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Mokhtari A, Razi S, Rahimipour K, Razi T. Effect of using different strips on reducing the most common error in panoramic imaging: A randomised controlled trial on palatoglossal air space shadow. J Med Radiat Sci 2024; 71:194-202. [PMID: 38323866 PMCID: PMC11177041 DOI: 10.1002/jmrs.753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024] Open
Abstract
INTRODUCTION Panoramic radiography quality can be impaired by some errors such as positioning errors. Palatoglossal air space shadow error is one of the most common positioning errors and it is due to the tongue not sticking to the roof of the palate. Techniques used to deal with this error might help prevent unnecessary radiation to patients and save them time and money. The study aimed to investigate the effects of using celluloid matrix and edible tapes (fruit leather and chewing gum) on reducing the palatoglossal air space shadow error in panoramic imaging. METHODS In our study, 270 patients referred to the Department of Radiology were randomised into three groups: a control group, a celluloid matrix group and an edible tapes group. Before panoramic imaging, all patients were instructed to adhere their tongues to the roof of their mouths, with the distinction that for the celluloid matrix and edible tapes groups, patients were asked to place celluloid tapes, fruit leathers, or chewing gums on their tongues before doing so. The routine imaging process was then performed, and the results were compared across groups to evaluate the incidence of palatoglossal air space shadow error. RESULTS The number of error-free images in each fruit leather, chewing gum and celluloid tape group were significantly higher than the control group (all cases P < 0.05). The chances of error-free images in the fruit leather groups were the highest (9.57 times). The age (P = 0.136) and gender (P = 0.272) of patients had no significant effect on the results of interventions. CONCLUSION The application of fruit leathers, chewing gums and celluloid tapes reduced the palatoglossal air space shadow error of panoramic imaging.
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Affiliation(s)
| | - Sedigheh Razi
- Department of Oral and Maxillofacial Radiology, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | - Kasra Rahimipour
- Department of Oral and Maxillofacial Radiology, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
| | - Tahmineh Razi
- Department of Oral and Maxillofacial Radiology, Faculty of DentistryTabriz University of Medical SciencesTabrizIran
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Ver Berne J, Politis C, Shaheen E, Jacobs R. Cumulative exposure and lifetime cancer risk from diagnostic radiation in patients undergoing orthognathic surgery: a cross-sectional analysis. Int J Oral Maxillofac Surg 2023; 52:1064-1070. [PMID: 36804279 DOI: 10.1016/j.ijom.2023.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 01/15/2023] [Accepted: 02/02/2023] [Indexed: 02/17/2023]
Abstract
Radiation doses in dentomaxillofacial imaging are typically very low. However, diagnostic and follow-up protocols in orthognathic surgery result in a patient-specific risk in effective dose. Estimating the cancer risks from these exposures remains abstract for many maxillofacial surgeons. In this study, 40 orthognathic patients were randomly sampled and their cumulative effective dose (ED) calculated. The lifetime attributable risk of cancer (LAR) was calculated based on the standard radiological protocol for orthognathic surgery follow-up using methods described in the BEIR VII report and RadRAT. The mean cumulative ED of the 40 sampled patients at the end of their 2-year follow-up period was 1.91 ± 0.58 mSv. The LAR at the end of follow-up was 17.65 (90% confidence interval 6.46-32.90) per 100,000 person-years for male orthognathic patients and 13.93 (90% confidence interval 6.27-25.24) per 100,000 person-years for female orthognathic patients. This represents 0.70% and 0.68%, respectively, of the baseline cancer risk for oral, thyroid, and brain cancer combined. Although theoretical, these results provide a framework for interpreting radiation doses and cancer risks in patients undergoing orthognathic surgery. Considering the increased radiation sensitivity in children and adolescents, indication-oriented and patient-specific imaging protocols should be advised.
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Affiliation(s)
- J Ver Berne
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium.
| | - C Politis
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
| | - E Shaheen
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium
| | - R Jacobs
- Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Belgium; OMFS-IMPATH Research Group, Department of Imaging and Pathology, Catholic University Leuven, Leuven, Belgium; Department of Dentistry, Karolinska Institutet, Stockholm, Sweden
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Auvinen A, Cardis E, Blettner M, Moissonnier M, Sadetzki S, Giles G, Johansen C, Swerdlow A, Cook A, Fleming S, Berg-Beckhoff G, Iavarone I, Parent ME, Woodward A, Tynes T, McBride M, Krewski D, Feychting M, Takebayashi T, Armstrong B, Hours M, Siemiatycki J, Lagorio S, Larsen SB, Schoemaker M, Klaeboe L, Lönn S, Schüz J. Diagnostic radiological examinations and risk of intracranial tumours in adults-findings from the Interphone Study. Int J Epidemiol 2022; 51:537-546. [PMID: 34648614 PMCID: PMC9082802 DOI: 10.1093/ije/dyab140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Exposure to high doses of ionizing radiation is among the few well-established brain tumour risk factors. We used data from the Interphone study to evaluate the effects of exposure to low-dose radiation from diagnostic radiological examinations on glioma, meningioma and acoustic neuroma risk. METHODS Brain tumour cases (2644 gliomas, 2236 meningiomas, 1083 neuromas) diagnosed in 2000-02 were identified through hospitals in 13 countries, and 6068 controls (population-based controls in most centres) were included in the analysis. Participation across all centres was 64% for glioma cases, 78% for meningioma cases, 82% for acoustic neuroma cases and 53% for controls. Information on previous diagnostic radiological examinations was obtained by interviews, including the frequency, timing and indication for the examinations. Typical brain doses per type of examination were estimated based on the literature. Examinations within the 5 years before the index date were excluded from the dose estimation. Adjusted odds ratios were estimated using conditional logistic regression. RESULTS No materially or consistently increased odds ratios for glioma, meningioma or acoustic neuroma were found for any specific type of examination, including computed tomography of the head and cerebral angiography. The only indication of an elevated risk was an increasing trend in risk of meningioma with the number of isotope scans, but no such trends for other examinations were observed. No gradient was found in risk with estimated brain dose. Age at exposure did not substantially modify the findings. Sensitivity analyses gave results consistent with the main analysis. CONCLUSIONS There was no consistent evidence for increased risks of brain tumours with X-ray examinations, although error from selection and recall bias cannot be completely excluded. A cautious interpretation is warranted for the observed association between isotope scans and meningioma.
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Affiliation(s)
- Anssi Auvinen
- Faculty of Social Sciences, Unit of Health Sciences, Tampere
University, Tampere, Finland
- STUK—Radiation and Nuclear Safety Authority, Helsinki,
Finland
| | - Elisabeth Cardis
- Barcelona Institute of Global Health (ISGlobal), Centre for Research in
Environmental Epidemiology, Universitat Pompeu Funebra, Barcelona,
Spain
- CIBER Epidemiologia y Salud Publica, Madrid, Spain
| | | | | | | | - Graham Giles
- Cancer Council Victoria, Melbourne, VIC, Australia
| | | | - Anthony Swerdlow
- Division of Genetics and Epidemiology, Institute of Cancer
Research, London, UK
- Division of Breast Cancer Research, Institute of Cancer
Research, London, UK
| | - Angus Cook
- School of Population and Global Health, University of Western
Australia, Crawley, WA, Australia
| | | | | | | | - Marie-Elise Parent
- INRS Centre Armand-Frappier Santé Biotechnologie, Institut National de la
Recherche Scientifique, Université du Québec, Laval, QC, Canada
| | - Alistair Woodward
- School of Population Health, University of Auckland,
Auckland, New Zealand
| | - Tore Tynes
- National Institute of Occupational Health, Oslo, Norway
| | - Mary McBride
- British Columbia Cancer Agency, Vancouver, BC, Canada
| | - Dan Krewski
- McLaughlin Centre for Population Health Risk Assessment, University of
Ottawa, ON, Canada
| | | | | | - Bruce Armstrong
- School of Public Health, University of Sydney, Sydney, NSW,
Australia
| | | | | | | | | | - Minouk Schoemaker
- Division of Genetics and Epidemiology, Institute of Cancer
Research, London, UK
| | - Lars Klaeboe
- Norwegian Radiation Protection Authority, Østerås, Norway
| | - Stefan Lönn
- Karolinska Institutet, Stockholm, Sweden
- Region Halland, Research and Development, Sweden
| | - Joachim Schüz
- International Agency for Research on Cancer, Lyon, France
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Văcăraș V, Maior T, Munțiu A, Taloș A, Mureșanu DF. Foramen Magnum Meningioma – A common histological tumor in a rare location. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Meningiomas located in the foramen magnum area are uncommon. We report the case of a patient with a mass lesion compressing the medulla, who was admitted to the Neurology Department for cervical pain and tetraparesis. On the MRI (Magnetic Resonance Imaging) examination, specific features for a meningioma were described, confirmed later by the histopathological examination. The patient presented a favorable evolution, at only one month after surgery.
Keywords: Meningioma, Tetraparesis, Foramen Magnum, Neurosurgery
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Affiliation(s)
- Vitalie Văcăraș
- 1 Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania 2 Neurology II Department, Cluj-Napoca County Emergency Hospital, Romania
| | - Tiberiu Maior
- 1 Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Aurora Munțiu
- 1 Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania 2 Neurology II Department, Cluj-Napoca County Emergency Hospital, Romania
| | - Aurora Taloș
- 2 Neurology II Department, Cluj-Napoca County Emergency Hospital, Romania
| | - Dafin-Fior Mureșanu
- 1 Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania 2 Neurology II Department, Cluj-Napoca County Emergency Hospital, Romania
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Abstract
Millions of patients benefit from medical imaging every single day. However, we have entered an unprecedented era in imaging practices wherein 1 out of 125 patients can be exposed to effective dose >50 mSv from a single CT exam and 3 out of 10,000 patients undergoing CT exams could potentially receive cumulative effective doses > 100 mSv in a single day. Recurrent imaging with CT, fluoroscopically guided interventions, and hybrid imaging modalities such as positron emission tomography/computed tomography (PET/CT) is more prevalent today than ever before. Presently, we do not know the cumulative doses that patients may be receiving across all imaging modalities combined. Furthermore, patients with diseases with longer life expectancies are being exposed to high doses of radiation enabling radiation effects to manifest over a longer time period. The emphasis in the past on improving justification of imaging and optimization of technique and practice has proved useful. While that must continue, the current situation requires imaging device manufacturers to urgently develop imaging technologies that are safer for patients as high doses have been observed in patients where imaging has been justified through clinical decision-support and optimized by keeping doses below the national benchmark doses. There is a need to have a critical look at the fundamental principles of radiation protection as cumulative doses are likely to increase in the coming years.
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Memon A, Rogers I, Paudyal P, Sundin J. Dental X-Rays and the Risk of Thyroid Cancer and Meningioma: A Systematic Review and Meta-Analysis of Current Epidemiological Evidence. Thyroid 2019; 29:1572-1593. [PMID: 31502516 DOI: 10.1089/thy.2019.0105] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background: Exposure to moderate-to-high doses of ionizing radiation is the only established environmental risk factor for thyroid cancer and brain and central nervous system tumors. Considering the high lifetime prevalence and frequency of exposure to dental X-rays, the most common source of diagnostic radiation exposure in the general population, even a small associated increase in cancer risk would be of considerable public health importance. With the objective to inform clinical practice and guidelines, we synthesized the current epidemiological evidence on the association between dental X-rays and the risk of thyroid cancer, meningioma, and other cancers of the head and neck region. Methods: The Medline, Embase, and Web of Science databases were searched to identify eligible studies. Summary odds ratio/relative risk estimates and confidence intervals were extracted, and pooled risk ratios (RRs) for each cancer were calculated using random effects meta-analysis. Results: The literature search identified 5537 publications; of these, 26 studies including 10,868 cancer patients were included in the synthesis. The random effects meta-analyses, based on seven studies of thyroid cancer (six case/control, one cohort) and eight studies of meningioma (all case/control), showed that multiple (or repeated) exposures to dental X-rays were significantly associated with an increased risk of thyroid cancer (pooled RR = 1.87 [95% confidence interval, CI 1.11-3.15]) and meningioma (pooled RR = 1.53 [CI 1.26-1.85]). There was no association with glioma, and there were too few studies of other cancers of the head and neck region to conduct a meaningful meta-analysis. Conclusions: Based on a meta-analysis of retrospective case/control studies, these findings provide some support to the hypothesis that multiple (or repeated) exposures to dental X-rays may be associated with an increased risk of thyroid cancer and meningioma. These studies did not include individual organ doses and ages at exposure, and are subject to recall bias and other limitations. Furthermore, the thyroid exposure has decreased dramatically over time from the use of thyroid shields and improved technology/equipment. Prospective studies, based on dental X-ray records and patient follow-up, are needed to test the hypothesis further and clarify the possible cancer risk associated with dental radiography, as although the risk at the individual level, particularly with improved technology/equipment, is likely to be very low, the proportion of the population exposed is high. Considering that about one-third of the general population in developed countries is routinely exposed to one or more dental X-rays per year, these findings manifest the need to reduce diagnostic radiation exposure as much as possible.
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Affiliation(s)
- Anjum Memon
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Imogen Rogers
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Priyamvada Paudyal
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
| | - Josefin Sundin
- Department of Primary Care and Public Health, Brighton and Sussex Medical School, Brighton, United Kingdom
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Hong JY, Han K, Jung JH, Kim JS. Association of Exposure to Diagnostic Low-Dose Ionizing Radiation With Risk of Cancer Among Youths in South Korea. JAMA Netw Open 2019; 2:e1910584. [PMID: 31483470 PMCID: PMC6727680 DOI: 10.1001/jamanetworkopen.2019.10584] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
IMPORTANCE Diagnostic low-dose ionizing radiation has great medical benefits; however, its increasing use has raised concerns about possible cancer risks. OBJECTIVE To examine the risk of cancer after diagnostic low-dose radiation exposure. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study included youths aged 0 to 19 years at baseline from South Korean National Health Insurance System claim records from January 1, 2006, to December 31, 2015. Exposure to diagnostic low-dose ionizing radiation was classified as any that occurred on or after the entry date, when the participant was aged 0 to 19 years, on or before the exit date, and at least 2 years before any cancer diagnosis. Cancer diagnoses were based on International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes. Data were analyzed from March 2018 to September 2018. MAIN OUTCOMES AND MEASURES The primary analysis assessed the incidence rate ratios (IRRs) for exposed vs nonexposed individuals using the number of person-years as an offset. RESULTS The cohort included a total of 12 068 821 individuals (6 339 782 [52.5%] boys). There were 2 309 841 individuals (19.1%) aged 0 to 4 years, 2 951 679 individuals (24.5%) aged 5 to 9 years, 3 489 709 individuals (28.9%) aged 10 to 14 years, and 3 317 593 individuals (27.5%) aged 15 to 19 years. Of these, 1 275 829 individuals (10.6%) were exposed to diagnostic low-dose ionizing radiation between 2006 and 2015, and 10 792 992 individuals (89.4%) were not exposed. By December 31, 2015, 21 912 cancers were recorded. Among individuals who had been exposed, 1444 individuals (0.1%) received a cancer diagnosis. The overall cancer incidence was greater among exposed individuals than among nonexposed individuals after adjusting for age and sex (IRR, 1.64 [95% CI, 1.56-1.73]; P < .001). Among individuals who had undergone computed tomography scans in particular, the overall cancer incidence was greater among exposed individuals than among nonexposed individuals after adjusting for age and sex (IRR, 1.54 [95% CI, 1.45-1.63]; P < .001). The incidence of cancer increased significantly for many types of lymphoid, hematopoietic, and solid cancers after exposure to diagnostic low-dose ionizing radiation. Among lymphoid and hematopoietic cancers, incidence of cancer increased the most for other myeloid leukemias (IRR, 2.14 [95% CI, 1.86-2.46]) and myelodysplasia (IRR, 2.48 [95% CI, 1.77-3.47]). Among solid cancers, incidence of cancer increased the most for breast (IRR, 2.32 [95% CI, 1.35-3.99]) and thyroid (IRR, 2.19 [95% CI, 1.97-2.20]) cancers. CONCLUSIONS AND RELEVANCE This study found an association of increased incidence of cancer with exposure to diagnostic low-dose ionizing radiation in a large cohort. Given this risk, diagnostic low-dose ionizing radiation should be limited to situations in which there is a definite clinical indication.
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Affiliation(s)
- Jae-Young Hong
- Division of Spinal Surgery, Department of Orthopedics, College of Medicine, Korea University, Seoul, South Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, Catholic University, Seoul, South Korea
| | - Jin-Hyung Jung
- Department of Biostatistics, College of Medicine, Catholic University, Seoul, South Korea
| | - Jung Sun Kim
- Division of Hematology/Oncology, Department of Internal Medicine, College of Medicine, Korea University, Seoul, South Korea
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Management of large pediatric ameloblastoma: Conservative approach with 4-years follow up. ORAL AND MAXILLOFACIAL SURGERY CASES 2019. [DOI: 10.1016/j.omsc.2018.100093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Chauhan V, Wilkins RC. A comprehensive review of the literature on the biological effects from dental X-ray exposures. Int J Radiat Biol 2019; 95:107-119. [PMID: 30496029 DOI: 10.1080/09553002.2019.1547436] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE Routine dental X-rays are among the most common sources of ionizing radiation exposure for healthy individuals globally, with 300 examinations/1000 individuals/year as documented by the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR) global survey of medical radiation usage and exposure. Furthermore, in the United States of America, an increased use of dental radiography is evident. However, with the shift from using film to digital image receptors, the dose of radiation per routine examination has decreased. Despite this, there remains public concern of dental X-rays. This continuing concern highlights the need to review the literature on biological and health effects related to exposure, from dental X-rays. MATERIAL AND METHODS This report presents studies investigating biological and health effects related to exposures using dental X-rays in patients and provides a critical evaluation. Relevant studies specific to dental X-rays are reviewed from 1970 and onward with the bulk data in this field resulting from epidemiological and biomonitoring studies. RESULTS While, most epidemiological studies suggest a possible correlation between head/neck related tumors and exposure to dental X-rays, evidence for causation is lacking. Biomonitoring studies suggest that exposure to low-level radiation such as that of dental radiography may not be a factor in inducing long-term chromosomal damage, but may result in localized cytotoxicity in the irradiated region of the mouth, with no long-term harm. CONCLUSIONS In general, the total number of studies is low and the majority of the data has been generated from poorly designed experiments. This review will highlight shortcomings that could influence outcomes and provide a more balanced interpretation that could impact the public perception and the level of public concern on the health effects resulting from dental X-rays.
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Affiliation(s)
- Vinita Chauhan
- a Consumer and Clinical Radiation Protection Bureau, Healthy Environments and Consumer Safety Branch , Health Canada , Ottawa , Canada
| | - Ruth C Wilkins
- a Consumer and Clinical Radiation Protection Bureau, Healthy Environments and Consumer Safety Branch , Health Canada , Ottawa , Canada
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Hwang SY, Choi ES, Kim YS, Gim BE, Ha M, Kim HY. Health effects from exposure to dental diagnostic X-ray. ENVIRONMENTAL HEALTH AND TOXICOLOGY 2018; 33:e2018017. [PMID: 30661338 PMCID: PMC6341170 DOI: 10.5620/eht.e2018017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 07/04/2018] [Indexed: 05/05/2023]
Abstract
The purpose of this review is to summarize the results of studies on of the association between exposure to dental X-rays and health risk. To perform the systematic review, We searched the PUBMED, EMBASE, and MEDLINE databases for papers published before December 15, 2016. A total of 2 158 studies, excluding duplicate studies, were found. Two reviewers independently evaluated the eligibility of each study. The final 21 studies were selected after application of exclusion criteria. In terms of health outcomes, there were 10 studies about brain tumors, 5 about thyroid cancer, 3 about tumors of head and neck areas, and 3 related to systemic health. In brain tumor studies, the association between dental X-ray exposure and meningioma was statistically significant in 5 of the 7 studies. In 4 of the 5 thyroid-related studies, there was a significant correlation with dental diagnostic X-rays. In studies on head and neck areas, tumors included laryngeal, parotid gland, and salivary gland cancers. There was also a statistically significant correlation between full-mouth X-rays and salivary gland cancer, but not parotid gland cancer. Health outcomes such as leukemia, low birth weight, cataracts, and thumb carcinomas were also reported. In a few studies examining health effects related to dental X-ray exposure, possibly increased risks of meningioma and thyroid cancer were suggested. More studies with a large population and prospective design are needed to elaborate these associations further.
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Affiliation(s)
- Su-Yeon Hwang
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
| | - Eun-Sil Choi
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
| | - Young-Sun Kim
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
| | - Bo-Eun Gim
- Expert Group on Health Promotion for Seoul Metropolitan Government, Seoul, Korea
| | - Mina Ha
- Department of Preventive Medicine, Dankook University College of Medicine, Cheonan, Korea
| | - Hae-Young Kim
- Department of Public Health Sciences, Graduate School, Korea University, Seoul, Korea
- Department of Health Policy and Management, College of Health Science, Korea University, Seoul, Korea
- Corresponding author: Hae-Young Kim Department of Health Policy and Management, College of Health Sciences, Korea University, 73 Inchon-ro, Seongbuk-gu, Seoul 02841, Korea E-mail:
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Pediatric cleft palate patients show a 3- to 5-fold increase in cumulative radiation exposure from dental radiology compared with an age- and gender-matched population: a retrospective cohort study. Clin Oral Investig 2017; 22:1783-1793. [PMID: 29188451 DOI: 10.1007/s00784-017-2274-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 11/07/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The objective of the study was to compare estimates of pediatric cumulative exposure and lifetime attributable risk (LAR) of radiation-induced cancer from dental radiology between cleft palate (CP) subjects and age- and gender-matched controls (non-CP), with and without orthodontic treatment. MATERIALS AND METHODS The radiation exposure frequency of CP subjects and non-CP controls with and without orthodontic treatment was compared for two-dimensional radiography (intra-oral, panoramic and cephalometric radiography), computed tomography (CT), and cone-beam CT (CBCT) using cumulative radiation dose as an estimate. From this dose estimate, the age- and gender-dependent risk for radiation-induced stochastic effects was calculated for each patient group. RESULTS CP patients received more radiographic examinations than non-CP controls, with the exception of intra-oral radiographs. The cumulative dose to CP patients was considerably higher (1963 μSv at the age of 20 years) than non-CP patients with (597 μSv) and without (383 μSv) orthodontic treatment, primarily due to the higher frequency of CT scanning. Accordingly, CP patients had a three to five times higher LAR than non-CP patients. CONCLUSIONS This study suggests a significantly higher lifetime radiation exposure to CP patients than non-CP controls from dental radiographic procedures. Diagnostic benefits from the use of CT and CBCT in children must be justified and appropriate dose optimization strategies implemented. CLINICAL RELEVANCE The present study indicates the need for proper justification and optimization of pediatric exposures in dentistry, with a special focus on high-risk groups.
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Cepeda-Pérez E, Moreno-Hernández C, López-Luke T, Monzón-Hernández D, de la Rosa E. Evaluation of bacterial presence in the root canal by Raman spectroscopy: a preliminary study. Biomed Phys Eng Express 2016. [DOI: 10.1088/2057-1976/2/6/065006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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13
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Affiliation(s)
- S V Jargin
- Peoples' Friendship University of Russia, Moscow, Russia.
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14
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Lin MC, Lee CF, Kao CH. Reply to the letter to the editor 'On the tumor risk from dental diagnostic X-ray exposure' by Jargin. Ann Oncol 2016; 27:1177-1178. [PMID: 26940684 DOI: 10.1093/annonc/mdw103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- M-C Lin
- Department of Nuclear Medicine, E-DA Hospital, I-Shou University, Kaohsiung
| | - C-F Lee
- Department of Oral and Maxillofacial Surgery, Buddhist Tzu Chi General Hospital, Taichung
| | - C-H Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung; Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.
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15
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Chen HH, Horng MH, Yeh SY, Lin IC, Yeh CJ, Muo CH, Sung FC, Kao CH. Glycemic Control with Thiazolidinedione Is Associated with Fracture of T2DM Patients. PLoS One 2015; 10:e0135530. [PMID: 26317995 PMCID: PMC4552881 DOI: 10.1371/journal.pone.0135530] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2015] [Accepted: 07/22/2015] [Indexed: 01/27/2023] Open
Abstract
Objective Diabetes is a common diseases and a major problem worldwide. Diabetic osteopathy might be elevated in diabetic patients and is usually caused by bone fracture. Several diabetes medications, such as thiazolidinediones (TZDs), could lead to increased risks of fracture. Methods We used the nationwide database to identified 32466 patients who had developed type 2 diabetes from 2000 to 2010 as the diabetic cohort and, from that group, we selected 3427 diabetic patients who had developed bone fracture to survey the possible risk factors, includng commonly used diabetes medication. Results We found that TZDs might present increased risks for fracture in patients who used it for an extended period (7 to 730 days before the index date), especially in female patients younger than 64 years old, for whom the risk was elevated from a 1.74- to a 2.58-fold odds ratio. Conclusions We recommend that clinics follow up with non-osteoporotic female patients younger than 64 years old who are using TZDs, to avoid the associated risks of fracture.
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Affiliation(s)
- Hsin-Hung Chen
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Metabolism & Endocrinology, Changhua Christian Hospital, Changhua, Taiwan
- Division of Metabolism & Endocrinology, Nantou Christian Hospital, Nantou, Taiwan
| | - Ming-Hwarng Horng
- Division of Critical Care Medicine, Department of Internal Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Changhua Christian medical foundation, Yuanlin Christian Hospital, Changhua, Taiwan
| | - Su-Yin Yeh
- Department of Healthcare Administration, Asia University, Taichung, Taiwan
| | - I-Ching Lin
- School of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Family Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Chih-Jung Yeh
- School of Public Health, Chung Shan Medical University, Taichung, Taiwan
- Education and Research on Geriatrics and Gerontology, Chung Shan Medical University, Taichung, Taiwan
- * E-mail: (C-HK); (C-JY)
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - Fung-Chang Sung
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- Graduate Institute of Clinical Medical Science and School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan
- * E-mail: (C-HK); (C-JY)
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16
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Liao YH, Lin CL, Tsai PP, Shen WC, Sung FC, Kao CH. Subsequent Cancer Risk of Women Receiving Hysterosalpingography: A Nationwide Population-Based Retrospective Cohort Study. Women Health 2015; 55:613-22. [PMID: 25909564 DOI: 10.1080/03630242.2015.1039185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The objective of this study was to estimate the subsequent cancer risk of women after receiving hysterosalpingography (HSG) by conducting a nationwide retrospective cohort study. We identified a study cohort of 4,371 patients who had had a HSG examination and a comparison cohort of 17,484 women without HSG examination between 1998 and 2005. Both cohorts were followed up with until the end of 2010 to measure the incidence of cancer. The risk of developing cancer for patients with HSG was assessed using the Cox proportional hazard model. In the multivariate analyses, the HSG cohort did not have a significantly greater risk of cancer (Hazard Ratio [HR] = 1.02, 95% CI = 0.79-1.31) than the non-HSG cohort. The HR was highest for genital cancer (HR = 1.32, 95% CI = 0.77-2.25), followed by urinary system cancer (HR = 1.11, 95% CI = 0.23-5.40), and abdominal cancer not involving the GU system (HR = 1.04, 95% CI = 0.53-2.03), all of which were non-significant elevations. The cancer incidence rates, especially that for urinary system cancer, were increased in the HSG cohort, but the increase in cancer incidence was small and not statistically significant.
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Affiliation(s)
- Yen-Hsiu Liao
- a Department of Radiology , China Medical University Hospital , Taichung , Taiwan
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17
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Xu P, Luo H, Huang GL, Yin XH, Luo SY, Song JK. Exposure to ionizing radiation during dental X-rays is not associated with risk of developing meningioma: a meta-analysis based on seven case-control studies. PLoS One 2015; 10:e0113210. [PMID: 25658814 PMCID: PMC4319947 DOI: 10.1371/journal.pone.0113210] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2014] [Accepted: 10/20/2014] [Indexed: 11/30/2022] Open
Abstract
Background Many observational studies have found that exposure to dental X-rays is associated with the risk of development of meningioma. However, these findings are inconsistent. We conducted a meta-analysis to assess the relationship between exposure to dental X-rays and the risk of development of meningioma. Methods The PubMed and EMBASE databases were searched to identify eligible studies. Summary odds ratio (OR) estimates and 95% confidence intervals (95% CIs) were used to compute the risk of meningioma development according to heterogeneity. Subgroup and sensitivity analyses were performed to further explore the potential heterogeneity. Finally, publication bias was assessed. Results Seven case-control studies involving 6,174 patients and 19,459 controls were included in the meta-analysis. Neither exposure to dental X-rays nor performance of full-mouth panorex X-rays was associated with an increased risk of development of meningioma (overall: OR, 0.97; 95% CI, 0.70–1.32; dental X-rays: OR, 1.05; 95% CI, 0.89–1.25; panorex X-rays: OR, 1.01; 95% CI, 0.76–1.34). However, exposure to bitewing X-rays was associated with a slightly increased risk of development of meningioma (OR, 1.73; 95% CI, 1.28–2.34). Similar results were obtained in the subgroup and sensitivity analyses. Little evidence of publication bias was observed. Conclusion Based on the currently limited data, there is no association between exposure to dental X-rays and the risk of development of meningioma. However, these results should be cautiously interpreted because of the heterogeneity among studies. Additional large, high-quality clinical trials are needed to evaluate the association between exposure to dental X-rays and the risk of development of meningioma.
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Affiliation(s)
- Ping Xu
- Gui Zhou provincial people’s hospital, Guiyang 550002, PR China
| | - Hong Luo
- Gui Zhou provincial people’s hospital, Guiyang 550002, PR China
| | - Guang-Lei Huang
- Gui Zhou provincial people’s hospital, Guiyang 550002, PR China
| | - Xin-Hai Yin
- Gui Zhou provincial people’s hospital, Guiyang 550002, PR China
| | - Si-Yang Luo
- Gui Zhou provincial people’s hospital, Guiyang 550002, PR China
| | - Ju-Kun Song
- Gui Zhou provincial people’s hospital, Guiyang 550002, PR China
- * E-mail:
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18
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White SC, Scarfe WC, Schulze RK, Lurie AG, Douglass JM, Farman AG, Law CS, Levin MD, Sauer RA, Valachovic RW, Zeller GG, Goske MJ. The Image Gently in Dentistry campaign: promotion of responsible use of maxillofacial radiology in dentistry for children. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 118:257-61. [DOI: 10.1016/j.oooo.2014.06.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Accepted: 06/02/2014] [Indexed: 11/27/2022]
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19
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Shih TY, Wu J, Muo CS, Kao CH. Association between leukaemia and X-ray in children: a nationwide study. J Paediatr Child Health 2014; 50:615-8. [PMID: 24909259 DOI: 10.1111/jpc.12605] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/15/2014] [Indexed: 11/30/2022]
Abstract
AIM The frequency of employing radiography is increasing. Long-term risks of performing X-ray procedures on children and adolescents for medical diagnosis have raised significant concerns. METHODS In this study, we adopt the case-control methodology to evaluate the relationship between the incidence rate of acute leukaemia and exposure to radiation during diagnostic X-ray examinations for children. Based on 1998-2010 data obtained from the Taiwan Bureau of National Health Insurance database, we selected 58 children with leukaemia and randomly selected an additional 232 children as the control group. RESULTS The mean age of children with leukaemia is 8.92 ± 5.24 years. The risk of leukaemia in children who underwent X-ray examinations increased 2.14-fold (95% CI, 1.18-3.87). In this study, we identified that, when undergoing X-ray examinations, the risk of leukaemia in children increased for both sex and age groups. Specifically, the relationship between leukaemia and X-ray in boys (OR = 3.28, 95%CI, 1.33-8.07) and in ages of 6 to 11 years (OR = 2.58, 95%CI, 1.09-6.10) was significant. Overall, the risk of leukaemia in children who underwent X-ray examinations progressively increased from a ratio of 1.65 to 3.14. Moreover, an identical trend was observed for boys (1.85 to 6.42). CONCLUSION Exposure to X-ray increased the risk of leukaemia in children.
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Affiliation(s)
- Tian-Yu Shih
- Department of Radiology, Cheng Ching Hospital at Chung Kang and Graduate Institute of Clinical Science, China Medical University, Taichung, Taiwan
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20
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Subsequent cancer risk of children receiving post voiding cystourethrography: a nationwide population-based retrospective cohort study. Pediatr Nephrol 2014; 29:885-91. [PMID: 24375011 DOI: 10.1007/s00467-013-2703-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Revised: 10/28/2013] [Accepted: 11/08/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND To estimate the subsequent cancer risk of children receiving post voiding cystourethrography (VCUG), a nationwide population-based retrospective cohort study with the data from the Taiwan National Health Insurance Research Database (NHIRD) were used for the analysis. METHODS In the VCUG cohort, 31,908 participants younger than 18 years of age who underwent VCUG between 1997 and 2008 were identified from the NHIRD. A comparison cohort, the non-VCUG cohort, was randomly selected among children without VCUG examination histories during 1997-2008, frequency matched for age (every 5 years), sex, geographic region area, parents' occupation, and index year based on a 1:4 ratio. Cox's proportional hazard regression analysis was conducted to estimate the subsequent cancer risk of children receiving VCUG. RESULTS The overall cancer risk of the VCUG cohort is 1.92-fold (95 % CI = 1.34-2.74) higher than that of the non-VCUG cohort with statistical significance. The genital cancer and urinary system cancer risks of the VCUG cohort are respectively 6.19-fold (95 % CI = 1.37-28.0) and 5.8-fold (95 % CI = 1.54-21.9) higher than those of the non-VCUG cohort with statistical significance. The hazard ratios are higher in genital cancer, urinary system cancer (the major radiation exposure area), and cancer of the abdomen, except for the genitourinary system (the minor radiation exposure area), in sequence. CONCLUSIONS Pediatric VCUG is associated with increased subsequent cancer risk, especially in the genitourinary system.
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