Diagnostic Imaging in Dentistry
Review Questions
Course Introduction
Diagnostic Imaging in Dentistry covers the principles and applications of radiographic and advanced imaging techniques essential for dental diagnosis and treatment planning. The course explores intraoral and extraoral radiography, digital imaging technologies, panoramic radiography, cone-beam computed tomography (CBCT), and their role in identifying dental and maxillofacial pathologies. Emphasis is placed on radiation safety, image interpretation, and the integration of imaging findings into clinical decision-making. Students gain practical skills in selecting, acquiring, and evaluating various diagnostic images to support comprehensive patient care in dental practice.
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) The determination of the size and shape of the x-ray beam is called ________.
Answer: collimation
Q2) Identify the particles that compose the nucleus of an atom:
A)electrons and photons
B)electrons and protons
C)protons and neutrons
D)neutrons
Answer: C
Q3) Which of the following is used in the high-voltage circuit?
A)a rectifier
B)a step-up transformer
C)a step-down transformer
D)a fuse
Answer: B
Q4) The amount of heat produced in the x-ray tube is ________ than the amount of radiation produced.
Answer: greater
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) With regard to the Inverse Square Law, if the focal spot-to-film distance (FFD)doubles, the exposure time should:
A)decrease by \(\frac {1} {4} \)
B)decrease by \(\frac {1} {2} \)
C)double
D)quadruple
Answer: D
Q2) The most common cause of lack of detail on a radiograph is __________.
Answer: patient movement
Q3) A radiographic image produced with a kVp setting of approximately 65 will appear as an:
A)image with high-contrast
B)image with short-scale contrast
C)image with mostly black and white areas
D)all of the above
Answer: D
Q4) When using the bisecting method the object-film distance is kept to a
Answer: minimum
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Chapter 4: Image Receptors
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Q1) Identify the fastest film speed currently available for intraoral radiography:
A)B
B)C
C)E
D)F
Q2) The main advantage of intensifying screens is:
A)quicker developing
B)less radiation to the patient
C)easier to prepare the cassette
D)better image definition
Q3) Film-screen imaging systems produce ___________ definition than intraoral film.
Q4) The plot of film density versus exposure time is called a (an)___________.
Q5) The lead foil backing is included in the intraoral film packet:
A)to absorb back-scattered radiation
B)to help keep the film packet light-tight
C)to hold the film in place
D)to protect the film from saliva
Q6) Film cassettes can be either _______ or _______.
Q7) A film that has been fogged will have decreased _____________.
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Chapter 5: Biologic Effects of Radiation
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Q1) To further protect our patients from excessive exposure to radiation in dental procedures, the ADA recommends the use of:
A)F-speed film and/or digital sensors
B)the use of selection criteria in ordering radiographic exams
C)rectangular collimation
D)all of the above
Q2) 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
Q3) A free radical:
A)is a uncharged molecule
B)is unstable
C)has an unpaired electron in the outer shell
D)combines with molecules to form toxins
E)all of the above
Q4) The output of a dental x-ray machine is expressed in ________.
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Chapter 6: Patient Protection
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Q1) 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
Q2) The use of pointed PIDs is prohibited because their use results in:
A)cone cutting
B)increased primary radiation
C)increased scatter radiation
D)greater likelihood of overlapping images
Q3) To get the diagnostic benefits from radiographs, optimum film viewing requirements include:
A)use of an illuminating device
B)use of a film mount
C)a darkened room
D)all of the above
Q4) It is predicted that the MPD will ________ be reduced in the near future.
Q5) Mechanical timers are usually inaccurate by at least a _________ second.
Q6) Presently the maximum permissible dose (MPD)for dental workers with ionizing radiation is _______________.
Page 7
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Chapter 7: Operator Protection
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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) The minimum size for a darkroom should be:
A)2 × 2 feet
B)4 × 4 feet
C)6 × 6 feet
D)none of the above
Q2) 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
Q3) If the developing time is 5 minutes, then the fixing time should be approximately
Q4) All of the following are advantages of automatic processing EXCEPT:
A)automated time-temperature processing
B)cost
C)time saved during processing procedures
D)increased volume of films that are processed
Q5) The protective coating on the emulsion is softened by the _______ and hardened by the _________.
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Chapter 9: Infection Control in Dental Practice
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Q1) Anything one touches after working in the patient's mouth is considered to be
Q2) Infection control procedures should be followed for __________ patients.
Q3) Barrier envelopes should be used for:
A)all patients
B)patients with a positive medical history
C)patients who are bleeding
D)patients with contaminated saliva
Q4) The steps of infection control are taken to benefit and protect:
A)ourselves
B)our fellow workers
C)our patients
D)all of the above
Q5) Identify the most common transmission route of HIV, HBV, and HCV:
A)saliva
B)blood
C)body fluids
D)aerosols
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) The phrase "dot in the slot and the white toward me" ensures that:
A)the patient's head is properly positioned for intraoral radiography
B)the film and tooth are kept parallel to each other
C)the patient will not move during radiographic procedures
D)the orientation dot will not be superimposed over the apex of the root and the film will not be exposed backwards
Q2) Vertical bitewings can be used in both anterior and posterior regions of the mouth. Exposure factors need to be increased (kVp, mA, time)when exposing vertical bitewings.
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) Identify the film that shows the teeth in occlusion with only the crowns visible:
A)bitewing
B)periapical
C)occlusal
D)cephalometric
Q4) An overexposed film will appear similar to a (an)__________ film.
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Chapter 11: Accessory Radiographic Techniques: Bisecting
Technique and Occlusal Projections
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Q1) A -5 degree vertical angulation for the lower incisors will produce a (an)________ image.
Q2) The imaginary angle that is bisected with the use of the Bisecting Angle Technique is formed between the long axis of the tooth and:
A)the long axis of the PID
B)the horizontal axis of the film
C)the long axis of the film
D)the horizontal axis of the tube head
Q3) The finger holding method should _____ be used with the bisecting technique.
Q4) In the bisecting technique the tooth-film distance is:
A)maximal
B)minimal
C)not important
D)none of the above
Q5) When compared with periapical films, topographic occlusal films have a __________.
Q6) If the vertical angulation of the PID is insufficient, _______ will result.
Page 12
Q7) A +75 degree vertical angulation for a maxillary cuspid will produce a (an)________ image.
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Chapter 12: Panoramic Radiography
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Q1) The main disadvantage of panoramic films is:
A)increased patient exposure
B)loss of definition and detail
C)lack of contrast
D)possible patient movement
Q2) The plane of the object that is not blurred on the panoramic radiograph is termed:
A)image layer
B)focal trough
C)plane of acceptable detail
D)all of the above
Q3) 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
Q4) A panoramic unit has a narrowly collimated __________.
Q5) All of the patient's __________ must be removed before taking a pantomogram.
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Chapter 13: Extraoral Techniques
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Q1) Depending on the type of panoramic unit, rigid or ________ cassettes are used.
Q2) Extraoral projections should use:
A)100 kVp
B)65 kVp
C)45 kVp
D)none of the above
Q3) The Waters' projection is taken in the:
A)coronal plane
B)sagittal plane
C)axial plane
D)none of the above
Q4) Which of the following methods is best for radiographing an impacted third molar?
A)posterior anterior
B)lateral oblique projection of the mandible
C)lateral skull
D)posterior anterior of the sinuses
Q5) The extraoral projection used in cephalometric analysis is the _________ projection.
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Chapter 14: Radiography of the Temporomandibular Joint
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Q1) A conventional panoramic projection will show both the right and left joints in the:
A)lateral plane
B)axial plane
C)cross-sectional plane
D)frontal plane
Q2) The major cause of TMJ disorders is the __________.
Q3) Identify the most common extraoral view used to examine the temporomandibular joint after the panoramic examination:
A)transcranial projection
B)submentovertex projection
C)skull projection
D)MRI
Q4) In TMJ radiography it is preferable to take films in the __________ positions.
Q5) _________ enables viewing of an area in three planes.
Q6) The ________ projection can be used to view the TMJ from the axial plane.
Q7) Images that are opaque on an image obtained by magnetic resonance imaging (MRI)have a _________ hydrogen density and a _________ signal.
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Chapter 15: Digital Imaging
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Q1) Digital imaging allows for manipulation of the image. All of the following can be manipulated EXCEPT:
A)the image can be darkened
B)the image can be magnified
C)elongation or foreshortening can be corrected
D)the image can be lightened
Q2) "The sensor is connected by a wire to the computer, and after exposure, the image appears instantly on the monitor" describes which type of digital system?
A)direct digital radiography
B)optically scanned digital imaging
C)storage phosphor system
D)indirect digital radiography
Q3) The wireless system that uses a plate and laser beam scanning to produce an image is known as:
A)direct digital radiography with CCD system
B)direct digital radiography with CMOS system
C)storage phosphor system
D)optically scanned digital imaging
Q4) In the optical scanning method one starts with the __________.
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Chapter 16: Advanced Imaging Systems
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Q1) CT images can be sent by _________ to specialists for consultation.
Q2) The wavelengths used in MRI are:
A)long
B)cannot cause ionization
C)do not produce a radiation dose to the patient
D)all of the above
Q3) CT scans are viewed in all of the following planes EXCEPT:
A)sagittal
B)axial
C)midsagittal
D)coronal
Q4) CT images for implant planning should have ________ and ___________ views.
Q5) The energy source for CT scans is:
A)gamma radiation
B)radio waves
C)ultrasound
D)x-radiation
Q6) A CT scan taken in the axial plane can be reformatted to the _______ and _________ planes.
Q7) ___________ sources of energy are used for CT scanning than for MRI.
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Chapter 17: Quality Assurance
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Q1) Inspections and calibration of x-ray machines include:
A)kilovoltage peak and milliamperage output
B)tubehead stability
C)accuracy of the timing device
D)all of the above
Q2) The task for reviewing radiographs for acceptable quality is assigned to:
A)the hygienist
B)the dentist
C)any member of the professional dental staff
D)the office manager
Q3) 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
Q4) An easy way to check solution strength in the darkroom is with:
A)a reference film
B)a step wedge
C)an ionizing chamber
D)a thermometer
Page 18
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Chapter 18: Patient Management and Special Problems
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Q1) In order to do any intraoral radiographic procedure, patient __________ is essential.
Q2) A film that is dragged across the patient's palate may cause ___________.
Q3) The main disadvantage of a metal rubber dam holder in endodontics is:
A)it is bendable
B)it is easier to use
C)it is easier to remove
D)its image will be superimposed on the film
Q4) Of the four techniques used for object localization, identify the one that is least reliable:
A)definition evaluation
B)tube shift
C)right angle
D)pantomography
Q5) All of the following are positive ways to relax the dental patient EXCEPT:
A)to recognize the patient by name
B)to develop a good chairside manner
C)to chew gum during radiographic procedures
D)using small talk prior to radiographic procedures
Q6) Marking grids should not be confused with grids used to __________.
Page 19
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Chapter 19: Film Mounting and Radiographic Anatomy
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Q1) If visible, identify the appearance of mandibular tori:
A)clearly outlined radiopacities
B)vague, diffuse radiolucencies
C)well outlined radiolucencies
D)tori do not appear radiographically
Q2) The nasal septum ends inferiorly at another radiopaque landmark known as the:
A)nasal conchae
B)anterior nasal spine
C)nasal cavity
D)nasopalatine foramen
Q3) Identify the most radiopaque tooth tissue:
A)enamel
B)dentin
C)cementum
D)pulp chamber
Q4) On a routine full-mouth survey it is not possible to see the:
A)mental foramen
B)incisive foramen
C)lingual foramen
D)mandibular foramen
20
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Chapter 20: Principles of Radiographic Interpretation
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Q1) Edentulous areas:
A)cannot be radiographed
B)should be radiographed
C)should not be radiographed
D)may sometimes be radiographed
Q2) The final diagnostic role rests with the _________.
Q3) If all the borders of a lesion are not seen, the dental professional should:
A)recommend further imaging
B)retake the periapical
C)retake the bitewing
D)not take or recommend further radiographs
Q4) Cysts and benign lesions usually grow:
A)rapidly
B)at no specific rate
C)slowly
D)at various rates
Q5) ___________________ are located in specific areas of the oral cavity and are well within normal limits.
Q6) ____% of all pathologic conditions seen in the jaws are the result of nonvital teeth and their sequela.
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Chapter 21: Caries and Periodontal Disease
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Q1) Identify the best way to detect occlusal caries:
A)periapical films utilizing bisecting angle technique
B)occlusal radiographs
C)bitewing radiographs
D)clinical exam with mouth mirror and explorer
Q2) Teeth with short conical roots and bone loss have a very _________ prognosis.
Q3) Caries that has penetrated halfway through the enamel surface is termed:
A)incipient
B)advanced
C)moderate
D)severe
Q4) Identify the most common reason for exposing dental radiographs:
A)to confirm the presence of periodontal disease
B)to confirm suspected pathology
C)caries detection
D)to locate impacted teeth
Q5) Cement bases under restorations appear __________ on a radiograph.
Q6) Radiographically when caries reaches the dentinoenamel junction it
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Q7) The height of alveolar bone is best evaluated on periapical films taken by the
Chapter 22: Pulpal and Periapical Lesions
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Q1) High pulp horns on teeth are usually associated with ___________.
Q2) Fistulous tracts are almost ________ seen on periapical radiographs.
Q3) 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
Q4) Periapical cemental osseous dysplasia is a three-stage lesion that is _________ and self-limiting, and for which no treatment is indicated.
Q5) How do a periapical cyst and a periapical granuloma appear radiographically?
A)they may appear identical
B)a cyst is always larger
C)a cyst is always smaller
D)none of the above
Q6) Both internal and external idiopathic root resorption result in:
A)root fracture
B)tooth movement
C)pulpal necrosis
D)all of the above
Page 23
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Chapter 23: Developmental Disturbances of Teeth and Bone
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Q1) A supernumerary tooth in the midline is referred to as a (an):
A)odontoform
B)mesiodens
C)enamel pearl
D)taurodont
Q2) Impacted teeth can be localized in their mesiodistal position by periapical, ___________, or lateral oblique films.
Q3) Dens "invaginatus" is:
A)an invagination of the enamel organ
B)usually at the point of the cingulum
C)not a "tooth within a tooth"
D)all of the above
Q4) The teeth in the area of fissural cysts usually test __________.
Q5) Radiographically in fusion we see:
A)two pulp canals
B)calcified canals
C)one pulp canal
D)all of the above
Q6) An S-shaped root condition is referred to as ______________.
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Chapter 24: Bone and Other Lesions
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Q1) 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
Q2) Bitewing projections cannot be used to detect:
A)periapical pathology
B)condensing osteitis
C)root fracture
D)all of the above
Q3) A cyst, demonstrating a decrease in density, would appear:
A)radiolucent
B)radiopaque
C)mixed lesion
D)none of the above
Q4) Fractures of the mandible will:
A)not be seen on periapical films
B)appear as radiopaque lines
C)appear as radiolucent lines
D)not be seen during the first 24 hours
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Chapter 25: Legal Considerations
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Q1) Dental radiographs of adult patients should be kept in the office for:
A)2 years
B)4 years
C)6 months
D)7 years
Q2) The dentist being physically present in the office during radiographic procedures is known as:
A)compliance
B)direct supervision
C)quality assurance
D)federal regulations
Q3) In the defense of a malpractice action, poor or nondiagnostic radiographs are:
A)admissible
B)useless
C)necessary
D)optional
Q4) A litigious society is one whose members are likely to _____ the dentist.
Q5) Dental radiographs, as other radiographs, are ______________.
Q6) Original radiographs should ________ be kept in the dental office.
Q7) The third party payers should not request _________ from the dentist.
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