Principles of Dental Imaging
Midterm Exam
Course Introduction
Principles of Dental Imaging introduces students to the foundational concepts, techniques, and safety protocols involved in acquiring and interpreting dental radiographic images. The course covers the physics of radiation, image formation, types of dental imaging modalities, and factors affecting image quality. Emphasis is placed on radiation safety, infection control, legal and ethical considerations, and the proper positioning of patients and film or digital sensors. Students also learn to recognize normal anatomical structures and common pathologies on intraoral and extraoral radiographs, preparing them for clinical practice and further study in dental diagnostics.
Recommended Textbook
Dental Radiography Principles and Techniques 5th Edition by Joen Iannucci DDS MS
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Chapter 1: Radiation History
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Q1) Your patient asked you why dental images are important.Which of the following is the correct response?
A)An oral examination with dental images limits the practitioner to what is seen clinically.
B)All dental diseases and conditions produce clinical signs and symptoms.
C)Dental images are not a necessary component of comprehensive patient care.
D)Many dental diseases are typically discovered only through the use of dental images.
Answer: D
Q2) Which discovery was the precursor to the discovery of x-rays?
A)Beta particles
B)Alpha particles
C)Cathode rays
D)Radioactive materials
Answer: C
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Chapter 2: Radiation Physics
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Q1) Which of the following statements is true of the wave concept of electromagnetic radiation?
A)Wavelength refers to the speed of the wave.
B)Velocity refers to the number of wavelengths that pass a given point in a certain amount of time.
C)Frequency is defined as the distance between the crest of one wave and the crest of the next.
D)Frequency and wavelength are inversely related.
Answer: D
Q2) The lead collimator
A)carries away the heat produced during the production of x-rays.
B)permits a small number of x-rays to exit from the x-ray tube.
C)filters the longer-wavelength x-rays from the beam.
D)restricts the size of the x-ray beam.
Answer: D
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4
Chapter 3: Radiation Characteristics
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Sample Questions
Q1) Milliamperage regulates the _________ of electrons produced at the cathode filament.
A)quality
B)quantity
C)speed
D)power
Answer: B
Q2) You have been using a dental x-ray machine that has a 4-inch PID.Your new machine has an 8-inch PID.Given that all exposure factors remain the same,according to the inverse square law,the resultant beam would be ___________ as intense.
A)four times
B)twice
C)half
D)one quarter
Answer: D
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Chapter 4: Radiation Biology
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Sample Questions
Q1) You could be exposed to each of these radiation sources in your daily activities.Which of these sources is human-made?
A)Radon gas
B)Atomic fallout
C)Terrestrial radiation
D)Radioactive potassium
Q2) A 1 in 1 million risk of a fatal outcome is associated with which of the following activities?
A)Riding 10 miles on a bike
B)Riding 300 miles in an auto
C)Riding 1000 miles in an airplane
D)All three of the above activities
Q3) According to the dose-response curve,when dose and damage are plotted on a graph,a _____________________ relationship is seen.
A)nonlinear,nonthreshold
B)linear,nonthreshold
C)nonlinear,threshold
D)linear,threshold
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6
Chapter 5: Radiation Protection
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Sample Questions
Q1) Your next patient is a 35-year-old man who you have been seeing for the past 10 years.The only treatment he has needed since coming to the dental practice has been his 6-month "prophys." He has no periodontal issues and is on a 6-month recall cycle.You last took four bite-wing images 1 year ago.Which of the following should you do?
A)Take bite-wings during this appointment.
B)Take the images in 6 months.
C)Take the images in 1 to 2 years.
D)No images will be needed for 5 years.
Q2) Which type of PID would be most effective in reducing patient exposure?
A)Conical
B)A 16-inch round PID
C)An 8-inch rectangular PID
D)A 16-inch rectangular PID
Q3) Added filtration in the dental x-ray tubehead
A)refers to the placement of tungsten discs in the path of the x-ray beam between the collimator and the tubehead seal.
B)filters out shorter-wavelength x-rays from the x-ray beam.
C)results in a lower-energy beam.
D)results in a more penetrating useful beam.
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Chapter 6: Dental X-Ray Equipment
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Q1) The _____________ allow(s)for positioning of the tubehead.
A)control devices
B)extension arm
C)control panel
D)exposure button
Q2) You have your patient in the chair,you have placed the receptor in your patient's mouth,and you have positioned the position-indicating device.Which of the following should you do next to take the x-rays?
A)Turn on the on-off switch.
B)Push the exposure button.
C)Turn on the exposure light.
D)Adjust the control devices.
Q3) The position-indicating device (PID)is an extension of the A)tubehead.
B)extension arm.
C)control panel.
D)exposure button.
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Chapter 7: Dental X-Ray Film
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Sample Questions
Q1) When you are placing the film packet in your patient's mouth,which side of the film packet would you place toward the patient's teeth?
A)The side with the flap that is used to open the dental film
B)The solid white side
C)The color-coded side
D)The identification dot side
Q2) Which component of x-ray film has a suspension of millions of microscopic silver halide crystals?
A)Film base
B)Adhesive layer
C)Gelatin
D)Halide crystals
Q3) Which of the following film speed is the fastest film currently available?
A)C-speed film
B)D-speed film
C)E-speed film
D)F-speed film
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9
Chapter 8: Dental X-Ray Image Characteristics
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Sample Questions
Q1) The primary factor that limits the size of the tungsten target is
A)the cost of the materials.
B)heat production.
C)the limited kinetic energy of the electrons.
D)the limited kinetic energy of the photons.
Q2) A longer position-indicating device (PID)results in
A)an increased target-receptor distance.
B)a more divergent x-ray beam.
C)more image magnification than when a shorter PID is used.
D)an increased object-receptor distance.
Q3) The teeth on your patient's images appear very radiopaque and the periodontium and tissue appear very radiolucent.Your patient's dental image has
A)high density.
B)low density.
C)low contrast.
D)high contrast.
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Chapter 9: Dental X-Ray Film Processing
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Q1) (1)The radiolucent image on the film becomes more visible during the development stage when the developing agent,sodium thiosulfate or ammonium thiosulfate,removes the unexposed,underdeveloped silver halide crystals from the film emulsion.(2)Continued development of the crystals during the fixing process is prevented by the acidifier,acetic or sulfuric acid,in the fixer.
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) You noticed that the top part of two of your radiographs is black when you take them out of the manual processing tanks.Which of the following was the cause of this?
A)Wash water is too cold.
B)Fixer cut off
C)Developer is too hot.
D)Developer cut off
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11
Chapter 10: Quality Assurance in the Dental Office
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Q1) If the image of the coin appears on the processed radiograph after the coin test
A)the safelight is safe to use with that type of film.
B)the safelight is not safe to use with that type of film.
C)conduct the test again with the darkroom door closed rather than open.
D)conduct the test again with the safelight off rather than on.
Q2) A film-screen contact test is used to test the A)output of the x-ray machine.
B)quality of intraoral films.
C)cassette holder for extraoral films.
D)freshness of extraoral film.
Q3) You are creating a cleaning log for the panoramic intensifying screens.How frequently should the screens be cleaned?
A)Daily
B)Weekly
C)Monthly
D)Yearly
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Chapter 11: Dental Radiographs and the Dental
Radiographer
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Q1) According to the text,__________ is one of the most important uses of dental images.
A)habitual rote frequency
B)detection
C)maintaining a routine
D)insurance verification
Q2) When should you avoid taking retakes?
A)Whenever it is convenient because the dose is so low
B)Only if the patient is uncomfortable with exposure
C)Only if older (pre-1975)equipment is used
D)At all times
Q3) An oral examination limits the practitioner to knowledge of what is seen clinically.Dental images allow the practitioner to see many conditions that are not apparent clinically.
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.
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Chapter 12: Patient Relations and the Dental Radiographer
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Sample Questions
Q1) If,while treating your patient,your nonverbal messages are consistent with your verbal messages,your patient is more likely to A)relax.
B)be distrustful.
C)be apprehensive.
D)be fearful.
Q2) Which of the following is the best way to show your patient that you are listening to him or her?
A)Interrupt if the patient gets "off track."
B)Correct the patient if he or she is wrong.
C)Finish the patient's sentences to show that the radiographer is following the patient's train of thought.
D)Give the patient undivided attention.
Q3) When a patient trusts the dental professional,the patient is
A)less likely to provide information.
B)less likely to cooperate during treatment.
C)more likely to comply with prescribed treatment.
D)less likely to return for further treatment.
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Chapter 13: Patient Education and the Dental Radiographer
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Q1) A patient who is knowledgeable about the importance of dental images is
A)less likely to realize the benefit of dental images.
B)less likely to follow prevention plans.
C)more likely to accept prescribed treatment.
D)less likely to cooperate.
Q2) Patient education is likely to result in decreased A)acceptance of prescribed treatment.
B)fears of x-ray exposure.
C)cooperation.
D)motivation for regular dental visits.
Q3) The frequency for taking images on your pediatric patients should be based on A)their age.
B)the individual needs of the child.
C)a 6-month interval for bite-wing images.
D)a 12-month interval for bite-wing images.
Q4) Original dental images are the property of A)the dentist.
B)the patient.
C)both patient and dentist.
D)the government.
15
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Chapter 14: Legal Issues and the Dental Radiographer
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Q1) The process of informing the patient about the particulars of exposing dental images is termed
A)a treatment alternative.
B)disclosure.
C)self-determination.
D)behavior modification.
Q2) The standard of care can be defined as the quality of care that is provided by dental practitioners in _______ locality under _________________ conditions.
A)any;similar or very different
B)a similar;the same or similar
C)any;the same or similar
D)a similar;similar or very different
Q3) Informed consent
A)must be in language that the patient can readily understand.
B)does not require that patients have their questions answered before x-ray exposure.
C)is waived if the patient is a minor.
D)does not require that patients receive enough information to make informed choices.
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16
Chapter 15: Infection Control and the Dental Radiographer
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Sample Questions
Q1) When handling film with barrier envelopes,the barrier envelopes are opened with __________ hands and the films unwrapped with ______________ hands.
A)gloved;gloved
B)gloved;nongloved
C)nongloved;gloved D)nongloved;nongloved
Q2) Covering exposed surfaces with disposable materials ____________ adequate protection ____________ the need for surface cleaning and disinfection between patients.
A)provides;while eliminating B)provides;but does not eliminate C)does not provide;but does eliminate D)neither provides;nor eliminates
Q3) Commercially available barrier envelopes
A)minimize contamination before exposure of the film.
B)minimize contamination after exposure of the film.
C)are made of a material that blocks the passage of photons. D)are made of a material that blocks the passage of electrons.
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Chapter 16: Introduction to Radiographic Examinations
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Q1) Your patient has no clinical sign of disease;how frequently should you take a CMS on your patient?
A)Every year
B)Every other year
C)Once every 3 to 5 years
D)You cannot take a CMS
Q2) Which of the following is used for an interproximal evaluation?
A)Periapicals
B)Bite-wing
C)Lateral jaw
D)Occlusals
Q3) Which of the following is an extraoral image?
A)Periapical
B)Bitewing
C)Lateral jaw
D)Occlusal
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Chapter 17: Paralleling Technique
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Sample Questions
Q1) The authors recommend using a size ____ receptor for anterior teeth and a size ____ receptor for posterior teeth.
A)1;1
B)2;2
C)1;2
D)2;1
Q2) When using film,the dot should always be placed ________ in relation to the bite-block.
A)down
B)up
C)distal
D)in the slot
Q3) Which posterior quadrant would be the best for you to begin with when using the paralleling technique?
A)Maxillary left quadrant
B)Maxillary right quadrant
C)Mandibular left quadrant
D)Mandibular right quadrant
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Chapter 18: Bisecting Technique
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Q1) The primary disadvantage of the bisecting technique when contrasted with the paralleling technique is
A)longer exposure times.
B)dimensional distortion.
C)requirement of a receptor holder.
D)greater magnification.
Q2) For the maxillary premolar exposure,the mesial edge of the receptor should be aligned with the midline of the maxillary
A)lateral incisor.
B)canine.
C)first bicuspid.
D)second bicuspid.
Q3) With the bite-wing technique,the vertical angulation is predetermined;the central ray is directed at ____ degrees to the occlusal plane.
A)+10
B)-10
C)+20
D)-20
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Chapter 19: Bite-Wing Technique
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Q1) According to the text,the identification dot on the film in bite-wing placement
A)should be oriented "dot down."
B)should be oriented "dot distal."
C)should be oriented "dot up."
D)has no significance.
Q2) Where should you position the mesial edge of the receptor when taking a molar bite-wing image?
A)Distal of the maxillary first premolar
B)Distal of the mandibular first premolar
C)Midline of the maxillary second premolar
D)Midline of the mandibular second premolar
Q3) Your 35-year-old patient has clinical attachment loss in the posterior teeth.What type of bite-wing images should you take,and what size receptor should you use?
A)Horizontal;1
B)Horizontal;2
C)Vertical;1
D)Vertical;2
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Chapter 20: Exposure and Technique Errors
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Q1) Which of the following choices may be the cause of an unexposed film or receptor?
A)Excessive exposure time
B)Failure to turn on the x-ray machine
C)Excessive kilovoltage
D)Excessive milliamperage
Q2) The cause of an excessive margin of receptor edge (which appears as a black band)on a nondiagnostic periapical image is
A)the edge of the receptor was not placed parallel to the incisal-occlusal surfaces of the teeth.
B)the receptor was not positioned in the patient's mouth to cover the apical regions of the teeth.
C)the receptor was underexposed.
D)the central ray was not directed through the interproximal spaces.
Q3) The appearance of a patient's finger on the image is called a A)hemangioma
B)phalangioma
C)myxoma
D)pericytoma
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Chapter 21: Occlusal and Localization Techniques
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Q1) The dental image is a _______-dimensional picture of a _______-dimensional object.
A)two;two
B)three;three
C)two;three D)three;two
Q2) In adults,size ____ receptor is used in the occlusal examination.
A)0
B)1
C)2 D)4
Q3) According to the SLOB rule,when two dental images are compared,the object that lies to the lingual appears to have moved in the same direction as the position-indicating device (PID),and the object that lies to the buccal appears to have moved in the opposite direction as the PID.
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.
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Page 23
Chapter 22: Panoramic Imaging
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Q1) A panoramic image is __________ image(s)taken using __________ technique.
A)a series of;intraoral
B)a series of;extraoral
C)a single;intraoral
D)a single;extraoral
Q2) The closer the rotation center is to the teeth,the narrower the focal trough.In most panoramic machines,the focal trough is wide in the anterior region and narrow in the posterior region.
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) An anatomic structure that is located outside of the focal plane and close to the x-ray source can cast a ghost image on the panoramic image.The ramus of the mandible is one example of a structure that can cast a ghost image on the panoramic image.
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.
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Chapter 23: Extraoral Imaging
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Q1) An occlusal receptor ________ be used for some extraoral images.When used extraorally,it covers a ________ area than a screen film.
A)may;smaller
B)may not;smaller
C)may;larger
D)may not;larger
Q2) The front side of the cassette is typically constructed of ________ and permits the passage of the x-ray beam,whereas the back side is made of _________ to reduce scatter radiation.
A)metal;metal
B)plastic;plastic
C)plastic;metal
D)metal;plastic
Q3) An extraoral image is placed __________ the mouth during x-ray exposure.Extraoral imaging is used to image _________ areas of the skull or jaws.
A)outside;small
B)outside;large
C)inside;small
D)inside;large
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25
Chapter 24: Imaging of Patients With Special Needs
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Q1) The mixed occlusal and periapical examination on an edentulous patient consists of _______ size 4 receptors and ________ size 2 receptors.
A)two;four
B)two;two
C)four;four
D)four;two
Q2) Which receptor placement is most likely to elicit the gag reflex?
A)Maxillary premolar
B)Maxillary molar
C)Mandibular premolar
D)Mandibular molar
Q3) A size ____ receptor is typically used for the edentulous examination.
A)0
B)1
C)2
D)4
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26
Chapter 25: Digital Imaging
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Q1) Sensors that cannot be sterilized
A)should be disposed of between patients.
B)are wiped off with a surface disinfectant (iodophor)between patients.
C)require complete coverage with disposable plastic sleeves for each patient.
D)are placed in an immersion disinfectant for an appropriate amount of time between each patient.
Q2) How does the CMOS detector differ from the CCD detector?
A)The CMOS detector is silicon-based and differs from the CCD detector in the way that the pixels are read.
B)The CMOS detector is currently manufactured by one company and claims 25% less resolution than the CCD detector.
C)The CMOS detector is more expensive to produce than the CCD detector.
D)The CMOS detector is less durable than the CCD detector.
Q3) How many shades of gray can the human eye distinguish?
A)16
B)32
C)64
D)256
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Chapter 26: Three-Dimensional Digital Imaging
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Q1) The number of gray-scale colors available to be chosen for each pixel in the image is called
A)two-dimensional volume rendering.
B)three-dimensional volume rendering.
C)spatial resolution.
D)contrast resolution.
Q2) (1)Until recently,three-dimensional imaging has been used primarily for medical image purposes.(2)Cone-beam computed tomography was developed for use in dentistry to evaluate the oral and maxillofacial areas of the head and neck.
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) The acronym,DICOM,stands for
A)Digital Imaging and Communication in Medicine.
B)Direct Imaging and Cone-beam Modality.
C)Distance Imaging and Communications in Medicine.
D)Divergent Images and Cone-beam Modus.
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28
Chapter 27: Normal Anatomy: Intraoral Images
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Q1) Which muscles attach to the genial tubercles?
A)Digastric and genioglossus
B)Genioglossus and geniohyoid
C)Geniohyoid and digastric
D)Mylohyoid and geniohyoid
Q2) The superior foramina of the incisive canal are located on the __________ of the nasal cavity.
A)lateral wall
B)medial wall
C)floor
D)roof
Q3) The conduit that extends from just below the ramus to the premolar region of the mandible is the
A)external oblique ridge.
B)mylohyoid ridge.
C)submandibular fossa.
D)mandibular canal.
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Chapter 28: Film Mounting and Viewing
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Q1) (1)The text recommends that you choose a particular order for viewing the mounted radiographs to prevent skipping a radiograph.(2)When viewing radiographs,you should look carefully at each film so that you only have to look at the set of radiographs once.
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) Mounted radiographs increase
A)chances of error in determining the patient's right and left sides.
B)handling of individual films.
C)chances of damage to the emulsion.
D)accessibility for interpretation.
Q3) In the labial mounting method,radiographs are placed in the film mount with the __________ side of the identification dot facing the viewer.They are then viewed from the _________ aspect.
A)depressed;labial
B)depressed;lingual
C)raised;labial
D)raised;lingual
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Page 30
Chapter 29: Normal Anatomy: Panoramic Images
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Q1) The nasal cavity is also known as the A)nasal spine.
B)nasal septum.
C)zygoma.
D)nasal fossa.
Q2) The lateral pterygoid plate is a wing-shaped bony projection of the __________ bone.
A)temporal
B)frontal
C)occipital
D)sphenoid
Q3) On a panoramic image,which of the following structures appears as a radiolucency?
A)Lateral pterygoid plate
B)Medial pterygoid plate
C)Pterygomaxillary fissure
D)Coronoid process
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Chapter 30: Introduction to Image Interpretation
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Q1) After exposing the dental images,you should review and interpret your patient's images
A)alone in a quiet room in the evening.
B)in front of the patient.
C)at the end of the week.
D)only when it is convenient.
Q2) Dental image interpretation enables the dental professional to play a vital role in the detection of _________ of the teeth and jaws that cannot be identified clinicall y.1.lesions
2)diseases
3)conditions
A)1,2,3
B)1,2
C)1,3
D)1 only
Q3) The definition of interpret is to
A)establish a diagnosis.
B)offer an explanation.
C)process radiographs.
D)mount radiographs.
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Chapter 31: Descriptive Terminology
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Q1) The cavitation caused by dental caries will appear _______________ on dental images because the area of caries will be ________ dense than surrounding structures.
A)radiopaque;more
B)radiopaque;less
C)radiolucent;more
D)radiolucent;less
Q2) Which of the following would be radiopaque and look similar to ground glass on a dental image?
A)Condensing osteitis
B)Osteosarcoma
C)Osteopetrosis
D)Benign cementoblastoma
Q3) Which of the following is an example of a soft-tissue opacity?
A)Osteitis deformans
B)Sialolith
C)Chondrosarcoma
D)Florid osseous dysplasia
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Chapter 32: Identification of Restorations, dental Materials, and Foreign Objects
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Q1) Amalgam overhangs,excess amalgam material that extends beyond the cavity margin,can be seen on dental images in the ____________ region of the crown of the tooth.
A)Buccal
B)Lingual
C)Interproximal
D)Occlusal
Q2) You are having difficulty determining whether the radiolucent area on tooth number 7 on the dental image is decay or a composite restoration.Which of the following should you do?
A)Ask your patient.
B)Perform a clinical examination.
C)Search on the Internet.
D)Look in a textbook.
Q3) Porcelain restorations are
A)radiolucent.
B)slightly radiolucent.
C)slightly radiopaque.
D)radiopaque.
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Chapter 33: Interpretation of Dental Caries
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Q1) Which of the following carious lesions cannot be found on a dental image and must be identified clinically?
1)Incipient
2)Moderate
3)Severe
A)1,2,3
B)1,3
C)2,3
D)1 only
Q2) ____________ caries are found between two teeth.
A)Occlusal
B)Buccal
C)Lingual
D)Interproximal
Q3) A carious lesion appears _________ on a dental image.
A)radiopaque
B)radiolucent
C)white
D)clear
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Page 35
Chapter 34: Interpretation of Periodontal Disease
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Q1) The normal periodontal ligament space appears as a ______________ line.
A)thin radiopaque
B)thin radiolucent
C)thick radiopaque
D)thick radiolucent
Q2) Which of the following should you use to determine the extent of your patient's periodontal disease?
A)Pocket depth
B)Recession
C)Amount of inflammation
D)Clinical attachment loss
Q3) Your patient is viewing her bite-wing images and has noticed the small radiopaque pieces on the interproximal surfaces below the contacts of some of her teeth.What is she looking at?
A)Crestal bone
B)Cemento-enamel junction
C)Composite restorations
D)Calculus
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Chapter 35: Interpretation of Trauma and Pulpal and Periapical Lesions
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Q1) The treatment for condensing osteitis is A)extraction.
B)root canal therapy.
C)osseous recontouring.
D)no treatment is necessary.
Q2) Which of the following describes luxation?
A)The atypical movement of teeth
B)The fragments of bone following traumatic injury
C)Hemorrhage,or bleeding
D)Swelling or edema
Q3) Condensing osteitis most frequently involves the _______________ tooth.
A)mandibular premolar
B)mandibular molar
C)maxillary premolar
D)maxillary molar
Q4) Teeth that exhibit pulpal obliteration
A)require extraction.
B)require endodontic therapy.
C)require occlusal restoration.
D)do not require treatment.
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