Earn 3 CE credits This course was written for dentists, dental hygienists, and assistants. For additional information on this topic, please see “Strategies for Optimal Intraoral Digital Strategies for optimal Imaging, Part 2” on www.DentalAcademyofCE.com intraoral digital imaging Part I: Intraoral receptors, techniques, and instrumentation A Peer-Reviewed Publication Written by Gail F. Williamson, RDH, MS Abstract Educational Objectives: Author Profile Radiographic examinations should be made only The goal of this course is to provide the reader Gail F. Williamson, RDH, BS, MS, is a professor of Dental Diagnostic Sciences in when the dentist has determined they are necessary with contemporary information on intraoral the Department of Oral Pathology, Medicine and Radiology at Indiana University for diagnostic and treatment purposes. Radiographic digital radiography. Upon completion of Part I of School of Dentistry in Indianapolis, Indiana. She received an A.S. in Dental Hygiene, selection criteria have been published by the American this course, the reader will be able to a B.S. in Allied Health, and a M.S. in Education, all from Indiana University. She Dental Association (ADA) to assist dentists in decision- 1. List and describe the types of digital recep- serves as Director of Allied Dental Radiology and Course Director for Dental Assist- making and justification of the prescription (See table tors used for intraoral radiographic imaging; ing and Dental Hygiene Radiology courses. A veteran teacher, Prof. Williamson has 1).1 Once such a determination has been made, it is 2. List and describe the principles of paralleling, received numerous awards for teaching excellence throughout her career. She is a the responsibility of the dentist to ensure that optimal bitewing, and bisecting angle techniques for published author and presents numerous continuing education courses on Oral and radiographic images are obtained at the lowest possible effective intraoral digital imaging; Maxillofacial Radiology on the national level. In addition, she is actively involved in dose of radiation. Because radiographic procedures are 3. List and describe the intraoral receptor the American Academy of Oral and Maxillofacial Radiology and currently serves as delegated to dental hygienists and dental assistants, it instruments that can be used to acquire a radiology expert on the American Dental Association’s Dental Hygiene National is important that these radiographers have the knowl- periapical and bitewing images. Board Test Construction Committee B. She can be reached at [email protected] . edge, skill, and technical acumen to obtain optimal results. Increasingly, digital radiographic imaging is Author Disclosure being used with two types of receptors: photostimulable Gail F. Williamson, RDH, BS, MS has no commercial ties with the sponsors or the phosphor plates and solid-state detectors. providers of the unrestricted educational grant for this course. INSTANT EXAM CODE 15135 Go Green, Go Online to take your course Publication date: Aug. 2010 This educational activity was made possible through an unrestricted educational grant by Dentsply. This course was written for dentists, dental hygienists and assistants, from novice to skilled. Review date: Oct. 2013, Supplement to PennWell Publications Educational Methods: This course is a self-instructional journal and web activity. Sept. 2016 Provider Disclosure: PennWell does not have a leadership position or a commercial interest in any products or services discussed or shared in this educational activity nor with the commercial supporter. No manufacturer or Expiration date: Aug. 2019 third party has had any input into the development of course content. Requirements for Successful Completion: To obtain 3 CE credits for this educational activity you must pay the required fee, review the material, complete the course evaluation and obtain a score of at least 70%. CE Planner Disclosure: Heather Hodges, CE Coordinator does not have a leadership or commercial interest with products or services discussed in this educational activity. Heather can be reached at [email protected] Educational Disclaimer: Completing a single continuing education course does not provide enough information to result in the participant being an expert in the field related to the course topic. It is a combination of many PennWell designates this activity for 3 Continuing Educational Credits educational courses and clinical experience that allows the participant to develop skills and expertise. Dental Board of California: Provider 4527, course registration number CA# 03-4527-15135 Image Authenticity Statement: The images in this educational activity have not been altered. “This course meets the Dental Board of California’s requirements for 3 units of continuing education.” Scientific Integrity Statement: Information shared in this CE course is developed from clinical research and represents the most current information available from evidence based dentistry. The PennWell Corporation is designated as an Approved PACE Program Provider by the Known Benefits and Limitations of the Data: The information presented in this educational activity is derived Academy of General Dentistry. The formal continuing dental education programs of this from the data and information contained in reference section. The research data is extensive and provides direct benefit program provider are accepted by the AGD for Fellowship, Mastership and membership to the patient and improvements in oral health. maintenance credit. Approval does not imply acceptance by a state or provincial board of Registration: The cost of this CE course is $59.00 for 3 CE credits. dentistry or AGD endorsement. The current term of approval extends from (11/1/2015) to Cancellation/Refund Policy: Any participant who is not 100% satisfied with this course can request a full (10/31/2019) Provider ID# 320452. refund by contacting PennWell in writing. Educational Objectives Introduction The goal of this course is to provide the reader with con- temporary information on intraoral digital radiography. Digital Radiographic Imaging: A Primer Upon completion of Part I of this course, the reader will To meet clinical requirements, dental radiographic im- be able to ages must be as accurate and detailed as possible. Digital 1. List and describe the types of digital receptors used for imaging has surpassed film radiography as the primary intraoral radiographic imaging; modality for acquiring and archiving intraoral images. 2. List and describe the principles of paralleling, bitewing, Digital imaging offers several advantages over film radi- and bisecting angle techniques for effective intraoral ography, including digital imaging; • the visualization of images on a monitor; 3. List and describe the intraoral receptor instruments that • computerized archiving of images; can be used to acquire periapical and bitewing images. • the ability to enhance acquired images; • the potential for radiation exposure reduction; and Abstract • rapid image acquisition without the need for chemi- Radiographic examinations should be made only when the cal processing, darkroom maintenance, and chemical dentist has determined they are necessary for diagnostic waste disposal. and treatment purposes. Radiographic selection criteria In order to produce high-quality diagnostic images, have been published by the American Dental Association careful technique is required. A clinician’s technique (ADA) to assist dentists in decision-making and justifica- must consider best practices, imaging principles, and tion of the prescription (See table 1).1 Once such a determi- patient comfort. Proper technique, effective patient nation has been made, it is the responsibility of the dentist management, and proper exposure maximize the infor- to ensure that optimal radiographic images are obtained at mation available from intraoral images and, therefore, the lowest possible dose of radiation. Because radiographic their diagnostic value. procedures are delegated to dental hygienists and dental Typically, clinicians perform radiographic examina- assistants, it is important that these radiographers have the tions to evaluate oral disease states such as periodontal knowledge, skill, and technical acumen to obtain optimal disease, caries, and periapical pathoses. For periodontal results. Increasingly, digital radiographic imaging is being disease and periapical pathoses, the radiographic projec- used with two types of receptors: photostimulable phos- tion of choice is usually a periapical image or series of phor plates and solid-state detectors. images that record the entire tooth and supporting bone. Table 1: Recommendations for Patient Selection in Brief Type of Patient Child Primary Child Transitional Adolescent Adult Dentate / Adult Edentulous Encounter Dentition Dentition Permanent Dentition Partially Edentulous New Bitewings if contacts Bitewings/Panoramic Bitewings/Panoramic Bitewings/Panoramic Individualized exam Patient closed; Selected PAS/ or Bitewings/ FM when indicated FM when indicated based on signs/ Occlusals Selected PAS symptoms Recall – Clinical Bitewings at 6-12 Bitewings at 6-12 Bitewings at 6-12 Bitewings at 6-18 Not Applicable Caries; Increased month intervals month intervals month intervals month intervals Caries Risk Closed contacts Closed contacts Recall - No Bitewings at 12-24 Bitewings at 12-24 Bitewings at 18-36 Bitewings at 24-36 Not Applicable Clinical Caries; month intervals month intervals month