1. RADIOGRAPHIC ERRORS AND ARTIFACTS
Dr. Walid Samir Salem
BDS, MS, MHPE
lecturer, Oral Surgery Department
Member, Dental education unit

2. Films with errors should be avoided due to the following reasons:
Retake will lead to:
Expose the patient to unnecessary radiation.
Waste film & time (money).
Interfere with accurate interpretation and diagnosis.

3. Causes of faulty radiograph
The majority of the errors produced can be categorized into three groups:
Technique & Projection errors.
Exposure errors.
Processing errors.

4. Technique & Projection errors:
a. Patient preparation error:
b. Film placment artifact:
Blurred image
Radiopaque artifact
Pressure mark
Reversed film
Double image
Apices cut off
Dot artifact
Dropped film corner
Crown not shown
Black line
Area of interest not shown
Distortion

5. c. Projection errors: Incorrect vertical angulation.
Incorrect horizontal angulation
PID alignment artifact

6. Technique & Projection errors
a. Patient preparation error
Radiopaque artifact
Dental appliances, body piercings, jewelry & eye glasses left in the mouth during exposure will appear as radiopaque artifact superimposed over the dental image.
Correction: all these items should be removed before placing of the film.

9. Technique & Projection errors
a. Patient preparation error
Blurred image
Movement of the film, patient or X-ray tube head during exposure will result in a blurred image.
Correction: the operator should explain for the patient & remind him to remain motionless during exposure.

11. Technique & Projection errors
a. Patient preparation error:
Pressure mark
Pressure from the incisal edge & cusps of the teeth (mostly in the pediatric occlusal radiograph).
May appear black or white.
Correction: ask the patient to bite gently.

12. Technique & Projection errors
b. Film placment artifact
Double image
When an exposed film is re-exposed the resulting film will have 2 superimposed images

13. Technique & Projection errors
b. Film placment artifact
Reversed film
Low density with herring bone, tire-track or dotted pattern, as a result of directing the X-ray through the lead foil side of the film back.

14. Technique & Projection errors
b. Film placment artifact
Dot artifact
The identification (embossed) dot produce a circular radiolucent artifact on the final radiograph. This may interfere with interpretation of the apical areas of the teeth.

15. Technique & Projection errors
b. Film placment artifact
Apices cut off
Occur when the film is not positioned apically enough to record the entire tooth.

16. Crown not shown There is no enough film extending occlusally.
Technique & Projection errors
b. Film placment artifact
Crown not shown
There is no enough film extending occlusally.

17. Technique & Projection errors
b. Film placment artifact
Dropped film corner
The film edge is not placed parallel to the occlusal surface of the teeth.

18. Area of interest not shown
Technique & Projection errors
b. Film placment artifact
Area of interest not shown
This is the result of not placing the film to cover all the teeth in the area of interest and not centralizing the film over the area of interest.

19. Technique & Projection errors
b. Film placment artifact
Black line
Due to excessive bending of the film prior to its placement inside the patient’s mouth (pressure causes ionization of silver halide upon processing will be darker).

20. Technique & Projection errors
b. Film placment artifact
Distortion
Due to bending of the film to eliminate the patient’s discomfort specially in lower premolar area and upper central incisors.
normal
distortion

21. Incorrect vertical angulation
Technique & Projection errors
c. Projection errors
Incorrect vertical angulation
It will lead to:
Elongated image due to insufficient v. angulation ( too flat), or
Shortened image due to excessive v. angulation ( too steep)

22. Technique & Projection errors
c. Projection errors

23. Technique & Projection errors
c. Projection errors

24. Incorrect horizontal angulation
Technique & Projection errors
c. Projection errors
Incorrect horizontal angulation
Is the appearance of the interproximal surfaces of the adjacent teeth over each other. This is due to improper H.A. due to improper alignment of the C.R. through the contact points i.e. not // to interproximal surfaces.

25. Technique & Projection errors
c. Projection errors

26. PID alignment artifact
Technique & Projection errors
c. Projection errors
PID alignment artifact
If the PID is misaligned and the x-ray is not centered over the film, a partial image is seen on the resultant radiograph, this partial image is called cone-cut.
It appear as a clear area with curved outline.

28. Asuan – Egy.

29. II. Exposure errors. Blank image. Low density image.
High density image.
Image with high and low contrast.

30. Exposure errors
Blank image
A film that didn’t receive radiation will have no image and will appear clear.

31. Low density (faint) image
Exposure errors
Low density (faint) image

32. Exposure errors
High density image

34. III. Processing errors Chemical errors: Film Handling errors:
Light image.
Dark image.
Blank image.
Reticulation.
Black spot or patch.
Black line.
White spot or patch.
Yellowish brown discoloration.
Film Handling errors:
Writing lines
Developer cut off
Fixer cut off
Overlapped film
Finger nail artifact
Smudge.
Scratched film
Static electricity

35. Processing errors
Chemical errors
Reticulation
When the film subjected to a sudden temperature changes between the developer and water.
Appear as cracked film.

36. Processing errors
Chemical errors
Black spot or patch
Developer contamination before immersion into the developer solution.

37. Black line Developer contamination processing hanger clips
Processing errors
Chemical errors
Black line
Developer contamination processing hanger clips
Dirty roller in automatic processor

38. White spot or patch Contamination with fixer before processing
Processing errors
Chemical errors
White spot or patch
Contamination with fixer before processing

39. Yellowish brown discoloration
Processing errors
Chemical errors
Yellowish brown discoloration
Exhausted solution or insufficient rinsing

40. Writing lines Finger nail artifact
Processing errors
Film Handling errors
Writing lines
Appear on the radiograph due to writing on the film packet with ballpoint pen or lead pencil.
It may appear black or white.
Finger nail artifact
Black or whit crescent shape mark due to rough handling of the film.

41. Processing errors
Film Handling errors
Developer cut off
A straight blank white border due to underdeveloped portion. The film may not be completely immersed in the developer solution.

42. Processing errors
Film Handling errors
Fixer cut off
A straight black border. The film may not be completely immersed in the developer solution.

43. Processing errors
Film Handling errors
Overlapped film
Film that overlap in developer are white, while that overlap in fixer are black

44. Processing errors
Film Handling errors
Smudge (finger print)
When the film touched by fingers contaminated with developer or fixer

45. Processing errors
Film Handling errors
Scratched film
White lines appear on the film due to careless handling of the film.

46. Processing errors
Film Handling errors
Static electricity
Thin black branching lines Occurs when two surfaces are rubbed together against each other vigorously, this creates an electric charges with visible light emitted which is capable of exposing the x-ray film, thus leading to ionization of AgBr crystals at this area.
Occur most frequently during periods of low humidity

49. Metallic partial denture
Blurred

50. Reverse image
Apices cut off

51. Dropped corner
Distortion

52. Horizontal overlap
Elongation
Double image

53. Static electricity
Low denisty

54. White spot or patch
Yellowish brown discoloration

55. Reverse image
Developer cut off
Cone-cut

56. Thank You