The document discusses x-ray films and the process of developing radiographic images. It describes the composition of intraoral x-ray films, including the film base, emulsion, and packet components. It then explains the processes of latent image formation when film is exposed to x-rays and the chemical steps to develop the latent image, including developing, fixing, washing and drying the film. Finally, it discusses factors that influence radiographic image quality such as density, contrast and sharpness.

1. X-ray Films Dr Saad Al Bayatti B.D.S., M.Sc. Oral Radiology February 14, 2012 Dr Saad Wahby Al Bayatti

2. X-ray Films The media on which the radiographic images of objects are recorded Images are stored as an unseen (latent) image that will be changed to a seen image by processing the film February 14, 2012 Dr Saad Wahby Al Bayatti

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4. Intra oral x-ray films (non-screen films) Types / Sizes February 14, 2012 Dr Saad Wahby Al Bayatti

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7. Intra Oral x- ray Film Composition Film Base Film base; clear transparent sheet of cellulose acetate with a bluish tint. Adhesive; connects the emulsion to the base. Emulsion; on both sides of the base where silver bromide(AgBr) crystals are distributed in an the gelatin emulsion Protective layer; protects the emulsion from mechanical damage February 14, 2012 Dr Saad Wahby Al Bayatti

8. Intra oral x- ray film composition Film base February 14, 2012 Dr Saad Wahby Al Bayatti Protective gelatin layer Adhesive Emulsion ( silver halide) Film base Cross sectional structure of double emulsion film

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10. Intra oral x- ray film composition Film Packet Outer plastic wrapper; protects the film from light, saliva and mechanical damage, has two sides: *Front; faces the x-ray tube, single color (white) *Back; opposite side to x-ray tube, two colors (white and green). It has an opening tab to open the film during processibg Black paper wrapper; protects the film base from light, saliva and damage during opening February 14, 2012 Dr Saad Wahby Al Bayatti

11. Lead foil; thin sheet of lead present at the back of the film, has certain shapes on its surface, it: *prevents x –rays from going to deeper tissues after passing through the film *prevents scattered radiation from deeper tissues to come back to the film Raised dot; an elevation embossed on each component of the film,has two surfaces Convex; indicates front of the film (facing x-ray) Concave; indicates back of film (facing lead foil) February 14, 2012 Dr Saad Wahby Al Bayatti

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15. Intra oral x- ray film composition Film Packet February 14, 2012 Dr Saad Wahby Al Bayatti Outer plastic cover Front Back Film Lead foil Protective black paper

16. February 14, 2012 Dr Saad Wahby Al Bayatti Front Back Film base Lead foil Black paper cover Dot Back Front Outer plastic cover Intra oral x- ray film composition Film Packet

17. Intra oral x- ray film composition Film Packet February 14, 2012 Dr Saad Wahby Al Bayatti Front Back

18. February 14, 2012 Dr Saad Wahby Al Bayatti Deep Tissues Behind film Incident x-rays Object (Tooth ) Film packet without a lead foil Scattered x-rays Back-scatter

19. February 14, 2012 Dr Saad Wahby Al Bayatti Deep Tissues Behind film Film packet with a lead foil No x-rays behind the film Incident x-rays Object (Tooth )

20. Latent image formation February 14, 2012 Dr Saad Wahby Al Bayatti Radiolucent object Thick Radiolucent object Radioopaque object Incident x-ray photons Incident x-ray photons Incident x-ray photons Emerging x-ray photons Emerging x-ray photons Emerging x-ray photons Max.Ag ppt Less Ag ppt No Ag ppt Latent image in the x-ray film Metals Enamel Dentin Cementum Bone Muscle Fat Air

21. Latent image formation February 14, 2012 Dr Saad Wahby Al Bayatti AgBr Ag + Br AgBr Ag + Br Ag + Ag = latent image ppt in emulsion precipitate gas precipitate gas Molecule split by ionization Molecule split by ionization X –ray photon

22. Latent image formation February 14, 2012 Dr Saad Wahby Al Bayatti Br gas Br gas X- ray photons Ag ppt

23. Processing of the x-ray films The sequence of events by which the unseen latent image is changed to a seen image. Steps of processing are; Developing : alkaline solution, it acts on the Ag atoms initially separated by the x-ray photons and are further precipitated and increased in size by Oxidization Washing : Water removes the alkaline developer and prevents the contamination of the acidic fixer. February 14, 2012 Dr Saad Wahby Al Bayatti

24. Processing of the x-ray films, cont’d Fixing : acidic solution, it acts on the AgBr crystals not affected by the x-ray photons, all crystals are removed from the gelatin emulsion into the fixer solution Washing : water removes fixer solution from the film to prevent oxidization of the remaining fixer and future contamination of the final radiograph Drying : air drying to remove water from the processed radiograph February 14, 2012 Dr Saad Wahby Al Bayatti

25. February 14, 2012 Dr Saad Wahby Al Bayatti Ag ppt Ag ppt Ag ppt Exposed film Developing Continuation of exposed silver precipitation (oxidation) Washing Fixation Washing & drying Removal of unexposed AgBr Final radiograph Steps of processing

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27. Processing of the x-ray films February 14, 2012 Dr Saad Wahby Al Bayatti

28. Processing of the x-ray films February 14, 2012 Dr Saad Wahby Al Bayatti

29. Dark Room Light tight room to allow opining the x- ray films safely without exposure to light Supplied with a safe light (red or orange > 600 nm wavelength) to permit unwrapping the films in otherwise total darkness Should be covered with acid resistant, washable benches Well ventilated, convenient,and clean. Supplied with disinfectants to disinfect films and other materials February 14, 2012 Dr Saad Wahby Al Bayatti

30. Manual Film Processing Unwrap the exposed film (in the dark room) Clip to a hanger Immerse the film in the developer for 4.5 min at 20 C. Agitate Wash Immerse film in the fixer for 8 minutes at 20 C Wash Dry Change exhausted solutions !! February 14, 2012 Dr Saad Wahby Al Bayatti o o

31. Automatic Film Processing Unwrap the exposed film (in the dark room) or in a day light loader Insert the film in the loading slot Receive the film dry from the film exit slot Change exhausted solutions !! February 14, 2012 Dr Saad Wahby Al Bayatti

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34. February 14, 2012 Dr Saad Wahby Al Bayatti GBX-2 safe light 15 watt bulb

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41. February 14, 2012 Dr Saad Wahby Al Bayatti Automatic processor

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46. Dark Room Light tight room to allow opining the x- ray films safely without exposure to light Supplied with a safe light (red or orange) to permit unwrapping the films in otherwise total darkness Should be covered with acid resistant, washable benches Well ventilated, convenient,and clean. Supplied with disinfectants to disinfect films and other materials February 14, 2012 Dr Saad Wahby Al Bayatti

47. Manual Film Processing Unwrap the exposed film (in the dark room) Clip to a hanger Immerse the film in the developer for 4.5 min at 20 C. Agitate Wash Immerse film in the fixer for 8 minutes at 20 C Wash Dry February 14, 2012 Dr Saad Wahby Al Bayatti o o

48. Automatic Film Processing Unwrap the exposed film (in the dark room) or in a day light loader Insert the film in the loading slot Receive the film dry from the film exit slot February 14, 2012 Dr Saad Wahby Al Bayatti

49. February 14, 2012 Dr Saad Wahby Al Bayatti Develop Wash Fix Wash Dry Safe light Processing solutions

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59. Checking the light leaks in the dark room ( light tightness) Turn all lights off Close door(s) Wait for 10 minutes Check light leaks by eye (door hinges, ceilings and other possible light leaks) Correct Check again Perform coin test February 14, 2012 Dr Saad Wahby Al Bayatti

60. Checking the safe light Check light tightness in the dark room If OK then, Turn the safe light ON Open an unexposed film under the light Put a metal coin on the film Wait for 5 minutes Process the film Clear film, light OK Dark film with clear image of the coin, improper safe light/light leak February 14, 2012 Dr Saad Wahby Al Bayatti

61. February 14, 2012 Dr Saad Wahby Al Bayatti Safe light Film Coin Light tight dark room Proper safe light Light leaks in dark room Improper safe light Dark room

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64. Radiographic Image Quality February 14, 2012 Dr Saad Wahby Al Bayatti

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66. Density The degree of blackness of the processed radiograph It is measured by the density meter which gives a Log scale of the transmitted light through the radiograph. Density can either be ; High (dark radiograph) Medium Low (light radiograph) February 14, 2012 Dr Saad Wahby Al Bayatti

67. Contrast Is the differences between black, grey and white shadow in the radiograph Contrast can either be; low when the difference between the shades is gradual High when the difference between the shades is sharp February 14, 2012 Dr Saad Wahby Al Bayatti

68. Sharpness The ability of the radiograph to produce sharp outlines of the borders of the object February 14, 2012 Dr Saad Wahby Al Bayatti

69. Factors that affect the radiographic image quality Object factors ; * object density (w/v) * object thickness Exposure factors * kVp * mA * exposure time * tube-film distance Film factors * film speed * lead foil * storage Processing solutions * temperature. * concentration. * time February 14, 2012 Dr Saad Wahby Al Bayatti

70. Density increases when Object factors; * object density (w/v) ------------ decreases * object thickness ------------ decreases Exposure factors * kVp ------------ increases * mA ------------ increases * exposure time ------------ increases * tube-film distance ------------ decreases February 14, 2012 Dr Saad Wahby Al Bayatti

71. Density increases when Film factors * film speed ------------ increases * lead foil (Opposite side) ------------ decreases * lead foil (If not used) ------------ increases *storage (at high Temp.) ------------ increases Processing solutions * temperature ------------ increases * concentration ------------ increases * time ------------ increases February 14, 2012 Dr Saad Wahby Al Bayatti

72. Contrast increases(HIGH) when Object factors; * object density (w/v) ------------ increases * object thickness ------------ increases Exposure factors * kVp ------------ decreases * mA ------------ decreases * exposure time ------------ decrease * tube-film distance ------------ increases February 14, 2012 Dr Saad Wahby Al Bayatti

73. Contrast increases(HIGH) when Film factors * film speed ------------ decreases * lead foil (Opposite side) ------------ decreases * lead foil (If not used) ------------ decreases *storage (at high Temp.) ------------ decreases Processing solutions * temperature ------------ decreases * concentration ------------ decreases * time ------------ decreases February 14, 2012 Dr Saad Wahby Al Bayatti

74. Sharpness increases when Object factors; * patient stability ------------ decreases * object density (w/v) ------------ NIL * object thickness ------------ decreases Exposure factors * x-ray head stability * kVp ------------ NIL * mA ------------ NIL * exposure time ------------ NIL * tube-film distance ------------ increases February 14, 2012 Dr Saad Wahby Al Bayatti

75. Sharpness increases when Film factors * film movement ------------ decreases * film speed ------------ decreases * lead foil (Opposite side) ------------ NIL * lead foil (If not used) ------------ NIL *storage (at high Temp.) ------------ NIL Processing solutions * temperature ------------ NIL * concentration ------------ NIL * time ------------ NIL February 14, 2012 Dr Saad Wahby Al Bayatti

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77. Radiographic Artifacts ( Errors) February 14, 2012 Dr Saad Wahby Al Bayatti

78. Radiographic Artifacts ( Errors) Films Cause(s) Storing film at high Temp./Humidity Storing film in a radiation area Films without lead foil Light leaks Improper safe light Severe bending of the film Error Fog: an increase in radiographic density that result from deposition of silver ion from reasons not caused by the primary beam Black line on radiograph February 14, 2012 Dr Saad Wahby Al Bayatti

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80. February 14, 2012 Dr Saad Wahby Al Bayatti Radiographs of an aluminum step wedge taken at different kVp

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83. Errors in Image Quality Density Error High density (dark film) Cause(s) Film opened in light Fog High speed film High kV High mA Incorrect safe light February 14, 2012 Dr Saad Wahby Al Bayatti

84. Errors in Image Quality Density Error High density (dark film) High exposure time High developing Temp High developing Time High developer Conc. February 14, 2012 Dr Saad Wahby Al Bayatti

85. Errors in Image Quality Density Error Low density (light film) Cause(s) Opposite side of film(zigzag/tire tracks) Low speed film Low kV Low mA Low exposure time February 14, 2012 Dr Saad Wahby Al Bayatti

86. Errors in Image Quality Density Error Low density (light film) Old developer solution Low developer Temp Low developing Time Low developer Conc. Incomplete fixation February 14, 2012 Dr Saad Wahby Al Bayatti

87. Errors in Image Quality Density Error No image (clear film) Cause(s) No exposure Old developer solution Film fixed directly February 14, 2012 Dr Saad Wahby Al Bayatti

88. Errors in Image Quality Sharpness Error Image unsharpness Cause(s) Curved film Film moved Patient moved Tube moved February 14, 2012 Dr Saad Wahby Al Bayatti

89. Errors in Image Quality Error Double image Images of Foreign objects Cause(s) Film exposed twice Failure to remove; * Eye glasses * Partial dentures * Ear/nose rings February 14, 2012 Dr Saad Wahby Al Bayatti

90. Errors in Image Quality Exposure Techniques Error Elongated image Shortened image Cause(s) Cone directed perpendicular to object Bent film Cone directed perpendicular to film February 14, 2012 Dr Saad Wahby Al Bayatti

91. Errors in Image Quality Exposure Techniques Error Overlapping contacts Cause(s) Cone not parallel to buccal surfaces of teeth (incorrect horizontal angulation) February 14, 2012 Dr Saad Wahby Al Bayatti

92. Errors in Image Quality Exposure Techniques Error Tooth incompletely seen(apex cut off) Cause(s) Free margin of film extending more that 2 mm Bent film Elongated image February 14, 2012 Dr Saad Wahby Al Bayatti

93. Errors in Image Error Part of film exposed Cause(s) Incomplete coverage of beam to film(cone cutting) Film partially immersed in developer Part of film immersed in fixer prior to developer February 14, 2012 Dr Saad Wahby Al Bayatti

94. Errors in dark room Error Tree like black lines Clear spots on radiograph Brown spots Two film stuck Finger prints Cause(s) Static electricity Fixer drops Failure to wash film Dirty rollers Film held from center February 14, 2012 Dr Saad Wahby Al Bayatti

95. Errors in dark room Error Cracked emulsion Scratches Cause(s) Difference in solution temperatures Wet film Cut your finger nails! February 14, 2012 Dr Saad Wahby Al Bayatti

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103. Processing of the x-ray films The sequence of events by which the (unseen) latent image is changed to a seen image. Steps of processing are; Developing : alkaline solution, it acts on the Ag atoms initially separated by the x-ray photons and are further precipitated and increased in size by Oxidization The developing solution is composed of; 1- Developer:Phenidone, hydroquinine 2- Activator: sodium (potassium) hydrozide. Buffers are added, e.g. sodium carbonate, sodium hydroxide, sodium metaborate or tetraborate 3- (Preservative (antioxidant): sodium sulfite 4- Restrainer: potassium or sodium bromide 5- Developer replenisher February 14, 2012 Dr Saad Wahby Al Bayatti

104. Processing of the x-ray films Washing : Water removes the alkaline developer and prevents the contamination of the acidic fixer. February 14, 2012 Dr Saad Wahby Al Bayatti

105. Processing of the x-ray films, cont’d Fixing : acidic solution, it dissolves and removes unexposed AgBr crystals not affected by the x-ray photons, all crystals are removed from the gelatin emulsion into the fixer solution The fixing solution is composed of; 1- Clearing agent: ammonium thiosulfate (hypo) 2- Acidifier: acetic acid 3- Preservative: sodium or ammonium sulfite 4- Hardener: ammonium salts February 14, 2012 Dr Saad Wahby Al Bayatti

106. Washing : water removes fixer solution from the film to prevent oxidization of the remaining fixer and future contamination of the final radiograph due to silver thiosulfate reaction Drying : air drying to remove water from the processed radiograph February 14, 2012 Dr Saad Wahby Al Bayatti

107. Waste disposal Dissolved silver Electroplating Metallic replacement Lead foil Collected to be disposed separately February 14, 2012 Dr Saad Wahby Al Bayatti

108. Radiographic Image Quality February 14, 2012 Dr Saad Wahby Al Bayatti

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110. Density The degree of blackness of the processed radiograph It is measured by the density meter which gives a Log scale of the transmitted light through the radiograph. Density can either be ; High (dark radiograph) Medium Low (light radiograph) February 14, 2012 Dr Saad Wahby Al Bayatti

111. Contrast Is the differences between black, grey and white shadow in the radiograph Contrast can either be; low when the difference between the shades is gradual High when the difference between the shades is sharp February 14, 2012 Dr Saad Wahby Al Bayatti

112. Sharpness The ability of the radiograph to produce sharp outlines of the borders of the object February 14, 2012 Dr Saad Wahby Al Bayatti

113. Resolution The ability of the radiograph to record separate structures that are close together, e.g. enamel and dentin February 14, 2012 Dr Saad Wahby Al Bayatti

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115. Factors that affect the radiographic image quality Object factors ; * object density (w/v) * object thickness Exposure factors * kVp * mA * exposure time * tube-film distance Film factors * film speed * lead foil * storage Processing solutions * temperature. * concentration. * time February 14, 2012 Dr Saad Wahby Al Bayatti

116. Density increases when Object factors; * object density (w/v) ------------ decreases * object thickness ------------ decreases Exposure factors * kVp ------------ increases * mA ------------ increases * exposure time ------------ increases * tube-film distance ------------ decreases February 14, 2012 Dr Saad Wahby Al Bayatti

117. Density increases when Film factors * film speed ------------ increases * lead foil (Opposite side) ------------ decreases * lead foil (If not used) ------------ increases *storage (at high Temp.) ------------ increases Processing solutions * temperature ------------ increases * concentration ------------ increases * time ------------ increases February 14, 2012 Dr Saad Wahby Al Bayatti

118. Contrast increases(HIGH) when Object factors; * object density (w/v) ------------ increases * object thickness ------------ increases Exposure factors * kVp ------------ decreases * mA ------------ decreases * exposure time ------------ decrease * tube-film distance ------------ increases February 14, 2012 Dr Saad Wahby Al Bayatti

119. Contrast increases(HIGH) when Film factors * film speed ------------ decreases * lead foil (Opposite side) ------------ decreases * lead foil (If not used) ------------ decreases *storage (at high Temp.) ------------ decreases Processing solutions * temperature ------------ decreases * concentration ------------ decreases * time ------------ decreases February 14, 2012 Dr Saad Wahby Al Bayatti

120. Sharpness increases when Object factors; * patient stability ------------ decreases * object density (w/v) ------------ NIL * object thickness ------------ decreases Exposure factors * x-ray head stability * kVp ------------ NIL * mA ------------ NIL * exposure time ------------ NIL * tube-film distance ------------ increases February 14, 2012 Dr Saad Wahby Al Bayatti

121. Sharpness increases when Film factors * film movement ------------ decreases * film speed ------------ decreases * lead foil (Opposite side) ------------ NIL * lead foil (If not used) ------------ NIL *storage (at high Temp.) ------------ NIL Processing solutions * temperature ------------ NIL * concentration ------------ NIL * time ------------ NIL February 14, 2012 Dr Saad Wahby Al Bayatti

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123. Radiographic Artifacts ( Errors) February 14, 2012 Dr Saad Wahby Al Bayatti

124. Radiographic Artifacts ( Errors) Films Cause(s) Storing film at high Temp./Humidity Storing film in a radiation area Films without lead foil Severe bending of the film Error Fog Black line on radiograph February 14, 2012 Dr Saad Wahby Al Bayatti

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126. Light radiograph (low density) Processing errors Underdevelopment Low temperature Short time Thermometer incorrect Depleted (exhausted) developer solution Diluted developer Contaminated developer Excessive fixation Under exposure Insufficient mA Low kVp Insufficient time Tube-film distance long Film reversed February 14, 2012 Dr Saad Wahby Al Bayatti

127. February 14, 2012 Dr Saad Wahby Al Bayatti Light film (low density) Film placed on reverse side

128. February 14, 2012 Dr Saad Wahby Al Bayatti Film fog Dark film Low contrast

129. Dark Radiographs Processing errors Overdevelopment high temp Increased developing time Developer concentration high Inadequate fixation Accidental exposure to light Improper safe lighting February 14, 2012 Dr Saad Wahby Al Bayatti

130. Dark Radiographs Over exposure High mA High kVp Excessive exposure time Tube-film distance short February 14, 2012 Dr Saad Wahby Al Bayatti

131. Insufficient contrast Underdevelopment Underexposure High kVp Excessive Film fog February 14, 2012 Dr Saad Wahby Al Bayatti

132. Film fog Improper safe lighting Improper filter Excessive bulb wattage Inadequate distance between safe light and working bench Prolonged exposure to safe light February 14, 2012 Dr Saad Wahby Al Bayatti

133. Film fog cont’d Light leaks Cracked safe light Light from doors Light from vents Overdevelopment Contaminated solutions Outdated film Films stored at high temperatures Films stored at high humidity Films stored in a radiation area February 14, 2012 Dr Saad Wahby Al Bayatti

134. Dark spots or lines Fingerprint contamination Back wrapping paper sticking to film surface Film contact with tank or wit another film during processing Film contaminated with developer before processing Excessive bending of the film Static discharge to film before processing Excessive roller pressure during automatic processing Dirty rollers in automatic processor February 14, 2012 Dr Saad Wahby Al Bayatti

135. Light spots Film contaminated with fixer before processing Film in contact with tank or another film during development Excessive bending of film February 14, 2012 Dr Saad Wahby Al Bayatti

136. Yellow or brown stains Depleted developer Depleted fixer Insufficient washing Contaminated solutions February 14, 2012 Dr Saad Wahby Al Bayatti

137. Blurring Movement of patient Movement of X-ray tube head Double exposure February 14, 2012 Dr Saad Wahby Al Bayatti

138. Partial images Top of film not immersed in developing solution Misalignment of X-ray tube head (cone cut) February 14, 2012 Dr Saad Wahby Al Bayatti

139. February 14, 2012 Dr Saad Wahby Al Bayatti Stuck films Blurred image

140. February 14, 2012 Dr Saad Wahby Al Bayatti Fixer drops Cone cutting