 Hello everyone welcome back to another session in dentistry and more. Today we have faulty radiographs in intraoral radiography. So we will be looking about the errors which can happen while taking x-rays and how to correct those mistakes. So those things will be dealt in this session. As we all know the dental radiograph is a two-dimensional picture of a three-dimensional object. So all the film processing can produce radiographs of excellent quality. In attention to detail may lead to many problems and images that are diagnostically suboptimal and the poor radiographs contribute to a loss of diagnostic information, loss of professional and patient's time. So there can be many factors theoretical and practical which can affect the radiographic image. So variation in these factors can lead to film falls and alterations in image. Since the diagnostic yield from the radiograph is related directly to the clarity of the image. So we need to have regular checkups and monitoring of these factors to achieve and maintain good quality radiographs. So the definition given by H.M. Worth is an ideal radiograph is one which has a desired density and overall blackness and which shows a part completely without distortion with maximum details and has a right amount of contrast to make the details fully apparent. So we have basically these three causes of faulty radiographs. Those are projection errors, exposure and processing errors, miscellaneous technique errors. The projection errors, the first one is apical end of the teeth is cut off. Mainly the causes film is placed too close to the teeth in maxillary arch in paralleling technique, too flat a vertical angulation which causes a elongation and film not positioned properly in patient's mouth. So this area will be cut off. So this area, this apical area we will not get exactly what is there at the periapical if we are looking for a periapical pathology. So how do we correct it? We need to move the film away from the teeth, increase the vertical angulation and no more than 1 by 8 inch of the film it should beyond extend beyond the incisal occlusion surface of the teeth. Next is the overlapping of teeth. The causes the plane of the film not parallel with lingual surfaces of the teeth and also could be due to incorrect horizontal angulation of the cone. So we can correct it by placing the film parallel to the lingual surface of the teeth and direct central ray of the x-ray beam perpendicular to the facial surface of the teeth. Next one is occlusion plane appears tilted or tipped. So can see the occlusion plane appears tilted or tipped is due to the edge of the film was not placed parallel to the incisal occlusion surface of the teeth and if the patient is not instruct to hold the film firmly against the tooth when the finger holding method is used. So we can easily correct it by instructing the patient to hold the film properly and make certain that the edge of the film is parallel to the incisal occlusion surface. Now we have all of the specific region not showing. So it could be due to the faulty film placement. We can correct it by centre the film over the teeth to be radiographed. Then crown of the teeth not showing. It is due to when not enough film showing below or above the crown of teeth or vertical angulation too flat causing elongation and we can correct it by approximately keeping one-eighth of the film below or above the crown and also increase the vertical angulation. Partial image that is cone cut when part of the image is not there when the exposure is not happened properly. So the cone of radiation not covering the area of interest or not using the film holder and if it is not properly aligned with the periapical film holder and top of the film not immersed in the developing solution. So we can correct it by make sure that the cone is properly centered over the area of interest and the film both vertically and horizontally and positioning it carefully by making that the PAD and the aiming ring are aligned and maintaining the level of the solution in processing tanks and make sure that the film is completely immersed during processing. Next one is a shape distortion. This foreshortening causes in the bisecting angle technique the vertical angulation of the cone was too acute or in the paralleling technique the film was not placed parallel to the long axis of the teeth. It would be corrected by reducing the vertical angulation and place the film parallel to the long axis of teeth. Then elongation could be due to the in bisecting angle technique the vertical angulation of the cone was too flat and in paralleling technique the film was not placed parallel to the long axis of teeth. It can be corrected by increasing the vertical angulation and place the film parallel to the long axis of the teeth. So it looks very elongated the tooth are very elongated and image distorted the film is bent as a patient bites on the film holder or bite blocks or as patient holds the film in the mouth. So when patient the biting so the distortion of the image will happen. So the magnification the cause is due to the film to object distance is increased. So this is the picture of magnification. So it is due to the distance from the X-ray film to the object is increased. So here we can see two pictures the first picture is showing the decreasing the distance between object and film increases the sharpness. So when the object this is object the tooth and this is the film. So when we decrease the distance so if we increase the distance what happens it will cause magnification so film to object distance is increased. So if we increase it will create magnification so the image will be magnified. So it will be bigger than the actual object. So if we decrease so this is the increased length and this is a decreased length. So when we decrease the distance between object and the film there will be increased sharpness and it results in the less magnification of the object. So this will be the image size and this is object size. But this is the object size and this will be the image size if it is to kept away that is a distance between object and film away there will be magnification. Next one is a very important shot not herringbone effect or tire track appearance it is due to the back side of the film so can see the tire track appearance here sorry so the tire track appearance. So it is due to backside of the film with lead foil placed facing towards the cone it should be vice versa but we are keeping the backside of the film with lead foil placing towards the cone and take care to place a pebbled or the front side of the film towards the cone. So when we keeping the opposite side towards the x-ray beam tire track or herringbone effect will be there. So this herringbone effect is very important then black dot in apical area so you can see a black dot in apical area. So it is due to the manufacturers identifying mark on the film placed towards a apical area of the teeth. So always place a raised dot of the film towards the occlusal or incisal surface of the teeth. So this black dot should be occlusal or incisal side. Then blurred image on the radiograph it is due to the movement of the film or patient or tube during exposure or double exposure happens also we may have blurred image. So always use film holders ask the patient not to move and keep unexposed and exposed film in different receptacle and label the exposed film. Next is a radio opaque artifacts on the radiograph. So we can see the radio opaque artifacts. So leaving dental appliances in the mouth or presence of foreign bodies in and around the area being radiographed we can see radio opaque artifacts like this. So instruct the patient to remove all removal appliances and other foreign bodies like earrings, glasses, no strings and other jewelry items before taking X-ray. Then anembration so that is cervical burnout. It is due to the horizontal angle of the beam is non-directed through the contact area of teeth. So I can see the cervical burnout. So this is a cervical burnout which is due to the horizontal angle of the beam is non-directed through the contact area. Now we have double image on the radiograph it is due to the film exposed twice to radiation. So always place exposed film in separate labeled receptacle. Now we are moving on to exposure and processing errors. When we have light radiograph that is due to the under exposure. It is due to too short an exposure or source film distance is too great too low milliampere film packet placed with the wrong side facing the tooth. This image of the lead foil is superimposed on the object image. So we can correct it by keeping the exposure time properly. Check the source film distance and increase KVP by approximately 5. Increase the milli ampere of the exposure time. Place the pebble side of the film facing the tooth towards the con. So the under development the causes could be improper development that is we keep too short time in the upper solution and low developer temperature or inaccurate thermometer. We can correct it keeping our dark room timer correct and raise the temperature to 70 degree Fahrenheit and also replace the thermometer. Exhausted or contaminated developer correction replacing the developer then diluted developer water added to raise the level of developer solution insufficient developer solution added to water. Then we need to add replenisher or replace developer and add more developer solution. Excessive fixation we need to regulate the time for fixing. Then high density film is exposure parameters causes could be exposure time is too long KVP too high for the exposure time and source film distance too short for the exposure time milli ampere too high for exposure. Correction said time are correctly and or reduce exposure time reduce KVP measure the source film distance and adjust the time accordingly and reduce milli ampere. Our development causes developing time too long developer temperature too high inaccurate thermometer over strength developer. We can correct it by use time temperature method with a dark room timer lower temperature to 70 degree Fahrenheit replace thermometer check tank capacity and mixing instructions in adequate fixation that is fixation biome should be standardized as per instructions or accidental exposure to light all dark room procedures should be done in safe light only high contrast you can see the very high contrast without defining any features causes insufficient penetration over development can correct it by increasing the kilo voltage use time temperature method with a dark room timer low contrast we can see very low contrast this also not giving any details so causes excessive penetration under development under exposure decrease kilo voltage sit dark room timer correct and check exposure time and set the timer correctly then fogging of the film this is fogging there is a fog like appearance causes prolonged exposure of film to safe light improper filter in safe light we can correct it by reducing exposure time of films to the safe light check types of filter and examine for cracks in the filter then reticulation so you can see a reticulate appear here that is due to the sudden extreme temperature change in processing we can fix a solution maintain uniform processing temperature and replenish or replace fix a solution then white sports and lines on film so you can see the white line white sports so it is due to hemulsion tears from rough handling of film in processing tanks film contamination with fixer before processing excessive bending of the film so we should not rub films against the side of the tank keep the tank room clean and dry black sports on the film so you can see the black sports black sports causes film splashed with developer before being placed in the developer tank black wrapping papers sticking to film surface finger contamination where the contaminant is a developer and correction by careful handling of the solution remove the black paper carefully with dry hands wash hands properly black lines can see the black lines this is due to static electricity these are caused by electrical discharges that produce visible light but occur on surface of the emulsion film is removed rapidly from the inter leaving paper stains on the film so you can see the stains so yellow or brown stains causes prolonged development in sufficient rinsing exhausted fixer solution and we can use correct development time rinse film for 15 to 20 seconds in fresh running water and replace fixer solution frequently clear film there is nothing in this film that is film is not exposed failure to switch on the x-ray machine electrical failure or exposed film first put in the fixing solution before developing solution ensure that the x-ray machine is working properly and position of the tanks containing the solution should be fixed should keep developer first then washer then the fixer then black films completely black the film exposed to light correction handling of the exposed and unexposed film should be done very carefully the emulsion peel it is due to the abrasion of image during processing and excessive time in wash water so next is miscellaneous technique errors that is phalangeoma patients finger on the film because the patient finger was incorrectly positioned in front of the film instead of the behind the film so you can see the fingers as a result the patient finger appears on the radiograph so make certain that the patient's finger used to stabilize the film is placed behind the film are not in front of the film then thyroid collar thyroid collars or lead aprons can also be recorded on radiographs this is normally caused by the collar being placed on too loosely or too high on the neck so finally to conclude so the radiographic examinations are a very important tool in dentistry to determine the disease status and formulate appropriate treatment plan so errors in taking radiographs increase patients radiation exposure and also waste time and money so this diagnostic yield from radiograph is related directly to the clarity of the image so we need to regularly check and monitor the factors causing errors so these are essential to achieve and maintain good quality of radiographs so that's all about faulty radiographs so I'll come up with a new topic in dentistry and more thank you