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Textbook of Dental Radiology
Pramod John R
CHAPTER 1:
History of Radiation
INTRODUCTION
KEY DEFINITIONS
Radiation
X-radiation
X-ray
Radiology
Radiograph
Radiography
Dental Radiology
Dental Radiograph
DISCOVERY OF X-RADIATION
Wilhelm Conrad Roentgen—Brief Biography (Fig. 1-1)
History of Radiography
A Second Source of Radiation
Health Concerns
CHRONOLOGY OF EVENTS IN THE EVOLUTION OF DENTAL RADIOLOGY
CHAPTER 2:
Radiation Physics
INTRODUCTION
IONIZING RADIATION
Particulate Radiation
Electromagnetic Radiation
X-RADIATION
Properties of X-rays
X-RAY PRODUCTION
X-RAY TUBE (FIG. 2-7)
LINE FOCUS PRINCIPLE
HEEL EFFECT
ELECTRICITY/ELECTRIC CURRENT AND CIRCUITS
TRANSFORMERS (FIG. 2-10)
WORKING OF THE X-RAY TUBE
TYPES OF RADIATION (FIG. 2-13)
Bremsstrahlung Radiation
Characteristic Radiation
FACTORS CONTROLLING THE X-RAY BEAM
Tube Voltage
Tube Current
Exposure Time
Filtration
Collimation
Inverse Square Law
QUALITY OF THE X-RAY BEAM
QUANTITY OF THE X-RAY BEAM
HALF-VALUE LAYER (FIG. 2-16)
CHAPTER 3:
Radiation Biology, Hazards of Radiation and Radiation Protection
INTRODUCTION
DIRECT EFFECT
INDIRECT EFFECT
Radiation Injury
Factors Influencing Radiation Injury
Total Dose
Dose Rate
Amount of Tissue Irradiated
Sensitivity of Cells
Age
Effects of Radiation
Short-term Effects
Long-term Effects
Somatic and Genetic Effects
UNITS OF MEASUREMENT OF RADIATION
Exposure
Absorbed Dose
Dose Equivalent
Quality Factor
Relative Biological Effectiveness
Radioactivity
HAZARDS OF RADIATION
Sources of Radiation Exposure
Natural Radiation (Background Radiation)
Man-made Radiation
Radiation-induced Changes In Biologic Molecules
Proteins
Nucleic Acids
Cells
Chromosome Aberrations
Oral Cavity
Taste Buds
Salivary Glands
Teeth
Bone
DOSIMETRY
Film Badges
lonization Chamber
Thermoluminescent Dosimeter
RADIATION PROTECTION
Protection of the Patient
Protection of the Operator
Protection of Other Persons
CHAPTER 4:
Films Used in Dental Radiography
INTRODUCTION
FILM COMPOSITION
Film Base
Adhesive Layer
Film Emulsion
INTRAORAL FILMS
Contents of the Film Packet (Fig. 4-2)
Types of Intraoral Films
Periapical Film
Bitewing Film
Occlusal Film
Classification of Films Based on Speed
EXTRAORAL FILMS
DUPLICATING FILMS
CHAPTER 5:
Grids, Intensifying Screens and Cassettes
GRIDS
Grid Density
Focusing Distance
Types of Grid
The Linear Grid
Focused Grid
Pseudofocused Grid
Crossed Grid
Moving Grid (Fig. 5-6)
INTENSIFYING SCREENS
Composition of Intensifying Screens (Fig. 5-8)
Base
Reflecting Layer
Phosphor Layer
Coat
CASSETTES
Types of Cassettes
Rigid Cassettes
Curved Cassettes
Gridded Cassette
Flexible Cassette
CHAPTER 6:
Processing of the X-ray Films
INTRODUCTION
LATENT IMAGE
DEVELOPER
Composition
Developing Agents
Accelerator
Restrainer or Retarder
Preservative
Solvent
DEVELOPER REPLENISHER
FIXER
Composition
The Fixing Agent
Acidifier
Hardener
Solvent
FIXER REPLENISHER
STEPS IN PROCESSING
Immersion in Developing Solution
Rinsing in Water
Immersion in the Fixing Solution
Film Washing
Drying and Mounting for Viewing
DARKROOM
TYPES OF PROCESSING
Manual Processing
Visual Method
Time-temperature Method
Automatic Processing
CHAPTER 7:
Dental X-ray Image Characteristics
INTRODUCTION
VISUAL CHARACTERISTICS
Density
Contrast
GEOMETRIC CHARACTERISTICS
Sharpness
Magnification
Distortion
Image Resolution
FACTORS INFLUENCING DIAGNOSTIC QUALITY OF A RADIOGRAPH
CHAPTER 8:
Causes of Faulty Radiographs
INTRODUCTION
FAULTY RADIOGRAPHS RESULTING FROM FAULTY RADIOGRAPHIC TECHNIQUES
Foreshortening of the Image
Elongation of the Image
Elongation of a Few Teeth
Overlapping of Proximal Surfaces
Slanting of Occlusal Plane or Incisal Plane
Image of Coronal Portion of the Teeth not Seen Completely
Image of the Apical Region not Seen
Blurred or Distorted Image
Cone-cut Appearance
Phalangioma
Double Exposure or Double Image
Reversed Film
Film Creasing
Crimp-marks
Light Image
Dark Image
FAULTY RADIOGRAPHS RESULTING FROM FAULTY PROCESSING TECHNIQUES
Light Image
Dark Image
Cracked or Reticulated Image
Dark Spots on the Film
White Spots on the Film
Blank Film
White Area on the Film
Dark Areas on the Film
Straight White Border
Straight Black Border
White Marks on the Film
Nail Marks
Thin Black Branching Lines or Tree-like Appearance
Fingermarks
Scratched Emulsion
Light Exposure
Fogged Film
CHAPTER 9:
Intraoral Radiographic Techniques and Indications for Intraoral Radiographs
INTRODUCTION
PARALLELING TECHNIQUE (FIG. 9-1)
BISECTING ANGLE TECHNIQUE (Fig. 9-2)
INDICATIONS FOR INTRAORAL PERIAPICAL RADIOGRAPH
INDICATIONS FOR BITEWING RADIOGRAPH
OCCLUSAL PROJECTION
Maxillary Occlusal Projection (Fig. 9-3)
Mandibular Occlusal Projection (Fig. 9-6)
Indications of Occlusal Radiographs
CHAPTER 10:
Normal Anatomic Landmarks
INTRODUCTION
ANATOMIC LANDMARKS COMMON TO THE MAXILLA AND THE MANDIBLE
Enamel
Dentin
Cementum
Pulp Cavity
Supporting Structures of the Teeth
Cortical Bone
Cancellous Bone
ANATOMIC LANDMARKS IN THE MAXILLA
Incisive Foramen
Superior Foramina of the Incisive Canal
Median Palatal Suture
Lateral Fossa
Nasal Fossa
Nasal Septum
Anterior Nasal Spine
Inferior Nasal Conchae
Maxillary Sinus (Fig. 10-1)
Inverted ‘Y’ Configuration
Maxillary Tuberosity
Hamular Process
Medial and Lateral Pterygoid Plates
Zygomatic Process of the Maxilla
Zygomatic (Malar) Bone
ANATOMIC LANDMARKS IN THE MANDIBLE
Genial Tubercles
Lingual Foramen
Nutrient Canals
Mental Ridge
Mental Fossa
Mental Foramen
Mylohyoid Ridge
Mandibular Canal
External Oblique Ridge
Submandibular Fossa
Coronoid Process
CHAPTER 11:
Extraoral Radiography
INTRODUCTION
PURPOSE OF EXTRAORAL RADIOGRAPHS
LATERAL JAW PROJECTION
Body of the Mandible Projection (Fig. 11-1)
Ramus of the Mandible Projection (Fig. 11-2)
SKULL RADIOGRAPHY
Lateral Cephalometric Projection (Figs 11-3 and 11-4)
Posteroanterior Projection (Figs 11-5A and B)
Waters Projection (Figs 11-6A and B)
Submentovertex Projection (Figs 11-7 and 11-8)
Zygomatic Arch Projection
Base of the Skull Projection
Reverse Towne Projection (Fig. 11-9)
TEMPOROMANDIBULAR JOINT (TMJ) VIEWS
Transcranial View (Fig. 11-10)
Transorbital View (Fig. 11-11)
Transpharyngeal View (Fig. 11-12)
Temporomandibular Joint Tomography
CHAPTER 12:
Panoramic Radiography
INTRODUCTION
Purpose and Uses
Disadvantages
Fundamental Principles of Panoramic Radiography
Technique
CHAPTER 13:
Localization Technique
INTRODUCTION
RIGHT-ANGLE TECHNIQUE
TUBE SHIFT PRINCIPLE
DEFINITION AND EVALUATION
PANTOMOGRAPHY
CHAPTER 14:
Specialized Radiographs in Dental Radiology
XERORADIOGRAPHY
Advantages of Xeroradiography
SIALOGRAPHY
CONVENTIONAL TOMOGRAPHY
COMPUTERIZED TOMOGRAPHY
MAGNETIC RESONANCE IMAGING
ULTRASOUND TECHNIQUE
NUCLEAR MEDICINE
THERMOGRAPHY
ARTHROGRAPHY
RADIOVISIOGRAPHY
DIGITAL PANORAMIC RADIOGRAPHY
CHAPTER 15:
Radiographic Features of Dental Caries
INTRODUCTION
CLINICAL EXAMINATION
RADIOGRAPHIC EXAMINATION
CLASSIFICATION OF CARIOUS LESIONS BASED ON RADIOGRAPHIC APPEARANCE
Interproximal Caries
Incipient Interproximal Caries
Moderate Interproximal Caries
Advanced Interproximal Caries
Severe Interproximal Caries
Occlusal Caries
Incipient Occlusal Caries
Moderate Occlusal Caries
Severe Occlusal Caries
Buccal and Lingual Caries
Root Surface Caries
Recurrent Caries
Rampant Caries
Nursing Bottle Caries
Radiation Caries
RADIOGRAPHIC DIFFERENTIAL DIAGNOSIS OF DENTAL CARIES
Cervical Burn Out
Abrasions and Attrition
Proximal Wear
Indirect Pulp Capping
Restorative Materials
CHAPTER 16:
Radiographic Features of Periodontal Disease
INTRODUCTION
USE OF RADIOGRAPHS IN THE DIAGNOSIS OF PERIODONTAL DISEASE
LIMITATIONS OF RADIOGRAPHS
RADIOGRAPHIC FEATURES OF PERIODONTAL DISEASE
EARLY PERIODONTITIS
MODERATE PERIODONTITIS
(i) Horizontal Bone Loss
(ii) Osseous Defects
Interproximal Crater
Proximal Intrabony Defect
Interproximal Hemisepta
Inconsistent Bony Margins
Bony Pockets
ADVANCED PERIODONTITIS
Defects in Furcation Area
Alveolar Dehiscence
JUVENILE PERIODONTITIS
CHAPTER 17:
Radiographic Features of Traumatic Injuries: Fracture of the Teeth and Jaws
INTRODUCTION
TRAUMATIC INJURIES INVOLVING THE TEETH
Concussion
Luxation
Avulsion
Fracture of the Teeth
Bennett's Classification of Fracture of Teeth
TRAUMATIC INJURIES INVOLVING THE JAWS
Radiographic Features of Fracture of the Jaws
Radiographic Features of Fractures
Fracture of Mandible
Classification of Fractures
Fractures of the Maxillofacial Complex
Radiographic Features of Fractures of Maxilla
Zygomatic Fractures
CHAPTER 18:
Inflammation and Infections of the Jaws
INTRODUCTION
INFECTIONS OF THE SUPPORTING TISSUES OF THE TEETH
PERICORONITIS AND PERICORONAL INFECTION
PERIAPICAL AND RESIDUAL INFECTIONS
Acute Periapical Abscess
Chronic Periapical Abscess
Periapical Granuloma
Residual Infection
OSTEOMYELITIS
Acute Osteomyelitis
Diffuse Sclerosing Osteomyelitis
Infantile Osteomyelitis
Garré's Osteomyelitis (Periostitis ossificans)
ACTINOMYCOSIS
CELLULITIS
LUDWIG'S ANGINA
CHAPTER 19:
Cysts of the Jaws
INTRODUCTION
ODONTOGENIC CYSTS
Radicular Cyst
Dentigerous Cyst
Residual Cyst
Odontogenic Keratocyst
Calcifying Odontogenic Cyst
Primordial Cyst
Globulomaxillary Cyst
Median Mandibular Cyst
NONODONTOGENIC CYSTS
Incisive Canal Cyst or Nasopalatine Cyst
Nasoalveolar Cyst
Median Palatine Cyst
Traumatic Bone Cyst
Aneurysmal Bone Cyst
CHAPTER 20:
Odontogenic Tumors
INTRODUCTION
Epithelial Odontogenic Tumors
Mesodermal Odontogenic Tumors
EPITHELIAL ODONTOGENIC TUMORS WITHOUT INDUCTIVE CHANGES
Ameloblastoma
Calcifying Epithelial Odontogenic Tumor
EPITHELIAL ODONTOGENIC TUMORS WITH INDUCTIVE CHANGES (MIXED ODONTOGENIC TUMORS)
Adenomatoid Odontogenic Tumor (Adenoameloblastoma) (Fig. 20-2)
Ameloblastic Fibroma
Ameloblastic Sarcoma
Ameloblastic Odontoma
Complex Odontoma
Compound Odontoma
Dentinoma
MESODERMAL ODONTOGENIC TUMORS
Odontogenic Fibroma
Odontogenic Myxoma
Cementifying Fibroma (Cementoma)
Gigantiform Cementoma
CHAPTER 21:
Benign and Malignant Nonodontogenic Tumors of the Jaws
INTRODUCTION
BENIGN TUMORS
Exostosis and Tori
Enostosis
Osteomas
Chondroma
Neurogenic Tumors (Neurilemoma, Neurofibroma)
Peripheral Fibroma with Calcification
Central Giant Cell Granuloma
Central Hemangioma of Bone
MALIGNANT TUMORS
Carcinoma
Mucoepidermoid Carcinoma
Sarcoma
Osteosarcoma or Osteogenic Sarcoma
Malignant Lymphoma
Chondrosarcoma
Multiple Myeloma
CHAPTER 22:
Fibro-Osseous Lesions
INTRODUCTION
FIBROUS DYSPLASIA
OSSIFYING FIBROMA
PERIAPICAL CEMENTAL DYSPLASIA
LOCALIZED FIBRO-OSSEOUS-CEMENTAL LESIONS
FLORID CEMENTO-OSSEOUS DYSPLASIA
CEMENTOBLASTOMA
JUVENILE AGGRESSIVE OSSIFYING/CEMENTIFYING FIBROMA
CHERUBISM
PAGET'S DISEASE (OSTEITIS DEFORMANS)
CHAPTER 23:
Radiographic Features of Systemic Diseases
DISORDERS OF THE ENDOCRINE SYSTEM
Disorders of the Pituitary Gland
Disorders of the Thyroid Gland
Disorders of the Parathyroid Gland
Hyperparathyroidism
Hypoparathyroidism and Pseudohypoparathyroidism
Diabetes Mellitus
Disorders of the Adrenal Gland
Cushing's Syndrome
METABOLIC DISORDERS
Idiopathic Histiocytosis (Langerhans cell disease)
Letterer-Siwe Disease
Hand-Schüller-Christian Disease
Eosinophilic Granuloma
Osteoporosis
Rickets and Osteomalacia
Hypophosphatasia
Hypophosphatemia
Renal Osteodystrophy
DISORDERS OF THE BLOOD AND HEMATOPOIETIC SYSTEM
Sickle Cell Anemia
Thalassemia
BONE DISEASE OF UNKNOWN ORIGIN
Osteogenesis Imperfecta (Fragilitas ossium)
REACTIVE LESIONS
Central Giant Cell Granuloma
HEREDITARY DISEASES
Osteopetrosis (Albers-Schönberg disease or Marble bone disease)
CHAPTER 24:
Pathologic Soft Tissue Calcification
INTRODUCTION
LYMPH NODES
SIALOLITH
ANTROLITH
CALCIFIED STYLOHYOID LIGAMENT
OSTEOMA
CALCIFIED BLOOD VESSEL
MYOSITIS OSSIFICANS
CYSTICERCOSIS
DYSTROPHIC CALCIFICATION
CHAPTER 25:
Radiographic Features of Diseases of the Maxillary Sinus
INTRODUCTION
INFLAMMATORY CHANGES
Mucosal Thickening
Sinusitis
Fluid Level
Empyema
Polyps
CYSTIC CONDITIONS
Mucous Retention Cyst
Serous Retention Cyst
Mucocele
TRAUMATIC CONDITIONS
TUMORS
CHAPTER 26:
Radiographic Features of Temporomandibular Joint Disorders
INTRODUCTION
DEVELOPMENTAL DISORDERS
ENLARGEMENT OF CORONOID PROCESS
ANKYLOSIS
DEGENERATIVE JOINT DISEASE
RHEUMATOID ARTHRITIS
TMJ OSTEOMA
NEOPLASMS
CHAPTER 27:
Infection Control in Dental Radiography
INTRODUCTION
PROTECTIVE ATTIRE AND BARRIER TECHNIQUES
HANDWASHING AND CARE OF HANDS
STERILIZATION AND DISINFECTION OF INSTRUMENTS
CHAPTER 28:
Radiographic Differential Diagnosis
RADIOLUCENCIES WITH DEFINITE BORDERS (FIG. 28-1)
ANATOMIC RADIOLUCENCIES
RADIOLUCENCIES OTHER THAN THE ANATOMIC RADIOLUCENCIES
MULTILOCULAR RADIOLUCENCIES (FIG. 28-2)
RADIOLUCENCIES WITH ILL-DEFINED BORDERS (FIG. 28-3)
GENERALIZED RAREFACTIONS
PERICORONAL RADIOLUCENCIES
LOCALIZED RADIOPACITIES (FIG. 28-5)
PERIAPICAL RADIOPACITIES (FIG. 28-6)
GENERALIZED RADIOPACITIES (FIG. 28-7)
Further Reading
INDEX
TOC
Index
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