YOU’VE JUST PURCHASED MORE THAN A TEXTBOOK TO ACCESS YOUR STUDENT RESOURCES, VISIT http://evolve.elsevier.com/Iannucci /dentalradiography/ • Self-Study Examination: 267 multiple-choice questions with answers, rationales, and page number references provided in instant feed back format. • Case Scenarios: One scenario per chapter presented with accompanying questions, answers, and rationales. • Glossary Exercises: Crossword puzzles based on the key terms from the chapters. • Labeling Exercises: Drag-and-drop labeling of equipment, positioning drawings, photographs, and radiographs • Interactive Exercises: Animations, case studies, and activities. • WebLinks: Links to relevant websites and information that supplement the content of the textbook and encourage further online research and fact-finding REGISTER TODAY! This page intentionally left blank Joen M. Iannucci, DDS, MS Professor of Clinical Dentistry The Ohio State University College of Dentistry Columbus, Ohio Laura Jansen Howerton, RDH, MS Instructor Wake Technical Community College Raleigh, North Carolina 3251 Riverport Lane St. Louis, Missouri 63043 Dental Radiography Principles and Techniques ISBN: 978-1-4377-1162-2 Copyright © 2012, 2006, 2000, 1996 by Saunders, an imprint of Elsevier Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Previous editions copyrighted 2006, 2000, 1996 Library of Congress Cataloging-in-Publication Data Iannucci, Joen M. Dental radiography : principles and techniques / Joen M. Iannucci, Laura Jansen Howerton. — 4th ed. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4377-1162-2 (pbk.) 1. Teeth—Radiography. I. Howerton, Laura Jansen. II. Title. [DNLM: 1. Radiography, Dental—methods. WN 230] RK309.H36 2012 617.6′07572—dc22 2011005794 Acquisitions Editor: Kristin Hebberd Developmental Editor: Joslyn Dumas Publishing Services Manager: Catherine Jackson Project Manager: Sara Alsup Design Direction: Teresa McBryan Cover Designer: Maggie Reid Working together to grow libraries in developing countries Printed in the United States of America www.elsevier.com | www.bookaid.org | www.sabre.org Last digit is the print number: 9 8 7 6 5 4 3 Dedications To my son, Michael — To my dad, Angelo — To my mom, Dolores — thank you for your everlasting love, your encouragement, and a life filled with laughter. To each of my coworkers — thank you for your brilliant creativity, your support, and your extraordinary sense of humor. To each of my students, past & present — thank you for all you have taught me, and for the true privilege of being a part of your life. JMI To my husband, Bruce, who inspires me every day of my life. LJH Reviewers Roseann Bass, CDA Jane Helen Slach, CDA, RDA, BA Dental Assistant Program Coordinator Professor Department of Extended Studies Department of Health Science Norwalk Community College Kirkwood Community College Norwalk, Connecticut Cedar Rapids, Iowa Terry L. Doty, RDH, MS Lynne C. Weldon, CDA, RDH Assistant Professor Adjunct Professor Department of Nursing and Allied Health Department of Health Sciences/Dental Assisting Baltimore City Community College Northwest Florida State College Baltimore, Maryland Niceville, Florida J. Blake Perkins, DDS April V. Williams, RDH, BHSA, MDH CEO Assistant Professor Cascadia Dental Career Institute Department of Dental Hygiene Vancouver, Washington University of Tennessee Health Science Center Part-time Clinical Faculty Memphis, Tennessee Department of Restorative Dentistry Pacific University School of Dental Health Science Hillsboro, Oregon Sheri Lynn Sauer, CODA, CDA Dental Assisting Instructor, Secondary Department of Dental Assisting Eastland Career and Technical Schools Groveport, Ohio vi Preface Welcome to the fourth edition of Dental Radiography: Prin- 25 – Digital Radiography has been completely updated with ciples and Techniques. As the title suggests, the purpose of this new illustrations and content. This section also includes a text is to present the basic principles of dental radiography, brand new chapter on Three-Dimensional Digital Imaging and provide detailed information about radiographic tech- (Chapter 26). Chapter discussions are updated and expanded niques. This text offers a reader-friendly format with a balance to provide additional information on all types of digital of theory and complete technical instruction to develop radi- imaging and implants. One of the biggest additions to the ography skills. Our goal has always been to facilitate teaching fourth edition is the TEACH Instructor’s Resources. For and learning; the fourth edition continues the two purposes more information about this, see the section entitled: About set forth by the previous edition. EVOLVE. The fourth edition is also presented in full color. This helps clearly delineate the various learning features, and engages ABOUT THIS EDITION the student in the content. Colored line drawings and posi- One of the strengths of this text is its organization. To facili- tioning photos help modernize them, and improves the tate learning, the fourth edition is divided into manageable clarity in this highly visual subject area. New photos were parts for both the reader and instructor: added throughout the text regarding newer products and • Radiation Basics equipment. Additional radiographs illustrate periodontal • Equipment, Film, and Processing Basics conditions, and interpretation of common soft-tissue find- • Dental Radiographer Basics ings seen on intraoral films. • Technique Basics • Digital Imaging Basics ABOUT EVOLVE • Normal Anatomy and Film Mounting Basics • Image Interpretation Basics A companion Evolve website is available to students and Each chapter includes several features to aid in learning. instructors. The site offers a wide variety of additional learn- A list of objectives and key terms to focus the reader on the ing tools and greatly enhances the text for both students and important aspects of the material are presented at the begin- instructors. In addition, all of the content that was contained ning of every chapter. Key terms are highlighted in magenta on the CD-ROM will now be on Evolve. and bold typeface as they are introduced in the text. A com- plete glossary of more than 600 terms is included at the end FOR THE STUDENT of the book. Step-by-step procedures that provide students with everything they need to know are included in the tech- Evolve Student Resources offers the following: nique chapters. The material is organized in an instruction- • Self-Study Examination. 200—multiple-choice questions ally engaging, sound way that ensures technique mastery and are provided in an instant feedback format. This helps the serves as a valuable reference tool. Each of the technique student prepare for class, and reinforces what they’ve chapters include Helpful Hints that help students learn to studied in the text. recognize and prevent the most common pitfalls in the per- • Case Studies. Scenarios similar to those found on the formance of that technique, and provides a checklist of items National Board Dental Hygiene (NBDH) examination, as to guide both the novice, or the experienced practitioner. well as clinical and radiographic patient data, is presented Summary tables and boxes are included throughout the text. with challenging self-assessment questions. There is also a These provide easy-to-read synopses of text discussions that case scenario in each chapter followed by three to five support visual learners, and serve as useful review and study questions. tools. Quiz questions are included at the end of each chapter • Glossary Exercises. Crossword puzzles by chapter or to immediately test knowledge. Answers and rationales to groups of related chapters created from the book’s key the quiz questions are provided to instructors on the Evolve terms and glossary. website. • Labeling Exercises. Drag-and-drop labeling of equipment and positioning drawings and photographs. • Radiograph Identification Exercises. Drag-and-drop NEW TO THIS EDITION labeling of radiographs. In this edition, you will find a new section entitled Digital • WebLinks. Links to relevant websites and information Imaging Basics that addresses the advances made in Digital that supplement the content of the textbook and encour- Imaging since the publication of the third edition. Chapter age further online research and fact-finding vii viii Preface FOR THE INSTRUCTOR • Image Collection. All the text’s images available electroni- cally for download into PowerPoint or other classroom Evolve Instructor Resources offers the following: lecture formats • TEACH Instructor Resource Manual. Includes the following: FROM THE AUTHORS  TEACH Lesson Plans. Detailed instruction by chapters and sections, with content mapping. Are there any tricks to learning dental radiography? Most  TEACH PowerPoint Slides. Slides of text and images definitely! Attend class. Stay awake. Pay attention. Ask ques- separated by chapter. tions. Read the book. Learn the material. Do not cram.  Test Bank in ExamView. Approximately 1000 objec- Prepare for tests. Do not give up. tive-style questions with accompanying rationales and We hope that you will find the textbook and Evolve website page/section references for textbook remediation to be the most comprehensive learning package available for  Answers to Textbook Quiz Questions and Student dental radiography. Self-Study Questions. A mixture of fill-in-the-blank and short-answer questions for each chapter, with self- Joen M. Iannucci, DDS, MS submission and instant feedback and grading. Laura Jansen Howerton, RDH, MS