Principles of Dental Imaging
Mock Exam
Course Introduction
Principles of Dental Imaging provides a comprehensive foundation in the fundamental concepts and techniques of radiographic imaging used in dentistry. The course covers the physics of radiation, image formation, and factors influencing image quality, alongside safety protocols and regulatory standards. Emphasis is placed on the correct use of dental X-ray machines, film and digital imaging, interpretation of radiographs, and troubleshooting common errors. Students will also learn about advances in imaging technology, such as cone beam computed tomography (CBCT). This course equips students with the essential skills to obtain high-quality diagnostic images while ensuring patient safety and adhering to ethical and legal guidelines in dental radiology.
Recommended Textbook
Dental Radiography Principles and Techniques 4th Edition by Iannucci DDS MS
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Chapter 1: Radiation History
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Sample Questions
Q1) The x-ray was discovered by:
A) Heinrich Geissler
B) Wilhelm Roentgen
C) Johann Hittorf
D) William Crookes
Answer: B
Q2) Current fast radiographic film requires less than ____ % of the initial exposure times used in 1920.
A) 25
B) 10
C) 5
D) 2
Answer: D
Q3) William Rollins:
A) Established the first college course in radiography for dental students.
B) Was the first to use film in intraoral radiography.
C) Developed the first dental x-ray unit.
D) Developed the first hot cathode x-ray tube.
Answer: C
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Page 3
Chapter 2: Radiation Physics
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Sample Questions
Q1) Thermionic emission of electrons occurs at the:
A) Tungsten filament in the anode.
B) Tungsten filament in the cathode.
C) Copper stem.
D) Molybdenum cup.
Answer: B
Q2) Which of the following elements is the simplest atom, with an atomic number of 1?
A) Hydrogen
B) Helium
C) Nitrogen
D) Oxygen
Answer: A
Q3) The nucleus of an atom contains:
A) Protons
B) Neutrons
C) Protons and neutrons
D) Electrons
Answer: C
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Chapter 3: Radiation Characteristics
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Sample Questions
Q1) Which of the following changes will increase x-ray beam intensity?
A) Decreasing the kilovoltage peak
B) Decreasing the milliamperage
C) Decreasing the exposure time
D) Decreasing the source-to-film distance
Answer: D
Q2) Exposure time is measured in:
A) kVp
B) Milliamperage
C) Density
D) Impulses
Answer: D
Q3) Aluminum filters are used to remove ____-energy, ____ -wavelength x-rays.
A) low; longer
B) high; longer
C) low; shorter
D) high; shorter
Answer: A
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Chapter 4: Radiation Biology
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Sample Questions
Q1) Uranium is an example of ____ radiation.
A) terrestrial
B) cosmic
C) artificial
D) Both a and c
Q2) Which of the following statements is true of somatic effects of irradiation?
A) Changes are not transmitted to future generations.
B) Changes are in the genetic cells of the individual.
C) Mutations occur that affect the health of offspring.
D) Damage cannot be repaired.
Q3) Which of the following mechanisms of radiation injury may occur when x-ray energy is absorbed by patient tissues?
A) Ionization
B) Free radical formation
C) Negative electrical potential
D) Both a and b
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Chapter 5: Radiation Protection
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Sample Questions
Q1) The thyroid collar:
A) Is recommended for all intraoral films.
B) Is recommended for all extraoral films.
C) May exist as a separate shield or as part of the lead apron.
D) Both a and c.
Q2) Which of the following types of position-indicating devices (PIDs) do not produce scatter radiation?
A) Rectangular
B) Conical
C) Round
D) Both a and c
Q3) To avoid the primary beam, the dental radiographer must be positioned at a ____-degree to ____-degree angle to the beam.
A) 0; 45
B) 45; 90
C) 90; 135
D) 135; 180
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Chapter 6: Dental X-Ray Equipment
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Sample Questions
Q1) A beam alignment device can be used to help the dental radiographer position the PID in relation to the ____ and film.
A) control panel
B) extension arm
C) collimator
D) tooth
Q2) During an exposure:
A) The exposure button is briefly depressed and then released to initiate the exposure.
B) The exposure button is firmly depressed until the preset exposure time is completed.
C) The exposure light on the control panel is illuminated to signal the completion of the exposure.
D) A beep sounds to signal initiation of the exposure.
Q3) The ____ activate(s) the machine to produce x-rays.
A) on-off switch
B) exposure button
C) exposure light
D) control devices
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8
Chapter 7: Dental X-Ray Film
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Sample Questions
Q1) An intensifying screen is a smooth plastic sheet coated with minute fluorescent crystals known as:
A) Nuclei of crystallization.
B) Germinal centers.
C) Sensitivity specks.
D) Phosphors.
Q2) The optimum temperature for film storage ranges from ____ to ____ degrees Fahrenheit.
A) 30; 50
B) 50; 70
C) 70; 90
D) 90; 110
Q3) Lack of contact between screen and film results in:
A) An overexposed film.
B) An underexposed film.
C) A light leak.
D) A loss of image sharpness.
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Chapter 8: Dental X-Ray Image Characteristics
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Sample Questions
Q1) When a high operating kilovoltage peak (>90 kVp) is used, (low/high) subject contrast and (many shades of gray/areas of black and white) are seen on the radiograph.
A) Low subject contrast; many shades of gray
B) Low subject contrast; areas of black and white
C) High subject contrast; many shades of gray
D) High subject contrast; areas of black and white
Q2) 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.
Q3) The typical stepwedge is constructed of:
A) Aluminum.
B) Steel.
C) Wood.
D) Copper.
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10
Chapter 9: Dental X-Ray Film Processing
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Sample Questions
Q1) The optimal temperature for the developer solution is ____ degrees Fahrenheit.
A) 64
B) 68
C) 72
D) 76
Q2) Which component of fixer solution is commonly known as "hypo"?
A) Sodium thiosulfate
B) Sodium sulfite
C) Potassium alum
D) Acetic acid
Q3) The purpose of a stirring rod is to:
A) Scrape bubbles from the surface of the films when they are in solution.
B) Mix the chemicals and equalize the temperature of the solutions.
C) Mix developer and fixer together in the master tank.
D) Recover the thermometer from the bottom of the master tank.
Q4) If films were processed below 60 degrees Fahrenheit:
A) Hydroquinone and elon would both be inactive.
B) Hydroquinone would be inactive, but elon would be active.
C) Hydroquinone would be active, but elon would be inactive.
D) Hydroquinone and elon would both be active.
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Chapter 10: Quality Assurance in the Dental Office
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Sample Questions
Q1) A reference radiograph is used to evaluate:
A) The viewbox.
B) Darkroom lighting.
C) Safelighting.
D) Developer strength.
Q2) Extraoral intensifying screens should be cleaned:
A) Daily
B) Weekly
C) Monthly
D) Yearly
Q3) To perform the coin test, the film and coin are exposed to:
A) The safelight.
B) The darkroom ceiling or white light.
C) The light with the darkroom door open.
D) No light at all.
Q4) A reference radiograph is compared with a radiograph taken each day for matched:
A) Milliamperage
B) kVp
C) Color
D) Density
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Chapter 11: Dental Radiographs and the Dental
Radiographer
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Sample Questions
Q1) Through the use of dental radiographs, the dental radiographer can detect ____ that cannot be detected clinically. 1. Diseases
2) Lesions
3) Conditions of teeth and bones
A) 1, 2, 3
B) 1, 2
C) 2, 3
D) 3 only
Q2) According to the text, "____ is one of the most important uses of dental radiographs."
A) Habitual rote frequency
B) Detection
C) Maintaining a routine
D) Insurance verification
Q3) Radiographs are a(n) ____ comprehensive patient care.
A) Adjunct to
B) Necessary component of
C) Option for
D) Supplement to
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Chapter
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Sample Questions
Q1) The term facilitation means :
A) Initiating.
B) The act of making easier.
C) The act of continuing.
D) Construction of a facility.
Q2) The patient's first impression of the dental team most often involves the:
A) Dentist.
B) Dental hygienist.
C) Dental auxiliary.
D) Entrance to the building.
Q3) ____ is a nonverbal communication skill associated with interest and warmth.
A) Leaning slightly away from the patient
B) A slumped posture
C) Tapping fingers
D) An attentive posture
Q4) Inviting a patient to ask questions:
A) Wastes time.
B) Discourages communication.
C) Enhances communication.
D) Intimidates the patient.
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Chapter 13: Patient Education and the Dental Radiographer
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Sample Questions
Q1) The time interval between radiographic examinations for children should be based on:
A) Their age.
B) The individual needs of the child.
C) A 6-month interval for bite-wing films.
D) A 12-month interval for bite-wing films.
Q2) With faster F-speed film, a single intraoral film results in a surface skin exposure of ____ milliroentgens.
A) 1.25
B) 12.5
C) 125
D) 1250
Q3) A patient with gum disease will require:
A) Less frequent radiographic examinations than a patient without such disease.
B) Less frequent radiographic examinations than a patient without such disease if pocket depth readings are regularly recorded.
C) Radiographic examinations at regular intervals regardless of circumstances.
D) More frequent radiographic examinations than a patient without such disease.
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15
Chapter 14: Legal Issues and the Dental Radiographer
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Q1) 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
Q2) Which of the following statements is true of radiographs and the patient's dental record?
A) Radiographs may be discarded when outdated.
B) It is advised to keep patient radiographs in a file separate from patient charts.
C) The dental record must include documentation of the number and type of radiographs exposed.
D) Dental radiographs are an optional rather than integral part of the dental record.
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16
Chapter 15: Infection Control and the Dental Radiographer
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Sample Questions
Q1) Which of the following viruses may be present in oral secretions?
1) Cytomegalovirus.
2) Hepatitis B virus.
3) Herpes simplex virus.
4) Human immunodeficiency virus.
A)1, 2, 3, 4
B)2, 3, 4
C)1, 2, 3
D)2, 4
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) Pathogens are:
A) Any microorganisms.
B) Bacteria but not viruses.
C) Viruses but not bacteria.
D) Microorganisms capable of causing disease.
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Chapter 16: Introduction to Radiographic Examinations
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Sample Questions
Q1) Which of the following is an extraoral technique for radiographic examination?
A) Panoramic
B) Interproximal
C) Periapical
D) Occlusal
Q2) A total of ____ to ____ films may be included in the CMRS.
A) 4; 7
B) 7; 14
C) 14; 20
D) 19; 21
Q3) CMRS stands for:
A) Complete mouth restorative series.
B) Complete mouth radiographic series.
C) Complete mouth restorative service.
D) Complete mouth radiographic service.
Q4) There are ____ methods for obtaining periapical radiographs.
A) Two
B) Three
C) Five
D) Ten
18
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Chapter 17: Paralleling Technique
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Sample Questions
Q1) The lingual cusp of the first premolar usually obscures the distal contact of the canine on the ____ exposure.
A) Maxillary canine
B) Maxillary incisor
C) Mandibular canine
D) Mandibular incisor
Q2) Parallel is defined as:
A) To cut across or through.
B) Intersecting at or forming a right angle.
C) Moving or lying in the same plane, always separated by the same distance and not intersecting.
D) An angle of 90 degrees formed by two lines perpendicular to each other.
Q3) The authors recommend that each film be placed in the bite-block with the dot:
A) Down.
B) Up.
C) Distal.
D) In the slot.
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Chapter 18: Bisecting Technique
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Sample Questions
Q1) Which of the following commercially available film holders is/are recommended for one-time use only?
A) Rinn XCP instruments
B) Rinn BAI instruments
C) Stabe bite-block
D) EEZEE-Grip film holder
Q2) The recommended posterior periapical exposure sequence for the bisecting technique is to begin with the:
A) Maxillary right quadrant.
B) Maxillary left quadrant.
C) Mandibular right quadrant.
D) Mandibular left quadrant.
Q3) Which size film is traditionally used with the bisecting technique?
A) #1 film for anterior teeth, #1 film for posterior teeth
B) #1 film for anterior teeth, #2 film for posterior teeth
C) #2 film for anterior teeth, #1 film for posterior teeth
D) #2 film for anterior teeth and for posterior teeth
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20
Chapter 19: Bite-Wing Technique
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Q1) ____ sizes of bite-wing films are available.
A) Two
B) Three
C) Four
D) Six
Q2) The bite-wing tab is a heavy paperboard tab or loop fitted around a periapical film and used to stabilize the film during exposure. The periapical film is oriented in the bite loop so that the tab portion extends from the white side (tube side) of the film.
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) Which size bite-wing film may be placed in a horizontal or vertical position?
A) Size 0
B) Size 1
C) Size 2
D) Size 3
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Chapter 20: Exposure and Technique Errors
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Q1) When the distal surfaces of the canines are not visible on a premolar bite-wing film, the solution is to:
A) Change the horizontal angulation of the tubehead.
B) Increase the vertical angulation of the tubehead.
C) Decrease the vertical angulation of the tubehead.
D) Position the anterior edge of the film at the midline of the mandibular canine.
Q2) A thin radiolucent line appears on the film with:
A) Film creasing.
B) Film bending.
C) Double exposure.
D) Patient movement.
Q3) The possibility of exposure of radiographic film to white light can be reduced by:
A) Turning off the safelight and unwrapping the films in a pitch-dark room.
B) Pre-exposing the entire package of film to radiation before opening the package.
C) Not unwrapping the film in a room with white light.
D) Turning off the fluorescent lighting in the treatment room before exposing radiographic films.
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Chapter 21: Occlusal and Localization Techniques
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Q1) The dental radiograph is a ____-dimensional picture of a ____-dimensional object.
A) Two; two
B) Three; three
C) Two; three
D) Three; two
Q2) The buccal object rule depends on a ____ image shift when trying to locate vertically aligned images. With the buccal object rule, an object to the buccal of the reference object will move in the ____ direction as the shift.
A) Vertical; same
B) Vertical; opposite
C) Horizontal; same
D) Horizontal; opposite
Q3) Which occlusal projection is used to locate foreign bodies or salivary stones in the region of the floor of the mouth?
A) Topographic occlusal projection
B) Lateral occlusal projection
C) Cross-sectional occlusal projection
D) Pediatric projection
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Chapter 22: Panoramic Imaging
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Sample Questions
Q1) Rare earth screens emit ____ light and are considered faster than calcium tungstate screens, which emit ____ light.
A) Blue; green
B) Blue; blue
C) Green; green
D) Green; blue
Q2) A lead apron ____ a thyroid collar should be used when exposing a panoramic film, and the patient should be told to raise the tongue up to the ____.
A) Without; palate
B) Without; occlusal plane
C) With; palate
D) With; occlusal plane
Q3) In panoramic radiography, the ____ is a theoretical concept used to determine where the dental arches must be positioned to achieve the clearest image.
A) Waypoint
B) Focal trough
C) Neutral zone
D) Home zone
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24
Chapter 23: Extraoral Imaging
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Sample Questions
Q1) For the ____ projection, the patient's head is tipped toward the side being imaged.
A) Body of the mandible
B) Lateral cephalometric
C) Reverse Towne
D) Waters
Q2) The purpose of the transcranial projection is to evaluate the articular eminence and ____ surface of the condyle.
A) Anterior
B) Posterior
C) Superior
D) Inferior
Q3) An extraoral radiograph is placed ____ the mouth during x-ray exposure. Extraoral radiography 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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Chapter 24: Imaging of Patients With Special Needs
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Q1) When intraoral films are impossible to obtain, the radiographer should:
A) Skip radiographs.
B) Use an injection of local anesthetic on the patient's throat and try again.
C) Use extraoral films to obtain diagnostic information.
D) Use an intraoral digital film sensor rather than conventional film.
Q2) The gag reflex is a(n) ____ effort, preceded by ____ of respiration.
A) voluntary; an increased rate
B) involuntary; cessation
C) voluntary; cessation
D) involuntary; an increased rate
Q3) Which of the following choices would represent the suggested film placement sequence for a patient who is likely to gag?
1) Anterior
2) Premolar
3) Molar
A)1, 2, 3
B)2, 1, 3
C)2, 3, 1
D)3, 1, 2
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Chapter 25: Digital Imaging
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Q1) Advantages of the use of digital imaging include which of the following?
A) The size of the digitized image makes it attractive as a patient education tool.
B) There is an opportunity for an increase in interactive dialogue between the patient and the radiographer.
C) The use of visualization can increase the patient's understanding of the disease process.
D) Some combination of the above.
E) All of the above.
Q2) Most digital imaging systems use a ____ as the x-radiation source.
A) Flat-bed scanner
B) Conventional dental x-ray unit
C) Commercial analog intraoral camera
D) Commercial digital intraoral camera
Q3) Advantages of digital imaging include:
A) All sensors can be autoclaved.
B) Increased speed of image viewing.
C) Color radiography rather than black and white.
D) Low initial setup costs.
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Chapter 26: Three-Dimensional Digital Imaging
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Q1) The purpose of three-dimensional imaging includes which of the following?
A) Eliminates deficiencies that could hinder accurate interpretation of images.
B) Used to enhance the evaluation of pathology.
C) Used to determine distances to critical anatomic landmarks.
D) All of the above.
Q2) Studies have compared the radiation dose of a typical CBCT scan to the radiation dose received from ____.
A) Three or four panoramic images.
B) Three or four full-mouth series of intraoral images.
C) A traditional CT procedure.
D) Bitewing images.
Q3) With CBCT, the divergent rays exit the machine and some of the radiation is attenuated by the patient. In this statement, attenuated means :
A) To dilute.
B) To make thin or weak.
C) To reduce the strength of.
D) All of the above.
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Chapter 27: Normal Anatomy: Intraoral Images
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Q1) The mental ridge is located on the ____ portion of the mandible.
A) External surface of the anterior
B) Internal surface of the anterior
C) External surface of the posterior
D) Internal surface of the posterior
Q2) A ____ is a tubelike passageway through bone that contains nerves and blood vessels.
A) Canal
B) Foramen
C) Fossa
D) Sinus
Q3) On a maxillary periapical radiograph, the anterior nasal spine appears as a ____-shaped radiopaque area located at the intersection of the floor of the nasal cavity and the nasal septum.
A) T
B) U
C) V
D) I
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29
Chapter 28: Film Mounting and Viewing
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Q1) 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
Q2) When all the windows of the film mount are not filled with radiographs, the text recommends placing ____ in the unused frames.
A) Masking tape
B) Nothing
C) Black opaque paper
D) An unexposed film
Q3) The dental radiographer should always mount films ____ after processing.
A) Immediately
B) 24 hours
C) 3 days
D) 1 week
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Chapter 29: Normal Anatomy: Panoramic Images
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Q1) The ____ is a marked prominence of bone found on the anterior superior ramus of the mandible.
A) Mandibular condyle
B) Coronoid notch
C) Coronoid process
D) Lingula
Q2) On a panoramic radiograph, the coronoid notch appears as a ____ to the coronoid process.
A) Concavity located mesial
B) Concavity located distal
C) Convexity located mesial
D) Convexity located distal
Q3) The mastoid process is a marked prominence of bone located ____ to the temporomandibular joint (TMJ).
A) Anterior and superior
B) Anterior and inferior
C) Posterior and superior
D) Posterior and inferior
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Chapter 30: Introduction to Image Interpretation
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Q1) In the dental setting, most films are examined in the:
A) Business office.
B) Darkroom.
C) Operatory.
D) Reception room.
Q2) To interpret films, the dental radiographer must be confident in the identification and recognition of the following:
1) Normal anatomy
2) Dental caries
3) Periodontal disease
4) Traumatic injuries and periapical lesions
A)1, 2, 3, 4
B)1, 2, 3
C)2, 3, 4
D)1, 2, 4
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 term ____ refers to a radiolucent lesion located around the crown of an impacted tooth.
A) Periapical
B) Inter-radicular
C) Pericoronal
D) Edentulous zone
Q2) Which of the following is an example of a soft-tissue opacity?
A) Osteitis deformans
B) Sialolith
C) Chondrosarcoma
D) Florid osseous dysplasia
Q3) The term ____ refers to a well-defined, localized radiopaque area surrounded by a uniform radiolucent halo.
A) Focal opacity
B) Target lesion
C) Multifocal confluent
D) Ground glass
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33
Chapter 32: Identification of Restorations, Dental Materials, and Foreign Objects
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Q1) Because metallic restorations absorb x-rays, the area of the film that corresponds to their location remains unexposed, and the metallic restorations appear completely ____ on a dental radiograph.
A) Radiosensitive
B) Radioresistant
C) Radiopaque
D) Radiolucent
Q2) Which of the following is the most common restorative material used in dentistry?
A) Porcelain
B) Cast gold
C) Amalgam
D) Acrylic
Q3) Of the nonmetallic restorations, ____ is the most dense and least radiolucent.
A) Unfilled acrylic
B) Filled acrylic
C) Composite
D) Porcelain
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Page 34
Chapter 33: Interpretation of Dental Caries
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Q1) ____ caries are found between two teeth.
A) Occlusal
B) Buccal
C) Lingual
D) Interproximal
Q2) Rampant caries are typically seen in children with ____ dietary habits or in adults with ____ salivary flow.
A) Poor; increased
B) Poor; decreased
C) Good; increased
D) Good; decreased
Q3) A carious lesion appears ____ on a dental radiograph.
A) Radiopaque
B) Radiolucent
C) White
D) Clear
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Chapter 34: Interpretation of Periodontal Disease
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Q1) Calculus ____ on a dental radiograph.
A) Appears radiolucent
B) Appears radiopaque
C) Does not appear
D) Appears dark or black
Q2) The severity of bone loss is measured by the:
A) Pocket depth.
B) Recession.
C) Amount of inflammation.
D) Clinical attachment loss.
Q3) In health, the lamina dura around the roots of the teeth appears as a(n) ____ line.
A) Dense radiolucent
B) Dense radiopaque
C) Intermittent radiolucent
D) Intermittent radiopaque
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Chapter 35: Interpretation of Trauma and Pulpal and Periapical Lesions
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Q1) Sclerotic bone is seen below the apices of ____ teeth.
A) Vital, carious
B) Vital, noncarious
C) Nonvital, carious
D) Nonvital, noncarious
Q2) ____ is the most common periapical radiopacity observed in adults.
A) Hypercementosis
B) Sclerotic bone
C) Condensing osteitis
D) Pulpal sclerosis
Q3) Luxation is:
A) The abnormal displacement of teeth.
B) Used to describe fragments of bone following traumatic injury.
C) Hemorrhage, or bleeding.
D) Swelling or edema.
Q4) Which of the following is a periapical radiolucency?
A) Hypercementosis
B) Condensing osteitis
C) Periapical cyst
D) Sclerotic bone
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