This document discusses common radiographic errors and artifacts that can occur during dental x-ray procedures. It identifies three main categories of errors: technique and projection errors, exposure errors, and processing errors. Technique errors include issues with patient preparation, film placement, and projection angles. Exposure errors result in over or underexposed images. Processing errors stem from chemical or film handling issues during development and fixing of the x-ray film. The document provides examples and explanations of specific errors like double images, cut-off areas, density problems, and chemical or physical marks that can affect image quality and interpretation.

1. RADIOGRAPHIC ERRORS AND ARTIFACTSDr. Walid Samir SalemBDS, MS, MHPElecturer, Oral Surgery DepartmentMember, Dental education unit

2. Films with errors should be avoided due to the following reasons:Retake will lead to:Expose the patient to unnecessary radiation.

3. Waste film & time (money).

4. Interfere with accurate interpretation and diagnosis.Causes of faulty radiographThe majority of the errors produced can be categorized into three groups:Technique & Projection errors.Exposure errors.Processing errors.

5. Technique & Projection errors:a. Patient preparation error:b. Film placment artifact:

6. c. Projection errors:Incorrect vertical angulation.

7. Incorrect horizontal angulation

8. PID alignment artifactTechnique & Projection errorsa. Patient preparation errorRadiopaque artifactDental appliances, body piercings, jewelry & eye glasses left in the mouth during exposure will appear as radiopaque artifact superimposed over the dental image. Correction: all this items should be removed before placing of the film.

11. Technique & Projection errorsa. Patient preparation errorBlurred imageMovement of the film, patient or X-ray tube head during exposure will result in a blurred image.Correction: the operator should explain for the patient & remind him to remain motionless during exposure.

13. Technique & Projection errorsa. Patient preparation error:Pressure markPressure from the incisal edge & cusps of the teeth (mostly in the pediatric occlusal radiograph).May appear black or white.Correction: ask the patient to bite gently.

14. Technique & Projection errorsb. Film placmentartifactDouble imageWhen an exposed film is re-exposed the resulting film will have 2 superimposed images

15. Technique & Projection errorsb. Film placmentartifactReversed filmLow 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.

16. Technique & Projection errorsb. Film placmentartifactDot artifactThe identification (embossed) dot produce a circular radiolucent artifact on the final radiograph. This may interfere with interpretation of the apical areas of the teeth.

17. Technique & Projection errorsb. Film placmentartifactApices cut offOccur when the film is not positioned apically enough to record the entire tooth.

18. Technique & Projection errorsb. Film placmentartifactCrown not shown There is no enough film extending occlusally.

19. Technique & Projection errorsb. Film placmentartifactDropped film cornerThe film edge is not placed parallel to the occlusal surface of the teeth.

20. Technique & Projection errorsb. Film placmentartifactArea of interest not shownThis 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.

21. Technique & Projection errorsb. Film placmentartifactBlack lineDue 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).

22. Technique & Projection errorsb. Film placmentartifactnormaldistortionDistortionDue to bending of the film to eliminate the patient’s discomfort specially in lower premolar area and upper central incisors.

23. Technique & Projection errorsc. Projection errorsIncorrect vertical angulationIt will lead to:Elongated image due to insufficient v. angulation ( too flat), or

24. Shortened image due to excessive v. angulation ( too steep)Technique & Projection errorsc. Projection errors

25. Technique & Projection errorsc. Projection errors

26. Technique & Projection errorsc. Projection errorsIncorrect horizontal angulationIs 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.

27. Technique & Projection errorsc. Projection errors

28. Technique & Projection errorsc. Projection errorsPID alignment artifactIf 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.It appear as a clear area with curved outline.

30. Asuan – Egy.

31. II. Exposure errors.Blank image.Low density image.High density image.Image with high and low contrast.

32. Exposure errorsBlank imageA film that didn’t receive radiation will have no image and will appear clear.

33. Exposure errorsLow density (faint) image

34. Exposure errorsHigh density image

36. III. Processing errorsChemical errors:Light image.

37. Dark image.

38. Blank image.

39. Reticulation.

40. Black spot or patch.

41. Black line.

42. White spot or patch.

43. Yellowish brown discoloration.Film Handling errors:Writing lines

44. Developer cut off

45. Fixer cut off

46. Overlapped film

47. Finger nail artifact

48. Smudge.

49. Scratched film

50. Static electricityProcessing errorsChemical errorsReticulationWhen the film subjected to a sudden temperature changes between the developer and water.Appear as cracked film.

51. Processing errorsChemical errorsBlack spot or patchDeveloper contamination before immersion into the developer solution.

52. Processing errorsChemical errorsBlack lineDeveloper contamination processing hanger clipsDirty roller in automatic processor

53. Processing errorsChemical errorsWhite spot or patchContamination with fixer before processing

54. Processing errorsChemical errorsYellowish brown discolorationExhausted solution or insufficient rinsing

55. Processing errorsFilm Handling errorsWriting linesAppear on the radiograph due to writing on the film packet with ballpoint pen or lead pencil.It may appear black or white.Finger nail artifactBlack or whit crescent shape mark due to rough handling of the film.

56. Processing errorsFilm Handling errorsDeveloper cut offA straight blank white border due to underdeveloped portion. The film may not be completely immersed in the developer solution.