The use of radiographic imaging technologies by general dentists in Ontario, Canada

Development and validation of a questionnaire on radiation protection knowledge, attitudes, and practices among Moroccan dentists

PURPOSE

This study aimed to develop and evaluate the validity and reliability of dentists' radiation protection knowledge, attitudes, and practices (DRP-KAPs) questionnaire.

METHODS

This study was conducted using a stepwise approach. In the first step, items were generated to determine the relevant content and domains after a thorough literature review. In the second step, the content validity of the questionnaire was assessed by seven experts using face and content validity. The content validity index for relevance and clarity (I-CVI, S-CVI/Av, and S-CVI/UA) and the content validity ratio (CVR) were performed. Then, the questionnaire was pre-tested with 10 dentists for face validation. In the third step, reliability was assessed using internal consistency (Kuder-Richardson-20 (KR-20) and Cronbach's alpha) and test-retest (Kappa and intraclass correlation coefficient [ICC]) methods by filling out the questionnaire by 100 dentists practicing in the Rabat-Salé-Kénitra region, in Morocco.

RESULTS

The finalized DRP-KAPs questionnaire contains 41 items covering knowledge, attitudes and practices (KAPs). The I-CVIs, S-CVI/UA and S-CVI/AV and CVR values of the 41 items were ≥0.86 for each item, ≥0.82, ≥0.97, and ≥0.71, respectively. With regard to internal consistency reliability, the KR-20 coefficients for the knowledge and practice domains were 0.70 and 0.68, respectively, and the Cronbach alpha for the attitude domain was 0.73. The DRP-KAPs questionnaire has good reliability with the ICC coefficients for attitude items ranging from 0.57 to 0.95 and Kappa coefficients for knowledge and practice items ranging from 0.64 to 1 and 0.77 to 1, respectively.

CONCLUSION

The developed DRP-KAPs questionnaire was found to be a noteworthy tool for assessing radiation protection among dentists, with acceptable internal consistency, good ICC and Kappa coefficients, and good content validity indices.

Attitudes and practices of radiation protection among Jordanian dental radiography practitioners

INTRODUCTION

Varying radiation protection practices have been documented in the literature. This study aims to evaluate the attitudes and practices of dental radiography practitioners towards radiation protection in Jordan, as no data currently explores their understanding and practices in this area.

METHODS

The survey involved 192 dental radiography practitioners. A cross-sectional, self-administered questionnaire containing 43 questions covered socio-demographic data, practices towards radiation protection, and attitudes.

RESULTS

The majority of participants were less than 40 years old (87.5 %), with 66.7 % working in private clinics and 53.6 % based in the capital city of Jordan. Nearly a quarter (26.5 %) of the practitioners used an X-ray tube voltage of 65-70 kVp; however, 14.6 % were unaware of the X-ray tube voltage used in their machines. Additionally, almost one quarter of the participants never or rarely used light beam positioning aids and available positioning guides in panoramic radiography practice. Only 33.3 % of practitioners consistently used lead aprons, with the main reasons for non-use being the weight of the apron or its unavailability. About 81 % of participants believed in spreading awareness about radiation protection and applying this knowledge in their daily practices.

CONCLUSIONS

The study found that the practitioners' practices were satisfactory to some extent, supported by a positive attitude towards radiation protection. The participants understand the importance of increasing their awareness and knowledge of radiation protection practices.

IMPLICATIONS FOR PRACTICE

The findings of this study highlight the need to improve radiation protection practices among dental radiography practitioners in Jordan by introducing standard dose protocols, supporting the transition to digital systems, establishing diagnostic reference levels, and encouraging the use of equipment over staff holding practices, and raising awareness about radiation safety.

Temporomandibular Joint Disorders and Pain Confounders: An Awareness Study

OBJECTIVES

Temporomandibular disorders (TMD) are the most common nonodontogenic cause of orofacial pain, leading to morbidity and impairment. TMD presents a diagnostic challenge due to many aetiologies that exhibit comparable symptoms and refer pain to the temporomandibular joint (TMJ) region. Patients may be referred to dental specialists without accounting for all pain sources. This study aims to identify radiographic confounders (RCs) that can be mistaken for TMD in patients undergoing TMJ assessment using cone-beam computed tomography (CBCT).

MATERIALS AND METHODS

A review of 369 CBCT oral maxillofacial radiology reports of the TMJ acquired between July 2020 and June 2023 was completed. Pertinent RCs were classified as endodontic lesions, impacted dentition, sinus pathologies, root fractures, soft tissue calcifications, and others. The chi-squared test assessed the significance of the relationship between RCs and patient variables.

RESULTS

A total of 283 RCs were identified in 202 of the 369 cases (54.7%). The most frequent findings included sinus abnormalities (32.5%), endodontic lesions (15.2%), impacted dentition (12.7%), and elongated/calcified stylohyoid process (9.2%). Significant associations were found between sinus pathologies with TMD signs (P = .009) and gender (P = .001).

CONCLUSION

Our results indicate that RCs that mimic TMD-related symptoms are prevalent in patients referred for TMJ CBCT imaging.

CLINICAL RELEVANCE

Clinicians should be aware of these RCs when diagnosing complaints related to the TMJ. We recommend clinicians first obtain dental clearance and investigate all other potential sources of a patient's complaint before initiating referrals to avoid unnecessary costs and delays in patient care.

Current status of cone-beam computed tomography teaching in Brazilian undergraduate endodontic programs - A web-based survey

PURPOSES

This study aimed to assess the current status of cone-beam computed tomography (CBCT) education in Brazilian undergraduate Endodontic programs.

METHODS

One hundred program directors were emailed. The questionnaire asked whether the CBCT topic was included in the program, the availability of a CBCT machine, and, the total length of the dental program. For the group that does not teach, seven questions discussed the reasons for not teaching and whether another subject included this topic. For the programs that included CBCT, seven questions discussed the number of hours included, and the impression of the program directors with the quality of the teaching. The chi-square test was used for the correlation between the availability of the CBCT machine and the length of the dental program with the inclusion of the topic.

RESULTS

Thirty-five program directors replied to the questionnaire. Twenty-six (74.3%) reported that the topic of CBCT is not included in their programs. There was no impact of the availability of a CBCT machine on the inclusion of the topic (p > 0.05). The increased length of the dental program decreased the inclusion of the topic (p < 0.05). Fifty percent of the directors replied that lack of time is the reason for not including the topic. Among the programs that include CBCT, the majority (55.6%) deliver 3-5 h of lectures. The practical activities range from 1 to 5 h or more. The majority (77.8%) of the directors are satisfied with the content delivered and 44.4% understand that the students are competent in the interpretation of CBCT images.

CONCLUSIONS

The majority of the Endodontic undergraduate programs in Brazil do not include CBCT in the program. The availability of a CBCT machine does not impact the inclusion of the topic, the increased duration of the dental program decreases the inclusion of the CBCT topic.

Thyroid Collars in Dental Radiology: 2021 Update

Background: In 2013, the American Thyroid Association (ATA) issued a "Policy Statement on Thyroid Shielding During Diagnostic Medical and Dental Radiology." The recently updated National Council on Radiation Protection and Measurement Radiation Protection in Dentistry and Oral and Maxillofacial Imaging (NCRP Report No. 177) prompts this review of progress related to patient thyroid shielding since the ATA statement was published. Summary: Relevant publications appearing since the ATA statement were identified by querying PubMed for "thyroid and dental and (collar or shielding)" and substituting specific dental radiographic procedures in the search. The search was expanded by reviewing the cited papers in the PubMed-retrieved papers and by use of the Web of Science to retrieve papers citing the PubMed retrieved publications. Although many quantitative studies have appeared reflective of current dental radiographic instrumentation and practice, much more can be done to foster minimizing radiation to the thyroid. Conclusions: We list seven areas that should be pursued. Among them are harmonizing guidelines for the use of thyroid collars based on the recent studies and a comprehensive survey of current dental radiological practice patterns.