Effects of contrast equalization on energy imparted to the patient: a comparison of two dental generators and two types of intraoral film.

Technical evolution in maxillofacial radiology has in the last decade provided faster films and the constant potential generator. The consequences of these innovations for radiographic contrast and energy imparted to the patient are analysed. On the basis of physical measurements a test model has been developed for correcting exposure parameters in order to maintain or restore image contrast. These measurements are expressed in and developed from basic radiological concepts and physical formulas presented in an earlier paper (Helmrot E. et al., Dentomaxillofac. Radiol. 1991; 20: 135-46). The test model can also be used to demonstrate the balance between contrast and energy imparted to the patient in the radiographic process. Changing to constant potential generators and faster film may each result in a degradation in contrast, which is possible to restore by a controlled adjustment of the kV-setting. Maintenance of constant image quality results in a slight reduction in the net gain in energy imparted, due to the generator and/or film shift. When, for example, a conventional single-pulse generator operated at 65kVp tube potential was replaced by a modern constant potential unit, the kV-setting had to be decreased by 5 to 8 kV to maintain the same radiographic contrast. This correction could be done without increasing energy imparted to the patient, taking into account the fact that the spectral characters of the photon energy are not identical. If, in addition, faster intraoral film with lower film contrast was introduced, together with the constant potential unit, the kV-setting had to be further decreased to maintain the radiographic contrast.(ABSTRACT TRUNCATED AT 250 WORDS)