Tomography and Dental Radiography - Coursework Example

Tomography and dental radiography Name Institution Subject Instructor Date Introduction The model of the Tomography and Dental Radiography machine in consideration here is Dental panoramic machine PC-100 and the company that manufactures it is the `Weiku.com’. The portable panoramic x-ray machine is also referred to as `MAYA’1 Dental Radiographs are often referred to as x-rays. Radiographs are used by dentists for several reasons: to look for dental structures, bone loss, benign masses and cavities that are hidden. The formation of a radiographic image is achieved through penetration of x-ray radiation into the oral structures. This happens at different levels since the radiation is subjected to controls. The level of penetration depends on the variation in the anatomic densities before a film or a sensor is stroke by the radiation. Radiology is very useful when it comes to providing diagnostic assessment to the patient with dental problems2. Guidelines used in selecting appropriate procedures for radiography for dental patients should be clearly provided and outlined. As soon as the exposure of a photographic film to the x-ray radiation has been done, its development follows with the use of a process that involves a series of chemicals with which the exposure of the film is carried out inside a dark room3. This is because of the sensitivity of the films to normal light4. This process, however, consumes a lot of time and retakes in the process can be necessitated by errors in the development process or incorrect exposure, and therefore the patient becomes exposed to additional radiation. X-rays that are digital in nature are used in place of an electronic sensor. They are very useful in addressing the issues of errors in the whole process due to their wide use in dentistry with the evolutions in technology. The electronic sensors require a small amount of radiation and take a shorter time to be processed as compared to conventional radiographic films5. However, the disadvantage of the electronic sensors in that they are extremely expensive and they are known to produce poor resolution but that has since been enhanced with the introduction of modern sensors. Relationship between Tomography angle and Section Thickness The accomplishment of tomography is obtained though the movement of the x-ray tube as well as the image receptor through a structure that is anatomic in nature. It can also be obtained through the movement of the anatomical components having the parts of interest. This entire process is referred to as Auto tomography6. Tomography is influenced by several factors which include; the distance between the focal planes and the objects, distance between the image receptor and the objects, the amplitude of exposure as well as the mode of tomography utilized. The tomography angle exposure and the section thickness are related in the sense that the tomography exposure angle makes determination of the section thickness of a tomographic image. An extended arc releases a tomographic section that is small in thickness whereas a smaller angle releases a tomographic section with a large or thick section. The contrast of the image is affected by the exposure angle. Safe operation details for the dental panoramic machine Warning Systems In comparison to the conventional dental x-ray machine, dental panoramic machine releases a general widely distributed dose in the course of exposures, and unlike conventional dental x-ray machine. Usually needs power from the mains to be constantly in supply throughout the operation day. It is recommended that the machine be in possession of the following features to ensure the safety of operation through the warning systems; warning lights that are two stage in functionality on the outer side of all entries to the room housing the machine. This should be operational automatically so as to be able to promptly alert the operator when the x-rays are just about to be emitted and also when the process of their emission is ongoing7. The intentions of the two lights should be well clarified and understood in compliance with the Health safety Sins and Signals. The one operating the machine should desist from always disconnecting the machine from its power source whenever there is an incident. Instead there should be in position appropriate emergency mains isolator as well as emergency on and off switches in a position that they can be operated by the operator without necessarily having to get into the room8. There should also be provision of sufficient guarding to prevent the machine from being operated by unauthorized person either willingly or unwillingly. Exposure Restriction It is fundamentally a requirement to enforce restriction to a reasonable and practical extent to which the staff or any other unintended person is exposed to the radiation. Procedural Controls In the case of a dental radiography that is conventional, the operator positioning him/herself at 1.5m way from the head of the tube producing the x-rays would have been normally sufficient; however, the usual greater levels of widely distributed radiation released in the course of examination could problematic9. This being the case, all other people except the patient should be behind a shielded area if they have to be in the room or be outside the room during the examinations. Critical examination It is upon the one installing to make sure that a critical examination done for all Dental panoramic machines. The performance of a critical examination of the machine should also be carried out in the event that any Dental Panoramic machine is relocated to different area. The critical examination should ensure that the safety measures regarding the patient and any other person around are fully observed10. Prior risk assessment Appropriate and sufficient risk assessment should be done in consultation with the relevant authorities before commencement of any new activity that uses the radiation. Personal protective equipment Lead apron should be appropriately worn by any other person present in the room apart from the patient during the examination. The lead aprons must be properly stored when they are not in use by hanging to avoid folding or creasing. Designation of areas It is a necessity effect the designation of areas that surround the room housing the equipment through control or supervision outside the room constructed according to the requirements of the relevant authorities. Classified persons It is necessary that any person that is working with the machine be classified according to the guidance as dosses that have the likelihood of being received in the course of reasonable predicted accidents and annual effective dosses which should be clearly indicated. Pregnant employees Since the dose taken by any employee is required to be substantially less than 1 mSv annually, the dose received by the fetus should as well be less than this given amount and therefore is not necessary to enforce any special measures. However there may be provisions of protective measures for the female employees for purposes of reassurance. Posting Posting of the following items will be done in the dental clinic; registration of the radiation machine, licenses of the health care workers, a description of the rights of workers to work in places with radiation, safety information, as well as warning or caution signs. Exposure Limits that is non-occupational to members of the public Necessary measures for safeguarding electromechanically safety in relation to the features of the system The switch to the main power input shall only be used to secure disconnection of the main power and the device. The only cord that shat shall be used for power connection to the x-ray machine is the one provided by the specialists and not any other. Every electrical connection to the x-ray device must be properly grounded. No metallic objects or any other objects shall be inserted or come into contact with the components of the x-ray device while in use or not in use11. A thorough check of the device cables shall always be done regularly for damaged cables before switching on the device. The damaged cables sockets and plugs must be replaced before switching on the device for use. Never come into contact with the naked supply outlets and simultaneously touch the patient. Ensure all the electrical connections are secure or put away from reach by water or damp environment. Gonad shields of Contact-type used in radiology of routine diagnostic must contain a lead of estimated thickness of a minimum of 0.25 mm and should possess a lead of estimated thickness of 0.5 mm12. Gonad shields of contact type must be of appropriate size and shape to remove the gonads totally from irradiation of primary beam. Protective gloves to be worn for use in fluoroscopy must possess attenuation that is estimated to at least 0.25 mm of lead. Necessary radiation protection measures The radiation protection measures for the safe operation of the Dental Panoramic machine systems are a must. Survey of radiation protection of facility is aimed at demonstrating that the installation of the device is operational in a safe environment and that all its components are properly functional. It is also a necessity to the functionality of the device provides safety to both the patient and the staff and that it functions in accordance to the acceptable standards. For this reason it is important to make regular survey of x-ray devices and facilities. The necessary radiation protection measures involve the following procedures; there should be a deferment of any operation of new installations it is declared by a qualified expert that it complies with installation regulations. A survey must also be done after any change in an old installation, which may lead to production of a radiation hazards which include alterations barriers used for protection, exchange of radiation equipment with equipment that operates at higher potentials or that brings about changes in operating procedures13. It is of great importance and also of necessity to carry out visual inspections when installation of a new device in underway, to for purposes of ensuring compliance with specifications and to make identification of faulty workmanship or material, because deficiencies can be discouraged in a more economical way at this juncture than at later stage14. Such inspections must consist of determining the thickness of lead or the thickness of concrete as well as its density, the extent of overlap between the sheets of lead as well as other barriers and also the density and thickness of the leaded glass in the viewing component of the device. In order to ensure a successful radiation protection measure in relation to the features of the system it is important to carry out a detailed and rigorous survey procedure for the emission of radiation from the gadget or device. The outcomes of the survey as well as the conclusions arrived at by the qualified personnel must be handed to the person or a responsible user and it should be in the form of a report that is properly written. All similar written reports should be under the custody of a responsible owner or the user. Necessary ways to maximize clinical utilization in relation to the features With regard to the features of the Dental panoramic machine, maximization of its clinical utilization can be made possible through ease of operation as a result of angled mirror and inscribed lines that enable accurate establishment of the density of skull as well as accurate settings. The aids in the elimination guess work which typically happens in radiographic panoramic procedures15. The panoramic machine also possesses easy and quick installation features. This allows wide and extensive use of the machine in the clinic. It can also be used by a wider range of the staff after a simple training lesson. The panoramic machine also has got standard accessories and components. This maximizes its utilization by making it possible for it to be used in different places and making its maintenance easy. Quality assurance task for the Dental Panoramic machine The QA program task is to ensure the machine is maintained at a state that makes it possible to restrict patient’s dose adequately. The QA program task shall entail the following; Appropriate testing Before commencement of the initial clinical activity which is usually referred to as acceptance testing Regular testing with the inclusion of in house checking at intervals that are appropriate that should follow any maintenance that is carried out majorly. Carrying out a patient dose that is representative in nature Extents of actions that are suspension and remedial Carrying out inspections according to the recommendations of the supplier as well as preventive maintenance Adequate testing Details of adequate testing as well as recommended standards of performance should be published and made clear. The tests that are performed following installation should be relevant and appropriate enough to allow comparisons to be made between them and those of manufacturer’s specifications. Achievable dose The achievable dose is provided with an intention to offer assistance to people who are responsible for the purchase of latest models of the dental panoramic machines. The persons responsible are expected to make selection of those that are able to offer doses to patients with restrictions during the process of dental examination. There should be application of doses that are achievable to the machines that are in existence so as obtain quality data sufficiently for clinical purposes16. Operators should be in a position to receive advice on how best to make optimization of radiations exposed to patients until the upgrading or replacement of the machine takes place. In situations where the dose of the patient is considerably high, it is recommended that the utilization of the machine only takes place only for better specific examination. Regular annual testing and modifications The machine should be subjected to appropriate testing at regular intervals. Tests should also be additionally carried out immediately after modifications or minor repairs of the equipment. If it is suspected that the modification or repairs may have in one way or another interfered with the functioning of the radiation system or the radiation safety of the equipment, then the performance of a critical examination must be done before any further usage of the equipment. The outcomes obtained from all the tests performed are subjected to comparison against the baseline outcomes gathered following the installation to confirm that there are no interferences in the quality performance of the image or increase in the dose of the patient considerably. Monthly checks Other than the regular yearly testing, it is a recommendation that checks done after every month be performed to ascertain the quality of the image as well as the equipment performance with the inclusion of the of the screen display17. This should be performed by the operator and subjected to comparison against the baseline values and performance specifications of the manufacturer. However, in the event that values of remedy are passed there should be actions to enhance the performance. If there is exceeding of the level of suspension, then withdrawal of the equipment from clinical use should take place immediately until rectification of the fault. Maintenance and examination of engineering controls The quality assurance in accordance with regulations should consist of inspection and preventive maintenance performed by a qualified and authorized practitioner. This should take into consideration warning and safety features as well as engineering controls availed alongside the machine. Appropriate as well as sufficient examination and maintenance of engineering controls is also a requirement in accordance with the regulations. Summary Just like any x-ray exposure, Dental Panoramic machine exposes the patient to risks. The initial step in getting rid of unneeded exposure is to make sure that any dental examination that is carried out is justified. Before commencing a dental examination, it must be there must be justification by a qualified and authorize practitioner. In such a case an adequately qualified practitioner is none other than a dentist. Dentists are the best qualified persons to take part in the performance of these roles. The decision in the justification of the exposure must appropriately highlight the following issues; All diagnostics that is potentially beneficial to the individual Risks of radiation that are related to the radiographic examination The availability of the results of radiographs carried out in the past The specific aims of the exposure with regard to examination as well as history off the patient The benefits, efficacy as well as risks associated with present methods with similar objectives but with the involvement of less or no exposure to radiation. It is useful to obtain strategies that involve administrative rules that need every radiation device and the registrants in charge to provide adequate shielding of the x-ray beams and radiations that proceed from the devices that are being used. The reason for this requirement is to make sure that members of the general public and operators of the machine are protected from unnecessary exposure to dangerous and harmful radiations and x-rays. The requirements of shielding by potential exposure of human beings and should take into consideration factors of occupancy such as distance and work done. As for units of dental intra oral position that is protected is a requirement for the operator and there is usually no requirement of additional shielding for the radiation that is scattered when walls are estimated to two thicknesses as compared to drywall. Mobile x-ray devices that are utilized should possess openings located at strategic positions for ease of use by the operators. References Atkinson, Martin. Anatomy for Dental Students. (Oxford: Oxford University Press, 2013), 67. Basrani, Bettina. Endodontic Radiology. Ames, (Iowa: John Wiley & Sons, Ltd, 2012), 58. Becker, Adrian. Orthodontic Treatment of Impacted Teeth. Chichester, (West Sussex, UK: Wiley-Blackwell, 2012), 23-45. Burket, Lester W., Martin S. Greenberg, Michael Glick, and Jonathan A. Ship. Burket's Oral Medicine. (Hamilton, Ont: BC Decker, 2008), 89. John R., Pramod. Essentials of Dental Radiology. (New Delhi: Jaypee, 1999), 38. Koch, Göran, and Sven Poulsen. Pediatric Dentistry: A Clinical Approach. (Chichester, UK: Wiley-Blackwell, 2009), 74-75. Langland, Olaf E., Robert P. Langlais, and John W. Preece. Principles of Dental Imaging. (Baltimore, Md: Lippincott Williams & Wilkins, 2002). Meyer-Lueckel, Hendrik, Sebastian Paris, and Kim R. Ekstrand. Caries Management: Science and Clinical Practice. (Stuttgart: Thieme, 2013) 39-47. Nield-Gehrig, Jill S., and Donald E. Willmann. Patient Assessment Tutorials: A Step-by-Step Procedures Guide for the Dental Hygienist. (Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins, 2013) 103. Pasler, Friedrich Anton, and Heiko Visser. Pocket Atlas of Dental Radiology. Stuttgart: Thieme, 2007. Rai, Balwant, and Jasdeep Kaur. Evidence-Based Forensic Dentistry. (Berlin: Springer, 2013) 49 United Nations. Sources and Effects of Ionizing Radiation Vol. 1 Sources. (New York: United Nations, 2000),110-113. Whaites, Eric, and R. A. Cawson. Essentials of Dental Radiography and Radiology. (Edinburgh: Churchill Livingstone, 2007), 92. www.dentalcare.com/media/en Health and medical supply information –health and medical suppliers and manufactures on,``Weiku integrating global trade links, ‘’ http://www.weiku.com/Measurement-Analysis-Instruments/buy-panoramic-x-ray-machine.html[ Acessed 7th may 2013] Read More

Relationship between Tomography angle and Section Thickness The accomplishment of tomography is obtained though the movement of the x-ray tube as well as the image receptor through a structure that is anatomic in nature. It can also be obtained through the movement of the anatomical components having the parts of interest. This entire process is referred to as Auto tomography6. Tomography is influenced by several factors which include; the distance between the focal planes and the objects, distance between the image receptor and the objects, the amplitude of exposure as well as the mode of tomography utilized.

The tomography angle exposure and the section thickness are related in the sense that the tomography exposure angle makes determination of the section thickness of a tomographic image. An extended arc releases a tomographic section that is small in thickness whereas a smaller angle releases a tomographic section with a large or thick section. The contrast of the image is affected by the exposure angle. Safe operation details for the dental panoramic machine Warning Systems In comparison to the conventional dental x-ray machine, dental panoramic machine releases a general widely distributed dose in the course of exposures, and unlike conventional dental x-ray machine.

Usually needs power from the mains to be constantly in supply throughout the operation day. It is recommended that the machine be in possession of the following features to ensure the safety of operation through the warning systems; warning lights that are two stage in functionality on the outer side of all entries to the room housing the machine. This should be operational automatically so as to be able to promptly alert the operator when the x-rays are just about to be emitted and also when the process of their emission is ongoing7.

The intentions of the two lights should be well clarified and understood in compliance with the Health safety Sins and Signals. The one operating the machine should desist from always disconnecting the machine from its power source whenever there is an incident. Instead there should be in position appropriate emergency mains isolator as well as emergency on and off switches in a position that they can be operated by the operator without necessarily having to get into the room8. There should also be provision of sufficient guarding to prevent the machine from being operated by unauthorized person either willingly or unwillingly.

Exposure Restriction It is fundamentally a requirement to enforce restriction to a reasonable and practical extent to which the staff or any other unintended person is exposed to the radiation. Procedural Controls In the case of a dental radiography that is conventional, the operator positioning him/herself at 1.5m way from the head of the tube producing the x-rays would have been normally sufficient; however, the usual greater levels of widely distributed radiation released in the course of examination could problematic9.

This being the case, all other people except the patient should be behind a shielded area if they have to be in the room or be outside the room during the examinations. Critical examination It is upon the one installing to make sure that a critical examination done for all Dental panoramic machines. The performance of a critical examination of the machine should also be carried out in the event that any Dental Panoramic machine is relocated to different area. The critical examination should ensure that the safety measures regarding the patient and any other person around are fully observed10.

Prior risk assessment Appropriate and sufficient risk assessment should be done in consultation with the relevant authorities before commencement of any new activity that uses the radiation. Personal protective equipment Lead apron should be appropriately worn by any other person present in the room apart from the patient during the examination. The lead aprons must be properly stored when they are not in use by hanging to avoid folding or creasing.

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