What is the principle of 'no dose without risk' in radiation safety?
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It emphasizes that any exposure to radiation carries some level of risk.
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What is the principle of 'no dose without risk' in radiation safety?
It emphasizes that any exposure to radiation carries some level of risk.
What factors must be set before taking an X-ray?
Select adult or child, film, PSP, or sensor, and Ant, Post, or BW.
What is the significance of gray level in radiographic images?
Gray level relates to contrast, which is relative.
What was the exposure time for the first dental radiograph?
25 minutes.
What is the effect of radiation on microvasculature?
It leads to reduced oxygenation of distal cells and tissues, causing infarction and fibrosis.
What should be commented on regarding the diagnostic quality of an image?
Any artifacts present in the image.
What is the initial or prodromal stage duration for Acute Radiation Syndromes?
0 - 48 hours.
What is the US standard frequency for alternating current in X-ray generators?
60 cycles/second.
What should you check for before operating a Hand Held X-ray device?
Check for power using the battery indicator.
What does the Gray (Gy) unit measure?
Absorbed dose for any type of radiation, but does not describe biological effects.
What advancement occurred in February 1896 regarding X-rays?
Shorter exposure time of 9 minutes was used for foreign body localization.
What factors influence absorption kinetics?
Absorption coefficient (z-value) and thickness of the absorber.
What is a convenience benefit of Hand Held X-ray devices?
Patients don’t need to be moved to a separate room.
What is the purpose of the focusing cup in the X-ray tube?
It helps focus the electron stream towards the anode.
What type of electricity source is used in X-ray generators?
Alternating current (A/C).
What is the dose threshold for Central Nervous System (CNS) damage in Acute Radiation Syndromes?
60 Gy.
What type of cancer is associated with a linear dose-response relationship?
Solid tumors.
What are the two fates of free radicals?
Dissociation and cross-linking.
How do advanced imaging techniques like CBCT differ from conventional radiographs?
CBCT provides true 3D images, while conventional radiographs are 2D.
What did William Coolidge develop in 1913?
Ductile tungsten and the 'hot' cathode tube.
What was the first panoramic X-ray machine developed?
In 1948.
What is the wavelength of X-rays?
Short but varied.
How do X-rays travel?
In a straight line; can be deflected or scattered.
What is the purpose of using occlusal exams?
To identify anomalies, occult disease, salivary stones, and jaw expansion.
What is the ionizing capability of X-rays?
They interact with materials they penetrate and cause ionization.
What is the dose threshold for Hematopoietic damage in Acute Radiation Syndromes?
10 - 30 Gy.
What is a disadvantage of using digital imaging in terms of cost?
Digital imaging can be expensive initially and long-term.
What kVp setting is recommended for contrast in caries detection?
70 kVp (low kVp, high contrast).
What settings are optimal for resolution and distortion?
Shortest object-receptor distance (ORD) and longest target-object distance (TOD).
What is the relationship between x-ray attenuation and radiographic density?
Differences in x-ray attenuation result in differences in radiographic density.
What is the annual dose limit for occupationally exposed adults?
50 mSv/year.
Which cells are more radiosensitive?
Less differentiated cells, such as bone marrow cells.
What is the role of the anode in the X-ray tube?
It serves as a tungsten target for the electrons, converting their kinetic energy into X-rays.
What is the relationship between penumbra size and focal spot size?
A large focal spot results in a large penumbra, while a small focal spot results in a small (or no) penumbra.
What are common intraoral exams for high-resolution imaging?
Bitewings (BW’s) and periapical (PA’s) plus full mouth series (FMX).
What is Bremsstrahlung radiation?
It is radiation produced when high-energy electrons are slowed in the presence of an atom's electric field, releasing energy.
What factors affect the absorption of X-rays?
Density of the subject and energy of the ray.
What is the radiation exposure level of a panoramic exam?
Approximately 10 times that of a periapical exam.
What is the second principle of shadow casting?
X-ray source must be perpendicular to both object and receptor.
What effect do X-rays have on certain substances?
They can cause certain substances to fluoresce.
What is the fourth principle of shadow casting?
Object and receptor should be as close as possible.
What effect do X-rays have on living tissue?
They can cause biological changes.
What is binding energy?
The work required to remove an electron from an atom.
Why is it important to record radiographic findings?
For quality care and legal aspects.
When is the risk to a fetus greatest from radiation exposure?
In the 1st and 2nd trimester.
What is the relationship between radiation dose and cancer risk?
Higher doses increase the chance of developing cancer.
What condition affected radium watch-dial painters in the 1930s?
Mandibular Osteogenic Sarcomas due to licking radium on brushes.
What should you provide if a patient specifically asks about cancer risk?
An estimate of cancer risk.
What is the function of the timer in an X-ray generator?
Controls the duration of exposure and the time high-voltage is applied to the tube.
What is the recovery time for Acute Radiation Syndromes?
8 - 12 weeks.
What should you do if the NOMAD handset has a low battery?
Charge the handset, as it will not emit x-rays with low battery.
What is the purpose of the 'Duty Cycle' in NOMAD operation?
To avoid overheating by managing cycle time between exposures.
How should the NOMAD device be cleaned?
Wipe down between patients; do not spray directly on the device or charger.
What is a hard sensor in intraoral systems?
An internal microchip that must be used with a barrier and allows for 'hot-swap' connection.
Who first described selection criteria for dentistry?
Valachovic and Lurie in 1980.
How does Low LET radiation interact with water?
It overcomes the binding energy of electrons, ionizing and ejecting them.
When was X-rays discovered?
November 1895.
What is the effective dose used for?
To normalize overall health effects of irradiating specific body parts, expressed in Sv.
What are conventional radiographs considered in terms of dimensionality?
Conventional radiographs are 2D images that represent superimpositions.
What is the function of the cathode in the X-ray tube?
It contains a coiled tungsten wire filament that releases outer shell electrons through thermionic emission.
What is the appearance of X-rays?
Invisible.
Do X-rays have mass?
No, they have no mass.
What are some key elements to consider in the perception of a radiographic image?
Recognition of familiar patterns, resolution of image details, and understanding 2D representation of 3D objects.
Why is tungsten used in X-ray tubes?
Tungsten is ductile, has low thermal expansion, a high atomic number, and a high melting point, making it suitable for X-ray production.
What is the recommended radiographic approach for new pediatric patients?
Assess diseases and development with posterior BWs if disease is suspected.
What is a benefit of using HIPAA compliant cloud servers for digital imaging?
They ensure data safety and compliance with privacy regulations.
What is the recommended radiographic frequency for adults with no caries/low risk?
Every 24 to 36 months.
What is a potential drawback of digitizing conventional films?
There is a likelihood of loss of information.
What is the goal regarding radiation use in radiographic exams?
Use the least amount of radiation as possible.
When were selection criteria for imaging in skull trauma first described?
In the mid-1970s.
What is the relationship between wavelength and energy?
Longer wavelength = lower energy; shorter wavelength = higher energy.
What is the dosage for whole body exposure with NOMAD?
0.12 - 0.3 mSv (sensor vs. D-speed film).
What does the unit Roentgen (R) measure?
Ionization in air caused by gamma or x-rays, used clinically to measure exposure in air.
What is the annual dose limit for the public, excluding medically necessary exposures?
1 mSv/year.
What are stochastic effects of radiation?
Effects where the probability of occurrence is dose-dependent, such as radiation-induced cancer.
What is the direct effect of photon energy on biological molecules?
Photon energy is deposited directly in biological molecules, resulting in damage.
Which populations are considered sensitive to radiation exposure?
Conceptus, children, and individuals with immune deficiency disorders.
What did Marie and Pierre Curie discover in 1898?
Radium.
What health hazards were associated with early X-ray use?
Leukemias in medical radiologists and squamous cell carcinomas in physicians and dentists.
What is a disadvantage of digital imaging related to patient comfort?
Receptor size can cause discomfort to patients.
What type of imaging is used for broad coverage in extraoral exams?
Panoramic (Pano) imaging.
What do radiographs reveal?
The effect or aftermath of disease, not the disease itself.
What does SOD/TOD refer to in shadow casting principles?
Source and object should be as far apart as possible.
What is the benefit of using photostimulable phosphor plates (PSP) in imaging?
They provide a 50-90% dose reduction compared to film.
What is the purpose of collimation in radiography?
To reduce exposure by 55% and improve image quality.
What does density refer to in radiographic image properties?
Overall degree of blackness on the image.
What are the primary tissue controlling factors for density?
Tissue unit volumetric density (z value) and tissue thickness.
What does contrast refer to in radiographic images?
Difference in densities between adjacent areas.
How does high kVp affect contrast?
It produces lower contrast by penetrating tissues more evenly.
When does radiation act more intensely on cells?
When the reproductive capacity is greatest and during prolonged mitotic processes.
What does a positive history include?
Previous endo or perio treatment, pain/trauma, and family history of dental anomalies.
What is the primary controlling factor for size distortion (magnification)?
Object-film distance (OFD) and target-film distance (TFD). Smaller OFD and longer TFD result in less magnification.
What is the most important finding in radiographic interpretation?
The absence of a normal structure that should be present.
What is the result of the interaction of energy with matter at the atomic or molecular level?
Radiographs.
What mAs setting is recommended for density?
0.5 seconds.
What is the role of a rectifier in X-ray generators?
Converts A/C to D/C, preventing electron production in the inverse cycle.
How does the transfer rate of larger data impact digital imaging?
Larger data results in longer transfer times.
What should the prescription of a radiographic exam be based on?
Patient history, clinical exam, and lab findings (where applicable).
What is the role of primary and secondary protective barriers?
Primary barriers reduce exposure to the usable beam; secondary barriers reduce exposure to leakage radiation.
What is the primary controlling factor for contrast?
kVp (kilovolt peak).
What are the two types of extraoral systems mentioned?
Panoramic and Cephalometric systems.
What is the primary mechanism of biological damage from diagnostic radiation?
Ionization of water leading to free radical formation.
What is the purpose of the Sievert (Sv) unit?
It derives equivalent dose, relating absorbed dose in human tissue to effective biological damage.
What is the target of radiation-induced damage?
DNA.
What is the benefit of a smaller focal point in X-ray imaging?
It results in better resolution.
What are the differences between a large and small focal spot?
A large focal spot allows better heat dissipation but results in poor image detail, while a small focal spot provides sharper images but has poor durability.
How does the length of the target-object distance (TOD) affect penumbra size?
A long TOD results in a small penumbra.
Can X-rays be focused to a point?
No, they cannot be focused to a point; they always diverge.
What is the first principle of shadow casting?
Object and receptor must be parallel.
What is the dose threshold for Gastrointestinal (GI) damage in Acute Radiation Syndromes?
40 Gy.
What is the annual dose of naturally occurring background radiation?
3 mSv/year.
What happens to x-ray intensity as it penetrates material?
It decreases; photons get absorbed, resulting in less energy.
What is the fifth principle of shadow casting?
The focal spot should be as small as possible.
What does the Inverse Square Law state about X-ray intensity?
Intensity is inversely proportional to the square of the distance between the source and the point of measure.
What happens to X-ray intensity when the distance is increased by 2x?
The intensity decreases by 4x.
Why is the old paradigm of mutagenic events considered incorrect?
It doesn't explain how radiation cancers can appear decades after exposure.
What is the recommended distance for operators from the radiation source?
At least 6 feet away.
What distinguishes x-rays from gamma rays?
X-rays are produced by bombarding a substance with high-velocity electrons, while gamma rays are emitted by the nucleus of a radioactive substance.
Which heavy metal absorbs the most x-rays?
Lead, due to its high attenuation.
What does ALARA stand for?
As Low As Reasonably Achievable.
What was significant about December 1895 in X-ray history?
The first radiograph was taken.
What is the benefit of a smaller cone in Hand Held X-ray devices?
It reduces radiation exposure by 25%.
What is the advantage of primary shielding in X-ray devices?
It reduces leakage.
What is the indirect effect of photon energy?
Photon energy is deposited in water, generating energized and radical water species that attack biological molecules.
How does digital imaging compare to film in terms of radiation exposure?
Digital imaging uses approximately 90% less radiation than D speed film.
What is a significant advantage of digital imaging regarding image acquisition?
Immediate image acquisition.
What are the steps involved in the production of X-rays?
What are the environmental benefits of digital imaging?
Elimination of processing equipment and chemicals, and no need for a dark room.
Why must A/C be converted to D/C in X-ray tubes?
A/C will damage the tungsten filament.
What is a key difference in archiving between film and digital imaging?
Film is an archived record with permanent errors, while digital has many archiving methods.
What is the recommended scanning sequence for reading films?
Start at the upper left and read clockwise.
What factors should be considered when acquiring diagnostic images?
Quality, number and type of images, and viewing conditions.
What type of current does a rectifier produce?
Direct current (D/C), which has unidirectional flow.
What are the two types of circuits in an X-ray generator?
High-voltage circuit and low-voltage circuit.
What is ionization?
The production of ions through the ejection of one or more electrons from an atom.
What should you not do before making an exposure with the NOMAD?
Don’t enable NOMAD pro until ready for exposure.
What is essential for making judgments in patient care?
Training and experience.
How can image resolution be increased?
By decreasing pixel size and increasing dots-per-inch (dpi).
How do you lock and unlock the X-ray device?
Press and hold the designated buttons.
What are secondary electrons also known as?
Delta rays.
What happens when the X-ray exposure is complete?
The tone emitted ends, indicating the trigger can be released.
Who was the first to take a dental radiograph in the USA?
Dr. Kells in April 1896.
What is thermionic emission?
The process where the filament heats up (~2200 °C) and releases outer shell electrons when current is applied.
What should be included when describing an abnormality in radiographic findings?
Location, size, shape, density, borders, and effect on adjacent structures.
What is the charge of X-rays?
None.
What are some clinical indications for radiographic exams?
Positive history, positive clinical findings, and high caries risk.
What happens when you increase the object-film distance (OFD) using the paralleling technique?
It results in a large penumbra.
What can X-rays penetrate?
Liquids, solids, and gases; penetration depends on the composition of the subject.
What is the effect of insufficient beam angulation on image size?
It causes elongation, making the image longer than the object.
What should be considered for symptomatic patients?
Use PA to examine specific sites and other techniques as appropriate.
How often should recall patients with clinical caries/high risk have posterior BWs?
Every 6 months.
What is digitization in the context of imaging?
Representing a particular object (image, diagram, etc.) in the form of numerical digits (binary system).
What are the two main components of an imaging system?
Source (method for generation of X-rays) and Detector (records the X-ray photons).
What are the geometric factors affecting resolution?
Focal spot size, object receptor distance, and tube object/receptor distance.
What is the role of image manipulation in digital imaging?
To improve diagnostic accuracy by changing density and contrast, taking measurements, and more.
What type of radiation is classified as Low LET?
X-rays and gamma rays.
What is the threshold dose for skin cancer (SCC) to show changes?
300 R.
What indicates that the device is ready to take X-rays?
READY + Green indicators.
What is Compton Scatter?
A process where a high-energy photon strikes a free outer shell electron, ejecting it and reducing the photon's energy.
How much does true DC voltage reduce radiation exposure?
By another 30%.
What type of damage is hereditary and can be caused by radiation?
Genetic damage.
What is the primary data format required for medical imaging?
DICOM compatible.
How does beam hardening affect X-ray beams?
It raises the median and mean energy, increasing the number of photons hitting the receptor and decreasing radiation dose to superficial structures.
What are the causes of Acute Radiation Syndromes?
Exposure to large, acute doses from weapon detonation, nuclear accidents, or excessive fallout.
What is the latent stage duration for Acute Radiation Syndromes?
2 - 3 weeks.
What causes shape distortion in radiographic images?
The angular relationship between teeth, receptor, and beam, as well as insufficient or excessive beam angulation.
What should you avoid saying when discussing radiation risk with patients?
It's nothing, unimportant, or similar dismissive statements.
Where did Hand Held X-ray Devices originate?
In veterinary clinics.
What is the radiation dose from a panoramic x-ray?
14.2 μSv (equivalent to 1.7 days of background radiation).
What does dense material appear as on a radiograph?
White.
What is the principle behind diagnostic ability in radiography?
"You see what you know" and "You see what you look for."
What is the effect of increasing kVp from 70 to 90?
It reduces dose by 23% and increases penetration.
What is the most important factor to control for exposure?
mAs (mA multiplied by exposure time).
What is linear energy transfer (LET)?
A measure of the energy transferred to a material as an ionizing particle travels through it.
What is the worst-case radiation dosage with NOMAD using D-speed film?
0.43 mSv.
What can imaging software help to enhance?
Carious lesions and apical resorption, using histogram 'gray scale' data.
What factors control the quantity and quality of the X-ray beam?
Quantity is controlled by exposure time and tube current (mA), while quality is controlled by tube voltage (kVp).
What is the effect of excessive beam angulation on image size?
It causes foreshortening, making the image shorter than the object.
What is the difference between step-up and step-down transformers?
Step-up transformers have more coils in the secondary circuit, increasing voltage; step-down transformers have more coils in the primary circuit, decreasing voltage.
How do X-rays affect film?
They produce an image.
What is the Bohr Model's formula for the number of electrons in each shell?
What should be used to protect patients during radiographic procedures?
Leaded aprons and thyroid collars.
What guidelines should be followed for pregnant patients and operators?
Follow all radiation safety guidelines.
What is the recommended occupational limit for hand/extremity exposure?
500 mSv.
What is the resolution capability of human eyes compared to digital images?
Human eyes can detect 4-6 line pairs/mm, while digital images can achieve 10 line pairs/mm.
What is a potential risk associated with digital image manipulation?
It may improve diagnosis of one disease while obscuring another.
Are all Hand Held X-ray Devices FDA approved?
No, not all are FDA approved.
What are Hand Held X-ray Devices ideal for?
Mobile locations, operating rooms (OR), and emergency rooms (ER) for a few PAs/occlusal images.
What is radiation hormesis?
An adaptive response where preirradiated human lymphocytes develop fewer chromosomal aberrations after subsequent irradiation.
What is the bystander effect in radiation exposure?
Irradiated cells signal distress to adjacent cells through direct interactions or chemical mediators.
What is genomic instability in the context of radiation exposure?
Enhanced rates of mutagenesis and alterations in cellular function or death, considered a hallmark of carcinogenesis.
What should you ensure when attaching a handset to the NOMAD?
It should 'click' into place and be secure by pushing towards the backscatter shield.
What is the purpose of a PSP scanner?
To return trapped electrons to the valence band, emitting laser light that is converted to digital information.
How do beta particles differ from alpha particles?
Beta particles are smaller, less energetic, and ejected at high velocity from a nucleus undergoing beta decay.
What is the radiographic recommendation for edentulous adults?
No radiographic exam required unless disease is suspected.
What does the high-voltage circuit do in an X-ray generator?
Connects cathode to anode and aids in the movement of electrons.
What is the function of the low-voltage circuit in an X-ray generator?
Regulates current through the filament, powered by a step-down transformer.
What type of particle is an alpha particle?
A positively charged particle with large electrical charge and mass.
What is a free radical?
An atom that has an unpaired electron with respect to spin; highly reactive.
What is the mass number of an atom?
The sum of protons and neutrons.
What is the function of a PSP system?
It absorbs X-ray energy, stores it as valence electrons, and later reads it with a laser beam.
What is resolution in the context of radiographic images?
The ability to distinguish between two closely spaced points.
What is penumbra?
The area of unsharpness in the projected shadow of an object.