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RADIOGRAPHIC ERRORS AND ARTIFACTS<br />Dr. Walid Samir Salem<br />BDS, MS, MHPE<br />lecturer, Oral Surgery Department<br />Member, Dental education unit<br />

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Films with errors should be avoided due to the following reasons:<br />Retake will lead to:<br /><ul><li>Expose the patient to unnecessary radiation.

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Waste film & time (money).

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Interfere with accurate interpretation and diagnosis.</li></li></ul><li>Causes of faulty radiograph<br />The majority of the errors produced can be categorized into three groups:<br />Technique & Projection errors.<br />Exposure errors.<br />Processing errors.<br />

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Technique & Projection errors:<br />a. Patient preparation error:<br />b. Film placment artifact:<br />

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c. Projection errors:<br /><ul><li>Incorrect vertical angulation.

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Incorrect horizontal angulation

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PID alignment artifact</li></li></ul><li>Technique & Projection errors<br />a. Patient preparation error<br />Radiopaque artifact<br />Dental appliances, body piercings, jewelry & eye glasses left in the mouth during exposure will appear as radiopaque artifact superimposed over the dental image. <br />Correction: all this items should be removed before placing of the film.<br />

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Technique & Projection errors<br />a. Patient preparation error<br />Blurred image<br />Movement of the film, patient or X-ray tube head during exposure will result in a blurred image.<br />Correction: the operator should explain for the patient & remind him to remain motionless during exposure.<br />

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Technique & Projection errors<br />a. Patient preparation error:<br />Pressure mark<br />Pressure from the incisal edge & cusps of the teeth (mostly in the pediatric occlusal radiograph).<br />May appear black or white.<br />Correction: ask the patient to bite gently.<br />

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Technique & Projection errors<br />b. Film placmentartifact<br />Double image<br />When an exposed film is re-exposed the resulting film will have 2 superimposed images<br />

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Technique & Projection errors<br />b. Film placmentartifact<br />Reversed film<br />Low density with herring bone, tire-track or dotted pattern, as a result of directing the X-ray through the lead foil side of the film back. <br />

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Technique & Projection errors<br />b. Film placmentartifact<br />Dot artifact<br />The identification (embossed) dot produce a circular radiolucent artifact on the final radiograph. This may interfere with interpretation of the apical areas of the teeth. <br />

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Technique & Projection errors<br />b. Film placmentartifact<br />Apices cut off<br />Occur when the film is not positioned apically enough to record the entire tooth.<br />

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Technique & Projection errors<br />b. Film placmentartifact<br />Crown not shown <br />There is no enough film extending occlusally. <br />

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Technique & Projection errors<br />b. Film placmentartifact<br />Dropped film corner<br />The film edge is not placed parallel to the occlusal surface of the teeth.<br />

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Technique & Projection errors<br />b. Film placmentartifact<br />Area of interest not shown<br />This is the result of not placing the film to cover all the teeth in the area of interest and not centralizing the film over the area of interest.<br />

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Technique & Projection errors<br />b. Film placmentartifact<br />Black line<br />Due to excessive bending of the film prior to its placement inside the patient’s mouth (pressure causes ionization of silver halide upon processing will be darker).<br />

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Technique & Projection errors<br />b. Film placmentartifact<br />normal<br />distortion<br />Distortion<br />Due to bending of the film to eliminate the patient’s discomfort specially in lower premolar area and upper central incisors.<br />

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Technique & Projection errors<br />c. Projection errors<br />Incorrect vertical angulation<br />It will lead to:<br /><ul><li>Elongated image due to insufficient v. angulation ( too flat), or

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Shortened image due to excessive v. angulation ( too steep)</li></li></ul><li>Technique & Projection errors<br />c. Projection errors<br />

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Technique & Projection errors<br />c. Projection errors<br />

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Technique & Projection errors<br />c. Projection errors<br />Incorrect horizontal angulation<br />Is the appearance of the interproximal surfaces of the adjacent teeth over each other. This is due to improper H.A. due to improper alignment of the C.R. through the contact points i.e. not // to interproximal surfaces.<br />

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Technique & Projection errors<br />c. Projection errors<br />

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Technique & Projection errors<br />c. Projection errors<br />PID alignment artifact<br />If the PID is misaligned and the x-ray is not centered over the film, a partial image is seen on the resultant radiograph, this partial image is called cone-cut.<br />It appear as a clear area with curved outline.<br />

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Asuan – Egy.<br />

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II. Exposure errors.<br />Blank image.<br />Low density image.<br />High density image.<br />Image with high and low contrast.<br />

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Exposure errors<br />Blank image<br />A film that didn’t receive radiation will have no image and will appear clear.<br />

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Exposure errors<br />Low density (faint) image<br />

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Exposure errors<br />High density image<br />

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III. Processing errors<br />Chemical errors:<br /><ul><li>Light image.

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Dark image.

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Blank image.

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Reticulation.

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Black spot or patch.

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Black line.

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White spot or patch.

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Yellowish brown discoloration.</li></ul>Film Handling errors:<br /><ul><li>Writing lines

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Developer cut off

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Fixer cut off

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Overlapped film

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Finger nail artifact

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Smudge.

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Scratched film

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Static electricity</li></li></ul><li>Processing errors<br />Chemical errors<br />Reticulation<br />When the film subjected to a sudden temperature changes between the developer and water.<br />Appear as cracked film.<br />

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Processing errors<br />Chemical errors<br />Black spot or patch<br />Developer contamination before immersion into the developer solution.<br />

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Processing errors<br />Chemical errors<br />Black line<br />Developer contamination processing hanger clips<br />Dirty roller in automatic processor<br />

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Processing errors<br />Chemical errors<br />White spot or patch<br />Contamination with fixer before processing<br />

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Processing errors<br />Chemical errors<br />Yellowish brown discoloration<br />Exhausted solution or insufficient rinsing<br />

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Processing errors<br />Film Handling errors<br />Writing lines<br />Appear on the radiograph due to writing on the film packet with ballpoint pen or lead pencil.<br />It may appear black or white.<br />Finger nail artifact<br />Black or whit crescent shape mark due to rough handling of the film.<br />

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Processing errors<br />Film Handling errors<br />Developer cut off<br />A straight blank white border due to underdeveloped portion. The film may not be completely immersed in the developer solution.<br />

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Processing errors<br />Film Handling errors<br />Fixer cut off<br />A straight black border. The film may not be completely immersed in the developer solution. <br />

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Processing errors<br />Film Handling errors<br />Overlapped film<br />Film that overlap in developer are white, while that overlap in fixer are black<br />

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Processing errors<br />Film Handling errors<br />Smudge (finger print)<br />When the film touched by fingers contaminated with developer or fixer<br />

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Processing errors<br />Film Handling errors<br />Scratched film<br />White lines appear on the film due to careless handling of the film.<br />

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Processing errors<br />Film Handling errors<br />Static electricity<br />Thin black branching lines Occurs when two surfaces are rubbed together against each other vigorously, this creates an electric charges with visible light emitted which is capable of exposing the x-ray film, thus leading to ionization of AgBr crystals at this area.<br />Occur most frequently during periods of low humidity <br />

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Metallic partial denture<br />Blurred <br />

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Reverse image<br />Apices cut off<br />

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Dropped corner<br />Distortion <br />

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Horizontal overlap<br />Elongation <br />Double image<br />

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Static electricity<br />Low denisty<br />

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White spot or patch<br />Yellowish brown discoloration<br />

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Reverse image<br />Developer cut off<br />Cone-cut<br />

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Thank You<br />