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Oral Radiology
Ram Kumar Srivastava
CHAPTER 1:
Introduction
CHAPTER 2:
Atomic Structure
ELECTRON SHELLS
IONIZATION AND EXCITATION
RADIATION AND RADIOACTIVITY
IONIZING RADIATION
PARTICULATE RADIATIONS
ELECTROMAGNETIC RADIATION
Particle (Quantum) Theory
Wave Theory
TYPES OF X-RAY RADIATION
Coherent Radiation
CONTINUOUS RADIATION SPECTRUM
PRODUCTION OF X-RAYS
BREMSSTRAHLUNG RADIATION (GENERAL RADIATION)
CHARACTERISTIC RADIATION
ELECTRICAL ENERGY CONVERSION TO X-RADIATION
ELECTRON INTERACTION WITH THE ANODE OF THE X-RAY TUBE
X-RAY INTERACTION WITH MATTER
X-RAY MACHINE
X-ray Tube Head
X-RAY TUBE
BASIC COMPONENTS OF AN X-RAY TUBE
Cathode
Anode
X-RAY GENERATING APPARATUS
Electricity
TRANSFORMER
Autotransformer
CONTROL PANEL
TIMER
X-RAY BEAM
BASIC OPERATION OF X-RAY TUBE
Main Features of an X-ray Tube
Main Properties and Characteristics of X-rays
COMPTON EFFECT
Stages in Compton Effect
Summary of Production of X-ray
CHAPTER 3:
X-ray Image Characteristics
CHARACTERISTICS OF X-RAY IMAGE
DENSITY
Measurement of the Opacity of the Film
Characteristic Curve
Milliamperage (mA)
Kilovoltage Peak (kVp)
Exposure Time
Subject Thickness
Subject Density
Radiopaque Objects
Radiolucent Objects
CONTRAST
High Contrast
Low Contrast
Subject Contrast
Film Contrast
Radiographic Speed
Film Latitude
Radiographic Noise
Radiographic Blurring
Image Receptor Blurring
Motion Blurring
Geometric Blurring
PROJECTION GEOMETRY AND IMAGE QUALITY
Image Quality
Contrast
Image Sharpness and Resolution
Image Geometry
Characteristics of the X-ray Beam
Magnification of the Image Size (Distortion)
Distortion of the Image Shapes
Coherent Scattering
CHAPTER 4:
Dose Units and Dosimetry
RADIATION-ABSORBED DOSE (D)
EQUIVALENT DOSE (H)
Effective Dose (E)
Collective Effective Dose or Collective Dose
Dose Rate
Annual Doses from Various Sources of Radiation
CHAPTER 5:
Biological Effects
RADIATION HAZARDS
Principle of Radiobiology
Cell Death
Stochastic Effects
Deterministic Effects
Somatic Deterministic Effects
Somatic Stochastic Effects
Genetic Stochastic Effects
Effects on the Unborn Child
HARMFUL EFFECTS IN DENTAL RADIOLOGY
Latent Period
DAMAGING EFFECTS OF RADIATION
Direct Damage
Indirect Damage
Radiation
Radiation-induced Subcellular Damage
Chromosome and Chromatic Aberrations
Oxygen Effect
Reoxygenation
Radiation-induced Cell Killing
Biological Effects of Radiation
Earlier Radiation Damage
Radiation Effects at Low Doses
Effective Dose Limits
BASIC PRINCIPLES OF PROTECTION
Time
Distance
Barriers
Protection of Radiological Practice
Protection of Patients
Pediatrics
Women of Reproductive Age
Pregnancy
CHAPTER 6:
Factors Controlling X-ray Beam
EXPOSURE TIME
TUBE CURRENT (mA)
TUBE VOLTAGE (kVp)
FILTRATION
COLLIMATION
X-ray Beam
X-RAY BEAM QUALITY AND QUANTITY
X-ray Beam Quality and Voltage
Kilovoltage and Kilovolt (kV)
Half-value Layer
Quantity
MILLIAMPERES (mA)
MILLIAMPERE-SECONDS (mAs)
X-RAY BEAM INTENSITY
Inverse Square Law
CHAPTER 7:
Film Mounting
CHAPTER 8:
Infection Control in Dental Radiography
FILM PACKETS
Processing Solutions
Precautions
On Chair Side Exposure Procedures
Processing Procedures in Darkroom
Precautions in Automatic Processing
Precautions Taken in the Panoramic X-ray Units
CHAPTER 9:
Characteristics of Radiographic Film
CHAPTER 10:
Film Processing
FILM PROCESSING
LATENT IMAGE FORMATION
From Latent Image to Visible Image
VISIBLE IMAGE
Radiolucent
Radiopaque
FILM PROCESSING STEPS
Developing Stage
Time-Temperature versus Sight Development
Rinsing
Fixation
Washing
Drying
RAPID PROCESSING
FILM PROCESSING SOLUTIONS
DEVELOPER SOLUTION
Developing Agent
Preservative
Accelerator
Restrainer
FIXER SOLUTION
Fixing Agent
Preservative
Hardening Agent
Acidifier
REPLENISHING
DARKROOM SPECIFICATIONS
Room Requirements
Location and Size
Lighting
Room Lighting
Safe lighting
Cell Phones
Processing Tanks
Thermometer
Timer
Film Hanger
Drying Racks
MANUAL PROCESSING PROCEDURES
AUTOMATIC FILM PROCESSING
Component Parts of the Automatic Processor
PROBLEMS DURING PROCESSING
Underdeveloped Film
Problems
OVERDEVELOPED FILM
CHEMICAL CONTAMINATION
Developer Spots
Fixer Spots
Problems
YELLOW-BROWN STAINS ON THE FILMS
Problems
OVERLAPPED FILMS
Solution
AIR BUBBLES
FINGERNAIL ARTIFACT
Solution
THIN, BLACK BRANCHING LINES APPEAR ON THE FILM
Solution
WHITE LINES APPEAR ON THE FILM (Figs 10.10A and B)
LIGHTING
Light Leak
Problem
Solution
FOGGED FILM
Problems
CHAPTER 11:
Dental X-ray Film Composition
FILM COMPOSITION
Film Base
Adhesive Layer
Film Emulsion or Vehicle
Gelatin
Protective Layer
TYPES OF FILM
Intraoral Film
Intraoral Film Packaging
X-ray Film
Film Fog
Film Contrast
Contents of Film Packet
Paper Film Wrapper
Lead Foil Sheet
Outer Package Wrapping
Intraoral Film Types
Periapical Film
Bitewing Film
Occlusal Film
Intraoral Film Sizes
Periapical Film
Bitewing Film
Occlusal Film
Intraoral Film Speed (Sensitivity)
Film Speed
CHAPTER 12:
Extraoral Radiography
INTRODUCTION
Purpose and Use
Advantages
EXTRAORAL FILM PACKAGING
FILM TYPES
Screen Film
Nonscreen Film
EXTRAORAL FILM EQUIPMENT
X-ray Unit
Film
Intensifying Screens
Cassette
Grid
EXTRAORAL PROJECTION TECHNIQUES
Lateral Jaw Radiography
Body of Mandible Projection
Mandibular Ramus Projection
Techniques
Skull Radiography
POSTEROANTERIOR PROJECTION
Purpose
Uses
Technique
LATERAL SKULL PROJECTION
Technique
OCCIPITOMENTAL PROJECTION (WATERS PROJECTION)
TOWNE'S PROJECTION
Technique
REVERSE TOWNE'S PROJECTION
Technique
SUBMENTOVERTEX PROJECTION (BASE PROJECTION)
Technique
DUPLICATING FILM
Technique of Duplicating the Film
CHAPTER 13:
Radiographic Techniques
PARALLELING TECHNIQUE
Principles
BISECTING TECHNIQUE
Principles
Vertical Angulation of the X-ray Tubehead
Horizontal Angulation
Disadvantages of Paralleling Technique
Advantage of the Paralleling Technique
Positioning Techniques in Periapical Radiography for Permanent Teeth
Incisor and Canines (Maxillary and Mandibular)
Premolars and Molars (Maxillary and Mandibular)
Procedure
Indications of Paralleling Technique
ADVANTAGES AND DISADVANTAGES OF BISECTING TECHNIQUE
Advantages
Disadvantages
Bisecting-angle Technique
Positioning Techniques
Bisecting Technique Using Film Holders
Bisecting Technique Using Patient' Finger
PARALLELING TECHNIQUE
Maxillary Incisor Exposure
Maxillary Canine Exposure
Maxillary Premolars Exposure
Maxillary Molars Exposure
Mandibular Incisors Exposure
Mandibular Canine Exposure
Mandibular Premolar Exposure
Mandibular Molars Exposure
BISECTING TECHNIQUE
Procedure
Basic Rule for Bisecting Technique
Maxillary Central and Lateral Incisors
Maxillary Canines
Maxillary Premolar
Maxillary Molars
Mandibular Incisor
Mandibular Canine
Mandibular Premolar
Mandibular Molars
CHAPTER 14:
Bitewing and Occlusal Radiography
BITEWING RADIOGRAPHY
Indications
Principles
BITEWING TECHNIQUES
Bitewing Tab
Technique
Using Bitewing Film Holder
Film Size
Exposure Factors for Bitewings
OCCLUSAL RADIOGRAPHY
Indications
Principles
TECHNIQUES IN OCCLUSAL RADIOGRAPHY
Maxillary Standard Occlusal
Technique
Maxillary Oblique Occlusal
Technique
Vertex Occlusal
Technique
Mandibular 90° Occlusal
Technique
Lower 45° Occlusal
Technique
Lower Oblique Occlusal
Technique
CHAPTER 15:
Panoramic Radiography (Pantomography)
PANORAMIC RADIOGRAPHY
Basic Concepts
Fundamentals
Uses
Basis of Panoramic Radiography
Rotational Tomography with a Narrow Beam
Dental Panoramic Tomography
Rotation Center
EQUIPMENT
PANORAMIC X-RAY UNITS
FILM
Intensifying Screens
Cassette
Procedure for Taking Panoramic Radiograph
Errors
GHOST IMAGES
Problem
LEAD APRON ARTIFACT
Problem
AN INTERPRETATION OF ANATOMIC STRUCTURES ON THE PANORAMIC IMAGE
Mandible
Midfacial Region
Teeth
Improper Positioning of the Lips and Tongue
CHAPTER 16:
Cephalometric Radiography
INTRODUCTION
Indications
Equipment
X-ray Generating Apparatus
PROJECTIONS
True Cephalometric
Cephalometric Posteroanterior of Jaws (PA View)
CEPHALOMETRIC ANALYSIS
LINES AND PLANES IN CEPHALOMETRICS
Vertical Line
Horizontal Planes
CHAPTER 17:
Radiography of the Temporomandibular Joint
ANATOMY OF TMJ
Transcranial Temporomandibular Joint Projection
Transpharyngeal Projection
Transorbital Projection
Panoramic Projection
Submentovertex (Basaler Projection)
Conventional Tomography
Computed Tomography
MRI
Contrast Investigation
TMJ Arthrography
Indications of Arthrography
CHAPTER 18:
Normal Anatomical Structures in Radiographs: Intraoral Radiographs
RADIOGRAPHIC APPEARANCE OF ANATOMY OF TOOTH AND ITS SUPPORTING STRUCTURES
NUTRIENT CANALS
ANATOMICAL STRUCTURES OF MAXILLA
Anterior Palatine (Incisive) Canal
Anterior Palatine (Incisive) Foramen
Superior Foramina of the Incisive Canal
Median Palatine Suture
Lateral Fossa (Canine Fossa)
Nasal Cavity
Nasal Septum
Floor of the Nasal Cavity
Anterior Nasal Spine
Maxillary Sinus
Inverted Y
Maxillary Tuberosity
Zygomatic Process of Maxilla
Malar Bone
Hamular Process
Nasolacrimal Duct
ANATOMICAL STRUCTURES OF MANDIBLE
Mental Foramen
Lingual Foramen
External Oblique Ridge
Mylohyoid (Internal Oblique) Ridge
Mental Ridge
Coronoid Process
Genial Tubercles
Mandibular Canal
Submandibular Fossa
TOOTH GERM AND PAPILLA
THE STYLOHYOID CHAIN
CHAPTER 19:
Maxillofacial Imaging
IMAGING METHODS
INTRAORAL RADIOGRAPHY
Advantage
OCCLUSAL X-RAY
Advantages
PANORAMIC RADIOGRAPHY
Advantages
DIGITAL IMAGING
Digital Radiography System (RVG)
Techniques
Sensor
Nature of Image in Digital Imaging
In the Second Technique (PSP Technique)
Digital Subtraction
Advantages of Digital Radiography
Disadvantages of Digital Radiography
Uses
CONVENTIONAL RADIOGRAPHY
Production of X-ray
Projections in Conventional Radiography
CONVENTIONAL TOMOGRAPHY
COMPUTED TOMOGRAPHY
Principle of Computed Tomography
Advantages of CT over Conventional Radiography
Spiral (Helical) CT
Advantages of Spiral (Helical) CT
Cone Beam Computed Tomography
Indications
ULTRASOUND
Principles of Ultrasound and Mechanism of Action
Doppler Effect
Advantages of Ultrasonography
Magnetic Resonance Imaging
Advantages of MRI
Disadvantages of MRI
SCINTIGRAPHY OR RADIONUCLIDE IMAGING (RADIOISOTOPE SCANNING)
Principles of Radionuclide Imaging
Indications in the Head and Neck Regions
Advantages
Disadvantages
CONTRAST STUDIES
Types of Contrast Media
Hazards of Contrast Media
Complications
Angiography
CHAPTER 20:
Benign and Malignant Tumors of the Jaw
BENIGN TUMOR
Characteristics
Difference between Benign and Malignant Tumor
TORUS PALATINES
TORUS MANDIBULARIS
AMELOBLASTOMA
In Early Stage of Development
In Advanced Cases
Root Resorption
Occlusal Radiographs
ODONTOMA
Compound Odontoma
Complex Odontoma
OSTEOMAS
CENTRAL HEMANGIOMAS
MALIGNANT TUMORS
SQUAMOUS CELL CARCINOMA
METASTATIC CARCINOMA
OSTEOSARCOMA
Earlier Sign
Enlarged Tumor (Three Forms)
MALIGNANT MELANOMA
CHAPTER 21:
Diseases of Bone
FIBRO-OSSEOUS LESIONS
Fibrous Dysplasia
Radiographic Appearance
Central Cementifying Fibroma
Giant Cell Lesions
Osteomas
Cherubism
Aneurysmal Bone Cyst
Other Benign Tumors of Jaw
Osteoblastoma
Osteochondroma (Osteocartilaginous Exostosis)
Chondromas
MALIGNANT LESIONS
Squamous Cell Carcinoma
Sarcomas
Osteosarcoma (Osteogenic Sarcoma)
Chondrosarcoma
Multiple Myeloma
Ewings Sarcoma
Metastatic Tumors of the Jaws
CHAPTER 22:
Preoperative Radiographic Assessment of Impacted Mandibular Third Molars and Canines
ASSESSMENT OF THE SURROUNDING BONE
MANDIBULAR THIRD MOLAR ASSESSMENT
Angulation (Fig. 22.1)
The Crown
The Roots
Depth of the Tooth in the Alveolar Bone
Winter's WAR Lines
Roots of Second Molar is Used As a Guide
Buccal or Lingual Obliquity
Mandibular Second Molar Assessment
The Crown
The Roots
PREOPERATIVE RADIOGRAPHIC ASSESSMENT OF UNERUPTED MAXILLARY CANINES
Assessment of Size and Shape of the Canine
The Crown
The Root
Assessment of Position of the Canine
The Principle of Parallax
Parallax in Horizontal Plane
Parallax in Vertical Plane
Use
Panoramic Radiograph
Use of Cross-sectional Spiral Tomography and Cone Beam CT
CHAPTER 23:
Radiopaque Lesions in the Jaws
CLASSIFICATION OF RADIOPACITIES IN THE JAWS
Abnormalities of the Teeth
BONY LESIONS HAVING RADIOPACITIES
RADIOPACITY CAUSED BY ABNORMALITIES OF THE TEETH
Unerupted, Embedded, Impacted, Misplaced, Supernumerary Teeth
Hypercementosis
Root Remnants
Bony Lesions Having Radiopacity
Developmental
TUMORS
Calcifying Epithelial Odontogenic Tumor (CEOT)
Radiographic Appearance
Ameloblastic Fibro-odontoma
Adenomatoid Odontogenic Tumor (AOT)
Calcifying Cystic Odontogenic Tumor
Cementoblastoma
Odontomas
Osteoma
Chondroma
Osteosarcoma
Osseous Dysplasia
Ossifying Fibroma
Fibrous Dysplasia
Paget Disease
Osteopetrosis
CHAPTER 24:
Radiolucent Lesions of the Jaws
INFLAMMATORY LESIONS
Periapical (Radicular) Cyst
Residual Cyst
Lateral Periodontal Cyst
Dentigerous Cyst
Odontogenic Keratocyst
NASOPALATINE DUCT CYST (INCISIVE CANAL CYST)
PSEUDOCYSTS
Aneurysmal Bone Cyst
Solitary (Simple) Bone Cyst
ODONTOGENIC TUMORS
Ameloblastoma
Ameloblastic Fibroma
Calcifying Epithelial Odontogenic Tumor (CEOT)
Adenomatoid Odontogenic Tumor (AOT)
Calcifying cystic odontogenic tumors
Odontogenic Fibroma
Odontogenic Myxoma
Central Hemangioma
Osteosarcoma
Fibrosarcoma and Chondrosarcoma
Squamous Cell Carcinoma
Metastatic Bone Tumors
Multiple Myeloma
Langerhans' Cells Disease
Central Giant Cell Tumor (Granuloma)
Primary and Secondary Hyperparathyroidism
Cherubism
Aneurysmal Bone Cyst
Osseous Dysplasia
Fibrous Dysplasia
Ossifying Fibrous Dysplasia
Stafne's Bone Cavity
CHAPTER 25:
Developmental Anomalies of Teeth and Facial Skeleton
DEVELOPMENTAL ANOMALIES
ANOMALIES OF THE TEETH
Abnormalities in Number of Teeth
Missing Teeth
Abnormalities in Shape
Abnormalities in Size
Abnormalities in Structure
Abnormalities in Position
Anomalies Affecting Roots
ANOMALIES OF BONE
Abnormalities of the Jaws
Abnormalities in the Condyles and Coronoid Processes
Cleft Lip and Palate
Treacher Collin's Syndrome
Gorlin's Syndrome
Eagle Syndrome
Crouzon's and Apert Syndrome
CHAPTER 26:
Dental Caries
INTRODUCTION
RADIOGRAPHIC DETECTION OF CARIES
INTERPROXIMAL CARIES
Incipient Interproximal Caries
Moderate Interproximal Caries
Advanced Interproximal Caries
Severe Interproximal Caries
OCCLUSAL SURFACE CARIES
Incipient Occlusal Caries
Moderate Occlusal Caries
Severe Occlusal Caries
BUCCAL AND LINGUAL SURFACE CARIES
ROOT SURFACE CARIES (CERVICAL CARIES)
RECURRENT OR SECONDARY CARIES
RAMPANT CARIES
CHAPTER 27:
Periodontal Disease
INTRODUCTION
RADIOGRAPHIC FEATURES IN PERIODONTAL DISEASE
MILD PERIODONTITIS (FIG. 27.3A)
MODERATE PERIODONTITIS (FIG. 27.3B)
SEVERE PERIODONTITIS (FIG. 27.3C)
AGGRESSIVE PERIODONTITIS
PERIODONTAL ABSCESS
HORIZONTAL BONE LOSS
VERTICAL BONE LOSS
BUCCAL OR LINGUAL CORTICAL PLATE LOSS
SYSTEMIC DISEASES CAUSING PERIODONTAL DISEASE
Diabetes
AIDS
INDEX
TOC
Index
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