Dental Radiology
Midterm Exam
Course Introduction
Dental Radiology is a specialized course that focuses on the principles and practices of radiographic imaging within the field of dentistry. Students will learn about the physics of X-ray generation, radiographic techniques, and interpretation of images used for diagnosing oral diseases. The course covers safety protocols, proper handling of radiographic equipment, digital imaging advancements, and regulatory considerations to ensure minimal radiation exposure for both the dental professional and the patient. Emphasis is placed on developing the skills required to produce high-quality diagnostic images and accurately assess dental and maxillofacial conditions through radiographic evaluation.
Recommended Textbook
Radiology for the Dental Professional 9th Edition by Herbert H. Frommer
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Chapter 1: Ionizing Radiation and Basic Principles of X-Ray Generation
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Q1) Examples of particulate radiation include:
A)alpha particles
B)electrons
C)neutrons
D)all of the above
Answer: D
Q2) Because of the alternating current supplied to the x-ray tube it is considered to be
Answer: self-rectified
Q3) All of the following are properties of x-rays EXCEPT:
A)x-rays are invisible
B)x-rays travel in wavy lines
C)x-rays can penetrate structures
D)x-rays can adversely affect human tissue
Answer: B
Q4) The quality of the x-ray photons is determined by the __________. Answer: kilovoltage
Q5) The quantity of x-ray photons produced is determined by the _________ setting. Answer: milliamperage
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Chapter 3: Image Formation
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Q1) Scatter radiation can be reduced by all of the following methods EXCEPT:
A)open-ended PIDs
B)lead foil inside the film packet
C)kVp settings of 65 and below
D)using as small a beam as possible
Answer: C
Q2) Long-scale contrast gives the radiograph a (an):
A)black and white appearance
B)gray appearance
C)underpenetrated appearance
D)fogged appearance
Answer: B
Q3) The best way to view radiographs is:
A)unmounted
B)on a viewbox
C)using ambient light
D)in the darkroom
Answer: B
Q4) The most common cause of lack of detail on a radiograph is __________.
Answer: patient movement
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Chapter 4: Image Receptors
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Q1) A film that has been fogged will have decreased _____________.
Q2) Rare earth intensifying screens differ from calcium tungstate screens in:
A)the cost
B)the amount of light photons generated in the cassette
C)their flexibility
D)the image definition
Q3) Film speed is determined by:
A)the thickness of the emulsion
B)the presence of radiosensitive dyes
C)the size of the silver halide crystals
D)all of the above
Q4) Identify the fastest film speed currently available for intraoral radiography:
A)B
B)C
C)E
D)F
Q5) Film cassettes can be either _______ or _______.
Q6) The plot of film density versus exposure time is called a (an)___________.
Q7) When the x-ray photons strike the phosphors of the intensifying screen ________ photons are produced.
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Chapter 5: Biologic Effects of Radiation
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Q1) Identify this type of interaction with matter: an x-ray photon has its path altered by the atom, but no change to the atom occurs;a photon of scatter radiation is produced.
A)no interaction
B)Thompson scatter
C)photoelectric effect
D)Compton effect
Q2) Identify the largest source of artificial radiation to which the population is exposed:
A)medical and dental radiation
B)consumer products
C)nuclear accidents
D)solar radiation
Q3) The output of a dental x-ray machine is expressed in ________.
Q4) The threshold erythema dose for skin is:
A)3000 R
B)250 R per 14-day period
C)100 mR per week
D)250 mR
E)none of the above
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Chapter 6: Patient Protection
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Q1) It is predicted that the MPD will ________ be reduced in the near future.
Q2) An area in which a secretary sits constantly that is adjacent to a dental operatory where radiographs are taken is said to have an occupancy factor of:
A)8 hours
B)1
C)1/4
D)1/16
E)5 days
Q3) The removal of the long wavelength, low energy x-ray photons from the beam is the job of the:
A)collimator
B)filters
C)insulating oil
D)open-ended cone
Q4) The collimator limits the size and shape of the x-ray beam to no more than:
A)one inch at the skin
B)2 \(\frac {3} {4} \) inches at the skin
C)3 \(\frac {1} {2} \)inches at the skin
D)5 inches at the skin
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Chapter 7: Operator Protection
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Sample Questions
Q1) Operators of dental radiographic equipment should be able to stand how far from the x-ray tube head during exposure:
A)3 feet
B)6 feet
C)12 feet
D)20 feet
Q2) The collimator limits the size and shape of the x-ray beam to no more than:
A)one inch at the skin
B)2 3/4 inches at the skin
C)3 1/2 inches at the skin
D)5 inches at the skin
Q3) When using rectangular collimation with the paralleling technique one must use a:
A)localizing film-holding device
B)bite tab
C)8-inch FFD
D)none of the above
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Chapter 8: Film Processing: the Darkroom
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Q1) In manual processing, the thermometer should be kept in which solution?
A)developer
B)fixer
C)water bath
D)any of the above
Q2) The protective coating on the emulsion is softened by the _______ and hardened by the _________.
Q3) Reticulation causes the processed film to have a wrinkled appearance. Identify the cause for reticulation:
A)sudden temperature change between processing solutions and water bath
B)fluoride contacted the film before processing
C)air was trapped on the emulsion during processing
D)films were dried to each other
Q4) Torn emulsion is usually the result of:
A)excessive drying
B)improper fixing
C)drying films in contact
D)inadequate rinsing
Q5) A clear film can be caused by ______ or _______.
Q6) Defective film hangers should be disposed of because they can cause
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Chapter 9: Infection Control in Dental Practice
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Sample Questions
Q1) Items to consider for infection control with radiographic procedures include:
A)lead apron
B)film packets
C)dental chair
D)all of the above
Q2) In a practice in which there are many HIV-positive patients, the film rollers in automatic processors should be:
A)scrubbed with an abrasive cleaner every day
B)autoclaved every day
C)disinfected after every use
D)treated in the usual acceptable manner
Q3) HBV and HBC are acronyms for types of the _________ virus.
Q4) Identify the most common transmission route of HIV, HBV, and HCV:
A)saliva
B)blood
C)body fluids
D)aerosols
Q5) Infection control procedures should be followed for __________ patients.
Q6) Although it does not get much publicity, _________ is the greatest health risk for dental health care workers.
Page 10
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Chapter 10: Intraoral Technique: the Paralleling Method
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Q1) Cracks in the film emulsion brought about by excessive bending of a film will appear:
A)dark
B)light
C)clear
D)cracks in the emulsion have no effect on the processed image
Q2) Identify the film that shows the teeth in occlusion with only the crowns visible:
A)bitewing
B)periapical
C)occlusal
D)cephalometric
Q3) Identify the film necessary to diagnose pathologic conditions of the tooth root:
A)bitewing
B)periapical
C)occlusal
D)skull
Q4) Using the paralleling technique to evaluate periodontal bone height is essential because the paralleling technique prevents excessive ______________.
Q5) Reversing the film to the x-ray beam will cause ___________.
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Chapter 11: Accessory Radiographic Techniques: Bisecting
Technique and Occlusal Projections
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Sample Questions
Q1) Identify a possible patient scenario in which the bisecting angle technique would be used:
A)an adult with a small mouth
B)a child
C)a person with a low palatal vault
D)all of the above
Q2) Occlusal films can be processed in the darkroom, with similar technique to standard intraoral films. The exposure times of occlusal films is usually greater than intraoral periapical films.
A)both statements are true
B)both statements are false
C)the first statement is true;the second statement is false
D)the first statement is false;the second statement is true
Q3) A -5 degree vertical angulation for the lower incisors will produce a (an)________ image.
Q4) The finger holding method should _____ be used with the bisecting technique.
Q5) When compared with periapical films, topographic occlusal films have a
Q6) If the vertical angulation of the PID is insufficient, _______ will result.
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Chapter 12: Panoramic Radiography
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Q1) Identify the error seen if a panoramic radiograph is exposed to the light from a cell phone during processing:
A)film will be darker
B)film will be lighter
C)film will be fogged
D)no change will be seen in the processed radiograph
Q2) A high thyroid collar placement should never be used when:
A)taking bitewings on children
B)taking occlusal films
C)taking pantomograms
D)the patient has a history of radiation therapy to the neck
E)all of the above
Q3) Patient movement during the taking of a pantomogram is reduced by:
A)a three-point fixation of the patient's head
B)reducing exposure time
C)having the patient rinse with mouthwash
D)taking the film sitting down
Q4) If the patient is not positioned properly in the focal trough, _____________ will result on the opposite side.
Q5) All of the patient's __________ must be removed before taking a pantomogram.
Page 13
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Chapter 13: Extraoral Techniques
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Sample Questions
Q1) Extraoral projections should use:
A)100 kVp
B)65 kVp
C)45 kVp
D)none of the above
Q2) Depending on the type of panoramic unit, rigid or ________ cassettes are used.
Q3) The limitation for using the posterior anterior projection for visualizing the maxillary sinus is:
A)exposure time
B)superimposition of the maxillary tuberosity
C)superimposition of the zygomatic arch
D)patient positioning
Q4) The Waters' projection is taken in the:
A)coronal plane
B)sagittal plane
C)axial plane
D)none of the above
Q5) Cassettes with intensifying screens are used in extraoral radiography to ________.
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Chapter 14: Radiography of the Temporomandibular Joint
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Q1) The major cause of TMJ disorders is the __________.
Q2) On the average, the exposure time at 65 kVp and 10 mA for a transcranial projection is:
A)7 to 10 impulses
B)7 to 10 seconds
C)7 to 15 impulses
D)7 to 15 seconds
Q3) Images that are opaque on an image obtained by magnetic resonance imaging (MRI)have a _________ hydrogen density and a _________ signal.
Q4) In TMJ radiography it is preferable to take films in the __________ positions.
Q5) Complications may occur with:
A)arthrography
B)MRI
C)CT
D)a panoramic radiograph
Q6) Four views of the TMJ can be seen by:
A)MRI
B)CT
C)arthrography
D)the transcranial technique
Page 15
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Chapter 15: Digital Imaging
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Q1) One of the advantages of digital radiography over film is _________.
Q2) Identify the main disadvantage of digital imaging:
A)bulky, rigid sensors
B)environmental waste issues
C)infection control
D)lack of definition and detail
Q3) Utilizing digital imaging, the operator should be standing at a minimum of:
A)one foot from the source of radiation
B)two feet from the source of radiation
C)six feet from the source of radiation
D)none of the above
Q4) Instead of duplication we can now send the third-party payer:
A)the original films
B)a hard copy of the digital radiograph
C)a telephone description
D)all of the above
Q5) Digital radiography is now another link to the ________ dental office.
Q6) In the optical scanning method one starts with the __________.
Q7) Two types of direct sensors are ________ and ________.
Q8) The cost of a digital imaging unit is approximately __________.
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Chapter 16: Advanced Imaging Systems
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Q1) CT scans are viewed in all of the following planes EXCEPT:
A)sagittal
B)axial
C)midsagittal
D)coronal
Q2) The energy source for CT scans is:
A)gamma radiation
B)radio waves
C)ultrasound
D)x-radiation
Q3) CT images for implant planning should have ________ and ___________ views.
Q4) CT images can be sent by _________ to specialists for consultation.
Q5) CBVT (CBCT)imaging may be utilized in dentistry for all of the following conditions EXCEPT:
A)evaluation of interproximal caries
B)implant treatment planning
C)oral pathologies
D)evaluation of impacted teeth
Q6) A CT scan taken in the axial plane can be reformatted to the _______ and _________ planes.
Page 17
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Chapter 17: Quality Assurance
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Sample Questions
Q1) It is acceptable for a radiographic darkroom to contain:
A)microwave oven and/or coffee maker
B)space for hats and coats
C)dental laboratory equipment
D)none of the above
Q2) Maintaining high levels of ________ competence is the basis of any quality assurance program.
Q3) Quality assurance programs include:
A)keeping accurate records
B)maintaining darkroom cleanliness
C)producing acceptable radiographs
D)all of the above
Q4) Guidelines for storage of unprocessed and unexposed films include all of the following EXCEPT:
A)storage in a warm, humid location
B)stored at temperatures between 50° F and 70° F
C)stored in a ventilated area
D)used before the expiration date on the package
Q5) The _______ has published an outline of preventive procedures for radiographic systems.
18
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Chapter 18: Patient Management and Special Problems
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Q1) Placebo techniques very often work with:
A)retarded patients
B)hearing impaired patients
C)physically handicapped patients
D)patients who have a tendency to gag
Q2) A patient with a shallow palatal vault presents a problem for which technique:
A)bitewing
B)bisecting angle
C)paralleling
D)occlusal
Q3) The phrase "same lingual, opposite buccal" refers to:
A)buccal-object rule
B)right angle localization
C)pantomography
D)inverse square law
Q4) It is __________ for a caregiver or parent to be in the operatory (with careful safety precautions taken)when radiographs are taken of a patient with a disability.
Q5) In taking a full-mouth survey, the first exposure should be of the __________ area.
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Chapter 19: Film Mounting and Radiographic Anatomy
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Q1) Identify the most radiopaque tooth tissue:
A)enamel
B)dentin
C)cementum
D)pulp chamber
Q2) It is extremely difficult radiographically to differentiate dentin from:
A)bone
B)enamel
C)cementum
D)all of the above
Q3) Identify the information that should appear on a radiographic film mount:
A)patient name
B)date of radiographic exam
C)patient date of birth
D)both a and b
Q4) Mandibular landmarks visible on panoramic radiographs include:
A)mandibular condyle
B)condylar neck
C)sigmoid notch
D)all of the above
20
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Chapter 20: Principles of Radiographic Interpretation
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Q1) In addition to radiographic findings, identify a symptom(s)that may be part of a diagnosis:
A)medical history
B)clinical examination
C)vitality testing
D)all of the above
Q2) ___________________ are located in specific areas of the oral cavity and are well within normal limits.
Q3) Edentulous areas:
A)cannot be radiographed
B)should be radiographed
C)should not be radiographed
D)may sometimes be radiographed
Q4) Cysts and benign lesions usually grow:
A)rapidly
B)at no specific rate
C)slowly
D)at various rates
Q5) The final diagnostic role rests with the _________.
Q6) Most lesions appear ________ on processed radiographs.
21
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Chapter 21: Caries and Periodontal Disease
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Q1) Teeth with short conical roots and bone loss have a very _________ prognosis.
Q2) Identify a radiograph recommended for detecting bone loss of 5 mm or greater:
A)vertical bitewing
B)periapical projections with bisecting angle technique
C)panoramic radiography
D)occlusal images
Q3) Radiographically, the alveolar crest appears more convex and pointed in the posterior areas. The alveolar crest appears flatter and smoother in the anterior areas.
A)both statements are true
B)both statements are false
C)the first statement is true;the second statement is false
D)the first statement is false;the second statement is true
Q4) Furcation involvement of periodontal disease could be found in which of the following teeth?
A)teeth #4, 5, 6
B)teeth #30, 31, 32
C)teeth #10, 11, 12
D)teeth #8, 9, 10
Q5) Cement bases under restorations appear __________ on a radiograph.
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Chapter 22: Pulpal and Periapical Lesions
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Q1) Identify the radiographic sign of pulpitis in the pulp chamber:
A)the presence of additional pulp denticles
B)widened lamina dura
C)no radiographic changes are seen
D)changes in alveolar bone
Q2) Fistulous tracts are almost ________ seen on periapical radiographs.
Q3) Identify a possible cause(s)for the formation of secondary dentin:
A)pulp capping
B)attrition
C)deep dental caries
D)all of the above
Q4) Both internal and external idiopathic root resorption result in:
A)root fracture
B)tooth movement
C)pulpal necrosis
D)all of the above
Q5) High pulp horns on teeth are usually associated with ___________.
Q6) Periapical cemental osseous dysplasia is a three-stage lesion that is _________ and self-limiting, and for which no treatment is indicated.
Page 23
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Chapter 23: Developmental Disturbances of Teeth and Bone
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Q1) A club-shaped root is usually a sign of:
A)pathology
B)concrescence
C)hypercementosis
D)cemental dysplasia
Q2) When a tooth has what appears to be two crowns and one root canal, the condition is called ___________.
Q3) When teeth chip easily and radiographs reveal short roots and early pulp calcification, __________ is present.
Q4) The teeth in the area of fissural cysts usually test __________.
Q5) Identify the teeth most commonly impacted:
A)maxillary and mandibular third molars
B)maxillary canines
C)mandibular premolars
D)mandibular canines
Q6) Identify the teeth most commonly associated with dentigerous cysts:
A)incisors
B)third molars
C)canines
Page 24
D)all teeth are associated with dentigerous cysts
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Chapter 24: Bone and Other Lesions
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Q1) A malignant lesion will usually have an ____________ border.
Q2) A slowly growing periapical cyst will have as its borders a ___________.
Q3) A malignant tumor of bone will appear _________ on radiographs.
Q4) An intrabony lesion that on a right-angle occlusal projection shows invasion of the buccal cortex is probably:
A)benign
B)infectious
C)malignant
D)developmental
Q5) One way to differentiate a retained root tip radiographically is by the appearance of a
Q6) Slow-growing lesions, such as cysts, will usually __________ teeth.
Q7) The radiographic appearance of the skull in Paget's disease will show:
A)a decrease in size
B)an increase in size
C)a cotton wool bony appearance
D)none of the above
Q8) Implants will appear _____________ on radiographs.
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Chapter 25: Legal Considerations
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Q1) Violations of the inspections of x-ray machines and radiation code may result in:
A)a warning given to the dentist
B)closing the dental practice for one month
C)suspension of a dentist's radiation permit
D)suspension of a dentist's license to practice
Q2) Radiographs belong to the ___________.
Q3) Identify the most regulated discipline within dentistry:
A)radiology
B)periodontics
C)oral surgery
D)endodontics
Q4) If a patient refuses a recommended radiographic examination:
A)dental procedures should go on as planned
B)the patient should sign a release form
C)it should be entered into the patient record and treatment should not be performed
D)the patient should be asked to leave the practice
Q5) Dental radiographs, as other radiographs, are ______________.
Q6) A litigious society is one whose members are likely to _____ the dentist.
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