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 IMAGE RECEPTORS

By
Dr: Abdullah Ibrahim

Lecturer of Oral Medicine, Periodontology,

Oral Diagnosis & Dental Radiology
Faculty of Dental Medicine, Al Azhar
University
• The term image refers to a picture of an
object, and the term receptor refers to
something that responds to a stimulus.

Dental film is an image receptor in the

form of a photographic plate onto which
the attenuated beam is received forming
a latent image that transforms to a visible
image by chemical processing
Types of Image receptors:-

1-Direct Exposure
Sensitive to x-rays and used
intraorally.

2-Indirect Exposure Film (Screen Film)

Sensitive to light, used with
intensifying screens extra orally.

3-Digital receptors
– Solid-state sensors
– Phosphor plates
 Extraoral Film
Intra-oral x-ray film (Direct Exposure
Film)
Constituents of an Intraoral Film Packet.
An outer cover or package wrapping,
Lead backing of foil sheet,
Black paper wrapper and
The film.
 Outer Package Wrapping
 The outer package
wrapping is a soft-
vinyl or paper
wrapper that
hermetically seals
the film, protective
paper, and lead foil
sheet.
 This outer wrapper
serves to protect
the film from
exposure to light
and saliva.
 Extraoral Film
The film packet has two sides:

1-Tube Side:- The tube side is solid, white and has a

raised Identification dot in one corner of the x-ray film.
When placed in the mouth, the white side (tube side) of
the film packet must face the teeth and the tube head.
After the film is processed, the raised identification dot
is used to distinguish between the left and right sides of
the patient.
So that the dot is significant in film mounting and
interpretation
2-Label Side:- The label side of the film packet has a flap
used to open the film packet and remove the film before
processing.

When placed in the mouth, the color- coded side (label

side) of the packet must face the tongue.
 Extraoral Film
The following information is printed on the label
side of the film packet :-

 A circle or dot that corresponds with the

raised identification dot on the opposite side of
the film
The manufacturer’s name
 The film speed
 The number of films enclosed
 Lead backing
 The lead backing is a single
sheet of lead foil within the film
packet that is located behind
the film to:

 Shield the film from

backscattered (secondary)
radiation that results in film
fog, without optimum contrast
that is required for the optimum
diagnostic quality of the
radiograph.

 Absorbs most of the x ray that

pass through and exit from the
film to prevent them from
reaching to the tongue and
 Backscatter

Primary x-rays

Scatter (secondary) x-rays

 Black paper Film Wrapper

 The paper film wrapper

within the film packet is a
protective sheet that
covers the film and
shields it from light.
 Film Composition
Extraoral Film
X-ray film has two principal components:

(1)Base (2) Emulsion .

The base is a plastic supporting material onto which the
x ray sensitive material (emulsion) is coated.

The film emulsion, is the thin component which is

sensitive to x rays and visible light and records the
radiographic image.

(3) An additional layer of vehicle is added to the

film emulsion as an overcoat to protect the film
from damage by scratching, contamination, or
pressure from rollers when an automatic processor
is used.
 Film Base
The base is the skeleton of the x-ray film made
of 0.2mm sheet of cellulose acetate, which
provides the proper degree of lightness and
flexibility that allow easy handling of the film but
at the same time rigid.

The function of the film base is to support the

gelatin and the crystals of the emulsion.
 Requirements of an ideal base:-
Enough flexible to enable easy handling

The base is uniformly translucent and casts no pattern

on the resultant radiograph.

Blue tint in color to provide the optimal viewing and

reading of the diagnostic details.

Radiographically inert

 (Dimensionally stable) with storage and processing

solutions
 Film Emulsion

The two principal components of emulsion are

1.silver halide crystals, which are sensitive to x

radiation and visible light and mainly composed
of silver bromide molecules (80-99%) and silver
iodide (1-10%) arranged in a lattice structure.

2.a vehicle of homogeneous matrix of gelatinous

and non-gelatinous material.
Function of emulsion

(homogeneous matrix)

Provide the framework onto which the silver

halide crystal are suspended

During film processing, the gelatin absorbs the

processing solutions and allows the chemicals to
react with the silver halide crystals.

(Silver halide crystals)

which are sensitive to x radiation, to produce

latent image.
 Film Sizes (Intra-oral)

 Size 0: (22x35 mm) Children (periapical

and Bitewing film).
 Size1: (24x40 mm) Adult anterior teeth
(periapical).
 Size2: (31x41 mm) Adult posterior (PA &
BW); also used as occlusal for children.
 size3: (53x26 mm) Extra long BW.
 size4: ( 57x76 mm) Occlusal.
#2 #3

#1
#4
#0
Film Types
 Film Types

Periapical radiograph:-
Size 0 (child)
Size 1 (adult anterior)
Size 2 (adult posterior)

Bitewing radiograph:-
Size 0 (child)
Size 2,3 (adult)

Occlusal radiograph:-
Size 2 (child)
Size 4 (adult)
 Intra-oral Film Types and Sizes

The intraoral film is manufactured in five sizes to

accommodate the varying mouth sizes of
children, adolescents, and adults.

Periapical Film:- Periapical views are used to

record the crowns, roots, and surrounding bone.
Three sizes (0, 1, and 2) of the periapical film are
available.
Bitewing (interproximal) views:- are used to
record the coronal portions of the maxillary and
mandibular teeth in one image.
They are useful for detecting interproximal caries
and evaluating the height of alveolar bone.

Size 2 film is normally used in adults, In small

children, size 0 may be used.

A relatively long size 3

is also available.
Occlusal View :- It is used to show larger areas
of the maxilla or mandible than may be seen on
a periapical film.

The name derives from the fact that the film is

held in position by having the patient bite lightly
on it to support it between the occlusal surfaces
of the teeth.
Size 4 film is
normally used in
adults, In small
children, size 2
may be used.
 ANSI Decimal system

(American National Standard Institute) for identification

of intraoral film by their uses and sizes by placing a point
between two numbers in which the left one represent the
type of the film according to the use, while the right
represent the size

as follow
1 for periapical
2 for bitewing
3 for occlusal

Example: 2.3 = represent bitewing film size 3

Example: Periapical radiograph (adult

 Film speed

Refers to the amount of radiation required to

produce a radiograph of standard density.

Factors affecting film speed

1. Size and shape of the silver halide crystals.
2. The thickness of emulsion.
3. Presence of special radiosensitive dyes, iodide
content which is larger than bromides or adding
trace element e.g., Sulphur containing
compounds or gold which increase the
photosensitivity of the halide.
 The larger the crystals, the more the number of the
silver halide sensitive molecules which are
responsible for the formation of image density per
unit are, the faster is the film speed.
As the sensitivity of the film increases, there
is a reduction in the sharpness of the image.
 tabular globular

top

side

- Tabular (flat) crystals with F-speed film (Insight) are

oriented with relatively large flat surface facing the radiation
source resulting in increased speed without loss of
sharpness.
- Globular (rounded) crystals with D-speed film (Ultra speed)
An alphabetical classification system is used
to identify film speed. X-ray films are given
speed ratings ranging from A speed (the
slowest) to F speed (the fastest).

Only the D- speed film (Ultra-Speed) and the

F-speed film (InSight) are used for intraoral
radiography; the F-speed film reduce 60% of
the exposure time of the D-speed film and has
comparable image contrast and resolution.
 Film storage and protection

Films are adversely affected by heat, humidity, and

radiation.

To prevent film fog, unexposed, unprocessed films

must be kept in a cool, dry place.

The optimum temperature for film storage ranges from

50° F to 70° F (10-21 c), and the optimum relative
humidity level ranges from 30% to 50%.

Films must be stored in areas that are adequately

shielded from sources of radiation and should not be
stored in areas where patients are exposed to x-
radiation.
 Image characteristics

Radiolucent refers to that portion of a

processed radiograph that appears dark or black
refers to structure that lacks density and permits
the passage of the x-ray beam with little or no
resistance e.g., air space and soft tissue.

Radiopaque refers to that portion of a

processed radiograph that appears light or white
refers to structures that are dense and absorb or
resist the passage of the x-ray beam e.g.,
enamel, dentin and bone.
 The ideal dental radiograph is not too light
and not too dark.

 The quality of a dental radiograph is

determined by its image characteristics.
visual characteristics as well as the
geometric characteristics
 Visual characteristics
Two visual characteristics of the radiographic
image directly influence the diagnostic quality of
a dental radiograph.

These two visual characteristics are:-

1.Density.
2.Contrast.
 Density
Density is the overall blackness or darkness of a
dental radiograph.

Three exposure factors control the density of a

dental radiograph, as follows:

• Milliamperage (mA)
• Operating kilovoltage peak (kVp)
• Exposure time

Any increase in such exposure factors, separately or

combined, increases the density of a dental
radiograph.
 Contrast
Contrast is the difference in the degrees of
(densities) between adjacent areas on a dental
radiograph. When viewed on a light source, a dental
radiograph that has very dark areas and very light
areas is said to have high contrast.

 A radiograph that instead has many shades of gray

is said to have low contrast.

Only Operating kilovoltage peak (kVp) can affects

contrast by increasing the average energy of the x-
rays producing higher energy x-rays that has the
ability to penetrate the different types of tissues
easily. As a result, more variations in tissue density
are recorded on the receptor and appear as varying
shades of gray.
 Geometric characteristics

Three geometric characteristics of

the radiographic image influence the
diagnostic quality of a dental
radiograph.

These geometric characteristics are:

1.Sharpness
2.Magnification
3.Distortion
 Sharpness
Sharpness refers to how well the smallest details of an
object are reproduced on a dental radiograph.

The sharpness of an image is influenced by the following

three factors:-
1- Focal spot size: The smaller the focal spot area, the
sharper the image appears; the larger the focal spot
area, the greater is the loss of image sharpness.
2- Film composition: Sharpness is relative to the size
of the crystals found in the film emulsion. The emulsion
of faster film contains larger crystals that produce less
image sharpness, whereas slower film contains smaller
crystals that produce more image sharpness.
3- Movement: A loss of image sharpness occurs if the
tube head, the receptor, or the patient moves during x-
ray exposure.
As the sensitivity of the film increases, there
is a reduction in the sharpness of the image.
 Magnification

Image magnification refers to a radiographic image

that appears larger than the actual size of the object
it represents. The image magnification on a dental
radiograph is influenced by the following:-

1- Target-object distance is the distance between

the source of x-rays and the radiographed object.

When a longer PID is used, more parallel rays from

the middle of the x-ray beam strike the object rather
than the diverging x-rays from the periphery of the
beam. Result in less image magnification, and a
shorter PID and target–object distance result in more
image magnification.
2- Object–Receptor Distance is the distance
between the object being radiographed (the tooth)
and the image receptor. The tooth and the receptor
should always be placed as close together as
possible.

The closer the tooth is to the receptor, the

less is the magnification of the image.
 Distortion
Dimensional distortion of a radiographic image is
a variation in the true size and shape of the
object being radiographed results from improper
receptor alignment or beam angulation.
 Extra oral x-ray film
(indirect Exposure Film)

Screen film; is the film that require the use of screen for exposure.

Intensifying screen; is a device that transfers x-ray energy into

visible light.

Due to density of the skull, intensifying screens must be used to

minimize the amount of radiation to the patient; the presence of
intensifying screens creates an image receptor system that is
more sensitive 10 to 60 times to X rays than the film
alone.

In all dental applications, intensifying screens are used in pairs,

one on each side of the film, and they are positioned inside a
Composition of intensifying screens:

1- Base: 0.25mm thick of polyester plastic,

used to support the phosphor layer.
2- Reflecting layer: is a white coat of titanium
dioxide applied to the base material. Its purpose
to reflect any light emitted from the phosphor
layer back to the x-ray film.
3- Phosphor layer: is composed of light-
sensitive phosphorescent crystals that emit
visible light photons, which expose the x-ray
film.
4- Coat: a protective coat of plastic is placed
over the phosphor layer.
Composition of intensifying screens
Fluorescent materials

1- conventional screen: phosphor layer is made of

Calcium tungstate (Ca Wo4) or barium lead sulphate.
2- Rare earth screen: phosphor layer is made of
gadolinium and lanthanum.

Conventional calcium tungstate screens have

phosphors that emit blue light. The newer rare earth
screens have phosphors that are not commonly found in
the earth (thus “rare earth”) and emit green light.

Rare earth intensifying screens are more efficient in

converting x-rays into light than calcium tungstate
intensifying screens.

As a result, rare earth screens require less x-ray

exposure than do calcium tungstate screens and are
considered faster.
Effect of intensifying screen on the final
image:

•Has an adverse effect on image sharpness because the

diverging visible light emitted by the screen
spread out beyond the original point which results
in blurring of the fine details on the radiograph.

•In addition to the crossover of the emitted light

from one screen to the opposite one which can be
solved by incorporating dyes into the base of the film
that prevent the crossover of light.
While the majority of extraoral films are
screen films but the direct (non-screen) film can
be used also.

Film/screen combinations are used as image

detectors whenever possible because of the
reduced dose of radiation to the patient
(particularly when very fine image detail is not
essential).
 Film Sizes (extraoral)

For skull view

5x7 inches
8x10 inches (most used)
6.5x8.5 inches
10x12 inches

For panoramic view

5x12 inches
6x12 inches
15x30.5 cm(most commonly used)
 CASSETTES

Cassette is a special light- tight device used

to holds extraoral film and the intensifying
screen in close contact with each other during
exposure.

Cassettes can be manufactured in different

sizes to accommodate
1.skull views with all their sizes,
2.Panoramic film
3.Occlusal film
 This film is sandwiched between two
intensifying screens of matching size and is
secured in a cassette.

 The purpose of a cassette is to hold each

intensifying screen in contact with the x-ray
film to maximize the sharpness of the
image. There is a felt padding layer at the
back side of the cassette to assure the proper
contact between the screen and the film.

 The cassette should have locked clamp or

spring and should be loaded and unloaded
Types of Cassettes
•Rigid Cassettes
•Flexible Cassette
Curved Cassettes
Straight (flat) cassettes
Gridded Cassette
 GRIDS (filter)

Grid is a device used to remove or reduce the

amount of scattered radiation that reach the
film.
 The x-ray grid acts as a filter, effectively
removing scatter radiation before it reaches the film
(the ideal name is anti-scatter grid).

 The grid does not prevent the production of

scattered photons but prevents them from reaching
the film.

 Accordingly, the grid is positioned between the

object and the film.
 A grid consists of many long, parallel strips of
radiopaque material (e.g., lead) interspersed
with radiolucent interspace material (plastic).

 The scattered radiation usually travels

obliquely, not in the same direction as the
primary x-ray beam. Hence, most of the
scattered radiation gets absorbed by the lead
strips of the grid.

 An ideal grid should be capable of

removing 80-90% of the scattered
radiation. The resultant image thus has
a better contrast.
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