Dental Radiography: Principles and Techniques

482 Pages·2016·42.04 MB·English

by  Joen Iannucci, Laura Jansen Howerton

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2015v1.0

DENTAL
RADIOGRAPHY

Principles and Techniques

This page intentionally left blank

5th EDITION

DENTAL
RADIOGRAPHY

Principles and Techniques

Joen M. Iannucci, DDS, MS

Professor of Clinical Dentistry
The Ohio State University
College of Dentistry
Columbus, Ohio

Laura Jansen How erton, RDH, MS

Instructor
Wake Technical Community College
Raleigh, North Carolina

3251 Riverport Lane
St. Louis, Missouri 63043

DENTAL RADIOGRAPHY: PRINCIPLES AND TECHNIQUES, FIFTH EDITION ISBN: 978-0-323-29742-4

Copyright © 2017 by Elsevier, Inc. All rights reserved.

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about the
Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance
Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).

Notices

Knowledge and best practice in this eld are constantly changing. As new research and experience broaden
our understanding, changes in research methods, professional practices, or medical treatment may become
necessary.

Practitioners and researchers must always rely on their own experience and knowledge in evaluating

and using any information, methods, compounds, or experiments described herein. In using such
information or methods they should be mindful of their own safety and the safety of others, including
parties for whom they have a professional responsibility.

With respect to any drug or pharmaceutical products identi ed, readers are advised to check the most

current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration,
and contraindications. It is the responsibility of practitioners, relying on their own experience and
knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each
individual patient, and to take all appropriate safety precautions.

To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any

liability for any injury and/or damage to persons or property as a matter of products liability, negligence or
otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material
herein.

Previous editions copyrighted 2012, 2006, 2000, and 1996.

Library of Congress Cataloging-in-Publication Data

Names: Iannucci, Joen M., author. | Howerton, Laura Jansen, author.
Title: Dental radiography: principles and techniques / Joen Iannucci, Laura
Jansen Howerton.
Description: 5th edition. | St. Louis, Missouri: Elsevier/Saunders, [2016] |
Includes bibliographical references and index.
Identi ers: LCCN 2016002397 | ISBN 9780323297424 (pbk.: alk. paper)
Subjects: | MESH: Radiography, Dental–methods
Classi cation: LCC RK309 | NLM WN 230 | DDC 617.6/07572–dc23
LC record available at http://lccn.loc.gov/2016002397

Content Strategist: Kristin Wilhelm
Content Development Manager: Ellen Wurm-Cutter
Content Development Specialist: John Tomedi, Spring Hollow Press
Publishing Services Manager: Julie Eddy
Project Manager: Abigail Bradberry
Design Direction: Miles Hitchen

Printed in Canada

Last digit is the print number: 9 8 7 6 5 4 3 2 1

To my son, Michael—
To my dad, Angelo—
To my mom, Dolores—

thank you or your everlasting love,

your encouragement, and a li e f lled with laughter.

To my students, past & present—

thank you or all you have taught me,

and or the sincere privilege o being a part o your li e.

To the faculty and staff on our radiology team—
thank you or your support, your sense o humor,

and or working with me to make radiology a true “destination” clinic

JMI

To my husband, Bruce, who inspires me every day of my life.

LJH

vi

REVI EW ERS

Joanna Campbell, RDH, MA
Instructor, Dental Hygiene Department
Bergen Community College
Paramus, New Jersey

Sharron Cook, CDA
Instructor
Columbus Technical College
Columbus, Georgia

Leslie Koberna, RDH, BSDH, MPH/HSA, PhD
Instructor, Dental Hygiene Program
Texas Woman’s University
Denton, Texas

Sheri Lynn Sauer, CDA, CODA
Program Director/Instructor, Dental Assisting (Secondary)
Eastland-Fairf eld Career and Technical Schools
Groveport, Ohio;
Instructor/Author/Speaker
Radiography, OSHA Compliance and Blood-Borne Pathogens,
Nitrous Oxide Sedation Monitoring
Columbus Dental Society
Columbus, Ohio

Catherine Warren, RDH, MEd
Instructor
University o Arkansas or Medical Sciences
Little Rock, Arkansas

vii

P REFACE

Welcome to the fth edition of Dental Radiography: Principles
and Techniques. The purpose of this text is to present the basic
principles of dental imaging, and provide detailed information
about imaging techniques. This text offers a straight-forward,
reader-friendly format with a balance of theory and technical
instruction to develop dental imaging skills. Our goal with this
fth edition, as with previous editions, is to facilitate teaching
and learning.

ABOUT THIS EDITION

The simplicity and organization of this text makes it exception-
ally easy to use. To facilitate learning, the fth edition is divided
into manageable parts for both the student and faculty:
• Radiation Basics
• Equipment, Film, and Processing Basics
• Dental Radiographer Basics
• Technique Basics
• Digital Imaging Basics
• Normal Anatomy and Film Mounting Basics
• Image Interpretation Basics

Each chapter includes a variety of features to aid in learning.

A list of objectives to focus the reader on the important aspects
of the material is presented at the beginning of every chapter.
Key terms are highlighted in blue and bold typeface as they
are introduced in the text. A complete glossary of more than
600 terms is included at the end of the book. Detailed, easy
to follow step-by-step procedures designed to guide the
student for the various intraoral and extraoral techniques.
The material is organized in an instructionally engaging way
that ensures technique mastery and serves as a valuable refer-
ence tool. Summary tables and boxes are included throughout
the text. These provide easy-to-read synopses of text discussions
that support visual learners, and serve as useful review and
study tools. Quiz questions are included at the end of each
chapter to immediately test knowledge. Answers and rationales
to the quiz questions are provided to instructors on the Evolve
website.

NEW TO THIS EDITION

This edition updates and expands the chapters on digital and
three-dimensional imaging with the most current technology,
ensuring students are prepared to practice in the modern dental
of ce. In addition, we have added a section on pediatric patients
that includes new content on the deciduous and mixed denti-
tions to aid the student in the interpretation of these often
challenging dental images.

Throughout the text, a Helpful Hint feature highlights

important material and offers tips to aid student understand-
ing. The hints help the student to learn and to recognize and
prevent the most common technique pitfalls while providing a
checklist to guide both the novice and the experienced dental
radiographer.

Photographs have been updated throughout the text to

depict the newest equipment, and revised art includes new illus-
trations of anatomy and technique. These enhancements help

to clearly delineate the various learning features, and engages
the student in the content. Enhanced line drawings are included
to improve the clarity in this highly visual subject area.

The panoramic imaging chapter has been expanded to

include more visuals. In the interpretation chapters of the text,
numerous dental images that illustrate a variety of conditions
are now included. A dental image interpretation checklist is
also included.

ABOUT EVOLVE

A companion Evolve website is available to students and
instructors. The site offers a wide variety of additional learning
tools and greatly enhances the text for both students and
instructors.

FOR THE STUDENT

Evolve Student Resources offers the following:
• Self-Study Examination. Over 250 multiple-choice ques-

tions are provided in an instant feedback format. This helps
the student prepare for class, and reinforces what they’ve
studied in the text.

• Case Studies. Scenarios similar to those found on the

National Board Dental Hygiene Examination (NBDHE), as
well as clinical and dental imaging patient ndings, are pre-
sented with challenging self-assessment questions. There is
also a case scenario in each chapter followed by three to ve
questions.

• Labeling Exercises. Drag-and-drop device assembly and

labeling of equipment, along with positioning drawings and
photographs.

• Dental Image Identi cation Exercises. Drag-and-drop lm

mounting and digital imaging.

FOR THE INSTRUCTOR

Evolve Instructor Resources offers the following:
• TEACH Instructor Resource Manual. Includes the

following:
• TEACH Lesson Plans. Detailed instruction by chapters

and sections, with content mapping.

• TEACH PowerPoint Slides. Slides of text and images

separated by chapter.

• TEACH Student Handouts. Exercises provide extra prac-

tice in the classroom.

• Test Bank in ExamView. Approximately 1000 objective-

style questions with accompanying rationales, CDA and
NBDHE exam tags, and page/section references for text-
book remediation.

• Answers to Textbook Quiz Questions, Case Studies, and

Case Scenarios. A mixture of ll-in-the-blank and short-
answer questions for each chapter, with self-submission and
instant feedback and grading.

• Image Collection. All the text’s images available electroni-

cally for download into PowerPoint or other classroom
lecture formats.

viii

Pr e f a c e

WORKBOOK AND LABORATORY MANUAL

Dental Radiography: A Workbook and Laboratory Manual is an
exciting new companion to the textbook, and seeks to provide
a complete and comprehensive solution for dental assisting
(DA) and dental hygiene (DH) educational programs. The rst
section of the Workbook contains written exercises and critical-
thinking exercises organized into seven modules that follow the
seven parts of the textbook, designed to offer students extra
practice and reinforce the material. The second section is struc-
tured as a Laboratory Manual, presenting the material and
instructions needed for students to perform each of the radio-
graphic techniques, establishing competency in the radiography
clinic through active learning.

FROM THE AUTHORS

Are there any tricks to learning dental imaging? Most de nitely!
Attend class. Stay awake. Pay attention. Ask questions. Read the
book. Learn the material. Do not cram. Prepare for tests. Do
not give up.

We hope that you will nd the textbook and Evolve website

to be the most comprehensive learning package available for
dental imaging.

Joen M. Iannucci, DDS, MS

Laura Jansen Howerton, RDH, MS

ix

ACKN OW LED GMEN TS

We express our deepest appreciation to our amilies, riends and colleagues or their unending
support during preparation o this manuscript.

The f th edition o this textbook would not have been possible without the incredible com-

mitment and enthusiastic dedication o the team at Elsevier—which includes Kristin Wilhelm,
Content Strategist; Ellen Wurm-Cutter, Content Development Manager; John Tomedi, Content
Development Specialist; and Project Manager, Abigail Bradberry.

We would also like to acknowledge the generosity and willingness o many dental manu actur-

ing companies who loaned their permissions to display imaging equipment, with an enormous
thanks to Jackie Raulerson, manager o media and public relations o DEXIS.

The authors would also like to thank the sta and dental o f ces o Dr. Timothy W. Godsey

o Chapel Hill, North Carolina, Drs. Robert D. Elliott and Julie R. Molina o Cary, North Carolina,
and Dr. W. Bruce Howerton, Jr., o Raleigh, North Carolina, or all their contributions o sample
images.

Joen M. Iannucci, DDS, MS

Laura Jansen Howerton, RDH, MS

x

CO N TEN TS

Reviewers, vi
Preface, vii
Acknowledgments, ix

PART I Radiation Basics

1 Radiation History, 2

Dentistry and X-Radiation, 2

Basic Terminology, 2
Importance of Dental Images, 2

Discovery of X-Radiation, 2

Roentgen and the Discovery of X-Rays, 2
Earlier Experimentation, 4

Pioneers in Dental X-Radiation, 4
History of Dental X-Ray Equipment, 4
History of Dental X-Ray Film, 5
History of Dental Radiographic Techniques, 5
History of Dental Digital Imaging, 6

2 Radiation Physics, 8

Fundamental Concepts, 8

Atomic and Molecular Structure, 8
Ionization, Radiation, and Radioactivity, 10
Ionizing Radiation, 10

X-Radiation, 12
X-Ray Machine, 12

Component Parts, 12
X-Ray Tube, 14
X-Ray Generating Apparatus, 15

Production of X-Radiation, 16

Production of Dental X-Rays, 16
Types of X-Rays Produced, 17
De nitions of X-Radiation, 17

Interactions of X-Radiation, 18

No Interaction, 18
Absorption of Energy and Photoelectric Effect, 18
Compton Scatter, 19
Coherent Scatter, 19

3 Radiation Characteristics, 24

X-Ray Beam Quality, 24

Voltage and Kilovoltage, 24
Density and Kilovoltage, 25
Contrast and Kilovoltage, 25
Exposure Time and Kilovoltage, 26

X-Ray Beam Quantity, 26

Amperage and Milliamperage, 26
Density and Milliamperage, 27
Exposure Time and Milliamperage, 27

Exposure Factor Tips, 27
X-Ray Beam Intensity, 27

Kilovoltage, 27
Milliamperage, 27
Exposure Time, 27
Distance, 28
Inverse Square Law, 28
Half-Value Layer, 29

4 Radiation Biology, 31

Radiation Injury, 31

Mechanisms of Injury, 31
Theories of Radiation Injury, 31
Dose-Response Curve, 32
Stochastic and Nonstochastic Radiation Effects, 32
Sequence of Radiation Injury, 33
Determining Factors for Radiation Injury, 33

Radiation Effects, 34

Short-Term and Long-Term Effects, 34
Somatic and Genetic Effects, 34
Radiation Effects on Cells, 34
Radiation Effects on Tissues and Organs, 36

Radiation Measurements, 36

Units of Measurement, 36
Exposure Measurement, 36
Dose Measurement, 37
Dose Equivalent Measurement, 37
Measurements Used in Dental Imaging, 37

Radiation Risks, 37

Sources of Radiation Exposure, 37
Risk and Risk Estimates, 37
Dental Radiation and Exposure Risks, 38
Patient Exposure and Dose, 38
Risk Versus Bene t of Dental Images, 38

5 Radiation Protection, 42

Patient Protection, 42

Before Exposure, 42
During Exposure, 46
After Exposure, 48

Operator Protection, 48

Protection Guidelines, 48
Radiation Monitoring, 49

Radiation Exposure Guidelines, 50

Radiation Safety Legislation, 50
Maximum Permissible Dose, 50
Cumulative Occupational Dose, 50
ALARA Concept, 50

Radiation Protection and Patient Education, 50

PART II Equipment, Film, and Processing Basics

6 Dental X-Ray Equipment, 54

Dental X-Ray Machines, 54

Performance Standards, 54
Types of Machines, 54
Component Parts, 54

Dental X-Ray Receptor Holders and Beam Alignment

Devices, 56
Types of Receptor Holders, 56
Types of Beam Alignment Devices, 57

7 Dental X-Ray Film, 60

Dental X-Ray Film Composition and Latent Image, 60

Film Composition, 60
Latent Image Formation, 61

Co n t e n t s
xi

Types of Dental X-Ray Film, 61

Intraoral Film, 61
Extraoral Film, 66
Duplicating Film, 69

Film Storage and Protection, 69

8 Dental X-Ray Image Characteristics, 72

Dental X-Ray Image Characteristics, 72
Visual Characteristics, 72

Density, 72
Contrast, 74

Geometric Characteristics, 75

Sharpness, 76
Magni cation, 78
Distortion, 78

9 Film Processing, 82

Film Processing, 82

Film Processing Fundamentals, 82
Film Processing Techniques, 83

Automatic Film Processing, 83

Film Processing Steps, 84
Equipment Requirements, 84
Step-by-Step Procedures, 85
Care and Maintenance, 85

Manual Film Processing, 86

Film Processing Steps, 86
Film Processing Solutions, 86
Equipment Requirements, 87
Equipment Accessories, 88
Step-by-Step Procedures, 89
Care and Maintenance, 89

The Darkroom, 90

Room Requirements, 90
Location and Size, 91
Lighting, 91
Miscellaneous Requirements, 92
Waste Management, 92

Film Duplication, 92

Equipment Requirements, 92
Step-by-Step Procedures, 93

Processing Problems and Solutions, 93

Time and Temperature, 93
Chemical Contamination, 96
Film Handling, 97
Lighting, 99

10 Quality Assurance in the Dental Of ce, 104

Quality Control Tests, 104

Equipment and Supplies, 104
Film Processing, 105
Digital Imaging, 109

Quality Administration Procedures, 109
Operator Competence, 109

PART III Dental Radiographer Basics

11 Dental Images and the Dental Radiographer, 113

Dental Images, 113

Importance of Dental Images, 113
Uses of Dental Images, 113
Bene ts of Dental Images, 113
Information Found on Dental Images, 114

The Dental Radiographer, 114

Knowledge and Skill Requirements, 114
Duties and Responsibilities, 114
Professional Goals, 114

12 Patient Relations and the Dental Radiographer, 118

Interpersonal Skills, 118

Communication Skills, 118
Facilitation Skills, 121

Patient Relations, 121

First Impressions and Patient Relations, 121
Chairside Manner and Patient Relations, 122
Attitude and Patient Relations, 122

13 Patient Education and the Dental Radiographer, 124

Importance of Patient Education, 124
Methods of Patient Education, 124
Frequently Asked Questions, 125

Necessity Questions, 125
Exposure Questions, 126
Safety Questions, 127
Digital Imaging Questions, 127
Miscellaneous Questions, 128

14 Legal Issues and the Dental Radiographer, 130

Legal Issues and Dental Imaging, 130

Federal and State Regulations, 130
Licensure Requirements, 130

Legal Issues and the Dental Patient, 130

Risk Management, 130
Malpractice Issues, 131
Patient Records, 132
Patients Who Refuse Exposure of Dental Images, 133

15 Infection Control and the Dental Radiographer, 135

Infection Control Basics, 135

Rationale for Infection Control, 135
Infection Control Terminology, 135

Guidelines for Infection Control Practices, 136

Personal Protective Equipment, 136
Hand Hygiene, 137
Care of Hands, 137
Sterilization and Disinfection of Instruments, 137
Cleaning and Disinfection of Dental Unit and

Environmental Surfaces, 137

Infection Control in Dental Imaging, 138

Infection Control Procedures Used Before

Exposure, 139

Infection Control Procedures Used During

Exposure, 142

Infection Control Procedures Used After Exposure, 142
Infection Control Procedures Used for Digital

Imaging, 142

Infection Control Procedures Used for Film

Processing, 143

PART IV Technique Basics

16 Introduction to Dental Imaging Examinations, 148

Intraoral Imaging Examination, 148

Types of Intraoral Imaging Examinations, 148
Complete Mouth Series/Full Mouth Series, 149
Diagnostic Criteria for Intraoral Images, 149

Extraoral Imaging Examination, 149
Prescribing Dental Images, 150

xii

Co n t e n t s

17 Paralleling Technique, 152

Basic Concepts, 152

Terminology, 152
Principles of Paralleling Technique, 152
Beam Alignment Devices and Receptor Holding

Devices, 154

Receptors Used for Paralleling Technique, 155
Rules for Paralleling Technique, 155

Step-by-Step Procedures, 155

Patient Preparation, 155
Equipment Preparation, 155
Exposure Sequence for Receptor Placements, 156
Receptor Placement for Paralleling Technique, 159

Modi cations in Paralleling Technique, 160

Shallow Palate, 160
Bony Growths, 169
Mandibular Premolar Region, 170

Advantages and Disadvantages, 170

Advantages of Paralleling Technique, 170
Disadvantages of Paralleling Technique, 170

18 Bisecting Technique, 175

Basic Concepts, 175

Terminology, 175
Principles of Bisecting Technique, 176
Receptor Stabilization, 177
Receptors Used for Bisecting Technique, 178
Position-Indicating Device Angulation, 178
Rules for Bisecting Technique, 179

Step-by-Step Procedures, 179

Patient Preparation, 182
Equipment Preparation, 182
Exposure Sequence for Receptor Placements, 182
Receptor Placement for Bisecting Technique, 183

Advantages and Disadvantages, 183

Advantages of Bisecting Technique, 183
Disadvantages of Bisecting Technique, 184

Helpful Hints, 193

19 Bite-Wing Technique, 197

Basic Concepts, 197

Terminology, 197
Principles of Bite-Wing Technique, 198
Beam Alignment Device and Bite-Wing Tab, 199
Bite-Wing Receptors, 200
Position-Indicating Device Angulation, 201
Rules for Bite-Wing Technique, 201

Step-by-Step Procedures, 202

Patient Preparation, 203
Equipment Preparation, 203
Exposure Sequence for Receptor Placements, 203
Receptor Placement for Bite-Wing Images, 204

Vertical Bite-Wings, 210
Modi cations in Bite-Wing Technique, 210

Edentulous Spaces, 210
Bony Growths, 210

Helpful Hints, 211

20 Exposure and Technique Errors, 214

Receptor Exposure Errors, 214

Exposure Problems, 214
Time and Exposure Factor Problems, 215

Periapical Technique Errors, 216

Receptor Placement Problems, 216
Angulation Problems, 217

Position-Indicating Device Alignment

Problems, 218

Bite-Wing Technique Errors, 218

Receptor Placement Problems, 219
Angulation Problems, 220
Position-Indicating Device Alignment Problems, 220

Miscellaneous Technique Errors, 221

21 Occlusal and Localization Techniques, 228

Occlusal Technique, 228

Basic Concepts, 228
Step-by-Step Procedures, 229

Localization Techniques, 229

Basic Concepts, 236
Step-by-Step Procedures, 237

Helpful Hints, 239

22 Panoramic Imaging, 244

Basic Concepts, 244

Purpose and Use, 244
Fundamentals, 244
Equipment, 247

Step-by-Step Procedures, 249

Equipment Preparation, 249
Patient Preparation, 249
Patient Positioning, 249

Diagnostic Panoramic Image, 251

Anatomic Features, 251
Density and Contrast, 251

Common Errors, 252

Patient Preparation Errors, 252
Patient Positioning Errors, 252

Advantages and Disadvantages, 256

Advantages of Panoramic Imaging, 256
Disadvantages of Panoramic Imaging, 257

Helpful Hints, 257

23 Extraoral Imaging, 260

Basic Concepts, 260

Purpose and Use, 260
Equipment, 260
Diagnostic Extraoral Image, 262

Step-by-Step Procedures, 262

Equipment Preparation, 262
Patient Preparation, 262
Patient Positioning, 262

Extraoral Projection Techniques, 262

Lateral Jaw Imaging, 262
Skull Imaging, 263
Temporomandibular Joint Imaging, 268

24 Imaging of Patients with Special Needs, 274

Patients with Gag Re ex, 274

Patient Management, 274
Extreme Cases of Gag Re ex, 276
Helpful Hints, 276

Patients with Disabilities, 276

Physical Disabilities, 276
Developmental Disabilities, 277
Patient Management Helpful Hints, 277

Pediatric Patients, 278

Tooth Eruption Sequences, 278
Prescribing of Dental Images, 278
Recommended Techniques, 278
Types of Examinations, 279
Digital Sensor Issues, 281

Co n t e n t s
xiii

Patient and Equipment Preparations, 281
Patient Management Helpful Hints, 281

Patients with Speci c Dental Needs, 281

Endodontic Patients, 281
Edentulous Patients, 282

PART V Digital Imaging Basics

25 Digital Imaging, 288

Basic Concepts, 288

Terminology, 288
Purpose and Use, 289
Fundamentals, 289
Radiation Exposure, 289
Equipment, 290

Types of Digital Imaging, 292

Direct Digital Imaging, 292
Indirect Digital Imaging, 293

Step-by-Step Procedures, 294

Intraoral Sensor Preparation, 294
Intraoral Sensor Placement, 294

Advantages and Disadvantages, 294

Advantages of Digital Imaging, 294
Disadvantages of Digital Imaging, 296

26 Three-Dimensional Digital Imaging, 299

Basic Concepts, 299

Terminology, 299
Fundamentals, 299
Training, 301
Equipment, 301
Common Uses, 304

Step-by-Step Procedures, 305
Advantages and Disadvantages, 305

Advantages of Three-Dimensional Digital Imaging, 305
Disadvantages of Three-Dimensional Digital

Imaging, 305

PART VI Normal Anatomy and Film

Mounting Basics

27 Normal Anatomy: Intraoral Images, 312

De nitions of General Terms, 312

Types of Bone, 312
Prominences of Bone, 313
Spaces and Depressions in Bone, 313
Miscellaneous Terms, 315

Normal Anatomic Landmarks, 315

Bony Landmarks of the Maxilla, 315
Bony Landmarks of the Mandible, 323

Normal Tooth Anatomy, 330

Tooth Structure, 330
Supporting Structures, 331

Primary and Mixed Dentitions, 332

Primary Dentition, 332
Mixed Dentition, 334

28 Film Mounting and Viewing, 338

Film Mounting, 338

Basic Concepts, 338
Normal Anatomy and Film Mounting, 340
Film Mounting Methods, 341
Step-by-Step Procedure, 342

Helpful Hints, 342
Film Viewing, 344

Basic Concepts, 345
Step-by-Step Procedure, 346

Helpful Hints, 347

29 Normal Anatomy: Panoramic Images, 351

Normal Anatomic Landmarks, 351

Bony Landmarks of Maxilla and Surrounding

Structures, 351

Bony Landmarks of Mandible and Surrounding

Structures, 353

Air Spaces Seen on Panoramic Images, 356
Soft Tissues Seen on Panoramic Images, 357

PART VII Image Interpretation Basics

30 Introduction to Image Interpretation, 363

Basic Concepts, 363

Interpretation Terminology, 363
Importance of Interpretation, 363

Guidelines, 363

Who Interprets Images?, 363
Interpretation versus Diagnosis, 364
When and Where Are Images Interpreted?, 364
What is the Sequence for Interpreting Images?, 364
How is Interpretation Documented?, 364
Interpretation and Patient Education, 366

31 Descriptive Terminology, 368

De nition and Uses, 368

What Is Descriptive Terminology?, 368
Why Use Descriptive Terminology?, 368
Descriptive Terminology versus Diagnosis, 368

Review of Basic Terms, 368

Radiolucent versus Radiopaque, 368
How to Describe Lesions, 369
Terms Used to Describe Radiolucent Lesions, 369
Terms Used to Describe Radiopaque Lesions, 371

32 Identi cation of Restorations, Dental Materials,

and Foreign Objects, 381
Identi cation of Restorations, 381

Amalgam Restorations, 381
Gold Restorations, 382
Stainless Steel and Chrome Crown Restorations, 384
Post and Core Restorations, 384
Porcelain Restorations, 384
Composite Restorations, 386
Acrylic Restorations, 386

Identi cation of Materials Used in Dentistry, 386

Materials Used in Restorative Dentistry, 388
Materials Used in Endodontics, 388
Materials Used in Prosthodontics, 388
Materials Used in Orthodontics, 389
Materials Used in Oral Surgery, 389

Identi cation of Objects, 393

Jewelry, 396
Eyeglasses, 398
Miscellaneous Objects, 398

33 Interpretation of Dental Caries, 403

Description of Caries, 403
Detection of Caries, 403

Clinical Examination, 403
Dental Image Examination, 404