request for the radio-graphs.

To perform the coin test for darkroom fog:A. Use the slowest film available.B. Use an exposed film.C. Turn off the safelight.D. Use a panoramic or cephalometric film ifintraoral radiographs are taken.

10. Before performing the coin test for safelightyou should:A. Eliminate all sources of extraneous whitelight.B. Be certain all extraneous sourcesof whitelight are "on."C. Avoid checking afelightbulb wattage, ilter,and distance ntil later.D . BandConlv .When wo mA settings, uchas L0 and 15 mA,availableon a machine. hesecircuits arechecbyt

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SPECIALMAGING ECHNIQUES

software, digital imagesallow for the completely paper-less office. Many new practitioners are setting up pa-perlessoffices today.

SUMMARYDigital images offer tremendous advantages to dentistryin terms of lower radiation exposure for patients, nodarkroom or processing problems, convenient imageenhancement techniques, and remote teledentistry pos-sibilities. Digital systems are now able to acquire al ltypes of images including panoramic and cephalomet-ric. As technology continues to improve, they will ulti-mately replace film as the medium of choice for dentalimaging.

EXERCISEI.I TOCALIZATIONMaterials nd EquipmentNeededL. Manikin, skull, animal jaw.2. Four No. 2 periapical films.3. One BB (small metal ball or,other metal object suchas a screw).4. X-ray machine and processing facility.InstructionsStep1: Obtain a manikin, skull, or animal jaw andplace a radiopaque object (BB) on the buccal orlingual side. Do not mark the film packet. Takea standard periapical view of this object andthen vary the horizontal angle by approxi-mately 20" and expose a second film.Step2: Now leave the BB in the same spot on the buc-cal or lingual side as n Step L. Do not mark thefilm packet. Take a standard periapical view ofthe obiect and then vary the vertical angle by

approximately 20o and expose a second film.Step 3: Processall four films and mount the films in abitewing mount. Place the two images with thehorizontal movement on one side and the twoimages with the vertical movement on the otherside.Step 4: Place your name on the bitewing mount and,becauseyou know where the BB was, exchangeyour mount with a classmate and take yourclassmate'smount.

\Uflorkingn pairs, try to figure out the locationof your classmate'sB.

CASE-BASED ROBLEM-SOLVINGIn the future, you will become aware of the hasslesofing track of inventories of x-ray supplies such aschemicals,bitewing tabs, biteblocks and film-positionidevices, nd barrier envelopes. lso, you will begin oderstand he maintenance roblemsassociatedwith amatic processors, he infection control procedureassociated with the daylight loader and the darkroom,the time t takes to get a radiograph processed especiwith manualprocessing)n a tiny cubbyholedarkwith no air circulation. Soyou arewonderingaboutdigiimaging. Should you trade one set of hassles or anTo helpyou decide, evelopa comparison hartcomparithe advantages and disadvantages of the two systemsyou see t. \7hat is your final decision?REVIEW QUESTIONS

\fhich of the following statements are truecerning cephalometric radiographs?L. The Frankfort horizontal plane s the classicplaneused n cephalometrics.It is not necessary o record the soft tissuefile in the ateralcephalometric adiograph.3 .4.

The posteroanterior cephalometric is thecommon cephalgmetric radiograph pThe accepted istance rom the x-ray souto patient in cephalometric radiography is 5feet.A. '1,r2, and3.B. 3 and4.C. L and4.D. 2,3, and .E. t r213, and .

2. A cephalometricadiograph:A. Is often used o measure hanges ndgrowth patterns.B. Containsa soft tissueoutline.C. Is commonlyusedby orthodontists .D. All of the above.

3. A radiographic.imagehat looks ike a pictureskull taken back o front is calleda:A. Cephalometricateralradiograph.B. Posteroanterior iew.C. Lateral aw.D. Panoramic adiograph.

4. The anatomical structures of primary imon TMJ proiections are:The condyle, joint space, and glenoid fossa.The condyle and the maxillary tuberosiw.

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MDIATION BIOLOGY

Nuclear Regulatory Commission (NRc)-Establishesradiation protection regulations and supervisesnu-clear power/weapons facilities. Formally known asthe Atomic Energy Commission.

Environmental Protection Agency (EPA)-Has the re-sponsibility in the United States or providing guid-ance to federal agencies.

Occupational Safety and Health Administration(OSHA)-Is responsible for all occupational radia-tion protection regulations that are not regulatedby the NRC.

National Center for Devices and Radiological Health(NCDRH)-Regulates the manufacture of radia-tion-producing equipment such as x-ray machines,microwave ovens, video display terminals, andmedical ultrasound equipment. The NCDRH (for-merly known as the Bureau of Radiological Health[BRH]) is an organization within the U.S. Foodand Drug Administration. The U.S. Food and DrugAdministration (FDA) is a part of the Departmentof Health, Education and Welfare (DHEW) of theU.S. government.

Have each student prepare an answer to a patient who re-fuses any x-tay examination in your dental office, becausethe patient is fearful of dental x-radiation and its harmfuleffects.

REVIEW QUESTIONS1. Cell sensitivityo radiation s morepronounced:

1. Duringmitosis.2. During periodsof increasedmetabolism.3. During embryonicdevelopment.4. In muscle ells.5. In nerve ells.A. 1.,2,and3.B. 1.,2,and5.C. L, 3, and5.D. 2,3, and .E. 2, 3, and5.

2. Which of the following tissuess most susceptibleto radiation?A. Nerve issue.B. Muscle issue.C. Brain issue.D. Blood-forming issue.

3. Theoretically, he biologic response o a gidoseof radiation would be greater moresevwith:A. An anoxiaof the tissuebeing rradiated.B. A higherdose ate.C. A smallerarcaof tissueexposure.D. Lower linear energy ransfer LET).Which of the following latent effects an beciatedwith low-dose,whole-body adiation?A. Shock.B. Epistaxis nose leed).C. Epilation lossof hair).D. Leukemia.To a person n theUnitedStates,he averagetive doseof ionizingradiationfrom naturalgroundradiation s about:A. L0 mSv/year.B. 3 mSv/year.C. 6 mSv/year.D. 50 mSv/year.

6. A certain amount of radiation is.neededbeforeclinical signs of damage to somatic cells aThe amount of radiation after which visibleage can be produced is called the:A. Latent dose.B. Threshold ose.C. Hazarddose.D. Scatteredadiationdose.E. Background adiationdose.\7hich of the following is an SI unit of raabsorbed oseexpressedn joulesperki lirradiated issue?A. RoentgenR).B. Curie.C. rem.D. Gray Gy).The SI unit of exposureof air is called:A. Onecoulombper kilogram.B. Gray.C. Rad.D. RelativebiologiceffectivenessRBE).A radiation-damagedell can passalongto offspringcells.This is an exampleof:A. Somaticeffect.B. Geneticeffect.C. Latent effect.D. Indirect effect.

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RADIOLOGIC EALTH ND PROTECTION

9. DuringpregnancY, Patient:A. Shouldbe advisedof her egal ightsbeforebeing rradiated.B. Shouldbe warnedabout possiblemiscarriage.C. Shouldneverbe rradiated or dental adio-graphs.D. May be rradiated or dental adiographsbytaking the necessaryrecautions.

10. As a radiationworker, Youshouldnot beexposedto more than an effectivedoseof 50 mSv a year.But in x-rayingyourself or dental reatment'youare exposed o about 50 mSv. (hich of the fol-lowing reconcileshese ontradictorystatements?A. Becauseou needdental adiographs, ou canbe givenan unlimitedamountof radiation.B. As a patientyou canbe givenanyamountof

radiation,regardlessf damage.C. Exceptions an be made.D. \fhole-body radiation s different rom spe-cific-region adiation.1L. The dental health-careworker should not holdthe:

A. Film duringexposure.B. Tube duringexposure.C. Patientduringexposure.D. All of the above.L2. Someof the most effectivemeansof controlling

secondaryadiationare:t. Lead inedBID.2. Increasing VP.3. Using ilters.4. Decreasingilm speed.A. 1 and3.B. 2 and3.C. L, 2, and3.D. 2r 3, and4.13. X-ray filtersareusuallymadeof:

A. Copper.B. Lead.C. Aluminum.D. Stainless teel.

14. Collimatorsare usuallymadeof:A. Copper.B. Lead.C. Aluminum.D. Stainlessteel.

15. A film badge:t. Is affectedby ionizingndiation.

328

Is affectedby other forms of radiantenergysuchasheat.Shouldbeworn by all occupationally xposedpersons.4. Is used o'identify x-tay films.L. 2 and4.B. 1 and3.C. 1.,2,and3.D. 1, 3, and4.

BIBLIOGRAPHYADA State Legislative Clearing House. Dental radiographysults. Chicago: American Dental Association,'l'983.Bengtsson G. Maxillofacial aspects of radiation protection: focus onJ.rrt r.r"utch regarding critical organs.Dentomaxillofac

2.3 .

1,978;7:5-1'1".Brown RF, Shaver W, LamelDA. The selectionof patients or x-rayaminaiions.HEI7 Publication FDA) 80-8104.Rockville,MD:Department f Health,Educationand'Welfare, 980.BushongSC.RadiologicScienceor Technologistl:Physics,Biand Protection.4th ed.St.Louis:CV Mosby, 1'990.Council on Dental Materials, Instruments and Equipment.dations in radiographic practices:an update,l'988. J Am Dent'1.989 1'18'11' 1'1,7Court-Brown WM, Doll R, SpiersFW',et al. Geographical ariationleukemia mortality in relation to background radiation andfactors. r Med lI1980;88:1753-1'759. aD'Ambrosio JA, Sciiff TG, McDavid WD, et al. Diagnosticqualitysus patient exposure with five panoramic screen-film combinaO ral Sur 1.96 61 40947L -Domon M, YoshinoN. Factors nvolved n the high radiographictivity of E speed llms. Oral Surg 7990;592713-1.19--FrommerHH, Jain RK. A comparativeclinical study of group Ddental llm. Oral Surg1'987;632738-742.GelskeyDE, Baker CG. Energy-selectiveiltration of dental xbeams.Oral Surg1'981";522565-567Gibbs sJ,Pujol A, chen TS, et al. Patientrisk from intraoral dentaldiography.D entomaxllo ac Radiol L988 77 1' 23 .

MD: US Department of Health, Education and Welfare, L976'Horton PS, Sippy FH, Kohout FJ, et al. A clinical comparison ofgroupsD fid E dentalx-ray films. Oral Surg 1984;58J,04-105.Kafle I, Littn.t MM, KuspetME. Densitometricevaluationof intrtx-ray films: Ektaspeedversus Ultraspeed.Oral Surg 7981i

Gonad-doiei and genetically significant dose from diagnostic radi1J.5.1.964 nd,'1.970.EW Publication FDA) 76-8034-

338-342.Kaffe I, Littner MM, Shlezinger , et al. Efficiencyof the cervicdshieldduring ntraoralradiography.Oral Surg 986;62:732-ra SF Tvndall DA. A clinical comparisonof imagequality aapa SF,Tyndall DA. A clin parison of imagequality andtient exposure reduction in panoramic radiography with heavyfiltration. Oral SurgL989;67 750-759Kapa SF,Tyndall DA, QuelletteTE. The applicationof L4d:dtration' to intraoral radiography. Dentomaxillofac1.990;1'9:67-74.Kircos LT, Vandre RH, Lorton L. Exposurereduction of 96Y"traoral radiography.l Am Dent Assoc '986;1L3:746-750-Kircos LT, StaninecM, Chou L. Rareearth filters for intraoralraphy: exposure reduction as a function of kV(p) withofimage quality. J Am Dent Assoc 7989;7782605-609.MacDonald JCF, Reid JA, Berthoty D. Drywall codstruction as aradiation barrier. Oral Surg 1983;55:319-326.MilesDA, Van Dis ML, PetersonMG.Information yield:aof Kodak T-Mat G, Ortho L, and RPX-Omat films.fac Radiol1989;1 :15-1 .National Councilon RadiationProtectionandMeasurements.ray protection.NCRPReport35.'Washington, C: NCRP, 1National Council on Radiation Protectionand Measurements.Vx-ray and gamma-ray protection for energigs up to 1'0 MeV


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APPENDICES

CHAPTER7:Answerso Cose-BosedQuestionsCase7-1.1,. BCase7-21,. BCase -31,. DCase7-41,. DCase7-5t . cCase7-6L . CCase7-7t .cCase7-8L . D2 . ACase7-9L . B2 . ACHAPTER8:Answerso Review uestions

t . B2 . E3 . D4 . D5 . C6 . 87. E8 . D9 . 810. A1, t . A1,2. E1,3. Bt4. A15. A

CHAPTER 9:Answerso Review uestions1,. C2 . A3 . D

Arrow 3-DArrow 4-AArrow 5-FArrow 6-BArrow 7-GArrow 8-EArrow 9-I

Case 0-2L . CCase 0-31,. DCase ,0-4

4 , A5 . C6 . B7. B8 . C9 . B10. E1,1,. Et2. D13. C1,4. D15. A

CHAPTER 9:Answerso Cose-BosedQuestionsCase -11,. B2 . CCase9-2

Case9-41,. BCase -5Matching1 . F2 . L3 . 84. I5 . D6 . H7 . J8 . A9 .K10. Gn.E12. C

CHAPTER I O:Answerso Review uestions1,. D2 . E3 . D4 . C5 . D6 . 87. C8 . D9. B10. c1,L. B1.2. D13. CL4. E15. B

CHAPTER IO:Answerso Cose-BosedQuestionsCase 0-L

1,. DCase 0-51,. ECase 0-61,. C

CHAPTER I I:Answerso Review uestionst . c2 . D3 . B4 . D5 . C6 . D7. B8 . D9. C10. BTT, A1,2. D1,3. A

L4. C15. E16. Dt7. c18 . B1,9. CCHAPTER I2:Answerso Review uestions

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1,. True2. True3. False4. True5. False6. True7. True8. False9. True10. True

Case -3L. True2. True3. True4. False5. True6. False7. False8. True9. True10. False

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Dental Radiology Text Problem