Estimation of the radiation dose for pediatric CBCT indications: a prospective study on ProMax3D

Marcu, Maria; Hedeșiu, Mihaela; Salmon, Benjamin; Pauwels, Ruben; Stratis, Andreas; Oenning, Anne Caroline Costa; Cohen, Mike E; Jacobs, Reinhilde; Băciuţ, Mihaela; Roman, Raluca; Dinu, Cristian; Rotaru, Horaţiu; Barbur, Ioan

doi:10.1111/ipd.12355

Cited by 37 publications

(24 citation statements)

References 23 publications

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“…Since these are performed in an area that may contain vital adjacent anatomical structures such as floor of the maxillary sinus, floor and lateral wall of the nasal cavity, incisive canal, and adjacent teeth, we suggest a view extended by 5 mm in each direction. Even taking this into account, our study indicates that the adequate FOV for imaging of maxillary impacted canines in children could be smaller than the fixed minimum FOV of many popular CBCT-devices [19]. The same concern exists for endodontic applications.…”

Section: Discussionmentioning

confidence: 86%

“…Risk on cancer has been estimated as 0.3 to 1.3 × 10 −6 for dental panoramic tomography, as 0.2 × 10 −6 for cephalometric radiography, and as 61.5 × 10 −6 for CBCT with a large FOV [18]. A large FOV increases the dose for sensitive organs such as the brain and the thyroid gland [19]. Notably the radiation dose in DPTs taken with different devices is within the same order of magnitude, whereas the use of different CBCT devices and their different scanning programs result in widely variable effective doses [19][20][21].…”

Section: Discussionmentioning

confidence: 99%

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Minimum size and positioning of imaging field for CBCT scans of impacted maxillary canines

et al. 2019

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Objectives In children and adolescents, cone-beam computed tomography (CBCT) is frequently used for localization of unerupted or impacted teeth in the anterior maxilla. CBCT causes a higher radiation dose than conventional intraoral and panoramic imaging. The objective was to analyze the location of impacted canines in a three-dimensional coordinate and thereby optimize the CBCT field-of-view (FOV), for radiation dose reduction. Materials and methods Location of 50 impacted maxillary canines of children under 17 years was retrospectively evaluated from CBCT scans. The minimum and maximum distances of any part of the right-and left-side canines to three anatomic reference planes were measured to assess the adequate size and position of a cylindrical image volume. Results A cylinder sized 39.0 (diameter) × 33.2 (height) mm, with its top situated 13.8 mm above the hard palate, its medial edge 8.4 mm across the midline, and anterior edge 2.5 mm in front of the labial surface of maxillary central incisors fitted all the analyzed canines. Conclusions In this sample, the FOV required for imaging maxillary impacted canines was smaller than the smallest FOV offered by common CBCT devices. We encourage development of indication-specific CBCT imaging programs and aids to facilitate optimum patient positioning. Clinical relevance An impacted maxillary canine is a common dental problem and a frequent indication for 3D imaging particularly in growing individuals. This article focuses on the optimization of CBCT of impacted canines. Our recommendation of a reduced FOV promotes radiation safety.

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Section: Discussionmentioning

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Minimum size and positioning of imaging field for CBCT scans of impacted maxillary canines

et al. 2019

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“…One more project currently aims to provide more evidence-based criteria and is currently in the stage of dose quantification. 13,36 Some limitations of the study need to be considered. The current database only comprises images taken in the first two years after installation of the device.…”

Section: Discussionmentioning

confidence: 99%

“…In exchange, the high variability in device settings can result in mistakes leading to high exposure doses or insufficient diagnostic quality. 30,36 Different clinics use different devices. The latter can produce different audit results caused by a high variability in design between those devices.…”

Section: Discussionmentioning

confidence: 99%

A reject analysis of cone-beam CTs in under-aged patients

Acker

Jacquet

Dierens

et al. 2019

Dentomaxillofacial Radiology

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Objectives: The main objective of this study was to perform a retrospective reject analysis (or audit) of 79 cone-beam CTs (CBCTs) taken in under-aged patients at the Ghent University hospital over a 2-year timespan. Methods: Observer agreement between two oral radiologists and two senior year Master students in Paediatric Dentistry was performed for quality, diagnostic and therapeutic value. The senior year Master Students followed appropriate modules of an online course. Descriptive and comparative statistics were performed. Results: For the oral radiologists, all intra rater reliabilities were moderate to good (Gwet's AC1 = 0.41-0.75). For the senior students in Paediatric dentistry, these varied highly from fair to very good (Gwet's AC1 = 0.28-0.95). There was a high level of disagreement between oral radiologists and students (Gwet's AC1 = 0.16-0.45) and in-between students concerning observed quality (Gwet's AC1 = 0.29). A total of 16 CBCTs (20%) was rejected, 24 images (30%) were acceptable and 39 images (50%) had an excellent quality. 50 CBCTs were perceived to have a diagnostic advantage. 13 of the images would have no influence on the therapy, according to the oral radiologists. A significant correlation was found between unacceptable quality, absence of perceived diagnostic advantage (p = 0.004, RR = 2.4) and influence on therapy (p < 0.0005, RR = 1.8). A small field of view (FOV) was positively correlated to an excellent quality of the image (p = 0.011, RR = 2.8). conclusions: Image quality did not reach the proposed boundary of 10% according to the European Guidelines on Radiation Protection in Dental Radiology. This is the first published audit on an overall database of under-age children for CBCT.

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“…In this case, CBCT was performed to evaluate the extent of the lesion and its relationship with inferior alveolar nerve and impacted third molar germ. Due to the young age of the patient, CBCT was chosen for its characteristics of reduced radiation dose compared with Multi-Slice CT 20…”

Section: Discussionmentioning

confidence: 99%

Cone Beam CT study of a case of eosinophilic granuloma of the mandible in a young patient

Izzetti¹,

Marco

Caramella

2019

BMJ Case Rep

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Eosinophilic granuloma (EG) is a rare bony disease deriving from abnormal proliferation of histiocytes, and is the most common form of presentation of Langerhans cell histiocytosis. EG predominantly affects the axial skeleton. However, when localised in the head and neck district, mandibular lesions account for the majority of cases. Mandibular lesions can mimic other pathological conditions, making biopsy fundamental for differential diagnosis. Treatment depends on the severity of the disease, ranging from pharmacological treatment to surgical approach. However, EG is also reported to possibly undergo spontaneous resolution. In this case report, we describe a rare case of EG with particularly aggressive behaviour in a young patient. Initially, local pharmacological treatment with intralesional administration of corticosteroids lead to worsening of the symptoms, increase in lesion’s dimensions, and disruption of the cortical bone. A more invasive therapeutic approach involving radical surgery was then performed, with consequent resolution of the disease.

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Estimation of the radiation dose for pediatric CBCT indications: a prospective study on ProMax3D

Abstract: The results revealed the variation of CBCT doses and the influence of FOV size in pediatric exposure.

Cited by 37 publications

References 23 publications

Minimum size and positioning of imaging field for CBCT scans of impacted maxillary canines

Minimum size and positioning of imaging field for CBCT scans of impacted maxillary canines

A reject analysis of cone-beam CTs in under-aged patients

Cone Beam CT study of a case of eosinophilic granuloma of the mandible in a young patient

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