ULTRASONOGRAPHY

The human Ear can detact sound in the frequency of 1500-20,000 cycles per second (hertz). Sound waves travelling in the frequency greater than 20 (kHz) are designated as ultrasound. Medical and dental diagnostic imaging sound waves in the range of 1-20 mHz are used.

WORKING PRINCIPLE
The equipment used for ultrasonograpbhy is made up of two principal components, namely the scanner and the transducer. The scanner generates electrical impulses and the transducer converts these electrical impulses into sonic waves. The transducer is made of Zirconate Titanate crystal (piezo electric crystal). When electric impulses from the scanner are applied to the crystals due to realignment of the dipoles, the crystal changes its thickness thereby producing sonic vibration. These sonic vibrations are directed towards the target region in the body. The tissue interface reflects the ultrasound to produce echoes. The reflected echoes are picked up by the transducer and converted back to electrical signals. These signals are displayed on the computer monitor as black, white and gray images.

INDICATIONS 1. To assess the content and location of soft tissue tumor. 2. To assess vascularity of soft tissue masses. 3. to estimate the extent of fascial space infections. 4. Evaluation of salivary gland tumors. 5. Temporomandibular joint imaging.
ADVANTAGES 1. Widely available and inexpensive. 2. No known harmful effects of ultrasound. 3. Can be used effectively to differentiate between different soft tissue masses.

LIMITATIONS 1. No image produced when tissue absorb ultra sonic waves. 2. not effective air filled cavities bone and calcified str.

CONVENTIONAL TOMOGRAPHY
Since the introduction of CT, MRI, cone beam imaging, which have superior contrast resolution, film based. Tomography has been used less frequently. When C. Tomography used in dentistry, it is applied primarily to high contrast anatomy such as TMJ and dental implant imaging. Conventional Tomography uses an x-ray tube and radiographic film rigidly connected and capable of moving about a fixed axis. The examination begins with the x-ray tube and film positioned on opposite side of fulcrum, which is located within the body of focal plane.

As the exposure begins, the tube and film move in opposite direction. Simultaneously through a mechanical linkage. With this synchronous movement of tube and film, the images of objects located within the focal plane (at the fulcrum) remain in fixed positions on the radiographic film throughout the length of tube and film travel and are clearly imaged. On the other hand, the images of objects located outside the focal plane have continuously changing positions on the film; as a result, the images of these objects are blurred beyond recognition by motion unsharpness. The resulting zone of sharp image is called the tomographic layer. Blurring of overlying structures is greatest under the following circumstances:
Overlying structures lie far from the focal plane. The focal plane lies far from the film. The distance of tube travel is large.

TYPES OF TOMOGRAPHIC MOVEMENT

Linear, Circular, Trispiral, Elliptical, Hypocycloidal and spiral.

TOMOGRAPHIC VIEWS ARE USED TO EXAMINE VARIOUS FACIAL STRUCTURES: i) Tomography of sinus. Affords the following advantages: It gives a more precise evaluation of sinus pathologies which are poorly visualizes on routine radiogaphy. When a pathology is strongly suspected clinically, but plain films are negative. Sphenoid and ethonoidal sinuses are more clearly visualized. ii) Tomography of facial bones, to study facial fractures. Extent of orbital blow out fractures. iii) Tomography of the mandible. iv) Tomography of the TMJ, especially when the pt. is unable to open his mouth or in conjunction with arthrography. v) For dental implant patients.