radiographic errors and artifacts

RADIOGRAPHIC ERRORS AND ARTIFACTS

Dr. Walid Samir SalemBDS, MS, MHPE

lecturer, Oral Surgery DepartmentMember, Dental education unit

Films with errors should be avoided due to the following reasons:Retake will lead to:

•Expose the patient to unnecessary radiation.•Waste film & time (money).•Interfere with accurate interpretation and diagnosis.

Causes of faulty radiographThe majority of the errors produced can be categorized into three groups:

I. Technique & Projection errors.

II.Exposure errors.III.Processing errors.

I. Technique & Projection errors:

a. Patient preparation error:

b. Film placment artifact:

•Blurred image

•Radiopaque artifact

•Pressure mark

•Reversed film •Double image

•Apices cut off •Dot artifact

•Dropped film corner

•Crown not shown

•Black line •Area of interest not shown

•Distortion

c. Projection errors:•Incorrect vertical angulation.•Incorrect horizontal angulation•PID alignment artifact

Technique & Projection errorsa. Patient preparation error

Radiopaque artifact

Dental 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.

Technique & Projection errorsa. Patient preparation error

Blurred image

Movement 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.

Technique & Projection errorsa. Patient preparation error:

Pressure mark

Pressure 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.

Technique & Projection errorsb. Film placment artifact

Double image

When an exposed film is re-exposed the resulting film will have 2 superimposed images


Reversed 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.


Dot 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.


Apices cut off

Occur when the film is not positioned apically enough to record the entire tooth.

Crown not shown


There is no enough film extending occlusally.


Dropped film corner

The film edge is not placed parallel to the occlusal surface of the teeth.


Area 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.


Black 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).


DistortionDue to bending of the film to eliminate the patient’s discomfort specially in lower premolar area and upper central incisors.

normal

distortion

Technique & Projection errorsc. Projection errors

Incorrect vertical angulation

It will lead to:•Elongated image due to insufficient v. angulation ( too flat), or•Shortened image due to excessive v. angulation ( too steep)


Incorrect horizontal angulation

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.


PID alignment artifact

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.It appear as a clear area with curved outline.

Asuan – Egy.

II. Exposure errors.

Blank image.Low density image.High density image.Image with high and low contrast.

Exposure errors

Blank image

A film that didn’t receive radiation will have no image and will appear clear.

Low density (faint) image

Exposure errors

Exposure errors

High density image

III. Processing errors

Chemical errors:•Light image.•Dark image.•Blank image.•Reticulation.•Black spot or patch.•Black line.•White spot or patch.•Yellowish brown discoloration.

Film Handling errors:•Writing lines•Developer cut off•Fixer cut off•Overlapped film•Finger nail artifact•Smudge.•Scratched film•Static electricity

Processing errorsChemical errors

Reticulation

When the film subjected to a sudden temperature changes between the developer and water.Appear as cracked film.


Black spot or patch

Developer contamination before immersion into the developer solution.

Black line


Developer contamination processing hanger clipsDirty roller in automatic processor

White spot or patch


Contamination with fixer before processing

Yellowish brown discoloration


Exhausted solution or insufficient rinsing

Processing errorsFilm Handling errors

Writing 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.

Developer cut off


A straight blank white border due to underdeveloped portion. The film may not be completely immersed in the developer solution.

Fixer cut off


A straight black border. The film may not be completely immersed in the developer solution.


Overlapped filmFilm that overlap in developer are white, while that overlap in fixer are black


Smudge (finger print)

When the film touched by fingers contaminated with developer or fixer


Scratched film

White lines appear on the film due to careless handling of the film.


Static electricityThin 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.Occur most frequently during periods of low humidity

Metallic partial denture

Blurred

Reverse image

Apices cut off

Dropped corner

Distortion

Elongation

Horizontal overlap

Double image

Low denisty

Static electricity

White spot or patch

Yellowish brown discoloration

Reverse image

Cone-cut

Developer cut off

Thank You

radiographic errors and artifacts

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