

Fundamentals of Dental Imaging
Textbook Exam Questions

Course Introduction
Fundamentals of Dental Imaging introduces students to the principles and techniques of dental radiography and imaging modalities used in clinical practice. The course covers the physics of radiation, equipment operation, image acquisition, and processing, as well as safety protocols to minimize exposure. Students will learn to identify normal and pathological structures on dental images, interpret radiographs accurately, and understand the legal and ethical considerations in dental imaging. Emphasis is placed on developing practical skills in film and digital radiography, intraoral and extraoral techniques, and appreciating the role of advanced imaging technologies in modern dentistry.
Recommended Textbook
Radiology for the Dental Professional 9th Edition by Herbert H. Frommer
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2

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) A diagnostic film is made at 10 mA and 4 impulses. The exposure that would produce the same image at 5 mA would be:
A)5 impulses
B)10 impulses
C)8 impulses
D)45 impulses
Answer: C
Q3) If a radiograph is described as "underpenetrated," then the error must be:
A)excessive kVp
B)too little mA
C)excessive mA
D)too little kVp
Answer: D
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Chapter 3: Image Formation
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Q1) A radiographic image produced with a kVp setting of approximately 90 will appear as an:
A)image with low-contrast
B)image with long-scale contrast
C)image with many shades of gray
D)all of the above
Answer: D
Q2) When the position-indicating device (PID)is positioned 2 inches away from the face and all other factors are equal, the resulting film will be:
A)light
B)dark
C)distorted
D)magnified
Answer: A
Q3) The pointed cone should _______ be used with the bisecting technique.
Answer: never
Q4) In order to increase the contrast on a radiograph one should ________ the kVp.
Answer: decrease
Q5) The most common cause of poor definition in a radiograph is ___________.
Answer: movement

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Chapter 4: Image Receptors
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Q1) Film fog may be caused by:
A)exhausted processing solutions
B)improper safelight conditions
C)unprotected storage of films
D)all of the above
Q2) Taking films to be duplicated out of the mounts:
A)is never necessary
B)makes processing easier
C)improves the detail of the duplicates
D)prolongs the life of the duplicating device
Q3) When the x-ray photons strike the phosphors of the intensifying screen ________ photons are produced.
Q4) Film-screen imaging systems produce ___________ definition than intraoral film.
Q5) The plot of film density versus exposure time is called a (an)___________.
Q6) 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
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) The quality factor in measuring x-radiation is ___________.
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) The total body radiation dose from a four bitewing examination utilizing E-speed film and rectangular collimation is approximately:
A)1 hour of background radiation
B)12 hours of background radiation
C)2 weeks of background radiation
D)1 month of background radiation
Q4) All of the following are traditional units of radiation measurement EXCEPT:
A)roentgen
B)gray
C)radiation absorbed dose
D)roentgen equivalent man
Q5) 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 recommended selection criteria are based on the patient's:
A)medical history
B)dental history
C)thorough clinical examination
D)caries risk assessment
E)all of the above
Q2) An x-ray machine that has tube-head drift may produce dental images that are:
A)distorted
B)blurred
C)cone-cut
D)all of the above
Q3) Identify the true statement concerning film badges:
A)film badges are expensive
B)the dental operator's radiation exposure can be easily evaluated
C)dental professionals can wear the film badge at all times, indoor and outdoor as well
D)dental professionals can wear the film badge during medical radiation procedures
Q4) Presently the maximum permissible dose (MPD)for dental workers with ionizing radiation is _______________.
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Chapter 7: Operator Protection
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Q1) 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
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) 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
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Chapter 8: Film Processing: the Darkroom
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Q1) Panoramic films are __________ sensitive to darkroom light than intraoral film.
Q2) All of the following affect the life of processing solutions EXCEPT:
A)the number of films processed
B)the size of the films processed
C)the age of the solutions
D)the type of safelight
Q3) Light leaks in the darkroom will cause:
A)overdevelopment of film
B)underexposure of film
C)fogging of film
D)all of the above
Q4) A well-designed darkroom has ____ different light sources.
A)3
B)4
C)5
D)10
Q5) A clear film can be caused by ______ or _______.
Q6) If the developing time is 5 minutes, then the fixing time should be approximately
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Q7) 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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Q1) Although it does not get much publicity, _________ is the greatest health risk for dental health care workers.
Q2) Anything one touches after working in the patient's mouth is considered to be
Q3) Barrier pack films:
A)need higher kVp
B)need more mAs
C)should only be used for the bisecting method
D)none of the above
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) HBV and HBC are acronyms for types of the _________ virus.
Q6) Infection control procedures should be followed for __________ patients.
Q7) Soaps for hand washing in the dental operatory should be _____________.
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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) Using the paralleling technique to evaluate periodontal bone height is essential because the paralleling technique prevents excessive ______________.
Q3) Identify the correct teeth to be radiographed with this film position: "the center of the film aligns with the second premolar":
A)incisors
B)canines
C)premolars
D)molars
Q4) Reversing the film to the x-ray beam will cause ___________.
Q5) An overexposed film will appear similar to a (an)__________ film.
Q6) When the PID is not positioned so that it almost touches the patient's face, a ________ film will result.
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Chapter 11: Accessory Radiographic Techniques: Bisecting
Technique and Occlusal Projections
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Sample Questions
Q1) A +75 degree vertical angulation for a maxillary cuspid will produce a (an)________ image.
Q2) If the vertical angulation of the PID is insufficient, _______ will result.
Q3) Identify the major disadvantage of the bisecting technique:
A)images produced are often distorted
B)it is difficult for the patient
C)the long cone required is bulky and hard to manage
D)film holding devices may be confusing
Q4) ____________________ exposure times can be used for the bisecting technique because of the shorter FFD.
Q5) 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
Q6) The finger holding method should _____ be used with the bisecting technique.
Q7) A -5 degree vertical angulation for the lower incisors will produce a (an)________ image. Page 12
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Chapter 12: Panoramic Radiography
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Q1) The bilateral radiolucent line that can be seen crossing the ascending ramus of the mandible on a panoramic radiograph is:
A)the hard palate
B)a fracture line
C)the pharyngeal air space
D)the maxillary sinus
Q2) Indications for dental office tomography include all of the following EXCEPT:
A)placement of dental implants
B)diagnosis of interproximal caries
C)evaluation of the temporomandibular joint
D)diagnosis of pathologic lesions
Q3) Identify the area of the mouth in which most overlapped images are seen during panoramic radiography:
A)incisors
B)canines
C)premolars
D)molars
Q4) A panoramic unit has a narrowly collimated __________.
Q5) The facial exposure from a panoramic radiograph is roughly equivalent to
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Chapter 13: Extraoral Techniques
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Q1) Extraoral films are processed:
A)in the same manner as intraoral films
B)only with automatic processors
C)by sight development
D)with a safelight of less intensity
Q2) The extraoral projection used in cephalometric analysis is the _________ projection.
Q3) Identify the projection used to view the maxillary sinus and middle third of the face:
A)lateral oblique
B)lateral skull
C)Waters' view
D)submentovertex
Q4) The best extraoral projection to detect a fracture of the zygomatic arch is the __________.
Q5) The Waters' projection is taken in the:
A)coronal plane
B)sagittal plane
C)axial plane
D)none of the above
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Chapter 14: Radiography of the Temporomandibular Joint
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Q1) When examining the TMJ, one disadvantage of computed tomography is that this type of scan does not include images of the:
A)external meatus of the ear
B)mandibular condyle
C)articular disc
D)articular eminence
Q2) Complications may occur with:
A)arthrography
B)MRI
C)CT
D)a panoramic radiograph
Q3) Images that are opaque on an image obtained by magnetic resonance imaging (MRI)have a _________ hydrogen density and a _________ signal.
Q4) The major cause of TMJ disorders is the __________.
Q5) The ________ projection can be used to view the TMJ from the axial plane.
Q6) For the transcranial technique, the central ray is aimed _____ inches above and _____ inch in front of the external auditory meatus.
Q7) In TMJ radiography it is preferable to take films in the __________ positions.
Q8) _________ enables viewing of an area in three planes.
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Chapter 15: Digital Imaging
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Sample Questions
Q1) One advantage of the storage phosphor technique is that the sensor:
A)is larger
B)is thicker
C)is slightly more flexible
D)is more sensitive to radiation
Q2) 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
Q3) 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
Q4) In the optical scanning method one starts with the __________.
Q5) Digital radiography is now another link to the ________ dental office.
Q6) Two types of direct sensors are ________ and ________.
Q7) One of the advantages of digital radiography over film is _________.
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Chapter 16: Advanced Imaging Systems
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Q1) 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
Q2) ___________ sources of energy are used for CT scanning than for MRI.
Q3) The CT number for air is:
A)-1000
B)1000
C)0
D)500
Q4) CT images can be sent by _________ to specialists for consultation.
Q5) CT scans are viewed in all of the following planes EXCEPT:
A)sagittal
B)axial
C)midsagittal
D)coronal
Q6) A CT scan taken in the axial plane can be reformatted to the _______ and _________ planes.
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Q7) CT images for implant planning should have ________ and ___________ views.

Chapter 17: Quality Assurance
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Q1) The sensors used with direct digital radiography should be covered with barrier sheaths before use to avoid sensor contamination. Phosphor plates used with indirect digital radiography should also be covered with an infection control barrier before use.
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
Q2) The _______ has published an outline of preventive procedures for radiographic systems.
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) 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
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Chapter 18: Patient Management and Special Problems
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Q1) The tube shift technique is useful clinically in:
A)localizing objects in the third plane
B)treating handicapped patients
C)patients with trismus
D)radiographing gagging patients
Q2) Good patient management techniques include all of the following EXCEPT:
A)praising patients for good cooperation
B)ignoring patient questions regarding radiation dose
C)instructing patients in a firm but polite tone
D)instructing patients with confidence
Q3) The reverse bitewing technique is really a(n):
A)lateral oblique projection
B)occlusal projection
C)bisecting projection
D)posterior anterior projection
Q4) Identify an option(s)for radiographing a patient with trismus:
A)extraoral radiographs
B)intraoral placement with a hemostat
C)panoramic radiographs
D)all of the above

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Chapter 19: Film Mounting and Radiographic Anatomy
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Q1) In order to improve viewing of radiographs, mounts should be made of _________.
Q2) Two soft tissue shadows often seen on periapical radiographs are the _______ and the ________.
Q3) 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
Q4) On periapical radiographs the external oblique ridge is always seen __________ the internal oblique ridge.
Q5) Mandibular landmarks visible on panoramic radiographs include:
A)mandibular condyle
B)condylar neck
C)sigmoid notch
D)all of the above
Q6) 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
Page 21
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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) _________ is an "explanation" of the structures seen radiographically.
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) If a lesion is not seen in three planes:
A)the operator should dismiss the patient
B)no advanced imaging is needed
C)the operator should reschedule the patient's appointment
D)further imaging is needed
Q5) The final diagnostic role rests with the _________.
Q6) Most lesions appear ________ on processed radiographs.
Page 22
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Chapter 21: Caries and Periodontal Disease
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Q1) 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
Q2) Resorption that occurs in a plane parallel to the cementoenamel junctions on adjoining teeth describes:
A)vertical bone loss
B)horizontal bone loss
C)infrabony pocket
D)all of the above
Q3) All of the following conditions resemble radiographic dental caries EXCEPT:
A)abrasion
B)attrition
C)amalgam overhang
D)cervical burnout
Q4) Teeth with short conical roots and bone loss have a very _________ prognosis.
Q5) Radiographically when caries reaches the dentinoenamel junction it
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Chapter 22: Pulpal and Periapical Lesions
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Q1) Fistulous tracts are almost ________ seen on periapical radiographs.
Q2) The first detectable radiographic sign of periapical pathology is:
A)hypercementosis
B)loss of the lamina dura
C)disruption of the lamina dura
D)thickening of the periodontal ligament
Q3) High pulp horns on teeth are usually associated with ___________.
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) To make the diagnosis of periapical pathology, the tooth involved must test
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Chapter 23: Developmental Disturbances of Teeth and Bone
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Q1) Cleft palate can occur in either the hard or soft palate, or both. Radiographically, a cleft palate will appear as a radiopaque area.
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
Q2) Radiographically in fusion we see:
A)two pulp canals
B)calcified canals
C)one pulp canal
D)all of the above
Q3) When a tooth has what appears to be two crowns and one root canal, the condition is called ___________.
Q4) 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

Page 25
Q5) An S-shaped root condition is referred to as ______________.
Q6) The teeth in the area of fissural cysts usually test __________.
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Chapter 24: Bone and Other Lesions
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Q1) Slow-growing lesions, such as cysts, will usually __________ teeth.
Q2) 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
Q3) 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
Q4) Bitewing projections cannot be used to detect:
A)periapical pathology
B)condensing osteitis
C)root fracture
D)all of the above
Q5) A malignant lesion will usually have an ____________ border.
Q6) Implants will appear _____________ on radiographs.
Q7) A slowly growing periapical cyst will have as its borders a ___________.
Page 27
Q8) A malignant tumor of bone will appear _________ on radiographs.
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Chapter 25: Legal Considerations
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Q1) Treating a patient without proper radiographs is a breach of the:
A)law of ALARA
B)Inverse Square Law
C)MPD
D)standard of care
Q2) Radiographs belong to the ___________.
Q3) In the defense of a malpractice action, poor or nondiagnostic radiographs are:
A)admissible
B)useless
C)necessary
D)optional
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) The third party payers should not request _________ from the dentist.
Q6) A litigious society is one whose members are likely to _____ the dentist.
Q7) Original radiographs should ________ be kept in the dental office.
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