Radiographic Faults

All About Radiographic Faults

Projection Errors

Fault: Apical ends of teeth are cut off
- Reason: Film is placed too close to the teeth in maxillary arch in paralleling technique
- Rectification: Place the film away from teeth
- Reason: Decreased vertical angulation
- Rectification: Increase the vertical angulation
- Reason: Improper positioning of film in oral cavity
- Rectification: Not more than 1/8th inch of the film edge should extend beyond the incisal-occlusal surface of teeth
Fault: Overlapping of teeth
- Reason: Plane of the film not parallel to the lingual surface of teeth
- Rectification: Film should be placed parallel to the lingual surface of teeth
- Reason: Incorrect horizontal angulation of the cone
- Rectification: Central ray of the X-ray beam should be directed perpendicular to the facial surface of teeth
Fault: Occlusal plane appears tipped or tilted
- Reason: Edge of film not placed parallel to the incisal-occlusal surface of the teeth
- Rectification: Edge of film should be parallel to the incisal-occlusal surafce
- Reason:Film not holded properly by patient if finger holding method is used
- Rectification:Instruct the patient to hold the patient correctly
Fault: Specific region is not showing
- Reason: Faulty film placement
- Rectification: Center the film over the teeth to be radiographed
Fault: Crown of the teeth not showing
- Reason: Insufficient film below or above crowns of teeth
- Rectification: 1/8th of the film should extend below or above crown
- Reason: Decreased vertical angulation
- Rectification: Increase the vertical angulation
Fault: Partial image
1. Cone Cut
  - Reason: Position Indicating Device not covering the area of intrest, not using film holder
  - Rectification: Cone should be centered over the area of intrest and the film, both vertically and horizontally
  - Reason: Upper edge of the film not immersed in the developing solution
  - Rectification: Maintain the level of developing solution in the processing tank and make sure film is completely immersed during processing
2. Distal Surface of canine not visible on bitewing film
  - Reason: Bitewing film positioned too far posterior in the mouth
  - Rectification: Antrior edge of bitewing film should be positioned at the midline of mandibular canine
3. Third molar region not visible on the film
  - Reason: Film is placed too far anterior in the mouth
  - Rectification: Anterior edge of the film should be placed at the midline of mandibular secomd premolar
4. Only a portion of film is exposed in panoramic films
  - Reason: Film casette incorrectly positioned in the starting position
  - Rectification: Place the cassette correctly
Fault: Shape Distortion
1. Forshortening
  - Reason: Increased vetical angulation in bisecting angulation technique
  - Rectification: Reduce the vertical angulation
  - Reason: Film not placed parallel to long axis if teeth in paralleling technique
  - Rectification: Film should be placed parallel to the long axis of teeth
2. Elongation
  - Reason: Decreased vertical angulation in bisecting angle technique
  - Rectification: Increase the vertical angulation
  - Reason: film not placed parallel to long axis if teeth in paralleling technique
  - Rectification: Film should be placed parallel to the long axis of teeth
3. Distorted Image
  - Reason: Film is bent as patient bites on the film holder
  - Rectification: Use a film backing
  - Reason: Negative vertical angulation ised in bitewing technique
  - Rectification: Always use +10 degree vertical angulation with bitewing radiograph
4. Overlapped Contacts
  - Reason: Central rays not directed through the interproximal spaces
  - Rectification: Central rays should be directed through interproximal spaces
5. Magnification
  - Reason: Increased film to object distance
  - Rectification: Use recommneded film to object distance
  - Reason: Pointed conical cone used which produces divergent beam
  - Rectification: Use open ended lead lined cones
Fault: Herring Bone Effect or Tyre Track Appearance
- Reason: Back side of film with the lead foil placed facing towards the cone
- Rectification: Place the front side of film towards the cone
Fault: Black dot in the film in apical area
- Reason: Identifying mark on the film towards the apical area of teeth
- Rectification: Place the raised dot on the film towards the occlusal or incisal surface of teeth
Fault: Artifacts on Radiograph
1. Writing lines on radiograph
  - Reason: Writing on the film pocket with ball pen or lead pencil
  - Rectification: Use a marker pen to write on film pocket
2. Black lines on the radiograph
  - Reason: Bending of the film to reduce patient discomfort
  - Rectification: Avoid bending of film
3. Random Artifacts on Film
  - Reason: Contaminants (paper,dust will prevent the X-ray from reaching the film
  - Rectification: Clean the screens inside the cassette
Fault: Double Images on Radiograph
- Reason: Film exposed twiced to radiation
- Rectification: Place exposed films in separate labelled compartment
Fault: Blurred Image on Radiograph
- Reason: Movement of the film, patient or tube during exposure
- Rectification: Use film holders
- Reason: Double exposure
- Rectification: Place exposed films in separate labelled compartment
Fault: Radiopaque Artifacts on Radiograph
- Reason: Dental appliance or foreign bodies in or area near to the radiograph
- Rectification: Ask the patient to remove dental appliance or any foreign bodies (Eg. eye glasses, nose ring, ear ring etc.)
Fault: Adumbration (Cervical Burn Out)
- Reason: Horizontal angle of beam is not directed through the contact area of teeth
- Rectification: Horizontal angle of beam should be redirected through contact area of teeth

Exosure and Processing Errors

Low Density Film (Light Radiograph)
1. Under Exposure
  - Reason: Short exposure time
  - Rectification: Set exposure time correctly
  - Reason: Increased source to film distance
  - Rectification: Maintain proper source to film distance
  - Reason: Low kVp
  - Rectification: Increase kVp by approximately 5kVp
  - Reason: Reduced mA
  - Rectification: Increase mA or exposure time
  - Reason: Film packet placed with wrong side facing the tooth causing the image of lead superimposed on the object image
  - Rectification: Place the pebbled side of film facing the tooth towards cone
  - Reason: Incorrect film screen combination used
  - Rectification: Always use right screen combination
2. Under development
  - Reason: Less developing time
  - Rectification: Set darkroom time correct
  - Reason: Low developer temperature
  - Rectification: Raise temperature to 70 degree F
  - Reason: Exhausted or contaminated or diluted developer
  - Rectification: Replace or replenish the developing solution
  - Reason: Excessive fixation
  - Rectification: Regulate time for fixing as per time table
Fault: High density film (Dark Radiograph)
1. Exposure parameters
  - Reason: Exposure time too long
  - Rectification: Set timer correctly or reduce exposure time
  - Reason: Increased kVp
  - Rectification: Reduce the kVp
  - Reason: Decreased source film distance
  - Rectification: Measure the source film distance and adjust the exposure time accordingly
  - Reason: Inaccurate time
  - Rectification: Check the timer
  - Reason: Increased mA for given exposure
  - Rectification: Reduce kVp or exposure time
2. Over development
  - Reason: Increased developing time
  - Rectification: Use time temperature method with darkroom timer
  - Reason: Increased developer temperature
  - Rectification: Lower temperature to 70 degree F
  - Reason: Concentrated developing solution
  - Rectification: Check mixing instructions
  - Reason: Inadequate fixation
  - Rectification: Fixation time should be standardized as per instructions
  - Reason: Accidental exposure to light or improper safe light
  - Rectification: All darkroom procedure should be done in safelight
Fault: High Contrast
- Reason: Insufficient penetration
- Rectification: Increase kilo voltage
- Reason: Over development
- Rectification: Use time temperature method
- Reason: High contrast films or intensifying screens
- Rectification: Use lower contrast film or slower speed screens
- Reason: Inaccuarte timer
- Rectification: Correct the timer
Fault: Low Contrast
- Reason: Excessive penetration
- Rectification: Decreased kilo voltage
- Reason: Under development
- Rectification: Set dark room timer correctly. Raise temperature to 70 degree F.
- Reason: Films with insufficent contrast and cassettes with slow intensifying screens
- Rectification: Use higher contrast films or higher speed screens
- Reason: Scatterred radiation
- Rectification: Use suitable cone
- Reason: Under exposure
- Rectification: Check exposure time
Fault: Fog
- Reason: Light streaks in darkroom or improper safe lights
- Rectification: Use recommended safe lights and check darkroom for any light leaks
- Reason: Turning on white light too early
- Rectification: Fix film for 2 minutes before turning on the white light
- Reason: Prolonged exposure to safe light
- Rectification: Reduce exposure of films to safe light
- Reason: Smoking in the dark room
- Rectification: Avoid smoking in darkroom
- Reason: Developer with high temperature, concentrated or contaminated
- Rectification: Check temperature, concentration and tanks of developer solution
- Reason: High humidity of storage area
- Rectification: Store films in a dry place with 50% relative humidity
- Reason: Out dated film
- Rectification: Use older film first
- Reason: Unused films exposed to radiation
- Rectification: Store unexposed films in lead container
Fault: Streaks on film
- Reason: Failure to agitate during development
- Rectification: Agitate films on immersing them in the developer
- Reason: Chemical deposits on hanger clips
- Rectification: Keep hanger clips clean
- Reason: Excessive drying temperature
- Rectification: Reduce air flow over films
- Reason: Insufficient fixing
- Rectification: Fixing time should be twice the developing time
- Reason: Contaminated water used to wash films
- Rectification: Wash films under clean running water
Fault: Blister of films
- Reason:Unbalanced processing temperature
- Rectification: Control the temperature of water bath
- Reason: Excessive acidity of of fixer
- Rectification: Replace the fixing solution
- Reason: Films not agitated when immersed in fixer
- Rectification: Agitate the film during fixing
Fault: Reticulation (Orange peel appearance)
- Reason: Sudden extreme temperature changes in processing
- Rectification: Maintain uniform processing temperature
- Reason: Weakened fixer solution
- Rectification: Replenish or replace fixer solution
Fault: Frilling
- Reason: Hot processing solution
- Rectification: Maintain 70 degree F processing temperature
Fault: Air bells
- Reason: Air bubbles trapped on film surface preventing uniform reduction of the emulsion
- Rectification: Agitate film into developer
Fault: White spots and line on films

Reason: Dust present on the film or screen
Rectification: Keep darkroom clean and periodically clean the screens
Reason: Emuslsion tear due to rough handling of film
Rectification: Dont rub the film against the side of tanks or other film hangers
Reason: Film contminated with fixer before developing
Rectification: Keep the dark room clean and dry
Reason: Excessive bending of film
Rectification: Handle the films gently
Reason: Crack in intensifying screens
Rectification: Replace the intensifying screens

Fault: Black spots on films
- Reason: Dust in contact with underdeveloped films
- Rectification: Prevent fine particles of developer coming in contact with the films
- Reason: Film splashed with the developer before placing in developing tank
- Rectification: Careful handling of solution and clean work area
- Reason: Films touching during developing
- Rectification: Films should not touch the processing tank
- Reason: Black wrapping paper sticking to film surface Rectification: Remove the black paper carefully woith dry hands
- Reason: Excessive bending of film due to cutvature of hard palate or excessive finger pressure applied on film Rectification: Check the film placement before exposure. Instruct the patient to hold the film gently. In case of hard palate curvature cotton rolls are used withb paralleling technique
- Reason: Finger contaminated due to developer
- Rectification: Wash hands properly
- Reason: Fingernail artifact
- Rectification: Avoid long nails during film processing
Fault: Artifacts from processing
- Reason: Black cresent due to rough film handling
- Rectification: Handle films by edges only
- Reason: Black smudge marks due to finger prints
- Rectification: Use dry finger while handling film
- Reason: Black lines due to static electricity
- Rectification: Install electric humidifier or cool vapor vaporizers in dark room
- Reason: Film creasing or film emulsion cracks causing thin radiolucent line on radiograph
- Rectification: Dont bend the film excessively
Fault: Stains on film
1. Yellow or Brown stains
  - Reason: Contaminated or oxidized developer or prolonged development
  - Rectification: Use fresh developing solution and recommended developing time
  - Reason: Insufficient rinsing
  - Rectification: Rinse films for 15-20 seconds under clean running water
  - Reason: Contaminated fixer solution
  - Rectification: Use fresh fixer solution
2. Dichoric radiograph (Two colors)
  - Reason: Old or contaminated developer or fixer
  - Rectification: Use fresh and clean developer and fixer
  - Reason: Film partially fixed in weak fixer , exposed to light and washed
  - Rectification: Replace fixer solution and follow recommended processing cycle
  - Reason: Prolong intermediate rinse in contaminated water
  - Rectification: Use fresh running water
Fault: Deposits on film
- Reason: Exhausted / Contaminated solution and rinsing water
- Rectification: Use fresh solution and clean running water
- Reason: Solution not mixed in correct proportion
- Rectification: Follow manufactureres instruction for solution preparation
Fault: Clear Film
- Reason: Film not exposed
- Rectification: Failure to switch on the X-ray machine or machine malfunction
- Reason: Exposed film first put into the fixing solution
- Rectification: Positions of processing tanks should be fixed and labelled
Fault: Black Film
- Reason: Film exposed to light
- Rectification: Exposed and unexposed film should be kept in seprate labelled container
Fault: Brittleness of finished radiograph
- Reason: Excessive drying temperature
- Rectification: Reduce dryer temperature
- Reason: Excessive drying time with high humidity
- Rectification: Reduce the drying time. Use wetting agent prior to placing the films in dryer
- Reason: Excessive fixer acidity
- Rectification: Replace fixer solution
Fault: Faded image on finished radiograph (Radiopaque appears Radiolucent)
- Reason: Exhausted fixer or inadequate fixing or final wash
- Rectification: Follow proper fixing guidelines
Fault: Dark flow marks
- Reason: Vigorous agitation producing solution currents
- Rectification: Agitation should be done gently
- Reason: Weak developer or high temperature of developing solution
- Rectification: Follow proper developing guidelines
Fault: Emulsion Peel
- Reason: Abrasion of film during processing
- Rectification: Handle the film with utmost care
Fault: Grainy appearance
- Reason: Developing solution too warm
- Rectification: Follow developing solution guidelines
Fault: Vertical white lines on panoramic radiograph
- Reason: Push button on exposure is accidently released and pressed down for remainder of excursion resulting in a blank space on radiographas radiation to film is cut off
- Rectification: Press the exposure button till exposure cycle

Automatic Processing Errors

Fault: Film Density Errors
- Reason: Decrease in film density due to low developer temperature, exhausted or contaminated developer or no agitation in developer tank
- Rectification: Drain and clean tank, install new developer
- Reason: Processing too fast
- Rectification: Follow processing guidelines
- Reason: Increase in film density due to high developer temperature
- Rectification: Decrease the developer temperature
- Reason: Light leak in processor cover
- Reason: Streaking due to rollers and crossovers encrusted with chemical deposit Rectification: Clean them periodically
- Reason: Fogged films due to contaminated solution, processor or dark room light leaks, excessive developer temperature
- Rectification: Use clean solution, prevent light leaks and lower the developer temperature
Fault: Film Drying Errors
- Reason: Depleted fixer or insufficient water flow
- Rectification: Install new fixer solution and check water flow
- Reason: Low dryer temperature or dryer thermostatic control is not working
- Rectification: Check the temperature settings
- Reason: Chemical imbalance
- Rectification: Replace with new solution
- Reason: Improper type of film for time cycle of processor
- Rectification: Check on the automatic processor manual for type of film
Fault: Abnormal film surface marks
1. Peeling of Emulsion
  - Reason: Developer temperature too high
  - Rectification: Reduce developer temperature
  - Reason: Improper fixer strength
  - Rectification: Replace fixer solution
  - Reason: Heavy developer deposits on developer rack rollers above solution level
  - Rectification: Keep cleaning the machine
  - Reason: Improper film
  - Rectification: Check the type of film used for particular machine
  - Reason: Rough handling of films
  - Rectification: Handle films gently
2. Pressure Marks
  - Reason: Foreign material or rough spot on roller
  - Rectification: Clean the rollers
  - Reason: Excessive pressure over films
  - Rectification: Handle films gently
3. Clody or smudgy film appearance
  - Reason: Depleted fixer
  - Rectification: Replace the fixer solution
  - Reason: Improper type of film used
  - Rectification: Use recommneded type of film
  - Reason: White cloudy appearance on film due to no water in water tank
  - Rectification: Check water level
4. Scratches on film surface
  - Reason: Foreign materials on rollers
  - Rectification: Clean the rollers
  - Reason: Improper handling of film
  - Rectification: Handle films gently
  - Reason: Damaged or defective films
  - Rectification: Check the films before use
  - Reason: Stalled or sticking roller
  - Rectification: Inspect racks, gears and gear mesh
5. Drying pattern on film surface
  - Reason: Dryer too hot
  - Rectification: Reduce dryer temperature
6. Dark spots or lines on film surface
  - Reason: Excessive roller pressure
  - Rectification: Get the processor serviced
  - Reason: Dirty rollers in the processors
  - Rectification: Clean rollers carefully
  - Reason: Contamination of film by dirty working area
  - Rectification: Clean the working area
7. Film Discolorations
  - Reason: Fixer in developer and too fast processing gives brown stains
  - Reason:Shiny films due to excessive hardening

Phalangioma

Reason: Patient's fingers on the film causing distal phalanges seen of patient's fingers seen on radiograph

Rectification: Patient's finger used to stabilize the film should be placed behind the film