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' v u r
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' a
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l u a r a r l u l p u B a u r l a r n s o d x f l
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a 8 e r e d u e { l p r p u e a r u r l a r n s o d x g
. g
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a 8 e r l o z r o l H p u e a r u r l e r n s o d x g
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u o r l s z r 8 r a u a e r n s o d x a S u l r n p p a c n p o r d u o r t ! r p e J
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- ? r - x ; o
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- e p e
l s o r u s l u e r u e t e t s E u r z u . o l l o J e r { r
J o
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' u o r l e n u a n e
I o
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p u e
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e J n l x r u e q 8 n o r q l S u r s s e d l u e r r n f ,
l e r r r r t r e l 1
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a l g l n r l l r g d y o d e c e p e l r l c p o l p p u
: f q e q n r A v y x e q l u l p a o n p o r d d i l e n t r e a r e s d
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r o
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p a r y u 8 e r u u e a q s B { 1
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a l p r l e u a d o r t 1 q " e l c r r r e d
I I E u r s V
: s r u o t o q d d e r - x
'
s u o r t e r p g r r r t o u 8 e u o r r c e l f l
' s u o r l e r p e r
r e l n r s n d r o 3
' s u o r l e r p e r
e q d l y
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c r d o c s o r S d l l
. 0 I
' s u o r l e r P e r
e l E l n f , r l r e d
i s a r r o B a l e t
u o r t ? r p e r E u r z n o l l o ; e r { r
J o
q J I q ^ \ o r 8 u o 1 e q s d e r - 1 1
' a E r u q c
a l r l e S o u J o e l r l r s o d e r a q l r a o A E H
' e S r e q r
a l r l e 8 a u
p
a A e H
' e z r r l e S a u
J o e l r l r s o d r a q l r e
' e 8 r e q c
o u e A p H
' a 8 r e q c
a i r r l r s o d e e L e H
- n u
e q l
P u n o r s
s i l e q s u r e ^ [ o ^ a t
w q t s u o r p e l e e q l
' d n c
E u r s n l o C
. C
' e P o u v ' J
' e P o q l E S ' f l
' l u a u r E l r c ' v
: e q l r u o r y o t e u r S r r o s d e r - x ' . q r , t f e r - x e q r u I
S N O I J S i I N b
a 1 0 u E r u o r y
P J ! o q p r E r ; o
e c e r d e p u e ' s s e 1 8 r o r r l s B l d
; o
e r a r d e
' r q 8 q g s e l J
p a z s - r a r y o d
i l " r u s
E e s n :
- o d x e
u o r l e r p e r r u o r t
J l e s a u o
t c e t o r d o t q l r , ( s u E
' l q 8 l
t u o 4
t u e r e J t r p e r e s d u r - y
' l q B I
o l r e l r r u r s a r e s z ( e r - y
' 1
: A , o q
l u a r e d l o
' a s n o d s '
- 1 r r 8
( p u e p ; d o q
e o r u r e l d x e p u e e u o q o E o l p a a u
' 7 r
' )
' f l
' v
. C
' f ,
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' v
' 6
C N I A T O S - W I I - I f l O U d A E S V T I
13.
NUTTTPN OF X.RAYS
Ionization occurs:
A. lfhen atoms lose electrons; they become defi-
cient in negative charges and therefore behave
as positively charged atoms.
B. I7hen atoms gain electrons; they become posi-
tively charged.
C.
' When
an atom loses its nucleus.
D. Only when a K orbit electron is ejected and
replaced by an L orbit electron.
\fhich electron has the greatest binding energy to
the nucleus?
A.
J
shell electron.
B. K shell electron.
C. L shell electron.
D.
Q
shell electron.
Select the correct statement:
A. X-rays cannot be focused to a point.
B. X-rays can be focused to a point.
C. X-rays cannot increase the electrical conduc-
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.
BI BLI OGRAPHY
Alpen E. Radiation Biophysics. Englewood Cliffs, NJ: Prentice HalL
1990.
14.
Bushberg
JT,
Seibert
JA,
Leidholdt EM
Jr,
Boone
JM.
The Essenti,
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JE,
Murry RC
Jr.
Christensen's Physics of Diag-
nosti c Radi ol ogy.4th ed. Phi l adel phi azLea & Febi ger, 1990.
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Ritenour F.E. Medical Imaging Physics.3rd ed. St. Louis
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phi a:' WB Saunders, 1,98t.
Langland OE, Sippy FH, Langlais RP. Textbook of Dental Radiolog'-
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Rezai RF, \Talkhoff O. Renaissance man of dentistry. Bull Hist Dent
1.986;34:L1.5-1.2L.
Roentgen'$7C. On a new kind of rays. Nature 1896;53:274-276.
Rohrmei r G,
' Wal khoff
FO. Leben und werk. \Turzburg, Germanr' :
'Wurzburg
University,
January
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Sellman
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The Fwndamentals of X-Ray and Radium Physics. Tth Ed-
Spri ngfi el d: Charl es C. Thomas, 1985.
Sprawls P
Jr.
Physical Principles of Medical Imaging.2nd ed. Gaithers-
burg: Aspen, t 993.
Squire LF, Novelline RA. Fundamentals of Radiology. 4th ed. Cam-
bridge: Harvard University Press, 1988.
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'Vfolbarst
AT. Physics of Radiology. East Norwalk, CT: Appleton-
Lange,1.993.
15.
t 6.
30
6 V
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' s ' v
t u o r l B r P s r - x
J o
s a s F d r u r
d u e r u ^ { o r l a J n p o r d p p o l l r a r n s o d x e p u o r a s - S : . g
V
' 9 ' C
' z ' )
. I ' T I
' s t ' 0 ' v
; ( s ) p u o r a s
d u e u r
1 \ 4 . o r l s r e r u t 1 e J n s o d x a ^ e u e q l
. V r u
S I
o l a r n s o d
- x e
p u o f , a s - S ' I p u "
V r u 0 I
r u o r y a n b r u q r a l a r n s o d
- x a
l e r o e r l u r
r a q r o s r q a 8 u u q e o l s a p r f , a p
N r l u e p
V
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p a p e e T
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: s r a n b u d o l p e r
$ o t u a q t s r l e q t e f , u e r s q n s a q l
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e r { r
J o
e u o N
. q
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, t - o 1 q t r r r , r . a 8 e
- r l o ^
r n d r n o - q 8 l q o r a E e t l o l
l n d u r - m , o 1 a E u e q 3
. 3
' d n > t
e q l d r e l o l r o t e r a d o a q r , t \ o i l v
. g
' l u e t u e l r ;
e q r
t e e q o l l u e r r n J a q r d n d e r s
. V
' : : j ; f f i T " i , , _ : , I J f f r :
' r a r u r o l s u e r l
u ^ r o p - d a t s e q l
. f ,
' r e u r o t s u e n
d n - d a r s a q 1
. { I
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e q l
. v
. : s l a q n l d e r
- x
e q l
t o
t u e r u B [ J a q t
l ? a q o l p e s n r e r u r o t s u e 4 e q l
' s u e a r J s
o 1 $ , 1 q l r ^ 4 ,
s u o r s l n u a e l t u r s d p o s a s n l r e s n e J a q r a l s e {
' t t l S T I
o l e l n r s u a s e r o t r
l
' s u e e J f , s
S u r d ; r s u a l
- u r
o ^ 4 , l u a e ^ u e q p a q J r ^ 4 , p u ? S
l o u u a q 4 , r e D e f l
. U O I I E I P B J
O I E A I 1 I S U O S E J O W
o l p r c s s r s u e a r J s S u r d ; r s u e l u q t r / r p e s n
( u l l J
e r l l
' r u l l J
l e s n l r f , o J o
u o n d a f , x a e q t q r l ^ { s l a 4 r e d
r u l r J
l B r o B r l u r J o
s e z r s
I I E
u r p e u r B l u o f , s r l I
. ( I
' u r l l J
p a s s o r o r d f l r a d o r d p u e
p a s o d x a d l r a d o r d u o u r a u g d e a t n p o r d d e u r
r I
. )
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a q r
t o
d r p r E r r a q r o l s e l n g r r l u o t
r I
. f l
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a r { r
J o
l u o r t u r
s ! r l s B
' u o r l e r p e r
p e r a p e r s - I r g q
t n o s r e l l r J
t I
. V
q
t u u r o u o r e n ' s r B u r r n o r r o r e u r , "
" j J : t i T r t J
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u r l r ;
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u r p a o r l d s r
I r o J
p u a l
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r r q d u r E o r p e r
{ r e p
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e r o J e q
l n q e r n s o d x a r a r y e
' e 8 e u r r
o r q d e r S o r p e r
r q 8 u
' u o r l e r u r o J
s t r u r a t e l d r e l s r t p q l
: s r a 8 B r u r
' l s p J l u o J
' 1 S ? J l U O f ,
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: a q o l
P r E s
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{ r e l q i l e
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t ? q t n , { e 1
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s a 8 e u r r l o t u q e r e q t u r S u o r n
t u e ^ ^ . r e q t r t r
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u r e u e d o r r t e u o a 8 e l q r s l ^ e I ' q p a r n r s q o , , (
e q r q t r ^ {
V
u e g r r e r q 8 1 e E u u r r u e p u u ! ( 3
l a s E r t x a
l u a r e d d e u e q t r ^ A ,
V
u e q r r e { r ? p a 8 e r m
- r u r )
t r l s e l d
t o
a r a r d r e a l f , E e { I q o o l u l p y
. a B
- [ o t
s B p e r e a d d e s r e q l o e g l
. p e J r a d
t n o s u r n l
a u o d p g
' s u r l l J
E u r n n a l r q J n o J
J o
t a s E u e { B r
r n l
C N I A - I O S - W i I T T I O U d
; s p r s d n
r o l l r s o u
J o
a r n s o d x a ( s ) e r e r r s u o u a p ( s ) r u g y q r ;
t s l s l s ^ r r
a P I F r l
- I S
e q r
I p ; o
a r n s o d x a ( s ) e r e r l s u o u a p ( s ) u r t t J
g ( s ) p r r e r e r u a n
'
: E t J o
S u r E e r u r ( s ) a r e r r s u o u e p ( s ) t u l $ q r l
; ( s ) p r i a r e u
- h l o r p e r ; o
S u r t e u r r
- q E
I E r r u a r e J J r P
a q r
( s ) a r e r r s u o u e p ( s ) u p ; q r r
i r a D e r u
d q s d e r - x
J o
u o t
( s ) e r e r r s u o u l a p ( s ) u p ; q r r
' 0 I
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' s
u B r , l l a J o u a g A E r u a J a r p p u B e f , u o u B r l l e J o t u p e s n
r e D e l q r B f l
' 1 9 1
d e l S r u o r y e r o
' p ' r ' q ' u )
( s
p a J J o J
e q t E u n r a s u r d q s u o r l s a n b t u r m o l l o ; e q r
' J e ^ t s u E
i I
I . U O I V U O T T V T U O C S N O r I S f l n b
q s s v s
THE X-MY MACHINE,
ATTENUATION,
AND RECORDING
OF MDIOGMPHIC
IMAGES
11. Some components
of the x_ray tube include:
A. An anode.
B. An aluminum
filament.
C. Helium.
D. Cooling
oil.
E. A lead collimator.
1,2. The kilovoltage
in an x_ray generating
system reg_
ulates:
A. The number
of electrons produced.
B. Thermionic
emission.
C. The velocity
of electrons
rraveling
from the
filament
to the target.
D. The velocity of x-ray photons
produced.
13' The interaction
in which the entire photon
of x-ra-
diation is removed
from the beam Uy *o_i. ;;
acion is called:
A. The Thomson
effect.
B. The photoelectric
effect.
C. The Compton
effect.
D. Excitation.
14' r7hich of the following
arc characteristics
of pho-
toelectric
absorption
?
A. It depends
on atomic number.
B. It differentiates
between
hard and soft tissues.
C. It is more likely to occur in inner orbits.
D. It occurs in dental radiography.
E. All of the above
L 5. Sensitization
specks:
A. Are defects in calcium
tungstate
crystals.
B. Are defects in silver bromide
cryst;ls.
C. Act as electron
traps.
D. A and C.
E. BandC
Bushong SC. Radiologic.science
for
Technologists, pbysics,
.^!:1!::::"ri':.
s+:d. s,:
_Lquf,Mosby_vear
Book, 1ee3.
Code of F:*ral Regulatio"g
?1tS!b-gfr"p#1,
ril;ifi;i";;
191!:Y:*1lqo"
DC,1eB4.
office of th. r.J.,"r ilil;;;
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physical principles
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Radiology.
_.
The University
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fne-luy!ryr^rytlk
of Radiography.
1,2th ed. Rochester,
Nt
Kodak. 1980.
Ter_-Pogossian
MM. The
physical
Aspects of Diagnostic
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_
"\:y,
l?:!. .Firn.:
6c, Row, H_o e b er tvte dic alb iu'i
"i""',-
t
g'
ez .
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g"r;""li."d"kJ;b;:
t 9
' s v t u
e q t e s u e r r u r p u e d n > 1 a q r e s p e r r u l
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. V
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r l l l , 1 6 .
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J o
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t u o r ; r o u r e l d e q t u o a p r s d q a p r s s d r l c r a d e d o m l
e q r e c e l d
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t u r z u , o y l o J e q r
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p e z r s - J e l l B r u s o A , l p u B s r u l r l
I e J o E J l u r u r s l q o
. I I
' 0 I
. L
DIAGNOSTIC
QUALITY OF DENTAL MDIOGMPHS
3. \fhich of the following would minimize the size of
the penumbra?
A. Large focal spot.
B. Long source-film distance.
C. Short source-film distance.
D. Long object-film distance.
4. lf by mistake you used the exposure time for the
short-BlD technique (8-inch
source-film distance)
whi l e usi ng the l ong-BID techni que (L6-i nch
source-film distance), what would be the densitv of
the film?
A. Too light.
B. No visible change in 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-film distance.
C. kVp.
D. Exposure time.
E. mA.
7. \7hich of the following properties of x-rays is the
basis for the rules of geometric projection?
A. X-rays travel at rhe speed of light.
B. X-rays travel in diverging straight lines from a
point source.
C. The course of an x-ray photon can be diverted
with an electromagnetic source.
D. X-rays can form a latent image on photo-
graphic film.
8. Regardless of the target-film distance, incorrecr
horizontal 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 does not control magnifi-
cation of the radiographed object?
A. Focal spor-film distance.
B. Alignment of film, objects, and radiation BID.
C. Object-film distance.
D. Cathode size.
I7hich of the following does not consritute an ad-
vantage of the smallest possible focal spot?
A. Decreased geometric unsharpness.
B. Increased magnification.
C. Increased definition.
D. Decreased penumbra.
12. The density of an intraoral film indicates rhe:
A. Degree of darkness.
B. Difference between densities.
C. Speed of the screens.
D. Kilovoltage used.
E. None of the above.
13. Fog affects rhe contrast of a:n intraoral film be-
cause it:
A. Decreases film density.
B. Increases film density.
C. Produces white specks on rhe film.
D. Produces phosphorus crystals on rhe film.
14. Adequate coverage of the area of interest on the
radiograph depends on which of these factors?
A. Proper alignment of film and the radiation
beam to the arca of. interest.
B. Proper selection of film types.
C. Proper selection of film-projection techniques.
D. All of the above.
15. \7hich of the following facrors minimize penum-
bra formation and magnification on a radiograph?
1.. Long BID.
2. Short target-film distance.
3. Film as close as possible to the teeth.
4. Large focal spor.
5. Short BID.
A. 2 and 5.
B. 5 only.
C. L and 3.
D. 3 and 4.
E. 1 and 4.
BI BLI OGRAPHY
Bloom_ wJ, Hollenbach
JL,
Morgan
JA.
Medical Radiographic Technic.
3rd ed. Springfield: Charles C. Thomas, 1969.
Bushong sc. Radiologic science
for
Tecbnologists.Sth ed. st. Louis:
Mosby-Year Book, 1993.
10.
L1..
I 8
' S ) l s ? w ' f l
' s a ^ o l c ' v
: s a P n l J
- u r
l u e r u d r n b a o l r l l e l o J d
l e u o s r a d
. l u r a u a 8
u 1
. 7
' s r e r u J o t
a r o d s e r e B r r e p e q r r u a t o q l e d
r s o T r q
. q
' s l u a 8 e
p c
- r u a q J
p u u p c r s d q d o r l u e t s r s e J d r a r r e r e d r q l
. f ,
' r a l l e r u
r r u e 8 r o d q
p a n a l o r d d g e n s n e r e l n q
r u {
o r d s u e a r e d r q l
' s f , r t o r q u u e
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: e s n e J e q
l u e u r d r n b e p u s s l u a r u n D s u r
d e r - x S u r z r 1 r r a l s u t u r e l q o t d e a t e s a r o d s
l e r r e l r e { J
. t
. 3
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t o
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. I
S N O I I S f l N b A N S I A S U
' r a l d e q c
e q l u n l l r ^ l s e a
- J E
[ E J e A e s
u r p e u o n u e r u e J ! s J o l \ s u " e q l
. r a l d e q r
s r y t r u r
* d q d u r t o 1 p " U
J r r u ? J o u e c l r o J p e p u e r u r u o J e g s a r n p e f , o r d
I o r l u o ]
u o I D e J u L
P u s . . 2 ( q d e r E o l p e u
l B r o e r l u l
u r s a r n p
- e f , o r d
l o n u o J
u o r 1 c e J u l
J o
s s p v , , p e e r d g n y a r e 3 : f u l H
' p o q r e u
o l u u r a l l e p e s o d o r d r n o d p u e / e u n s q l n o u
- l l n J
e r l r t u u e d u r o J
u e q J u o s r r e d u o J
l o r l u o J
u o r n e J u r u B
a { B I
I ; d e r r r n s
q r n o u - l l n J e r l r J o s E s s e r l
l o r l u o r
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J o
l s o u l n o q t r ^ , l l n q
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I e o r r u o l e u e
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r e t 8 n s n o d u e c
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1 E
a r e l d o t e s o r l r n o d d q r n u r e l d x g
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l x e u e q l J o J r u o o J a q l S u r r
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r u a u r d l n b 3
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u o 8 u r u r B u l a . r e I p p o o t d u e
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D N I A - I O S - W I I T f l O U d C A S V f l
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RADIOGRAPHIC INFECTION CONTROL PROCEDURES
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 on
a patient who has no medical conditions as indi-
cated by the medical history and interview. For
this appointment the dental professional should
wear:
A. Gloves only.
B. Glasses and a face mask.
C. Glasses and gloves.
D. Glasses, gloves, and a face mask.
6. \7hich of the following statements is/are correct?
A.. Taking sterilized x-ray instruments out of a
package and placing them in clean drawers is
recommended.
B. Hands should be washed thoroughly before
and 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 for
hepatitis B.
D. Both A and C are correct.
E. Both A and B are correct.
7. The most commonly used glove type for x-ray pro-
cedures is what kind of gloves?
A. Medical grade vinyl.
B. Sterile vinyl.
C. Unsterile latex.
D. Sterile latex.
E. Medical grade latex.
8. The class of chemical that is least effective 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 the
following statements is 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 is not a virus?
A. Epstein-Barr.
B. Pneumococci.
C. Herpes simplex.
D. Hepatitis B.
11,. Glove powder can affect some film emulsi
thus, powder-free gloves are recommended. Gl
powder may also be responsible for:
A. Allergic reactions.
B. Dirty uniforms.
C. Nonallergic skin reactions.
D. All of the above.
t2. The OSHA Bloodborne Pathogen Rule is enfor
byt
A. Federal inspections.
B. State inspections.
C. Employees.
D. All of the above.
Using the recommended infection control meth
for processing films, as stated by the authors
this chapter, how many pairs of gloves are actu
used from the beginning to the end of the p
dure?
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 survi
in the processing solutions?
A. Yes.
B. No.
15. Is it true that microbial contamination of an x
film can survive the processing cycle?
A. Yes.
B. No.
BI BLI OGRAPHY
American Academy of Oral and Maxillofacial Radiology. Infection
trol guidelines for dental radiographic procedures. Oral Surg
Med Oral Pathol L992;73:248-249.
American Dental Association. Infection control
the dental office and dental laboratory.
1.996;1.27:672-680.
I
Am Dent
Bachman CE,'White
JM,
Goodis HE, et al. Bacterial adherence and
tamination during radiologic processing. Oral Surg Oral Med
P ath ol 79 9 0
;7
6 :112-1, 1,9 .
Bajuscak RE, Hall EH, Giumbarresi LI. Bacterial contamination of
tal radi ographi c fi l m
[abstract]. J
Dent Res t991;70:1.439.
Bajuscak RE, Hall EH, \Teaver T, et al. Sporicidin and chlorine b
di si nfectant of dental radi ographi c fi l m
[abstract]. J
Dent
13.
recommendations
1.991;70:1.439.
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' S C N I A T O S - h I I I T T I O U d C i I S V g -
TNTRAORAL RADTOGRAPHTC TECHNTQUES
11. Why is the extension or long BID a necessary ad-
junct
to the paralleling technique?
A. To avoid magnification of the image.
B. To avoid shape distortion of the image.
C. To reduce secondary radiation.
D. To facilitate correct vertical angulation of the
BID.
E. To avoid superimposition of structures.
L2. Compared with the short BID (bisecting angle)
technique, the right angle (paralleling) technique
using 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 paralleling
technique only.
C. The short BID is used correctly with either the
paralleling or the bisecting angle technique.
D. Film-holders are not necessary with the paral-
leling technique.
t4. In order to increase the periapical coverage in the
mandibular 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 in intraoral radiograpiry, the bisecting an-
gle technique is one in which the central x-ray
beam 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 angle
formed by the object and the film packet.
Perpendicular to the long plane of the film
packet.
CASE-BASED
QUESTIONS
cAsE 5. 1
The patient is a 3S-five-year old woman and a long-stand-
ing, usually cooperative patient. She complained of dis-
comfort when the film was being placed. This is a
mandibular premolar radiograph.
QUESTTONS
L. Forgetting for now that the apices are not showi
mesiodistallv the film is:
A. Poorly placed because part of the canine is
missing.
B. Poorly placed because the second premolar is
not centered on the biteblock.
C. \fell placed because the second premolar is in
the middle of the film.
D. \7ell placed because the distal of the canine
and first molar are in the image.
2. \7ith respect to the apices, the problem could
best corrected by:
A. Increasing the negative vertical angulation,
because this will also align the lingual and
buccal cusp tips.
B. Asking the patient to raise the tongue
ter film placement.
C. Asking the patient to bite down more
for bet-
firmly
on the biteblock.
D. Positioning the film more lingually to avoid
traumatizing the lingual torus.
3. Match the columns by identifying the following.
Arrow L
Arrow 2
Arrow 3
Arrow 4
A. Mandibular torus.
B. Buccal cusp tip.
C. Lingual cusp tip.
D. Lamina dura.
L T . I
r o J J I u q J a l a l S u e S u r p a s r q p e z r p r e p u " t s p u e p a r y l d r u r 5
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.
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a c e l d d p a d o r d q
6 q 4 1 u e u r
p u e e u r q r e u r d e i _ x a q i
' : ' : ' '
. i l q s
J o u r T r u E I
J
. ( l s r o e r r q )
s u r l l J
Z
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l q S H
e r l ^ e p B u r p l o q _ u r p g
' d r u r e J
S u r s s a c o r d p u e e u r r l J e r u d e r - y
p e p e e N
r u e r u d ; n b 3 p u !
9 N I l 9 V l { l I V I N I C J O S l l d l f N t u d
s N o l r s i n b a o . i l n g u
s u o u u r r n i l H H ) r r i l u o v u l N l
ANALYSIS OF ERRORS AND ARTIFACTS
7. What is the function of the raised dot on the film?
A. It identifies the side of the film toward the line
of occlusion.
B. It identifies the side of the film toward the
tongue.
C. It identifies the side of the film toward the
beam of radiation.
D. It identifies the maxillary or mandibular
teeth, depending on how the film is placed in
the mouth.
E. It identifies Ef type of film.
8. If an unexposed film is stripped from its film
packet, exposed to light, and then processed, it
will:
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-
cessed properly in dark conditions, and then ex-
posed to 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 where
x-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 unsafe
place.
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 of
foreshortening 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 of
elongation 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 cause
overlapping 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 in the image of a proces
film are caused by:
A. Bending of corners of film.
B. Incidental crimping of film.
C. Saliva contamination.
D. Static electricity.
E. All of the above.
15.
CASE-BASED
QUESTIONS
cAsE 7. I
QUESTTON
1. Identify the error in this radiograph: (Disregard
rows)
A. Film conraminated by fixer before develop
ment.
B. The film packet was reversed.
C. Excessive exposure to thermal changes
development.
D. Improper use of Styrofoam biteblock.
E. Use of outdated film.
174
s L l
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P a e d s - r 3 ^ , \ o l s
3 e s n
. a
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S u r d o l e z r e p o s e e r J e c
. f ,
' q l n o r u
e g t u r p r E ^ D I r B q u p y a c e l d
t o u o C
. f l
. a S e I I o I o I D I
a S E e J J a Q
. Y
t r o r r e
c r q d u r 8
- o r p B r
s r r . l t r o J l J e r r o J o r p o q l e l ' u l s e q e q l s r
r E q / N
. I
N O I I S : l n O
' p e r r r l s
u e e g e ^ E q p u p r l s e r y o r e s u o n n l o s S u r s s e c o r d o q J
. p a r e p
- r o
s r e { e l e r e p u e ' s p a e u c D s o u S e r p r n o d r o ; d r o n e ; s r t e s
t o u
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. A \ o l
u , l \ o p p a u r n r s r J o l u u r r u
- n l l r
e q t ; o
r q 8 q a q t p u e
' t u o o r
p a u a { r e p E u r r o l e u l u n l l l
u E u o p e e e l d s r q d e r S o r p e r S u u r o r r q e q l
. r r l s o u 8 e r p u n
s r
r I t n q
' t u e l l e c x e
s r q d e r S o r p e r o q r , ( l e o r u q r o l
. e r r l l o
r n o d
u r e l ? r u a l p 1 o - r e a d - g I u B
J o
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V
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P u e I
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J o
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N O I f S : l n O
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S u r m a t r q
l u e l l n s a l
s r r l J
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s r q l u o s e u r u E r e q r
J o { e r s r p
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r e l o u r e r d E e { B l o l p a r r n b e r s E . 1 \ . t u e p n l s e u a r 8 d q
1
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. g
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e r { r q r y \ { p a u E q e s n u s E A \
C I g
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. g
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' V
i r o r r o
c r q d u r S o r p
- e r
u o r u r u o f , s r r { l
J o
a s n e r d p { I
t s o r u e q t s r r e q l i l
N O
q d e r S o r p e r o r { J ' u e > l e l
s q r p e q e w l e d e l r t r s u e s
r l e l a r a q
q d e r S o r p e r r e l o t u a r d f : e
t N l t v N l l v l N l c l o s r r d D N t H J
l . l e i t e q t y \ {
l r r 8
p 1 o - r
ANALYSIS OF ERRORS AND ARTIFACTS
cAsE 7.5
After taking a maxillary pfemolar radiograph using the
Dentsply/Rinn
instruments and manual processing, a fel'
low worker tells you that there were common efrors on
the radiograph, and
You
agree.
QUESTI ON
1. How would you correct for these errors?
1. Leave film in the water bath longer after ftxa-
tion.
Leave film in the developer longer.
Decrease vertical angulation.
Place dot in the slot of the film-holder.
Position the film more mesiallY.
Position the film more distallY.
tr 3, and 6.
L, 4, and 5.
3, 4, and 5.
2 and 4.
1.r 2, and 6.
cAsE 7.6
A loyal patienr of your dental clinic comes to you for her
L-year check up and this radiograph was taken.
QUESTI ON
L.
'What
caused the common errors in this radiograph!
L. Too flat a vertical angulation of the BID'
2. Too steep a vertical angulation of the BID'
3. Fixer aftlfact.
4. Developer stain.
5. Air on emulsion
6. Rough handling of film.
A. 1 and 3.
B. 2 and 4.
C. 2 and 6.
D. 3 and 6.
E. t and 5.
cAsE 7.7
Your office has purchased a new automatic proce
The first time you use it, two films come out stuck to
other, with the resultant film.
QUESTION
1. \fhat causes this error?
A. Processing temperatures are too high.
B. The rollers are set too slow.
C. Films were inserted too fast in the same
D. Films have bent edges.
E. Dryer not working
ProPerlY.
176
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. T V I N ] O
J O S l t d D N t u d
QUALITY
ASSURANCE AND LEGAL ASPECTS
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. Serves as a guide for continuing education
topics.
C. Provides some measure of the operator's com-
petence.
D. Reduces the amount of paperwork.
The half-value layer test is used to evaluate which
of the following?
A. Filtration.
B. Collimation.
C. kVp.
D. mA.
E. Beam alignment.
'V7hen
using a radiographic normalizing and mon-
itoring device, there is a difference of two or more
steps noted for a monitoring film when compared
with a baseline density number determined previ-
ously under ideal conditions. What should you do?
1,. Take a preexisting reference film from the re-
frigerator and develop it.
2. Take a reference film from the refrigerator,
expose it with standard exposure factors, and
develop it.
3. If the reference film matches within two steps,
the problem is most likely a processing prob-
lem.
4. If the reference film matches within two steps,
the problem is most likely in the x-ray equip-
ment or technique.
5. If the reference film does not match within
two steps, the 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 regard-
ing the legal aspects of dental radiography?
L. The patient's radiographs rightfully belong to
the patient.
2. The patient's radiographs are legal property
of the dentist.
3. The dentist should not give original radio-
graphs to the patient.
4. Radiographs should always be taken before
and after each tooth extraction.
5. One of the most common causes of dental
malpractice suits is the use of radiographs by
the dentist when they are not necessary to ren-
der a diagnosis.
A. 2, 4, and 5.
B. 1 and 5.
C. 2, 3, and 5.
D. 1 and 4.
E. 2 and 3.
8. A patient is moving to another city. He stops by
your dental office before leaving and asks you for
the radiographs that you took previously.'Sfhat is
the correct method to handle this situation?
Give the radiographs to the patient. After all,
they legally belong to the patient because the
patient paid for them.
Give the radiographs to the patient and tell
the patient to give them to his dentist in the
other city.
Tell the patient he cannot have the radio-
graphs because the radiographs legally belong
to the dentist.
D. Tell the patient that after he has found a new
dentist in the other city, the new dentist
should 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 if
intraoral radiographs are taken.
10. Before performing the coin test for safelight
you should:
A. Eliminate all sources of extraneous white
light.
B. Be certain all extraneous sources of white
light are "on."
C. Avoid checking safelight bulb wattage, filter,
and distance until later.
D. BandConl v.
When two mA settings, such as L0 and 15 mA,
available on a machine. these circuits are chec
byt
5.
A.
B.
6.
C.
9.
7.
L1,.
A.
B.
C.
D.
mAs reciprocity.
mA meter (ammeter).
Multiplying the output at I0 mA by 1.5.
A professional technician, as this cannot be
done in the office.
t96
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D N I D V N I I V I N ] C I O S ] I d I f N I U d
A H d V U 0 0 r ' t 8 t 8
SPECIAL IMAGING TECHNIQUES
software, digital images allow for the completely paper-
less office. Many new practitioners are setting up pa-
perless offices today.
SUMMARY
Digital images offer tremendous advantages to dentistry
in terms of lower radiation exposure for patients, no
darkroom or processing problems, convenient image
enhancement techniques, and remote teledentistry pos-
sibilities. Digital systems are now able to acquire all
types of images including panoramic and cephalomet-
ric. As technology continues to improve, they will ulti-
mately replace film as the medium of choice for dental
imaging.
EXERCISE I I.I TOCALIZATION
Materials and Equipment Needed
L. Manikin, skull, animal
jaw.
2. Four No. 2 periapical films.
3. One BB (small metal ball or,other metal object such
as a screw).
4. X-ray machine and processing facility.
Instructions
Step 1: Obtain a manikin, skull, or animal
jaw
and
place a radiopaque object (BB) on the buccal or
lingual side. Do not mark the film packet. Take
a standard periapical view of this object and
then vary the horizontal angle by approxi-
mately 20" and expose a second film.
Step 2: Now leave the BB in the same spot on the buc-
cal or lingual side as in Step L. Do not mark the
film packet. Take a standard periapical view of
the obiect and then vary the vertical angle by
approximately 20o and expose a second film.
Step 3: Process all four films and mount the films in a
bitewing mount. Place the two images with the
horizontal movement on one side and the two
images with the vertical movement on the other
side.
Step 4: Place your name on the bitewing mount and,
because you know where the BB was, exchange
your mount with a classmate and take your
classmate's mount.
\Uflorking
in pairs, try to figure out the location
of your classmate's BB.
CASE-BASED PROBLEM-SOLVING
In the future, you will become aware of the hassles of
ing track of inventories of x-ray supplies such as
chemicals, bitewing tabs, biteblocks and film-positioni
devices, and barrier envelopes. Also, you will begin to
derstand the maintenance problems associated with a
matic processors, the infection control procedure
associated with the daylight loader and the darkroom,
the time
!t
takes to get a radiograph processed (especi
with manual processing) in a tiny cubbyhole dark
with no air circulation. So you are wondering about digi
imaging. Should you trade one set of hassles for an
To help you decide, develop a comparison chart compari
the advantages and disadvantages of the two systems
you see it. \7hat is your final decision?
REVIEW
QUESTIONS
\fhich of the following statements are true
cerning cephalometric radiographs?
L. The Frankfort horizontal plane is the classic
plane used in cephalometrics.
It is not necessary to record the soft tissue
file in the lateral cephalometric radiograph.
3.
4.
The posteroanterior cephalometric is the
common cephalgmetric radiograph p
The accepted distance from the x-ray sou
to patient in cephalometric radiography is 5
feet.
A.
'1,r
2, and 3.
B. 3 and4.
C. L and 4.
D. 2, 3, and 4.
E. t r 21 3, and 4.
2. A cephalometric radiograph:
A. Is often used to measure changes and
growth patterns.
B. Contains a soft tissue outline.
C. Is commonly used by orthodontists.
D. All of the above.
3. A radiographic.image that looks like a picture
skull taken back to front is called a:
A. Cephalometric lateralradiograph.
B. Posteroanterior view.
C. Lateral
jaw.
D. Panoramic radiograph.
4. The anatomical structures of primary im
on TMJ proiections are:
The condyle,
joint
space, and glenoid fossa.
The condyle and the maxillary tuberosiw.
1. .
2.
Step 5:
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9 N I 9 V N I I V I N ] C J O S ] I d I ] N I U d
MDIATION BIOLOGY
Nuclear Regulatory Commission (NRc)-Establishes
radiation protection regulations and supervises nu-
clear power/weapons facilities. Formally known as
the Atomic Energy Commission.
Environmental Protection Agency (EPA)-Has the re-
sponsibility in the United States for providing guid-
ance to federal agencies.
Occupational Safety and Health Administration
(OSHA)-Is responsible for all occupational radia-
tion protection regulations that are not regulated
by 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, and
medical ultrasound equipment. The NCDRH (for-
merly known as the Bureau of Radiological Health
[BRH])
is an organization within the U.S. Food
and Drug Administration. The U.S. Food and Drug
Administration (FDA) is a part of the Department
of Health, Education and Welfare (DHEW) of the
U.S. government.
Have each student prepare an answer to a patient who re-
fuses any x-tay examination in your dental office, because
the patient is fearful of dental x-radiation and its harmful
effects.
REVIEW
QUESTIONS
1. Cell sensitivity to radiation is more pronounced:
1. During mitosis.
2. During periods of increased metabolism.
3. During embryonic development.
4. In muscle cells.
5. In nerve cells.
A. 1. , 2, and 3.
B. 1. , 2, and 5.
C. L, 3, and 5.
D. 2, 3, and 4.
E. 2, 3, and 5.
2. Which of the following tissues is most susceptible
to radiation?
A. Nerve tissue.
B. Muscle tissue.
C. Brain tissue.
D. Blood-forming tissue.
3. Theoretically, the biologic response to a gi
dose of radiation would be greater (more sev
with:
A. An anoxia of the tissue being irradiated.
B. A higher dose rate.
C. A smaller arca of tissue exposure.
D. Lower linear energy transfer (LET).
Which of the following latent effects can be
ciated with low-dose, whole-body radiation?
A. Shock.
B. Epistaxis (nose bleed).
C. Epilation (loss of hair).
D. Leukemia.
To a person in the United States, the average
tive dose of ionizing radiation from natural
ground radiation is about:
A. L0 mSv/year.
B. 3 mSv/year.
C. 6 mSv/year.
D. 50 mSv/year.
6. A certain amount of radiation is.needed before
clinical signs of damage to somatic cells a
The amount of radiation after which visible
age can be produced is called the:
A. Latent dose.
B. Threshold dose.
C. Hazard dose.
D. Scattered radiation dose.
E. Background radiation dose.
\7hich of the following is an SI unit of ra
absorbed dose expressed in
joules per kil
irradiated tissue?
A. Roentgen (R).
B. Curie.
C. rem.
D. Gray (Gy).
The SI unit of exposure of air is called:
A. One coulomb per kilogram.
B. Gray.
C. Rad.
D. Relative biologic effectiveness (RBE).
A radiation-damaged cell can pass along
to offspring cells. This is an example of:
A. Somatic effect.
B. Genetic effect.
C. Latent effect.
D. Indirect effect.
4.
5.
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t N t S v h t t v . | - N l c J O S l t d D N t u d
RADIOLOGIC HEALTH AND PROTECTION
9. During pregnancY, d
Patient:
A. Should be advised of her legal rights before
being irradiated.
B. Should be warned about possible miscarriage.
C. Should never be irradiated for dental radio-
graphs.
D. May be irradiated for dental radiographs by
taking the necessary precautions.
10. As a radiation worker,
You
should not be exposed
to more than an effective dose of 50 mSv a year.
But in x-raying yourself for dental treatment' you
are exposed to about 50 mSv. \(hich of the fol-
lowing reconciles these contradictory statements?
A. Because you need dental radiographs, you can
be given an unlimited amount of radiation.
B. As a patient you can be given any amount of
radiation, regardless of damage.
C. Exceptions can be made.
D. \fhole-body radiation is different from spe-
cific-region radiation.
1L. The dental health-care worker should not hold
the:
A. Film during exposure.
B. Tube during exposure.
C. Patient during exposure.
D. All of the above.
L2. Some of the most effective means of controlling
secondary radiation are:
t. Lead lined BID.
2. Increasing kVP.
3. Using filters.
4. Decreasing film speed.
A. 1 and 3.
B. 2 and 3.
C. L, 2, and 3.
D. 2r 3, and 4.
13. X-ray filters are usually made of:
A. Copper.
B. Lead.
C. Aluminum.
D. Stainless steel.
14. Collimators are usually made of:
A. Copper.
B. Lead.
C. Aluminum.
D. Stainless steel.
15. A film badge:
t. Is affected by ionizingndiation.
328
Is affected by other forms of radiant energy
such as heat.
Should be worn by all occupationally exposed
persons.
4. Is used to'identify x-tay films.
L. 2 and 4.
B. 1 and 3.
C. 1. , 2, and 3.
D. 1, 3, and 4.
BIBLIOGRAPHY
ADA State Legislative Clearing House. Dental radiography
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factors. Br Med l I1980;88:1753-1' 759. !a
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JA,
Sciiff TG, McDavid WD, et al. Diagnostic quality
sus patient exposure with five panoramic screen-film combina
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tivity of E speed fllms. Oral Surg 7990;592713-1.19--
Frommer HH,
Jain
RK. A comparative clinical study of group D
dental fllm. Oral Surg 1'987;632738-742.
Gelskey DE, Baker CG. Energy-selective filtration of dental x
beams. Oral Surg 1'981";522565-567 -
Gibbs sJ, Pujol A, chen TS, et al. Patient risk from intraoral dental
diography. D entomax illo
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MD: US Department of Health, Education and Welfare, L976'
Horton PS, Sippy FH, Kohout FJ, et al. A clinical comparison of
groups D fid E dental x-ray films. Oral Surg 1984;58J,04-105.
Kafle I, Littn.t MM, Kuspet ME. Densitometric evaluation of intrt
x-ray films: Ektaspeed versus Ultraspeed. Oral Surg 7981i
Gonad-doiei and genetically significant dose from diagnostic radi
1J.5.1.964 and,'1.970. HEW Publication (FDA) 76-8034-
338-342.
Kaffe I, Littner MM, Shlezinger T, et al. Efficiency of the cervicd
shield during intraoral radiography. Oral Surg t986;62:732-
ra SF^ Tvndall DA. A clinical comparison of image quality a
Kapa SF, Tyndall DA. A clin parison of image quality and
tient exposure reduction in panoramic radiography with heavy
filtration. Oral Surg L989;67 z7 50-7 59 -
Kapa SF, Tyndall DA,
Quellette
TE. The application of
L4d:d -tration'
to intraoral radiography. Dentomaxillofac
1.990;1'9:67-74.
Kircos LT, Vandre RH, Lorton L. Exposure reduction of 96Y"
traoral radiography.l Am Dent Assoc 1'986;1L3:746-750-
Kircos LT, Staninec M, Chou L. Rare earth filters for intraoral
raphy: exposure reduction as a function of kV(p) with
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Am Dent Assoc 7989;7782605-609.
MacDonald
JCF,
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JA,
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radiation barrier. Oral Surg 1983;55:319-326.
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of Kodak T-Mat G, Ortho L, and RPX-Omat films.
fac
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x-ray and gamma-ray protection for energigs up to 1'0 MeV
9 V n
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APPENDICES
CHAPTER 7:
Answers to Cose-Bosed
Questions
Case 7-1.
1,. B
Case 7-2
1,. B
Case 7-3
1,. D
Case 7-4
1,. D
Case 7-5
t . c
Case 7-6
L. C
Case 7-7
t . c
Case 7-8
L. D
2. A
Case 7-9
L. B
2. A
CHAPTER 8:
Answers to Review
Questions
t . B
2. E
3. D
4. D
5. C
6. 8
7. E
8. D
9. 8
10. A
1, t . A
1,2. E
1, 3. B
t 4. A
15. A
CHAPTER 9:
Answers to Review
Questions
1,. C
2. A
3. D
Arrow 3-D
Arrow 4-A
Arrow 5-F
Arrow 6-B
Arrow 7-G
Arrow 8-E
Arrow 9-I
Case L0-2
L. C
Case 10-3
1,. D
Case 1,0-4
4, A
5. C
6. B
7. B
8. C
9. B
10. E
1,1,. E
t 2. D
13. C
1,4. D
15. A
CHAPTER 9:
Answers to Cose-Bosed
Questions
Case 9-1
1,. B
2. C
Case 9-2
Case 9-4
1,. B
Case 9-5
Matching
1. F
2. L
3. 8
4. I
5. D
6. H
7. J
8. A
9. K
10. G
n. E
12. C
CHAPTER I O:
Answers to Review
Questions
1,. D
2. E
3. D
4. C
5. D
6. 8
7. C
8. D
9. B
10. c
1, L. B
1.2. D
13. C
L4. E
15. B
CHAPTER I O:
Answers to Cose-Bosed
Questions
Case L0-L
1,. D
Case L0-5
1,. E
Case 10-6
1,. C
CHAPTER I I :
Answers to Review
Questions
t . c
2. D
3. B
4. D
5. C
6. D
7. B
8. D
9. C
10. B
TT, A
1,2. D
1, 3. A
L4. C
15. E
16. D
t 7. c
18. B
1,9. C
CHAPTER I 2:
Answers to Review
Questions
t . A
2. D
3. 8
4. D
5. 8
6. 8
7. D
8. A
9. B
10. c
1, t . A
L2. D
t 3. c
1,. True
2. True
3. Fal se
4. True
5. Fal se
6. True
7. True
8. Fal se
9. True
10. True
Case 9-3
L. True
2. True
3. True
4. False
5. True
6. False
7. False
8. True
9. True
10. Fal se
Matching
Arrow 1-C
Arrow 2-F{
1,. A
2. 4
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