Dental Radiography: Principles and Techniques [6 ed.] 0323695507, 9780323695503

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Joen M lannucci Laura Jansen Howerton

RADOGRAPHY PRINCIPLES AND TECHNIQUES SIXTH EDITION

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ELSEVIER 2019v1.0

Dental RADIOGRAPHY PRINCIPLES

AND

TECHNIQUES

SIXTH

Joen

Professor

The

Ohio

College

M.

of

State

of

Laura

University

Jansen

Howerton,

RDH,

Educator

Ohio

The

University

State

University,

of

T echnical

Raleigh,

ELSEVIER

MS

Ohio

The

Wake

DDS,

Dentistry

Dentistry

Columbus,

Retired

Iannucci,

Clinical

EDITION

North

North

Columbus,

Carolina,

Community

Carolina

Ohio

Chapel

College

Hill,

North

Carolina

MS

Elsevier

3251

Riverport

Lane

St. Louis, Missouri

63043

DENTAL

RADIOGRAPHY:

Copyright

©

No

part

of

2022

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by

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Center

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any

on

can

be

to

with

found

contained

in

any

information

how

arrangements

contributions

TECHNIQUES, SIXTH

EDITION

ISBN:

978-0-323-69550-3

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responsibility

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Number :

Dumas/Kelly

Content

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Content

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Manager:

Deepthi

Senior

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1996.

2021943199

Skelton

Luke

Held

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Broeker

Unni

Mohan

L. Buxton

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Working together to grow libraries in developing countries

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9

8

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6

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1

• www. bookaid.org

To

To

To

ank

your

To

for

my

my

you

son, Michael—

dad, Angelo—

mom, Dolores—

for

your

encouragement, and

ank

and

my

the

all

you

my

for

sincere

everlasting

a

life

lled

students, past

ever ything

privilege

of

that

&

a

laughter.

present—

you

being

love,

with

have

part

taught

of

your

me,

lives.

JMI

To

my

husband, Bruce, who

inspires

LJH

me

ever y

day

of

my

life.

R E V I E W E R S

Deborah

Associate

Dental

Bush-Munson, CDA, EFDA, MS

Professor

Technologies

St. Louis

Community

Dental

College

at

Forest

Park

St. Louis, Missouri

Joanne

Clare

Certied

Science

Gibbons-Smyth, CDA, BA, ID

Okanagan

and

CDA

Chairperson

Department

Columbia

Program

Director

T ena A

State

College

Professor

Dental Assisting

Jennifer

S

Associate

and

State

Dental

Hygiene

Community

Programs

College

Sherr y, RDH, MSEd

Professor

Hygiene

Southern

Denison, Texas

Program

Illinois

University

Carbondale, Illinois

Hiter, RDH, BS, MDH

Michelle

ibault, RDH

Dental

Hygiene

Instructor

Manager, Dental

Dental

Hygiene

Program

Niagara

Mississippi

Community

Phillips, DDS

Assistant

Dental

College

Linda Adams

Chattanooga

Professor

Department

Chattanooga, Tennessee

Science

Grayson

Director, Associate

Hygiene

Chattanooga

Hance, BAAS, CDA, RDA

Dental Assisting

Health

Health

Program

College

Kelowna, British

T onya

Maida, CDA, RDH, Med

Chattanooga, Tennessee

Dental Assistant

Tech

Angie

Program

Delta

Community

College

Programs

College

Welland, Ontario, Canada

Moorhead, Mississippi

L aura

Dean

L efebvre, MAED, BS, RDH, CAET

Instructor

School

of

in

the

Health

Saskatchewan

Dental

Hygiene

Sciences

Polytechnic

Regina, Saskatchewan, Canada

iv

Program

Dental

J Webb, MSHSA, RDH, FAADH, CDA-Emeritus

Hygiene

Education

LFW

Education

Provider

Education

Fallon, Nevada

Ser vices

Program

Consultant

&

Continuing

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Joen

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M. Iannucci, DDS, MS

Jansen

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A C K N O W L E D G M E N T S

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Joen

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M. Iannucci, DDS, MS

Jansen

Howerton, RDH, MS

vii

C O N T E N T S

P ART

I

Radiation

Basics

and

Dental

Image

20.

Bisecting

21.

Bite-Wing

Technique,

22.

Exposure

23.

Occlusal

24.

Imaging

190

Technique, 211

Characteristics

1.

Radiation

History,

1

2.

Radiation

Physics,

3.

Radiation

Biology,

4.

Radiation

Protection,

5.

Radiation

Characteristics, 43

6.

Dental

7

P ART

II

Image

Equipment

7 .

Dental

X-Ray

8.

Digital

Imaging,

9.

III

Dental

Film

X-Ray

Characteristics, 50

and

Digital

Equipment,

Imaging

Film,

Imaging

Extraoral

Processing,

11.

Film

Mounting

Panoramic

26.

Extraoral

Dental

13.

Patient

Relations

14.

Patient

Education

15.

Legal

16.

Infection

17 .

Quality

27 .

Three-Dimensional

and

Viewing, 111

and

the

and

the

Prevention

19.

Paralleling

viii

to

Imaging, 306

Normal

Anatomy

28.

Normal

Anatomy:

Intraoral

29.

Normal

Anatomy:

Panoramic

Image

30.

Introduction

31.

Descriptive

Basics

Images, 320

Images, 346

Interpretation

Basics

in

Dental

the

the

Dental

Dental

and

the

Radiographer, 123

Dental

Radiographer, 127

Radiographer, 133

Radiographer, 138

the

Dental

Dental

Technique

Dental

Imaging

Technique, 167

to

32.

Identication

Image

Interpretation, 357

Terminology, 362

of

Restorations,

Dental

Materials,

and

Basics Objects,

Interpretation

of

Dental

34.

Interpretation

of

Periodontal

35.

Interpretation

of

Trauma,

Lesions,

427

Radiographer, 143

Ofce, 155

Basics

Examinations, 163

378

33.

Glossary,

Intraoral

Introduction

Digital

78

and

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18.

273

290

Basics

Appendix,

P ART V

Imaging,

Imaging,

Basics

60

Radiographer

12.

Issues

Needs, 260

Basics

Foreign

Images

Techniques, 243

Special

89

and

Dental

With

Imaging

25.

P ART VIII Film

IV

Patients

66

10.

P ART

Errors, 229

33

P ART VII

P ART

of

Technique

Localization

21

P ART VI

X-Ray

and

and

Index,

442

447

459

Caries, 403

Disease, 413

Pulpal

Lesions,

and

Periapical

P ART

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therapy,

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PIONEERS

IN

DENTAL

X-RADIATION compared

Aer

the

shape

discover y

the

histor y

radiography

gators

and

raphy

died

can

of

of

be

x-rays

dental

in

a

radiography.

attributed

practitioners.

1895,

to

Many

the

of

the

number

e

research

early

of

pioneers

development

of

hundreds

pioneers

in

helped

of

of

dental

dental

short

with

exposure

1920, which, in

overexposure

discovered, nothing

from

using

these

was

known

penetrating

to

radiation.

about

rays.

the

At

the

hidden

time

dangers

of

the

than

turn, reduces

past. At

2%

the

of

present, fast

the

initial

patient’s

lm

requires

exposure

exposure

to

times

a

ver y

used

in

radiation.

radiog-

x-rays

that

lms

investi-

HISTORY from

the

time, less

OF

DENTAL

RADIOGRAPHIC

TECHNIQUES

were

resulted

e

intraoral

technique,

the

techniques

paralleling

used

in

dentistry

technique,

and

include

the

the

bite-wing

bisecting

technique.

P ART

4

TABLE

of

Radiation

Highlights

1-1

Dental

I

Basics

in

the

and

Dental

Image

Characteristics

History

Imaging

Pioneer/

Y ear

Event

1895

Discovery

Manufacturer

1896

First

dental

radiograph

1896

First

dental

radiograph

States

1896

First

of

W.

O.

C.

Roentgen

Walkhoff

in

United

W.

in

United

C.

J.

Morton

(skull)

dental

States

x-rays

radiograph

(living

paper

on

1901

First

1904

Introduction

dangers

1913

First

dental

1913

First

prewrapped

1913

First

x-ray

1920

First

machine-made

1923

First

dental

of

E.

Kells

patient)

of

bisecting

x-radiation

technique

text

W.

H.

Rollins

W.

A.

Price

H.

dental

lms

R.

tube

W.

lm

Raper

Eastman

packets

D.

Kodak

Company

Coolidge

Eastman

Kodak

Company

Fig 1-4

x-ray

machine

Victor

X-Ray

Corp,

White

1925

Introduction

1933

Concept

of

of

bite-wing

rotational

technique

H.

R.

Victor CDX shockproof tube housing (1923). (Courtesy Goaz PW,

Chicago

Raper

1987 ,

SC:

Oral

radiology

and

principles

of

interpretation,

ed

2,

St

Louis,

Mosby.)

panoramics

proposed

e

1947

Introduction

of

long-cone

paralleling

1948

Introduction of panoramic radiography

1955

Introduction

F.

G.

Fitzgerald

technique

1896.

in

practical

modern

nique of

D-speed

lm

paralleling

in

L ater,

in

dental

dental

with

technique

1920,

introduced

W .

radiography.

radiography, ”

the

was

Franklin

F.

Gordon

revived

introduction

of

by

McC ormack

the

C.

Edmund

used

the

Fitzgerald,

interest

in

long-cone

the

Kells

technique

the

“father

paralleling

paralleling

of

tech-

technique

(Kodak

in

1947.

Ultra-speed)

e 1957

First

variable-kilovoltage

dental

x-ray

General

extraoral

technique

used

most

oen

in

dentistr y

is

panoramic

Electric

radiography. In

1933

Hisatugu

Numata

of

Japan

was

the

rst

to

expose

machine

a

1978

Introduction

of

dental

panoramic

Introduction

of

E-speed

lm

(Kodak

Introduction

ing

in

Yrjo

oramic

Ektaspeed)

1987

Paatero

intraoral

digital

of

Finland

radiography. ” He

intensifying

of

however,

the

lm

was

placed

lingually

to

the

xeroradiography

teeth.

1981

radiograph;

is

considered

experimented

screens, and

rotational

with

to

a

be

slit

the

“father

beam

of

of

pan-

radiography,

techniques.

imag-

France

HISTORY

1989

Dental

tomography

1994

Introduction

1995

Introduction

scanners

OF

DENTAL

DIGITAL

IMAGING

become

Radiographs

have

been

produced

using

radiographic

lm

for

well

over

available

a of

Kodak

Ektaspeed

of

digital

sensor

centur y.

ing Plus

in

the

Traditional

dental

Introduction

of

cone-beam

computed

tomography

for

use

dental

CBCT

Oral

that

scanners

and

(CBCT)

tions. In

phy

available

maxillofacial

in

is

a

Introduction

specialty

of

In

Europe

in

F-speed

Dental

scanners

United

while

1987, the

technique

nal

bisecting

Raper

also

of

the

most

imag-

signicant

instant

and

capability

easy

diagnostic

waste

benets

technolog y

in

transmission

that

reduce

potential

associated

the

France

to

is

patient

of

images

has

with

exposure

profound

traditional

to

implica-

radiogra-

environment.

used

when

to

the

support

rst

dental

intraoral

digital

imaging

imag-

sensor

introduced.

lm

was

In

1989

rst

an

article

published

in

describing

U.S. dental

direct

digital

literature. Since

imaging

then, dig-

(Kodak/

in

imaging

technolog y

improvements

in

has

become

sensor

design

widely

and

accepted

supporting

and

has

evolved

technolog y.

the

States

Price, a

1904,

and

technique

wrote

dentistr y.

INSIGHT)

available

practitioners

in

increasing

introduced

DIGITAL dental

in

for

e

addition, chemical

HISTORY

include W eston

allows

storage.

reduced, which

was

with

e

one

digital

dentistry

ital Carestream

CBCT

occurred

imaging

technolog y

2001

is

by

radiology

was becomes

have

electronic

radiation

ing

2000

imaging

replaced

unit

and

1999

Digital

being

for

Digital

panoramic

1999

oce.

is

lm

advances

1998

radiography

one

of

who

developed

Cleveland

Howard

and

the

Riley

introduced

rst

these

dentist, who

dental

Raper,

the

radiographic

introduced

who

radiography

THREE-DIMENSIONAL

techniques

the

redened

bite-wing

OF

IMAGING

bisecting

the

technique

textbooks

in

in

origi-

1925.

1913.

In

1999, cone-beam

this

allows

for

point

in

computed

viewing

of

the

time, imaging

tomography

oral

was

structures

techniques

introduced

in

three

allowed

to

dentistr y ;

dimensions.

viewing

of

Up

to

this

structures

in

two dimensions only; no magnication, distortion, or superimposition

CHAPTER

of

of

structures

extraoral

ance

of

have

a

is

seen

with

imaging

surgical

three-dimensional

allows

for

procedures.

considerable

eect

on

diagnosis

digital

of

ree-dimensional

the

eld

of

imaging. is

disease

and

image

digital

type

•

guid-

imaging

will

dentistr y.

•

Digital

imaging,

allows

for

patient

exposure, and

In

1999,

allows

one

instant

viewing

the

Radiation

most

review

cone-beam

for

of

1

and

improves

computed

of

the

oral

History

signicant

advances

transmission

the

of

diagnostic

tomography

and

5

in

dentistr y,

images,

reduces

potential.

was

introduced,

maxillofacial

complex

which

in

three

dimensions.

HISTORY

OF

ORAL

AND

•

MAXILLOFACIAL

Also

in

1999, the American

maxillofacial

RADIOLOGY

In

1999,

the

radiolog y

as

Dental Association

a

specialty

eld

of

recognized

oral

and

dentistr y.

EDUCATION

American

Dental

Association

recognized

its

ninth

BIBLIOGRAPHY specialty

program:

program

provides

illofacial

region,

Oral

and

advanced

including

Maxillofacial

training

the

in

Radiolog y

radiolog y

management

of

of

(OMFR).

the

diseases

oral

and

and

is

max-

disorders.

Frommer HH, Stabulas-Savage JJ: Ionizing radiation and basic principles of

Persons

interested

in

this

program

complete

a

2-

or

3-year

aer

completion

of

dental

school,

followed

by

an

JI, Lind

LJ:

e

importance

of

dental

radiographs

and

interpretation.

residency

In

term

x-ray

generation. In Radiology for the dental professional, ed 9, St Louis, 2011, Mosby.

Haring

Radiographic

interpretation

for

the

dental

hygienist, Philadelphia, 1993,

international Saunders.

board

examination.

OMFR

joins

the

other

specialty

programs

of

denJohnson

tistr y

including

oral

and

maxillofacial

pediatric

dentistr y,

ON:

periodontics,

prosthodontics,

dental

for

dental

oral

and

medicine, and

maxillofacial

orofacial

of

dental

patholog y,

dental

assistants

radiography. In

and

Essentials

hygienists, ed

9, Upper

of

dental

Saddle

radiogra-

River, NJ, 2011,

public Prentice

health,

Histor y

surger y, orthodontics, endodonphy

tics,

anesthesiolog y,

oral

pain.

Langlais

Hall.

RP:

Exercises

in

oral

radiolog y

and

interpretation, ed

4, St

Louis,

2004, Saunders.

Langland

Oral

OE, Langlais

Surg

Langland

Oral

RP:

Med

OE, Langlais

Early

Oral

pioneers

Pathol

RP , Preece

of

oral

and

maxillofacial

radiolog y,

80(5):496, 1995.

JW: Production

of

x-rays. In

Principles

of

S U M M A R Y dental

Mallya

•

An

x-ray

is

a

beam

of

energ y

that

has

the

power

to

penetrate

and

record

image

shadows

on

an

image

SM, Lam

A

radiograph

is

a

two-dimensional

and

An

image

receptor

lm, phosphor

•

Dental

tions

•

is

anatomic

Disease

is

a

recording

plate, or

imaging

of

8, St

and

Pharoah’s

oral

radiolog y :

prin-

Louis, 2019, Elsevier.

representation

of

a

SM, Lam

EWN:

Safety

and

protection. In White

and

Pharoah’s

oral

threeprinciples

and

interpretation, ed

8, St

Louis, 2019, Elsevier.

object. Miles

•

Physics. In White

interpretation, ed

radiolog y :

dimensional

EWN:

& Wilkins.

receptor. Mallya

•

2, Baltimore, MD, 2002, Lippincott Williams

subciples

stances

imaging, ed

the

digital

detection

is

one

of

for

of

examples

include

x-ray

sensor.

creation

structures

medium;

the

tion

of

Dis

ML, Williamson

x-rays. In

Radiographic

GF , etal:

imaging

X-ray

for

properties

the

dental

and

the

team, ed

genera-

4, St

Louis,

2009, Saunders.

digital,

the

DA, V an

print,

purpose

most

of

or

lm

representa-

Mosby's

dental

dictionar y, ed

2, St

Louis, 2008, Mosby.

diagnosis.

important

uses

for

dental

WEBSITES images.

•

Wilhelm

Conrad

•

Following

the

Roentgen

discover y

of

discovered

the

x-ray,

the

x-ray

numerous

in

American

1895.

investigators

con-

Dental Association:

Dental

Specialties. https://www.ada.org/en/

ncrdscb/dental-specialties

U.S. Food and Drug Administration: Dental Cone-Beam Computed T omography.

tributed

to

advancements

in

dental

radiography.

www.FDA.gov

Q U I Z

Q U E S T I O N S

Matching _____6. A

For

questions

1

to

9,

match

each

term

(a

to

i)

with

its

corresponding

denition.

of

high-energ y

electrons

_____7. e

science

radiation

with

or

a

study

of

target

in

radiation

as

Radiation

b.

Radiograph

c.

Radiograph, dental

_____9. A two-dimensional representation of

Radiographer, dental

For

Radiography

tions

e.

f.

g.

h.

i.

tures

questions

(a

to

by

10

the

to

Radiography, dental

a.

Used

b.

Discovered

c.

X-ray

_____1. A

of

_____2. A

photographic

x-rays

beam

and

_____3. A

d.

to

of

teeth

energ y

image

energ y

person

image

_____5. e

of

record

form

_____4. Any

image

through

that

produced

and

has

shadows

carried

who

on

related

the

on

by

power

receptor

to

by

the

passage

or

a

and

substances

lm.

stream

exposes,

of

x-rays.

of

radiographs

by

the

particles.

processes

exposure

g.

h.

x-ray

receptors.

production

e.

f.

penetrate

photographic

waves

positions,

a

structures.

of

a

receptor

exposure

19,

match

of

image

the

the

used

of

a

beam

tube.

in

medicine.

the teeth and adjacent struc-

receptors

dental

collision

x-ray

to

x-rays.

a three-dimensional object.

pioneers

with

their

contribu-

j).

Radiolog y

X-radiation

radiographs of

by

an

a.

d.

_____8. e production of

produced

metal

paralleling

Developed

Introduced

Exposed

Wrote

Exposed

rst

rst

dental

paper

rst

Introduced

x-ray

bisecting

rst

rst

technique

in

practical

dental

radiography

x-rays

on

dental

tube

technique

radiograph

the

long-cone

dental

danger

radiograph

in

paralleling

x-radiation

the

United

States

(skull)

technique

i.

Wrote

j.

Exposed rst dental radiograph in the United States (living patient)

____10.

Coolidge

____11.

Fitzgerald

____12.

Kells

text;

of

introduced

bite-wing

technique

P ART

6

I

Radiation

Basics

and

Dental

Image

Characteristics

____13.

McCormack

____23.

Cone-beam

____14.

Morton

____24.

Introduction

of

intraoral

____15.

Price

____25.

Introduction

of

cone-beam

____16.

Raper

____17.

Roentgen

____18.

Rollins

26.

Discuss

____19.

W alkho

27.

Summarize

the

following

available

in

digital

the

in

order

of

discover y

____20.

Introduction

of

F-speed

____21.

Introduction

of

D-speed

____22.

Introduction

of

panoramic

from

earliest

lm

lm

radiography

to

latest:

the

importance

the

of

discover y

dental

of

United

States

imaging

computed

Essay

Ordering

Arrange

scanners

images.

x-radiation.

tomography

2

Radiation

L E

Aer

A

R

N

I N

completion

key

G

O

this

Dene

2.

Identify

3.

Describe

4.

Discuss

5.

List

the

two

6.

List

the

characteristics

7.

List

the

properties

the

the

understand

understand

standing

concepts

edge

of

how

also

ionization,

concepts

acterize

and

of

necessar y.

mental

to

describe

a

the

between

of

are

and

in

S

be

able

to

do

the

following:

physics.

8.

Identify

9.

Label

radiation

an

and

and

radioactivity.

give

examples

of

each.

10.

Describe

11.

List

x-ray

and

of

how

the

of

structure

and

the

machine,

this

x-rays

complete

of

and

the

a

working

is

tube,

to

are

to

is

circuitr y

the

char-

machine,

chapter

with

atomic

which

e

world

occupies

also

matter.

as

the

e

composed

and

fundamental

atoms,

the

the

is

or

tiny

atom

is

unit

necessar y

production

of

of

has

Structure

matter

mass;

of

invisible

and

when

matter

is

the

particles. An

before

the

energ y.

Matter

is

atom. All

of

radiographer

anything

energ y

matter

understanding

dental

is

altered,

is

that

results.

composed

the

structure

can

of

understand

an

e

atom

consists

determined by the composition of

orbiting

electrons. At

Nucleus.

particles

e

known

tons carry

present, 118

nucleus,

as protons

positive

the

the

atom

size

of

a

Atoms

sition. e

is

empty

football

dier

or

of

two

parts:

(1)

central

core

neutrons

atoms

of

(also

the

have

been

atom,

known

is

its

identied.

composed

of

no

electri-

example, if

one

nucleus

another

protons

on

and

an

atom

would

the

basis

neutrons

be

of

in

were

the

their

the

imagined

size

of

a

nuclear

nucleus

of

to

be

football.

inside

nucleus

and

determines

equals

the

the

x-ray

machine.

tubehead

and

the

dental

x-ray

how

the

dental

x-rays

possible

are

produced.

interactions

of

x-rays

with

matter.

the

atomic

number

number

of

of

electrons

the

outside

atom.

Each

atom

shells

are

2-3).

(Figure

is

binding

binding

(eV)

or

electron

as

a

the

Each

has

an

of

type

atomic

of

a

or

number

number

(Figure

with

the

has

2-2).

of

on

atom,

the

most

118. Atoms

a

chart

Elements

charged

approximately

of

the

solar

travel

of

and

particles

1/1800

electrons

system.

around

the

seven

as

and

Just

the

shells, each

representing

letters

nucleus

a

simplest

are

known

are

sub-

that

have

much

as

neutrons

as

the

nucleus

a

in

planets

in

well-

shells

maximum

nucleus

the

ununoctium,

atom.

miniature

orbits

shell

of

tiny, negatively

weighs

electrons

to

that

atomic

arrangement

of

hydrogen,

to

located

dierent

K, L, M, N, O, P , and

and

maximum

has

the

highest

number

of

at

energ y

a

Q;

the

energ y

electrons

spe-

levels.

K

level

it

can

2-4).

are

maintained

between

as

the

energ y

energ y

the

is

energies

of

the

and

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closest

outer

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their

determined

found

in

in

positive

binding

is

electron

located

kilo

are

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sun,

closest

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the

designated

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that

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order

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the

from

attraction,

is

of

only

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dened

(Figure

table

Electrons

distance

from

number

ascending

up

around

is

ranging

by

or

the

to

the

(keV).

for

are

(One

a

in

weak

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K

in

electron

electron.

the

e

force,

electrons.

an

nucleus

strongest

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measured

kilo

of

between

each

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electrostatic

the

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the

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by

and

whereas

energ y.

electron

volt

equals

e

volts

1000

volts.)

e energy required to remove an electron from its orbital shell must

exceed the binding energy of

the electron in that shell. A great amount of

energy is required to remove an inner-shell electron, but electrons loosely

held

the

in

the

outer

tungsten

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chapter, the

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sources

10.

chemic al

of

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chemica l

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therapy. Although

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the

study

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through

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molecule

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the

lifetime

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of

this

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injur y,

to

comprehend

to

detail

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to

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describe

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basic

appreciate

the

these

mechanisms

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measurements,

and

and

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and

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discuss

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of

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the

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a

ity,

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combine

peroxide

RADIATION

exposure

Mechanisms

of

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tion

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photon

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tion. Two

dental

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receptor ;

some

are

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the

patient’s

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from

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x-ray

is

in

photon

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biologic

possible:

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by

to

patient

patient

damage. Two

ionization

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tissues?

specic

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free

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radical

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mechanisms

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radiation

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that

injur y

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ton

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in

the

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or

hydrogen

cellular

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2

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the

a

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cell.

infrequently ; most

no

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result

cell

or

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from

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theor y

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from

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of

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an

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biologic

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to

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hits

photons

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pass

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theor y.

directly

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hit

absorption

radiation

if

tissues

direct

indirect

radiation

damage

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to

from

accompanied

describe

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critical

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a

cell

and

direct

when

the

cell,

to

theor y

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results

within

of

are

a

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within

within

direct

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radiation

water

organism.

or

other

seconds.

areas,

directly

strike

injur y

to

ionizing

through

the

that

critical

cell

the

irra-

radiation

and

cause

damage.

Theory.

e

indirect

theor y

of

radiation

injur y

suggests

that x-ray photons are absorbed within the cell and cause the formation of

s et

t is-

ioniza-

w hich

with

O

the

(1)

targets,

the

recombine

ordinar y

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to

by

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In diagnostic imaging, not all x-rays pass through the patient and reach

Absorption, as dened in Chapter 2, refers to the total transfer of

may

10

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INJURY

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21

P ART

22

X-ray

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tissue

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CHAPTER

TABLE

and

A

3-1

Comparison

Stochastic

Effects

of

of

Non-Stochastic

TABLE

(deterministic

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Bone

effects)

Stochastic

or

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therapy

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Biology

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23

Effect

Radiation

marrow

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radiation

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oral

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cancer Thyroid

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P ART

24

HELPFUL

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Radiation

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RADIATION

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