Sinar-X pergigian itu jelas.

A natural word-by-word breakdown is:

• sinar-X = X-ray
• pergigian = dental, related to teeth/dentistry
• itu = that; in many contexts it also helps make the noun phrase definite, a bit like the
• jelas = clear

So the structure is:

• sinar-X pergigian itu = that dental X-ray
• jelas = is clear

Malay often leaves out the verb to be in simple descriptive sentences.

So instead of saying something like X-ray dental that is clear, Malay simply says:

• Sinar-X pergigian itu jelas

This is very normal.
A few similar patterns are:

• Dia tinggi = He/She is tall
• Rumah itu besar = That house is big

So in this sentence, jelas works as the predicate, and no separate is is needed.

It can feel like either, depending on context.

Most directly, itu means that. But in real usage, it often also marks something as specific/known, so English may translate it as the if that sounds more natural.

So:

• sinar-X pergigian itu could be understood as that dental X-ray
• in context, it might also come across as the dental X-ray

Malay does not always match English articles exactly, so itu is not a perfect one-to-one equivalent of either that or the.

In Malay, demonstratives such as ini and itu usually come after the noun phrase they refer to.

So Malay says:

• rumah besar itu = that big house
• kereta merah itu = that red car
• sinar-X pergigian itu = that dental X-ray

The order is different from English. English puts that first, but Malay usually puts itu at the end of the whole noun phrase.

Pergigian is a word related to teeth and dentistry.

It comes from gigi, which means tooth/teeth.
The form pergigian is a derived word meaning something like dental or related to dentistry.

So in this sentence, pergigian modifies sinar-X:

• sinar-X pergigian = dental X-ray

Even though English uses the adjective dental, Malay often uses a noun-like or derived form as a modifier.

Because the sentence follows a very common Malay pattern:

• Subject
  • description

Here:

• Sinar-X pergigian itu = subject
• jelas = description

So the sentence literally follows the pattern:

• That dental X-ray
  • clear

This is normal Malay word order for descriptive sentences.

Jelas is quite flexible. It can mean clear in several senses, including:

• visually clear: a clear image, clear writing
• easy to understand: a clear explanation
• obvious/plain: something is clear or evident

In Sinar-X pergigian itu jelas, the most natural meaning is that the X-ray image is clear/distinct.

Yes, you can, but the meaning changes slightly.

• Sinar-X pergigian itu jelas = That/The dental X-ray is clear
• Sinar-X pergigian jelas = A dental X-ray is clear / Dental X-rays are clear / a more general or less specifically anchored statement

Without itu, the noun phrase is less definite. Whether it sounds natural depends on context.

A simple learner-friendly pronunciation guide is:

• sinar-X → see-nar eks
• pergigian → per-gee-gee-an
• itu → ee-too
• jelas → juh-las

A rough full pronunciation would be:

• see-nar eks per-gee-gee-an ee-too juh-las

A few helpful notes:

• X is pronounced like eks
• j in Malay sounds like English j in jam
• Malay pronunciation is usually quite regular compared with English