Dr. Axel Ruprecht - Cephalometrics (Radiology Lectures)

Cephalometrics (Radiology Lectures)

Department:	Orthodontics
Course Title:	Cephalometrics (Radiology Lectures)
Course Number:	89:217
Curriculum Level	Graduate I
Course Director:	Dr. K. Southard
Course Contributor:	Dr. A. Ruprecht
	Ms. R. Stanley

Students seeking academic accommodations for disabilities should contact the instructor and/or the Assistant Dean for Student Affairs.

I. COURSE DESCRIPTION

The radiology lectures/seminars, one clinic, and the assigned and suggested reading material present an overview and review of certain features of radiology that are of interest and concern to practitioners in orthodontics or pediatric dentistry. The areas covered range from the production of x rays, their interaction with matter, through radiation biology and protection, to the production of the radiograph. Various other imaging systems and methods that are commonly used in diagnostic imaging departments are also introduced or reviewed.

II. SYNOPSIS OF GOALS

The student will have a review of materials previously covered in predoctoral dental programs sufficient to allow him or her to undertake independent in-depth review of those aspects of radiology that will pertain to his or her future practice in this area, and to discuss these further, on an individualized basis, with faculty members in Radiology or Orthodontics.

III. COURSE OUTLINE

Lectures:

Lecture 1 Production of the X Ray (Curry et al, pp 10-60)

Lecture 2 Absorption of the X Ray. (Curry et al, pp 61-86)

Lecture 3 Radiation Biology/Hygiene (Curry et al, pp 372-391 & reading list)

Lecture 4 When patients ask

Lecture 5 Tomography and Pantomography (Curry et al, pp 242-256)

Lecture 6 Production of the Radiograph/Processing(Curry et al, pp 99-164)

Lecture 7 Newer Imaging Modalities

Clinic:

Clinic PA Hand /Wrist radiograph

Pantomograph (specifically Panorex®)

10 film periapical series (10 CMS)

III. METHODOLOGY

References:

ADA Recommendations for radiographic darkrooms and darkroom practices. JADA 104:886-887, June 1982.

ADA Biological effects of radiation from dental radiography. JADA 105:275-281, 1982.

ADA Recommendations in radiographic practices: an update, 1988. JADA 118:115-117, Jan. 1989.

Curry T.S., Dowdy J.E. and Murry, R.C. Christiansen's Introduction to the Physics of Diagnostic Radiology. 3ed.Lea & Febiger, Philadelphia, 1984.

Friedland, G. and Klein, R.S. Transmission of the Human Immunodeficiency Virus. N Engl J Med 317:1125-1134, October 1987.

Hardman, P.K. Tilman, M.F. and Taylor, T.S. Radiographic solution contamination. Oral Surg, Oral Med, Oral Pathol 63:733-737, June 1987.

Kodak. Exposure and Processing for Dental Radiography. Eastman Kodak Co., Rochester, 1990.

Kodak. Improved Image Quality for Cephalometric and Extraoral Radiography. Eastman Kodak Co., Rochester, 1989.

Kodak. Kodak Ektaspeed Dental Film. Eastman Kodak Co., Rochester, 1987.

Kodak. Kodak GBX Chemicals. Manual Processing Guide for Dental Radiography. Eastman Kodak Co., Rochester, 1989.

Kodak. Kodak X-Omat Duplicating Film. Eastman Kodak Co., Rochester, 1987.

Kodak. Quality Assurance in Dental Radiography. Eastman Kodak Co., Rochester, 1990.

Kodak. Radiation Safety in Dental Radiography. Eastman Kodak Co., Rochester, 1990.

Kodak. Successful Intraoral Radiography. Eastman Kodak Co., Rochester, 1990.

Kodak/FDA. Guidelines for Prescribing Dental Radiographs. Eastman Kodak Co., Rochester, 1989.

Langland, O.E. and Sippy, F.H. Anatomic Structures as Visualized on the Orthopantomogram. Oral Surg, Oral Med, Oral Pathol 26:475-484, 1968.

MacDonald, J.C., Reid, J.A. and Berthoty, D. Drywall construction as a dental radiation barrier. Oral Surg, Oral Med, Oral Pathol 55:319-326, March 1983.

Reid, J.A. and MacDonald, J.C. Use and workload factors in dental radiation-protection design. Oral Surg, Oral Med, Oral Pathol 57:219-224, Feb, 1984.

Ruprecht, A. Radiologic Anatomy. University of Iowa, Iowa City, 1987. (available for review in the main Oral and Maxillofacial Radiology Interpretation Room, DSB S-351)

Sewerin, I.P. Mechanically induced images on dental x-ray films. Oral Surg, Oral Med, Oral Pathol 63:241-248, Feb, 1987.

Smith, C.J. and Fleming, R.D. A comprehensive review of normal anatomic landmarks and artifacts as visualized on Panorex radiographs. Oral Surg, Oral Med, Oral Pathol 37:291-304, Feb, 1974.

Tyndall, D.A. and Bedsole, S.M. Exposure reduction and image quality for pantomographic radiography. Radiol Tech 59:51-53, 1987.

The Dental Radiographic Selection Panel and Joseph, L.P. The Selection of Patients for X-Ray Examinations: Dental Radiographic Examinations. HHS Publication FDA 88-8873, Rockville, 1987.

University of Iowa College of Dentistry. Use of Radiation in the Dental Clinics, 1988.

University of Iowa College of Dentistry. Asepsis for Radiology, 1991.

Recommended Other Reading

Selman, J. Fundamentals of X-Ray and Radium Physics, 7th ed. Charles C. Thomas, Springfield, 1985. (on reserve in Health Sciences Library)

V. PRE-REQUISITES AND/OR CO-REQUISITES

A. Pre-requisites

Predoctoral Radiology.

B. Co-requisites

None.

VI. BEHAVIORAL OBJECTIVES

1.01	The student will be able to identify the parts of a stylized x-ray unit circuit.
1.02	The student will be able to explain how a transformer works.
1.03	The student will be able to explain how an autotransformer works.
1.04	The student will be able to explain what is meant by cycles and frequency.
1.05	The student will be able to explain what is meant by thermionic emission.
1.06	The student will be able to explain what is meant by full and half-rectification and why it is important.
1.07	The student will be able to explain the difference between a stationery and rotating target (anode) tube and why each is necessary.
1.08	The student will be able to explain how bremsstrahlung (braking radiation) is produced in the target of tube.
1.09	The student will be able to explain how characteristic radiation is produced in the tube.
1.10	The student will be able to explain the heel effect and where it is useful.
2.01	The student will be able to describe and explain the inverse square law.
2.02	The student will be able to explain Thomson effect.
2.03	The student will be able to explain photoelectric effect.
2.04	The student will be able to explain Compton effect.
2.05	The student will be able to explain the relationship among frequency, wavelength, and energy levels of radiation.
2.06	The student will be able to explain HVL.
2.07	The student will be able to explain how secondary and scatter radiation are produced.
3.01	The student will be able to describe and differentiate between direct and indirect effects of radiation on biological molecules.
3.02	The student will be able to explain ionization and radical production.
3.03	The student will be able to explain the proper procedures for radiation protection of the patient, staff and operator in a clinic where x rays are used to make radiographs.
3.04	The student will be able to explain by example the concept of MPD (MAD).
4.01	The student will have an appreciation of what patients wish to know in answer to commonly asked questions.
5.01	The student will be able to explain the principle underlying tomography.
5.02	The student will be able to explain the principle underlying pantomography.
5.03	The student will be able to explain why a thin slit beam is used for pantomography.
5.04	The student will have a simple understanding of the nature and role of the various alternative imaging modalities available to the health sciences for patient management.
6.01	The student will be able to explain density.
6.02	The student will be able to explain contrast.
6.03	The student will be able to explain detail.
6.04	The student will be able to explain definition.
6.05	The student will be able to explain the effect of kVp on density, contrast, detail and definition.
6.06	The student will be able to explain mA.
6.07	The student will be able to explain the effect of time on exposure.
6.08	The student will be able to list the major components of developer and their role in processing.
6.09	The student will be able to list the major components of fixer and their role in processing.
6.10	The student will be able to list the types of distortion and their cause.
6.11	The student will be able to describe the major components of a film packet, their location and role.
6.12	The student will be able to describe and x-ray film and tell for what the components are used.
6.12	The student will be able to describe and x-ray film and tell for what the components are used.
6.13	The student will be able to describe a film-screen system and what each part is for.
6.14	The student will be able to describe and explain stationery and movable grids.
6.15	The student will be able to recognize and explain the cause of major radiographic clinical darkroom technique errors.
6.16	The student will be able to explain the role of the collimator.
6.17	The student will be able to explain the role of the filter.
6.18	The student will be able to understand and appreciate the questions asked by patients regarding radiation, and see how to formulate answers appropriate to the situation.
7.01	The student will be able to appreciate the various changes in imaging technology, and recognize how these may be utilized in dentistry for the benefit of the patient.

VII. MEASUREMENT AND EVALUATION

The student will be required to know how to produce satisfactory radiographs of the teeth, skull (cephalometric), and wrist that are necessary for the practice of orthodontics, while practicing proper radiation hygiene. This section of the cephalometric course will be examined by using objective questions, as part of the overall examination.