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Nitanda A, Iwawaki A, Otaka Y, Tamatsu Y, Ishii T, Ochiai A, Otomo Y, Kito S, Saka H. Fundamental research for dose control during supine dental panoramic radiography. J Oral Biosci 2023; 65:365-370. [PMID: 37717634 DOI: 10.1016/j.job.2023.09.003] [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: 04/13/2023] [Revised: 09/07/2023] [Accepted: 09/10/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE This study aimed to control radiation doses when using a portable supine dental panoramic radiography system by measured the scattered doses. METHOD The study used LPX7007 (Asahi Roentgen) for the panoramic radiography system. The subjects comprised a cylinder phantom (QualitA) and a RANDO Phantom (Alderson). The semiconductor dosimeter was an X2 survey sensor (RaySafe). The phantom was set at a height of 1 m from the floor, and the sensor was set at 1 m from the floor at the genital level and 1.5 m at the lens level. Measurements were taken at 30°intervals clockwise from 0°at distances of 0.5 m and 1 m in radius around the phantom. The occupational exposure range was defined as 0 ± 30° and the public exposure range was defined as the occupational exposure range and 30° to 150° and 210° to 330° as the public exposure range. RESULT The highest doses were observed in the 120° and 240° directions, and the lowest in 0° ± 30° range. The lowest limit number of images taken in the occupational exposure range was 130 images at a distance of 0.5 m, 452 images at 1 m at the lens level for the cylinder phantom, and 320 images at 0.5 m and 1098 images at 1 m for the RANDO Phantom. In the public exposure range at the genital level, there was one image at 0.5 m and six images at 1 m for the cylinder phantom, and two images at 0.5 m and eight images at 1 m for the RANDO Phantom. CONCLUSION We found that radiation exposure can be reduced by keeping a distance from the subject, avoiding working at 120° and 240° and staying within 0° ± 30° behind the panoramic radiography system.
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Affiliation(s)
- Atsuharu Nitanda
- Division of Forensic Odontology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan.
| | - Atsushi Iwawaki
- Division of Forensic Odontology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Yusei Otaka
- Division of Dental Radiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan; Forensic Odontology Center, Meikai University School of Dentistry, Saitama, Japan
| | - Yuichi Tamatsu
- Department of Gross Anatomy and Forensic Dentistry, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan
| | - Takeru Ishii
- Division of Forensic Odontology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Akihiro Ochiai
- Division of Forensic Odontology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Yuko Otomo
- Division of Forensic Odontology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Shinji Kito
- Division of Dental Radiology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan
| | - Hideki Saka
- Division of Forensic Odontology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan; Forensic Odontology Center, Meikai University School of Dentistry, Saitama, Japan
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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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Fux-Noy A, Rohana R, Rettman A, Moskovitz M, Nadler C. Panoramic errors in pediatric patients with special needs. Sci Rep 2023; 13:11757. [PMID: 37474557 PMCID: PMC10359285 DOI: 10.1038/s41598-023-38823-1] [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: 05/28/2023] [Accepted: 07/15/2023] [Indexed: 07/22/2023] Open
Abstract
This study aimed to analyze the types and frequencies of panoramic technical errors in pediatric patients with special needs, as compared to matching images of patients with normal developmental patterns. Panoramic images of 100 pediatric patients, with equal numbers of either special needs or healthy controls, referred to our Oral Maxillofacial Imaging unit, were retrospectively examined by four blinded observers for the presence of four common technical errors: palatoglossal air space, movement, positioning errors, and foreign bodies appearance. In addition, they subjectively determined the image quality on an ordinal scale. The statistical examination included inter-observer correlation and correlations between demographic factors (age, gender, developmental status) and the number and types of errors. The frequencies of demonstrated errors were, in descending order: movement, positioning, palatoglossal air space, and foreign bodies' appearance. The special needs group images showed significantly more errors and were rated as low-quality radiographs. Younger patients in both groups showed more movement and positioning errors. Technical errors in panoramic images of patients with special needs were more frequently found. Therefore, increased awareness of the staff and appropriate pre-imaging instructions to the patients, are required when imaging pediatric patients, especially those with special needs.
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Affiliation(s)
- Avia Fux-Noy
- Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, P.O.B. 12272, 9112102, Jerusalem, Israel.
| | - Rasha Rohana
- Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, P.O.B. 12272, 9112102, Jerusalem, Israel
| | - Andra Rettman
- Oral Maxillofacial Imaging Unit, Oral Medicine, Sedation and Maxillofacial Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Moti Moskovitz
- Department of Pediatric Dentistry, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, P.O.B. 12272, 9112102, Jerusalem, Israel
| | - Chen Nadler
- Oral Maxillofacial Imaging Unit, Oral Medicine, Sedation and Maxillofacial Imaging, Hadassah Medical Center, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Somerkivi V, Sellerer T, Pantsar T, Lohman H, Pfeiffer F. Spectral photon counting for panoramic dental imaging. Biomed Phys Eng Express 2023; 9. [PMID: 36898144 DOI: 10.1088/2057-1976/acc339] [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: 11/15/2022] [Accepted: 03/10/2023] [Indexed: 03/12/2023]
Abstract
Panoramic x-ray imaging is a versatile, low-dose imaging tool, which is routinely used for dental applications. In this work, we explore a further improvement of the concept by introducing recently developed spectral photon-counting detector technology into a conventional panoramic imaging unit. In addition we adapt spectral material decomposition algorithms to panoramic imaging needs. Finally, we provide first experimental results, demonstrating decomposition of an anthropomorphic head phantom into soft tissue and dentin basis material panoramic images, while keeping the noise level acceptable using regularization approaches. The obtained results reveal a potential benefit of spectral photon-counting technology also for dental imaging applications.
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Affiliation(s)
- V Somerkivi
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, 85748 Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748 Garching, Germany
- Planmeca Oy, 00880 Helsinki, Finland
| | - T Sellerer
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, 85748 Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748 Garching, Germany
| | - T Pantsar
- Oy Direct Conversion Ltd / Varex Imaging Corp, 84104 Salt Lake City, United States of America
| | - H Lohman
- Oy Direct Conversion Ltd / Varex Imaging Corp, 84104 Salt Lake City, United States of America
| | - F Pfeiffer
- Chair of Biomedical Physics, Department of Physics, School of Natural Sciences, Technical University of Munich, 85748 Garching, Germany
- Munich Institute of Biomedical Engineering, Technical University of Munich, 85748 Garching, Germany
- Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, 81677 Munich, Germany
- Institute for Advanced Study, Technical University of Munich, 85748 Garching, Germany
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Ruetters M, Kim TS, Hagenfeld D, Kronsteiner D, Gehrig H, Lux CJ, Sen S. Ex vivo assessment of the buccal and oral bone by CBCT. J Orofac Orthop 2023; 84:41-48. [PMID: 34370050 PMCID: PMC9852115 DOI: 10.1007/s00056-021-00335-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/08/2021] [Indexed: 01/28/2023]
Abstract
PURPOSE Identifying buccal and oral bone as an important supporting periodontal structure for teeth provides important information for treatment planning in periodontics and orthodontics. This study aims to add evidence to the knowledge of preciseness of cone beam computed tomography (CBCT) measurements of the vertical dimension of buccal and oral bone. The hypothesis is that CBCT is an accurate and reliable method to measure vertical vestibular and oral bone loss. METHODS The amount of vertical buccal and oral bone loss (bl) of 260 sites of 10 human cadavers was investigated clinically and radiographically by CBCT. Radiographic measurements were rated by two blinded raters. Measurements and the corresponding differences between clinical and radiological findings are described by medians and quartiles (Q1-Q3). For statistical analysis, Lin's concordance correlation coefficient (CCC) and Bland-Altman plots were calculated. RESULTS The CCC between the raters was 0.994 (95% confidence interval 0.992-0.995). The median bone loss (bl) distance from the cementoenamel junction (CEJ) to the bony defect (BD) was 3.5 mm (range 3-5 mm). The median bl measured in the CBCT was 3.8 mm (range 3.1-4.8 mm). The median difference of the 2 measurements for all sites included in the study (N = 260) was -0.2 mm (-0.7 to 0.3 mm). CONCLUSIONS CBCT seems to be an accurate and highly reliable method to detect and describe vertical buccal and oral bone loss. It could improve planning and prediction for successful combined periodontal and orthodontic therapies.
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Affiliation(s)
- M. Ruetters
- Section of Periodontology, Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - T.-S. Kim
- Section of Periodontology, Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - D. Hagenfeld
- Department of Periodontology and Restorative Dentistry, University Hospital Münster, Waldeyer Str. 30, 48149 Münster, Germany
| | - D. Kronsteiner
- Institute of Medical Biometry and Informatics, University Hospital Heidelberg, Im Neuenheimer Feld 130.3, 69120 Heidelberg, Germany
| | - H. Gehrig
- Section of Endodontology, Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - C.-J. Lux
- Department of Orthodontics, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
| | - S. Sen
- Department of Orthodontics, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
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Influence of Voxel Size on Evaluation of Trabecular Bone Microstructure on Human Mandibles: A CBCT study. JOURNAL OF BASIC AND CLINICAL HEALTH SCIENCES 2022. [DOI: 10.30621/jbachs.1037333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Purpose: This study aims to assess the effect of voxel size on trabecular microstructural evaluation onhuman cadaver mandiblesusing cone beam computed tomography (CBCT) images.
Methods: Twenty two Volumes of Interest were obtained from to human cadaver mandibles which were scanned in three different voxel sizes using CBCT. Scanning performed in 0.125 mm (Group 1), 0.2 mm (Group 2) and 0.3 mm (Group 3) voxel sizes. Regions of interest are calculated in both mandibles for both voxel sizes which are adjusted from apical third of all interdental alveolar trabecular bone from anterior and posterior mandible. Trabecular thickness (Tb. Th); trabecular separation (Tb. Sp); Bone Volume/Total Volume (BV/TV) values were obtained using plug in BoneJ of the software ImageJ. The results were evaluated statistically in software IBM SPSS Statistics 21.
Results: Trabecular thickness and trabecular separation showed significant difference between first and the third and the second and the third groups (p=0.000), while first and second group did not. BV/TV values showed no significant difference between whole groups.
Conclusion: Beside microstructural analysis is not their first purpose CBCT images carry knowledge about trabecular bone microstructure could be a valuable bone quality assessment tool. High correlation between values with 0.125 mm and 0.2 mm and low correlation between values with 0.125 mm and 0.3 mm voxel sizes suggest that; this knowledge is clinically more valuable when voxel size is 0.2 mm or thinner.
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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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Shatskiy I. EFFECTIVE DOSES AND RADIATION RISKS FROM COMMON DENTAL RADIOGRAPHIC, PANORAMIC AND CBCT EXAMINATIONS. RADIATION PROTECTION DOSIMETRY 2021; 195:296-305. [PMID: 34086952 DOI: 10.1093/rpd/ncab069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 03/30/2021] [Accepted: 04/12/2021] [Indexed: 06/12/2023]
Abstract
This study was aimed at the estimation of the effective doses and radiation risks from dental X-ray examinations based on the data collection in St. Petersburg and the Leningrad Region. The range of mean values of effective doses for intraoral examinations on the X-ray units with film detectors was from 3.5 to 8.2 μSv and for the units with digital detectors-from 1.2 to 2.5 μSv. The mean effective doses for panoramic examinations were 22.9 μSv and for cone-beam computed tomography (CBCT)-530.6 μSv, respectively. The highest detriment-adjusted lifetime risk values were estimated for the 20-24-year-old age group: 40.8 × 10-6 in females and 32.7 × 10-6 in males for CBCT. Effective doses in St. Petersburg and Leningrad region were comparable or higher compared with the published data.
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Affiliation(s)
- I Shatskiy
- Laboratory of radiation hygiene of medical facilities, St-Petersburg Research Institute of Radiation Hygiene after Professor P.V. Ramzaev, Mira st. 8, St-Petersburg 197101, Russia
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Modern 3D cephalometry in pediatric orthodontics-downsizing the FOV and development of a new 3D cephalometric analysis within a minimized large FOV for dose reduction. Clin Oral Investig 2021; 25:4651-4670. [PMID: 33492515 DOI: 10.1007/s00784-021-03779-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 01/05/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Dose reduction achieved by downsizing the field of view (FOV) in CBCT scans has brought no benefit for pediatric orthodontics, until now. Standard 2D or 3D full-size cephalometric analyses require large FOVs and high effective doses. The aim of this study was to compare a new 3D reduced-FOV analysis using the Frankfurt horizontal (FH) plane as reference plane with a conventional full-size analysis using the Sella-Nasion (S-N) plane as reference plane. MATERIALS AND METHODS Thirty-eight CBCT data sets were evaluated using full- and reduced-FOV analysis. The measurements of a total of 20 skeletal and dental standard 3D full-size variables were compared with the measurements of 22 corresponding 3D reduced-FOV variables. Statistical analysis was performed to prove mathematic relation between standard and alternative variables. Regression analyses were carried out. RESULTS Coefficients of determination (R2) between 0.15 and 0.95 (p < 0.001-0.055) were described. All variables showed obvious relations of different strength except for SNA and its alternative Po_R-Or_R-A (°) (R2 = 0.15, p = 0.055), but a second variable Ba_A (mm) showed stronger relation (R2 = 0.28, p = 0.003). CONCLUSIONS All standard variables related to the reference plane S-N could be described with alternative variables related to the FH. Further research should define more reliable landmarks for coordinate systems and reference points. CLINICAL RELEVANCE Minimized large FOVs meet the demand of 3D cephalometric analyses and enable the application of CBCT scans in pediatric orthodontic patients in many specific indications. Dose reduction is accompanied by increasing access to all the advantages of 3D imaging over 2D imaging.
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Does dose optimisation in digital panoramic radiography affect diagnostic performance? Clin Oral Investig 2020; 25:637-643. [PMID: 32845471 DOI: 10.1007/s00784-020-03535-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To compare the overall diagnostic performance of digital panoramic radiographs obtained with low-dose protocols and to estimate the absorbed dose in the head and neck. MATERIALS AND METHODS Forty-eight panoramic radiographs were obtained from eight imaging phantoms using six exposure protocols of progressively lower tube voltages (kVp) and currents (mA), as follows: (1) 70 kVp and 12.5 mA, (2) 66 kVp and 10 mA, (3) 66 kVp and 8 mA, (4) 66 kVp and 5 mA, (5) 66 kVp and 4 mA and (6) 66 kVp and 3.2 mA. Five oral radiologists independently evaluated the images and reported all detectable radiographic findings. Intra-examiner reproducibility was assessed by re-evaluation of 25% of the images. The data were analysed using the McNemar and weighted Kappa tests. Absorbed doses of the six protocols were obtained from thermoluminescent dosimeters placed inside a Rando phantom and compared using one-way ANOVA with post hoc Tukey (α = 0.05). RESULTS The overall diagnostic performance of panoramic radiographs obtained with low-dose protocols did not differ from that of panoramic radiographs obtained with the highest dose (p > 0.05). Moreover, substantial agreement was observed between all protocols. Protocol 1 resulted in the highest absorbed dose and protocols 4, 5 and 6 in the lowest absorbed doses, with the difference being significant (p ≤ 0.05). CONCLUSION Although digital panoramic radiography is considered a relatively low-dose examination, the radiation dose can be further reduced without negatively affecting its overall diagnostic performance. CLINICAL RELEVANCE Considering the risks associated with X-rays, digital panoramic radiographs can be obtained at even lower exposure levels.
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Van Acker JWG, Pauwels NS, Cauwels RGEC, Rajasekharan S. Outcomes of different radioprotective precautions in children undergoing dental radiography: a systematic review. Eur Arch Paediatr Dent 2020; 21:463-508. [PMID: 32557182 DOI: 10.1007/s40368-020-00544-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 06/07/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To evaluate the effectiveness of all radioprotective measures in underage patients who undergo a dental radiodiagnostic examination. METHODS A systematic review was performed including randomised controlled trials (RCTs), or cluster trials, cohort studies, cross-sectional studies, case-control studies and comparative in vitro research. These studies examined the healthy underage human population (below 18 years) undergoing a dental radiodiagnostic examination. All radioprotective measures were included except for justification as an intervention. The primary outcomes were in vivo mortality and morbidity. Some surrogate or indirect outcomes such as in vitro effective dose and organ absorbed doses were also accepted. Secondary outcomes with regards to image quality and therapeutic value were also analysed. RESULTS Eighteen papers were eligible for implementation. Fifteen studies underwent narrative synthesis. Regression analysis was performed on three studies. CONCLUSION The following radioprotective measures can reduce the exposure dose. For lateral cephalometry: collimation, filtration, the fastest receptor type and circumstantial thyroid shielding. For oblique lateral radiographs: the shortest exposure time, a smaller horizontal angulation, a longer focus to skin distance. For intraoral radiography: rectangular collimation, the fastest image receptor speed and thyroid shielding when the thyroid gland is in line of or very close to the primary beam. For panoramic radiographs: collimation, the fastest receptor type and the use of automatic exposure control (AEC) or manual adjustment of intensity. For cone-beam computed tomography: collimation, the largest voxels size in relation to the treatment need, change in image settings such as ultra-low dose settings, shorter exposure time, a lower amount of projections, lower beam intensity, reduction of the potential, use of a thyroid shield except in two situations and the use of AEC. All of the changes in exposure parameters should be performed while maintaining a sufficient therapeutic value on an individual and indication-based level.
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Affiliation(s)
- J W G Van Acker
- Department of Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, C. Heymanslaan 10 (P8), 9000, Ghent, Belgium.
| | - N S Pauwels
- Knowledge Center Ghent, Ghent University Hospital, C. Heymanslaan 10 (K3), 9000, Ghent, Belgium
| | - R G E C Cauwels
- Department of Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, C. Heymanslaan 10 (P8), 9000, Ghent, Belgium
| | - S Rajasekharan
- Department of Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, C. Heymanslaan 10 (P8), 9000, Ghent, Belgium
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A H P, S M R A, T B, M G, M M. Dosimetry of Occupational Radiation around Panoramic X-ray Apparatus. J Biomed Phys Eng 2019; 9:525-532. [PMID: 31750266 PMCID: PMC6820020 DOI: 10.31661/jbpe.v0i0.466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 12/20/2015] [Indexed: 11/16/2022]
Abstract
Background: Panoramic imaging is one of the most common imaging methods in dentistry. Regarding the side-effects of ionizing radiation, it is necessary to survey different aspects and details of panoramic imaging. In this study, we compared the absorbed x-ray dose around two panoramic x-ray units: PM 2002 CC Proline (Planmeca, Helsinki, Finland) and Cranex Tome (Soredex, Helsinki, Finland).
Materials and Methods: In this cross-sectional study, 15 thermoluminescet dosemeters (TLD-100) were placed in 3 semi-circles of 40cm, 80cm and 120cm radii in order to estimate x-ray dose. Around each unit, the number of TLDs in each semi-circle was 5 with equal intervals. The center of semicircles accords with the patient’s position. Each TLD was exposed 40 times. These dosemeters were read out with a Harshaw Model 4000 TLD Reader (USA). The calibration processing and the reading of dosemeters were performed by the Atomic Energy Organization of Iran.
Results: The mean absorbed dose in three lines of PM 2002 CC Proline was 123.2±15.1, 118.0±11.0 and 108.0±9.1 µSv, (p=0.013). The results were 140.4±15.2, 120.2±10.4 and 111.6±11.2 µSv in Cranex Tome (p=0.208), which reveals no significant difference between two systems.
Conclusion: There are no significant differences between the mean absorbed dose of surveyed models in panoramic imaging by two units (PM 2002 CC Proline and Cranex Tome). These results were less than occupational exposure recommended by ICRP, even at the highest calculated doses.
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Affiliation(s)
- Pakravan A H
- MD, Department of Prosthodontics, Faculty of Dentistry, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Aghamiri S M R
- PhD, Department of Radiation Medicine, Shahid Beheshti University, Tehran, Iran
| | - Bamdadian T
- MD, Department of Prosthesis, Faculty of Dentistry, Mazandaran University of Medical Sciences, Mazandaran, Iran
| | - Gholami M
- PhD, Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- PhD, Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moshfeghi M
- MD, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Colceriu-Şimon IM, Băciuţ M, Ştiufiuc RI, Aghiorghiesei A, Ţărmure V, Lenghel M, Hedeşiu M, Băciuţ G. Clinical indications and radiation doses of cone beam computed tomography in orthodontics. Med Pharm Rep 2019; 92:346-351. [PMID: 31750433 PMCID: PMC6853038 DOI: 10.15386/mpr-1434] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 08/21/2019] [Indexed: 11/23/2022] Open
Abstract
Cone beam computed tomography can be used in pediatric population when a tridimensional analysis of dental and maxillofacial bone structures is required. Even though CBCT is considered a low dose radiological examination, ionizing radiation is a known human carcinogenic factor. Furthermore, biological effects are more important in young patients because of their higher radiosensitivity. Orthodontic treatment is typically initiated at young ages and the most common radiographs at this age are dental. This makes it important to quantify the effects of diagnostic radiographs, in particular of CBCT, due to the fact that the radiation doses are higher compared to conventional radiological methods. So far, the carcinogenic response after low dose radiation exposure is not fully understood in the scientific literature. The aim of our review was to emphasize the main indications of CBCT in orthodontics and to evaluate the radiation doses and potential risks of CBCT irradiation of pediatric patients.
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Affiliation(s)
- Ioana Maria Colceriu-Şimon
- Department of Orthodontics and Dentofacial Orthopedics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Băciuţ
- Department of Oral Rehabilitation, Maxillofacial Surgery and Implantology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Rareş Ionuţ Ştiufiuc
- Department of Pharmaceutical Physics-Biophysics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Alexandra Aghiorghiesei
- Department of Prosthetic Dentistry and Dental Materials, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Viorica Ţărmure
- Department of Orthodontics and Dentofacial Orthopedics, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Manuela Lenghel
- Department of Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Mihaela Hedeşiu
- Department of Oral Radiology, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Grigore Băciuţ
- Department of Cranio-Maxillofacial Surgery, Iuliu Hatieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
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Abdelkarim A. Cone-Beam Computed Tomography in Orthodontics. Dent J (Basel) 2019; 7:E89. [PMID: 31480667 PMCID: PMC6784482 DOI: 10.3390/dj7030089] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 07/05/2019] [Accepted: 08/09/2019] [Indexed: 12/15/2022] Open
Abstract
Unlike patients receiving implants or endodontic treatment, most orthodontic patients are children who are particularly sensitive to ionizing radiation. Cone-beam computed tomography (CBCT) carries risks and benefits in orthodontics. The principal risks and limitations include ionizing radiation, the presence of artifacts, higher cost, limited accessibility, and the need for additional training. However, this imaging modality has several recognized indications in orthodontics, such as the assessment of impacted and ectopic teeth, assessment of pharyngeal airway, assessment of mini-implant sites, evaluation of craniofacial abnormalities, evaluation of sinus anatomy or pathology, evaluation of root resorption, evaluation of the cortical bone plate, and orthognathic surgery planning and evaluation. CBCT is particularly justified when it brings a benefit to the patient or changes the outcome of the treatment when compared with conventional imaging techniques. Therefore, CBCT should be considered for clinical orthodontics for selected patients. Prescription of CBCT requires judicious and sound clinical judgment. The central question of this narrative review article is: when does CBCT add value to the practice of orthodontics? To answer this question, this article presents discussion on radiation dosage of CBCT and other imaging techniques used in orthodontics, limitations of CBCT in orthodontics, justifying the use of CBCT in orthodontics, and the benefits and evidence-based indications of CBCT in orthodontics. This review summarizes the central themes and topics in the literature regarding CBCT in orthodontics and presents ten orthodontic cases in which CBCT proved to be valuable.
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Affiliation(s)
- Ahmad Abdelkarim
- Department of Orthodontics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS 39216, USA.
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15
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Efficacy of the Monte Carlo method and dose reduction strategies in paediatric panoramic radiography. Sci Rep 2019; 9:9691. [PMID: 31273279 PMCID: PMC6609601 DOI: 10.1038/s41598-019-46157-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 06/19/2019] [Indexed: 11/12/2022] Open
Abstract
Monte Carlo (MC) simulation is a simpler radiation dose assessment method than the conventional method, thermoluminescent dosimetry (TLD). MC simulation and TLD were compared as tools to evaluate the effective dose from paediatric panoramic radiography. Various exposure conditions and machine geometries were simulated using the MC method to investigate factors resulting in effective dose reduction. The effective dose of paediatric panoramic radiography was obtained using an MC simulation and its reliability was verified by a comparison with the value obtained using TLD. Next, 7 factors determining the effective dose in the MC simulation were input with 6 equally-spaced values, and a total of 36 simulations were performed to obtain effective dose values. The correlations between each dose-determining factor and the resulting effective dose were evaluated using linear regression analysis. The TLD-measured dose was 3.850 µSv, while the MC simulation yielded a dose of 3.474 µSv. Beam height was the factor that most strongly influenced the effective dose, while rotation angle and focus-to-patient distance were the least influential factors. MC simulation is comparable to TLD for obtaining effective dose values in paediatric panoramic radiography. Obtaining panoramic radiography with a short beam height can effectively reduce the dose in paediatric patients.
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Authors' response. Am J Orthod Dentofacial Orthop 2018; 154:750-754. [DOI: 10.1016/j.ajodo.2018.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 09/06/2018] [Accepted: 09/07/2018] [Indexed: 11/23/2022]
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17
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Abdelkarim A, Jerrold L. Clinical considerations and potential liability associated with the use of ionizing radiation in orthodontics. Am J Orthod Dentofacial Orthop 2018; 154:15-25. [DOI: 10.1016/j.ajodo.2018.01.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 01/01/2018] [Accepted: 01/01/2018] [Indexed: 10/28/2022]
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18
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Irradiation provided by dental radiological procedures in a pediatric population. Eur J Radiol 2018; 103:112-117. [DOI: 10.1016/j.ejrad.2018.04.021] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 03/06/2018] [Accepted: 04/21/2018] [Indexed: 11/20/2022]
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19
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Heiden KR, Rocha ASPSD, Filipov D, Salazar CB, Fernandes Â, Westphalen FH, Setti JAP. Absorbed doses in salivary and thyroid glands from panoramic radiography and cone beam computed tomography. ACTA ACUST UNITED AC 2018. [DOI: 10.1590/2446-4740.03717] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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20
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Schulze RKW, Cremers C, Karle H, de las Heras Gala H. Skin entrance dose with and without lead apron in digital panoramic radiography for selected sensitive body regions. Clin Oral Investig 2016; 21:1327-1333. [DOI: 10.1007/s00784-016-1886-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2016] [Accepted: 06/13/2016] [Indexed: 10/21/2022]
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21
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Bell G, Donaldson K, Walton R, Morrison J. Justification of full width panoramic radiography in Oral Surgery. ACTA ACUST UNITED AC 2016. [DOI: 10.1111/ors.12229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- G.W. Bell
- Oral & Maxillofacial Surgery; Dumfries & Galloway Royal Infirmary; Dumfries UK
| | - K.J. Donaldson
- Dental & Maxillofacial Radiology; Dundee Dental Hospital and School; Dundee UK
| | - R.L. Walton
- Dumfries & Galloway Royal Infirmary; Dumfries UK
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Hoogeveen RC, Hazenoot B, Sanderink GCH, Berkhout WER. The value of thyroid shielding in intraoral radiography. Dentomaxillofac Radiol 2016; 45:20150407. [PMID: 27008105 PMCID: PMC5084701 DOI: 10.1259/dmfr.20150407] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 03/11/2016] [Accepted: 03/21/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To evaluate the utility of the application of a thyroid shield in intraoral radiography when using rectangular collimation. METHODS Experimental data were obtained by measuring the absorbed dose at the position of the thyroid gland in a RANDO(®) (The Phantom Laboratory, Salem, NY) male phantom with a dosemeter. Four protocols were tested: round collimation and rectangular collimation, both with and without thyroid shield. Five exposure positions were deployed: upper incisor (Isup), upper canine (Csup), upper premolar (Psup), upper molar (Msup) and posterior bitewing (BW). Exposures were made with 70 kV and 7 mA and were repeated 10 times. The exposure times were as recommended for the exposure positions for the respective collimator type by the manufacturer for digital imaging. The data were statistically analyzed with a three-way ANOVA test. Significance was set at p < 0.01. RESULTS The ANOVA test revealed that the differences between mean doses of all protocols and geometries were statistically significant, p < 0.001. For the Isup, thyroid dose levels were comparable with both collimators at a level indicating primary beam exposure. Thyroid shield reduced this dose with circa 75%. For the Csup position, round collimation also revealed primary beam exposure, and thyroid shield yield was 70%. In Csup with rectangular collimation, the thyroid dose was reduced with a factor 4 compared with round collimation and thyroid shield yielded an additional 42% dose reduction. The thyroid dose levels for the Csup, Psup, Msup and BW exposures were lower with rectangular collimation without thyroid shield than with round collimation with thyroid shield. With rectangular collimation, the thyroid shield in Psup, Msup and BW reduced the dose 10% or less, where dose levels were already low, implying no clinical significance. CONCLUSIONS For the exposures in the upper anterior region, thyroid shield results in an important dose reduction for the thyroid. For the other exposures, thyroid shield augments little to the reduction achieved by rectangular collimation. The use of thyroid shield is to be advised, when performing upper anterior radiography.
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Affiliation(s)
- Reinier C Hoogeveen
- Department of Oral and Maxillofacial Radiology, Academic Centre for
Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Bart Hazenoot
- Department of Oral and Maxillofacial Radiology, Academic Centre for
Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - Gerard C H Sanderink
- Department of Oral and Maxillofacial Radiology, Academic Centre for
Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
| | - W Erwin R Berkhout
- Department of Oral and Maxillofacial Radiology, Academic Centre for
Dentistry Amsterdam (ACTA), Amsterdam, Netherlands
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23
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Svenson B, Larsson L, Båth M. Optimization of exposure in panoramic radiography while maintaining image quality using adaptive filtering. Acta Odontol Scand 2015; 74:229-35. [PMID: 26478956 DOI: 10.3109/00016357.2015.1100752] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Objective The purpose of the present study was to investigate the potential of using advanced external adaptive image processing for maintaining image quality while reducing exposure in dental panoramic storage phosphor plate (SPP) radiography. Materials and methods Thirty-seven SPP radiographs of a skull phantom were acquired using a Scanora panoramic X-ray machine with various tube load, tube voltage, SPP sensitivity and filtration settings. The radiographs were processed using General Operator Processor (GOP) technology. Fifteen dentists, all within the dental radiology field, compared the structural image quality of each radiograph with a reference image on a 5-point rating scale in a visual grading characteristics (VGC) study. The reference image was acquired with the acquisition parameters commonly used in daily operation (70 kVp, 150 mAs and sensitivity class 200) and processed using the standard process parameters supplied by the modality vendor. Results All GOP-processed images with similar (or higher) dose as the reference image resulted in higher image quality than the reference. All GOP-processed images with similar image quality as the reference image were acquired at a lower dose than the reference. This indicates that the external image processing improved the image quality compared with the standard processing. Regarding acquisition parameters, no strong dependency of the image quality on the radiation quality was seen and the image quality was mainly affected by the dose. Conclusions The present study indicates that advanced external adaptive image processing may be beneficial in panoramic radiography for increasing the image quality of SPP radiographs or for reducing the exposure while maintaining image quality.
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MESH Headings
- Filtration/instrumentation
- Humans
- Image Processing, Computer-Assisted/methods
- Image Processing, Computer-Assisted/standards
- Phantoms, Imaging
- Radiation Dosage
- Radiographic Image Enhancement/methods
- Radiography, Dental, Digital/methods
- Radiography, Dental, Digital/standards
- Radiography, Panoramic/methods
- Radiography, Panoramic/standards
- Skull/diagnostic imaging
- Technology, Radiologic/methods
- X-Ray Intensifying Screens
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Affiliation(s)
- Björn Svenson
- a Department of Oral Radiology , Postgraduate Dental Education Center , Örebro , Sweden
- b Faculty of Medicine and Health , School of Health and Medical Sciences, Örebro University , Örebro , Sweden
- c Department of Radiology , Skaraborg Hospital Skövde , Skövde , Sweden
| | - Lars Larsson
- c Department of Radiology , Skaraborg Hospital Skövde , Skövde , Sweden
| | - Magnus Båth
- d Department of Medical Physics and Biomedical Engineering , Sahlgrenska University Hospital , Gothenburg , Sweden
- e Department of Radiation Physics , Institute of Clinical Sciences at Sahlgrenska Academy, University of Gothenburg , Gothenburg , Sweden
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24
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Davis AT, Safi H, Maddison SM. The reduction of dose in paediatric panoramic radiography: the impact of collimator height and programme selection. Dentomaxillofac Radiol 2014; 44:20140223. [PMID: 25352427 DOI: 10.1259/dmfr.20140223] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES The aim of this work was to estimate the doses to radiosensitive organs in the head of a young child undergoing panoramic radiography and to establish the effectiveness of a short collimator in reducing dose. METHODS Thermoluminescent dosemeters were used in a paediatric head phantom to simulate an examination on a 5-year-old child. The panoramic system used was an Instrumentarium OP200 D (Instrumentarium Dental, Tuusula, Finland). The collimator height options were 110 and 140 mm. Organ doses were measured using exposure programmes intended for use with adult and child size heads. The performance of the automatic exposure control (AEC) system was also assessed. RESULTS The short collimator reduced the dose to the brain and the eyes by 57% and 41%, respectively. The dose to the submandibular and sublingual glands increased by 32% and 20%, respectively, when using a programme with a narrower focal trough intended for a small jaw. The effective dose measured with the short collimator and paediatric programme was 7.7 μSv. The dose to the lens of the eye was 17 μGy. When used, the AEC system produced some asymmetry in the dose distribution across the head. CONCLUSIONS Panoramic systems when used to frequently image children should have programmes specifically designed for imaging small heads. There should be a shorter collimator available and programmes that deliver a reduced exposure time and allow reduction of tube current. Programme selection should also provide flexibility for focal trough size, shape and position to match the smaller head size.
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Affiliation(s)
- A T Davis
- Department of Medical Physics, Portsmouth Hospitals NHS Trust, Queen Alexandra Hospital, Portsmouth, UK
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25
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Kim YH, Yang BE, Yoon SJ, Kang BC, Lee JS. Diagnostic reference levels for panoramic and lateral cephalometric radiography of Korean children. HEALTH PHYSICS 2014; 107:111-116. [PMID: 24978282 DOI: 10.1097/hp.0000000000000071] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Pediatric patients are considered to be more radiosensitive than adults; thus, radiation dose evaluations based on radiologic examinations are particularly important in this population. However, no national diagnostic reference levels (DRLs) are available for pediatric patients in the Republic of Korea. Therefore, the aim of this study was to determine the usage of panoramic and cephalometric radiography under the National Health Insurance (NHI) scheme and to investigate the current DRLs for child panoramic and lateral cephalometric radiography using dose area product (DAP). DAP values were obtained for standard child exposure settings used routinely by dentists. Analysis was performed on data obtained from 28 panoramic and 20 cephalometric x-ray units for the DAP investigation. DRLs for child panoramic and cephalometric radiography were found to be 95.9 mGy cm and 121.3 mGy cm, respectively. These DRLs are higher than those recommended in the UK and Germany, which indicates that further effort is required to reduce pediatric doses in the Republic of Korea.
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Affiliation(s)
- Young-Hee Kim
- *Dental Science Research Institute, School of Dentistry, Chonnam National University, Gawngju, Republic of Korea
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26
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Massillon-J L G, Cabrera-Santiago A, Minniti R, O'Brien M, Soares CG. Influence of phantom materials on the energy dependence of LiF:Mg,Ti thermoluminescent dosimeters exposed to 20-300 kV narrow x-ray spectra, 137Cs and 60Co photons. Phys Med Biol 2014; 59:4149-66. [PMID: 25004055 DOI: 10.1088/0031-9155/59/15/4149] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
LiF:Mg,Ti, are widely used to estimate absorbed-dose received by patients during diagnostic or medical treatment. Conveniently, measurements are usually made in plastic phantoms. However, experimental conditions vary from one group to another and consequently, a lack of consensus data exists for the energy dependence of thermoluminescent (TL) response. This work investigated the energy dependence of TLD-100 TL-response and the effect of irradiating the dosimeters in different phantom materials for a broad range of energy photons in an attempt to understand the parameters that affect the discrepancies reported by various research groups. TLD-100s were exposed to 20-300 kV narrow x-ray spectra, (137)Cs and (60)Co photons. Measurements were performed in air, PMMA, wt1, polystyrene and TLDS as surrounding material. Total air-kerma values delivered were between 50 and 150 mGy for x-rays and 50 mGy for (137)Cs and (60)Co beams; each dosimeter was irradiated individually. Relative response, R, defined as the TL-response per air-kerma and relative efficiency, RE, described as the TL-response per absorbed-dose (obtained through Monte Carlo (MC) and analytically) were used to describe the TL-response. Both R and RE are normalized to the responses in a (60)Co beam. The results indicate that the use of different phantom materials affects the TL-response and this response varies with energy and material type. MC simulations reproduced qualitatively the experimental data: a) R increases, reaches a maximum at ~25 keV and decreases; b) RE decreases, down to a minimum at ~60 keV, increases to a maximum at ~150 keV and after decreases. Independent of the phantom materials, RE strongly depends on how the absorbed dose is evaluated and the discrepancies between RE evaluated analytically and by MC simulation are around 4% and 18%, dependent on the photon energy. The comparison between our results and that reported in the literature suggests that the discrepancy observed between different research groups appears to be most likely related to supralinearity effect, phantom materials, difference on the energy-spectra and geometry conditions during each experiment rather than parameters such as heating-rate or annealing procedure, which was supported by MC simulation. From the results obtained in this work and the strict analysis performed, we can conclude that for clinical applications of TLD-100, special attention must be taken when published data are used to convert TL calibration curve from (60)Co to low-energy photons. Otherwise, this can lead to incorrect results when later used to measure absorbed dose in human tissue.
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Affiliation(s)
- G Massillon-J L
- Instituto de Física, Universidad Nacional Autónoma de México, 01000 Distrito Federal, México
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27
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Abstract
INTRODUCTION Although the development of CT have represented a landmark in diagnostic imaging, its use in Dentistry turned out very discretely over the years. With the appearance of programs for analysis of three-dimensional images, specific for Orthodontics and Orthognathic surgery, a new reality is being built. OBJECTIVE The authors of this study aim to inform the orthodontic society of fundamentals about digital cephalometric radiographic image and computed tomography, discussing about: Field of view (FOV), radiation doses, demands for the use in Orthodontics and radiographic simulations.
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28
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Lee CYS, Koval TM, Suzuki JB. Low-Dose Radiation Risks of Computerized Tomography and Cone Beam Computerized Tomography: Reducing the Fear and Controversy. J ORAL IMPLANTOL 2014; 41:e223-30. [PMID: 24669832 DOI: 10.1563/aaid-joi-d-13-00221] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Regulations for protecting humans against stochastic biological effects from ionizing radiation are based on the linear no-threshold (LNT) risk assessment model, which states that any amount of radiation exposure may lead to cancer in a population. Based on the LNT model, risk from low-dose radiation increases linearly with increasing doses of radiation. Imaging procedures in medicine and dentistry are an important source of low-dose ionizing radiation. The increased use of computerized tomography (CT) and cone beam computerized tomography (CBCT) has raised health concerns regarding exposure to low-dose ionizing radiation. In oral and maxillofacial surgery and implant dentistry, CBCT is now at the forefront of this controversy. Although caution has been expressed, there have been no direct studies linking radiation exposure from CT and CBCT used in dental imaging with cancer induction. This article describes the concerns about radiation exposure in dental imaging regarding the use of CT.
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Affiliation(s)
- Cameron Y S Lee
- 1 Private practice in oral, maxillofacial and reconstructive surgery, Aiea, Hawaii; Department of Periodontology and Oral Implantology, Temple University Kornberg School of Dentistry, Philadelphia, Penn
| | - Thomas M Koval
- 2 Center for Biotechnology Education, Advanced Academic Programs, Krieger School of Arts and Sciences, Johns Hopkins University, Rockville, Md
| | - Jon B Suzuki
- 3 Temple University, Kornberg School of Dentistry, Department of Periodontology and Oral Implantology, School of Medicine, Department of Microbiology and Immunology, Philadelphia, Penn
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Rottke D, Grossekettler L, Sawada K, Poxleitner P, Schulze D. Influence of lead apron shielding on absorbed doses from panoramic radiography. Dentomaxillofac Radiol 2013; 42:20130302. [PMID: 24174012 DOI: 10.1259/dmfr.20130302] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study investigated the absorbed doses in a full anthropomorphic body phantom from two different panoramic radiography devices, performing protocols with and without applying a lead apron. METHODS A RANDO(®) full body phantom (Alderson Research Laboratories Inc., Stamford, CT) was equipped with 110 thermoluminescent dosemeters at 55 different sites and set up in two different panoramic radiography devices [SCANORA(®) three-dimensional (3D) (SOREDEX, Tuusula, Finland) and ProMax(®) 3D (Planmeca, Helsinki, Finland)] and exposed. Two different protocols were performed in the two devices. The first protocol was performed without any lead shielding, whereas the phantom was equipped with a standard adult lead apron for the second protocol. RESULTS A two-tailed paired samples t-test for the SCANORA 3D revealed that there is no difference between the protocol using lead apron shielding (m = 87.99, s = 102.98) and the protocol without shielding (m = 87.34, s = 107.49), t(54) = -0.313, p > 0.05. The same test for the ProMax 3D showed that there is also no difference between the protocol using shielding (m = 106.48, s = 117.38) and the protocol without shielding (m = 107.75, s = 114,36), t(54) = 0.938, p > 0.05. CONCLUSIONS In conclusion, the results of this study showed no statistically significant differences between a panoramic radiography with or without the use of lead apron shielding.
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Affiliation(s)
- D Rottke
- Dental Diagnostic Center, Freiburg, Germany
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Han GS, Cheng JG, Li G, Ma XC. Shielding effect of thyroid collar for digital panoramic radiography. Dentomaxillofac Radiol 2013; 42:20130265. [PMID: 24005060 DOI: 10.1259/dmfr.20130265] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To evaluate the shielding effect of thyroid collar for digital panoramic radiography. METHODS 4 machines [Orthopantomograph(®) OP200 (Instrumentarium Dental, Tuusula, Finland), Orthophos CD (Sirona Dental Systems GmbH, Bensheim, Germany), Orthophos XG Plus (Sirona Dental Systems GmbH) and ProMax(®) (Planmeca Oy, Helsinki, Finland)] were used in this study. Average tissue-absorbed doses were measured using thermoluminescent dosemeter chips in an anthropomorphic phantom. Effective organ and total effective doses were derived according to the International Commission of Radiological Protection 2007 recommendations. The shielding effect of one collar in front and two collars both in front and at the back of the neck was measured. RESULTS The effective organ doses of the thyroid gland obtained from the 4 panoramic machines were 1.12 μSv for OP200, 2.71 μSv for Orthophos CD, 2.18 μSv for Orthophos XG plus and 2.20 μSv for ProMax, when no thyroid collar was used. When 1 collar was used in front of the neck, the effective organ doses of the thyroid gland were 1.01 μSv (9.8% reduction), 2.45 μSv (9.6% reduction), 1.76 μSv (19.3% reduction) and 1.70 μSv (22.7% reduction), respectively. Significant differences in dose reduction were found for Orthophos XG Plus and ProMax. When two collars were used, the effective organ doses of the thyroid gland were also significantly reduced for the two machines Orthophos XG Plus and ProMax. The same trend was observed in the total effective doses for the four machines. CONCLUSIONS Wearing a thyroid collar was helpful when the direct digital panoramic imaging systems were in use, whereas for the indirect digital panoramic imaging systems, the thyroid collar did not have an extra protective effect on the thyroid gland and whole body.
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Affiliation(s)
- G-S Han
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China
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Lee GS, Kim JS, Seo YS, Kim JD. Effective dose from direct and indirect digital panoramic units. Imaging Sci Dent 2013; 43:77-84. [PMID: 23807930 PMCID: PMC3691377 DOI: 10.5624/isd.2013.43.2.77] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2012] [Revised: 10/30/2012] [Accepted: 11/07/2012] [Indexed: 02/03/2023] Open
Abstract
Purpose This study aimed to provide comparative measurements of the effective dose from direct and indirect digital panoramic units according to phantoms and exposure parameters. Materials and Methods Dose measurements were carried out using a head phantom representing an average man (175 cm tall, 73.5 kg male) and a limbless whole body phantom representing an average woman (155 cm tall, 50 kg female). Lithium fluoride thermoluminescent dosimeter (TLD) chips were used for the dosimeter. Two direct and 2 indirect digital panoramic units were evaluated in this study. Effective doses were derived using 2007 International Commission on Radiological Protection (ICRP) recommendations. Results The effective doses of the 4 digital panoramic units ranged between 8.9 µSv and 37.8 µSv. By using the head phantom, the effective doses from the direct digital panoramic units (37.8 µSv, 27.6 µSv) were higher than those from the indirect units (8.9 µSv, 15.9 µSv). The same panoramic unit showed the difference in effective doses according to the gender of the phantom, numbers and locations of TLDs, and kVp. Conclusion To reasonably assess the radiation risk from various dental radiographic units, the effective doses should be obtained with the same numbers and locations of TLDs, and with standard hospital exposure. After that, it is necessary to survey the effective doses from various dental radiographic units according to the gender with the corresponding phantom.
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Affiliation(s)
- Gun-Sun Lee
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Oral Biology Research Institute, Chosun University, Gwangju, Korea
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Li G. Patient radiation dose and protection from cone-beam computed tomography. Imaging Sci Dent 2013; 43:63-9. [PMID: 23807928 PMCID: PMC3691375 DOI: 10.5624/isd.2013.43.2.63] [Citation(s) in RCA: 94] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 03/04/2013] [Accepted: 03/11/2013] [Indexed: 11/18/2022] Open
Abstract
After over one decade development, cone beam computed tomography (CBCT) has been widely accepted for clinical application in almost every field of dentistry. Meanwhile, the radiation dose of CBCT to patient has also caused broad concern. According to the literature, the effective radiation doses of CBCTs in nowadays market fall into a considerably wide range that is from 19 µSv to 1073 µSv and closely related to the imaging detector, field of view, and voxel sizes used for scanning. To deeply understand the potential risk from CBCT, this report also reviewed the effective doses from literatures on intra-oral radiograph, panoramic radiograph, lateral and posteroanterior cephalometric radiograph, multi-slice CT, and so on. The protection effect of thyroid collar and leaded glasses were also reviewed.
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Affiliation(s)
- Gang Li
- Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing, China
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Four rooted maxillary second molar confirmed with cone beam computer tomography – A case report. GIORNALE ITALIANO DI ENDODONZIA 2013. [DOI: 10.1016/j.gien.2013.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Eskandarloo A, Mirshekari A, Poorolajal J, Mohammadi Z, Shokri A. Comparison of cone-beam computed tomography with intraoral photostimulable phosphor imaging plate for diagnosis of endodontic complications: a simulation study. Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 114:e54-61. [PMID: 22981099 DOI: 10.1016/j.oooo.2012.05.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Revised: 05/24/2012] [Accepted: 05/28/2012] [Indexed: 11/15/2022]
Affiliation(s)
- Amir Eskandarloo
- Department of Dentomaxillofacial Radiology, School of Dentistry, Hamadan University of Medical Sciences, Hamadan, Islamic Republic of Iran
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Batista WOG, Navarro MVT, Maia AF. Effective doses in panoramic images from conventional and CBCT equipment. RADIATION PROTECTION DOSIMETRY 2012; 151:67-75. [PMID: 22171097 DOI: 10.1093/rpd/ncr454] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Dental radiology is being extensively used especially after the consolidation of the dental implant technique. Although dental radiology has always been regarded as a low-dose technique, this scenario has changed with the introduction of volumetric techniques and consequent changes that have resulted from the use of the new technique. To compare dose values related to the use of different technologies used in the acquisition of dental panoramic images, the effective dose associated with this image technique was calculated using two different conversion factors for kerma-area product, P(KA), in the effective dose. Twenty-four pieces of equipment were evaluated and distributed into three categories: (1) 19 units of conventional equipment, (2) 3-cone beam computed tomography equipment (CBCT) which has a specific sensor to obtain panoramic images and (3) 2 items of CBCT equipment which only have sensors for volumetric acquisition, and the obtainment of panoramic images is through software reconstruction. The results show values of PKA and effective dose are higher for devices using digital image receptors. It is concluded that optimisation procedures and critical analysis should always be applied when adopting new technologies.
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Affiliation(s)
- W O G Batista
- Federal Institute of Education, Science and Technology of Bahia, Rua Emídio Santos, Salvador, Bahia, Brazil.
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Cone-beam computed tomography and radiographs in dentistry: aspects related to radiation dose. Int J Dent 2012; 2012:813768. [PMID: 22548064 PMCID: PMC3324904 DOI: 10.1155/2012/813768] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2011] [Revised: 09/19/2011] [Accepted: 01/31/2012] [Indexed: 11/18/2022] Open
Abstract
Introduction. The aim of this study was to discuss the radiation doses associated with plain radiographs, cone-beam computed tomography (CBCT), and conventional computed tomography (CT) in dentistry, with a special focus on orthodontics. Methods. A systematic search for articles was realized by MEDLINE from 1997–March 2011. Results. Twenty-seven articles met the established criteria. The data of these papers were grouped in a table and discussed. Conclusions. Increases in kV, mA, exposure time, and field of view (FOV) increase the radiation dose. The dose for CT is greater than other modalities. When the full-mouth series (FMX) is performed with round collimation, the orthodontic radiographs transmit higher dose than most of the large FOV CBCT, but it can be reduced if used rectangular collimation, showing lower effective dose than large FOV CBCT. Despite the image quality, the CBCT does not replace the FMX. In addition to the radiation dose, image quality and diagnostic needs should be strongly taken into account.
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Pauwels R, Beinsberger J, Collaert B, Theodorakou C, Rogers J, Walker A, Cockmartin L, Bosmans H, Jacobs R, Bogaerts R, Horner K. Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol 2012; 81:267-71. [DOI: 10.1016/j.ejrad.2010.11.028] [Citation(s) in RCA: 407] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2010] [Revised: 11/10/2010] [Accepted: 11/12/2010] [Indexed: 02/04/2023]
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de Oliveira-Santos C, Souza PHC, de Azambuja Berti-Couto S, Stinkens L, Moyaert K, Rubira-Bullen IRF, Jacobs R. Assessment of variations of the mandibular canal through cone beam computed tomography. Clin Oral Investig 2011; 16:387-93. [DOI: 10.1007/s00784-011-0544-9] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2010] [Accepted: 03/07/2011] [Indexed: 10/18/2022]
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Modern dental imaging: a review of the current technology and clinical applications in dental practice. Eur Radiol 2010; 20:2637-55. [PMID: 20544352 DOI: 10.1007/s00330-010-1836-1] [Citation(s) in RCA: 106] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 04/15/2010] [Accepted: 04/29/2010] [Indexed: 02/02/2023]
Abstract
A review of modern imaging techniques commonly used in dental practice and their clinical applications is presented. The current dental examinations consist of intraoral imaging with digital indirect and direct receptors, while extraoral imaging is divided into traditional tomographic/panoramic imaging and the more recently introduced cone beam computed tomography. Applications, limitations and current trends of these dental "in-office" radiographic techniques are discussed.
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Jayaratne YSN, Zwahlen RA, Lo J, Tam SC, Cheung LK. Computer-Aided Maxillofacial Surgery: An Update. Surg Innov 2010; 17:217-25. [DOI: 10.1177/1553350610371626] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Introduction. Recent developments in technology have revolutionized medicine and surgery. This article aims at providing an update on the current trends in computer-aided maxillofacial surgery and illustrates these advances with clinical cases. Methods. The PubMed database was searched for articles published during the past 5 years using the keywords “maxillofacial” and “surgery, computer-assisted.” Full texts of relevant articles were retrieved, and their study details were extracted. Results. Among the 133 articles, most focused on cone-beam computed tomography (CBCT), stereophotography, surgical panning software, and intraoperative navigation. Stereophotography produces 3D facial photographs with natural color and texture, whereas CBCT generates excellent hard-tissue images with a substantially lower radiation than conventional CT scans. Information gathered from CBCT and stereophotography can be used for accurate diagnosis, virtual planning, and simulation of surgery with the aid of specialized software. The preplanned treatment can be executed accurately via intraoperative surgical navigation. Conclusion. Tremendous potential exists for computer-aided maxillofacial surgery as it moves from research to clinical care.
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Affiliation(s)
- Yasas S. N. Jayaratne
- Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Roger A. Zwahlen
- Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - John Lo
- Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Stephen C. Tam
- Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR
| | - Lim K. Cheung
- Discipline of Oral & Maxillofacial Surgery, Faculty of Dentistry, The University of Hong Kong, Hong Kong SAR,
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Kottoor J, Hemamalathi S, Sudha R, Velmurugan N. Maxillary second molar with 5 roots and 5 canals evaluated using cone beam computerized tomography: a case report. ACTA ACUST UNITED AC 2010; 109:e162-5. [PMID: 20123395 DOI: 10.1016/j.tripleo.2009.09.032] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2009] [Accepted: 09/28/2009] [Indexed: 12/16/2022]
Abstract
This case report presents the endodontic management of maxillary right second molar exhibiting 5 roots and 5 root canals. The diagnosis was confirmed with the help of cone beam computerized tomography (CBCT). The article also describes the varied morphology associated with maxillary second molar and the use of a high-end diagnostic imaging modality like CBCT in diagnosing and negotiating these anatomic variations.
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Affiliation(s)
- Jojo Kottoor
- Department of Conservative Dentistry and Endodontics, Meenakshi Ammal Dental College and Hospital, Tamil Nadu, India.
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Thilander-Klang A, Helmrot E. Methods of determining the effective dose in dental radiology. RADIATION PROTECTION DOSIMETRY 2010; 139:306-309. [PMID: 20211918 DOI: 10.1093/rpd/ncq081] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A wide variety of X-ray equipment is used today in dental radiology, including intra-oral, orthopantomographic, cephalometric, cone-beam computed tomography (CBCT) and computed tomography (CT). This raises the question of how the radiation risks resulting from different kinds of examinations should be compared. The risk to the patient is usually expressed in terms of effective dose. However, it is difficult to determine its reliability, and it is difficult to make comparisons, especially when different modalities are used. The classification of the new CBCT units is also problematic as they are sometimes classified as CT units. This will lead to problems in choosing the best dosimetric method, especially when the examination geometry resembles more on an ordinary orthopantomographic examination, as the axis of rotation is not at the centre of the patient, and small radiation field sizes are used. The purpose of this study was to present different methods for the estimation of the effective dose from the equipment currently used in dental radiology, and to discuss their limitations. The methods are compared based on commonly used measurable and computable dose quantities, and their reliability in the estimation of the effective dose.
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Affiliation(s)
- Anne Thilander-Klang
- Department of Medical Physics and Biomedical Engineering, Sahlgrenska University Hospital, SE-413 45 Gothenburg, Sweden.
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Maxillary first molar with seven root canals diagnosed with cone-beam computed tomography scanning: a case report. J Endod 2010; 36:915-21. [PMID: 20416446 DOI: 10.1016/j.joen.2009.12.015] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2009] [Revised: 11/30/2009] [Accepted: 12/08/2009] [Indexed: 11/22/2022]
Abstract
INTRODUCTION The purpose of this article was to emphasize the importance of having a thorough knowledge about the root canal anatomy. METHODS This case report presents the endodontic management of a maxillary first molar with three roots and seven canals. The clinical detection of the seven canals was made using a surgical operating microscope and confirmed using cone-beam computed tomography (CBCT) scanning. RESULTS CBCT axial images showed that both the palatal and distobuccal root have a Vertucci type II canal pattern, whereas the mesiobuccal root showed a Sert and Bayirli type XV canal configuration. CONCLUSION This report describes and discusses the variation in canal morphology of maxillary first molar and the use of latest adjuncts in successfully diagnosing and negotiating them.
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AL-JUNDI SH, DABOUS IM, AL-JAMAL GA. Craniofacial morphology in patients with hypophosphataemic vitamin-D-resistant rickets: a cephalometric study. J Oral Rehabil 2009; 36:483-90. [DOI: 10.1111/j.1365-2842.2009.01963.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Panoramic radiographic findings as predictors of mandibular nerve exposure following third molar extraction: Digital versus conventional radiographic techniques. ACTA ACUST UNITED AC 2009; 107:e36-40. [DOI: 10.1016/j.tripleo.2008.12.004] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2008] [Revised: 11/29/2008] [Accepted: 12/02/2008] [Indexed: 11/19/2022]
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Comparison between effective radiation dose of CBCT and MSCT scanners for dentomaxillofacial applications. Eur J Radiol 2008; 71:461-8. [PMID: 18639404 DOI: 10.1016/j.ejrad.2008.06.002] [Citation(s) in RCA: 332] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2008] [Revised: 04/30/2008] [Accepted: 06/03/2008] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To compare the effective dose levels of cone beam computed tomography (CBCT) for maxillofacial applications with those of multi-slice computed tomography (MSCT). STUDY DESIGN The effective doses of 3 CBCT scanners were estimated (Accuitomo 3D, i-CAT, and NewTom 3G) and compared to the dose levels for corresponding image acquisition protocols for 3 MSCT scanners (Somatom VolumeZoom 4, Somatom Sensation 16 and Mx8000 IDT). The effective dose was calculated using thermoluminescent dosimeters (TLDs), placed in a Rando Alderson phantom, and expressed according to the ICRP 103 (2007) guidelines (including a separate tissue weighting factor for the salivary glands, as opposed to former ICRP guidelines). RESULTS Effective dose values ranged from 13 to 82 microSv for CBCT and from 474 to 1160 microSv for MSCT. CBCT dose levels were the lowest for the Accuitomo 3D, and highest for the i-CAT. CONCLUSIONS Dose levels for CBCT imaging remained far below those of clinical MSCT protocols, even when a mandibular protocol was applied for the latter, resulting in a smaller field of view compared to various CBCT protocols. Considering this wide dose span, it is of outmost importance to justify the selection of each of the aforementioned techniques, and to optimise the radiation dose while achieving a sufficient image quality. When comparing these results to previous dosimetric studies, a conversion needs to be made using the latest ICRP recommendations.
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