Radiation dose from X-ray examinations of impacted canines: cone beam CT <i>vs</i> two-dimensional imaging

Kadesjö, Nils; Lynds, Randi; Nilsson, Mats; Shi, Xie‐Qi

doi:10.1259/dmfr.20170305

Cited by 34 publications

(28 citation statements)

References 31 publications

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“…CBCT imaging does still have a higher dose of ionization radiation compared to two‐dimensional imaging using periapicals or panoramics (Kadesjö, Lynds, Nilsson, & Shi, 2018). From an ALARA‐ perspective, that is ionization radiation should be “as low as reasonable achievable,” the three‐dimensional imaging needs to be justified in each individual case (Sowby, 1978).…”

Section: Introductionmentioning

confidence: 99%

Impact of CBCT image quality on the confidence of furcation measurements

Rinne

Dagassan-Berndt

Connert

et al. 2020

J Clinic Periodontology

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Background To investigate the impact of scanning parameter in cone‐beam computed tomography (CBCT) images on accuracy and confidence with measurements of furcation involvement (FI) in maxillary molars. Material and methods Six half cadaver heads with present maxillary molars (n = 10) were available. CBCT scans with the fixed‐parameter field of view (4 × 4 cm, 12 × 17 cm) amperage and voltage (4 mA, 90 kV) and with varying scan modes (SM), that is images/scan (IS), voxel sizes (VZ) and rotation (R), were performed using one CBCT apparatus. The images were analysed by two calibrated investigators. Horizontal FI's were measured in mm or a “through and through” destruction (FI degree III) was recorded. Each rater scored the FI measurements performed in each scan as “confident” or as “not confident”. Data were statistically analysed using chi‐square tests. Results The agreement between CBCT FI measurements and intra‐surgical FI measurements varied according to SM (SM HiSp 180°, 0.08: kappa 0.538, CI; 95%: 0.362–0.714; SM Std. 360°, 0.25: kappa 0.698, CI; 95%: 0.534–0.861). The number of measurements scored as “confident” varied according to SM (SM Std. 360°, 0.08:52 out of 60 measurements; SM Std. 360°, 0.25:16 out of 60 measurements; p < .001). Conclusions SM of CBCT significantly affect the confidence with FI measurements in maxillary molars.

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Section: Introductionmentioning

confidence: 99%

Impact of CBCT image quality on the confidence of furcation measurements

Rinne

Dagassan-Berndt

Connert

et al. 2020

J Clinic Periodontology

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“…Observer calibration was performed according to PAI score system, obtaining adequate Kappa values for intra-observer and inter-observer reproducibility ( 27 ). Panoramic radiographs showed high specificity and positive predictive value diagnosing apical periodontitis ( 36 ), can be obtained with convenience and speed, and have the advantage of producing an average patient exposure of only 4.1μSv ( 37 ).…”

Section: Discussionmentioning

confidence: 99%

Apical periodontitis and glycemic control in type 2 diabetic patients: Cross-sectional study

Pérez‐Losada¹,

López‐López²,

Martín-González³

et al. 2020

J Clin Exp Dent

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Background The objective of this study was to analyze the possible relationship between the glycemic control and the prevalence of apical periodontitis in type 2 diabetic patients. The null hypothesis was that apical periodontitis is not associated with glycemic control. Material and Methods In a cross-sectional design, the radiographic records of 216 type 2 diabetic patients (65.0 ± 10.7 years), 117 men (54.2%) and women (45.8%), were examined. Glycated hemoglobin (HbA1c) was used to assess glycemic control, considering an HbA1c level < 6.5% as well-controlled diabetes. Apical periodontitis was diagnosed as radiolucent periapical lesions using the periapical index score. The Student t test, chi-square test, and logistic regression analysis were used in the statistical analysis. Results The average HbA1c value was 7.0 ± 2.2%. Forty seven (21.8%) had HbA1c levels under 6.5% (mean ± SD = 6.0 ± 2.2%), being considered well-controlled patients, and 169 (78.2%) had an HbA1c level ≥ 6.5% (mean ± SD = 7.8 ± 2.24%), being considered poor controlled patients. Forty four per cent of diabetics had apical periodontitis, 12.5% had root-filled teeth, and 52.3% had root filled teeth with radiolucent periapical lesions. No significant differences were observed in any of these three variables between patients with good or poor glycemic control. In the multivariate logistic regression analysis the presence of radiolucent periapical lesions in at least one tooth did not correlate significantly with HbA1c levels (OR = 1.4; 95% C.I. = 0.70 – 3.09; p = 0.31). Conclusions The results reveal no association of glycemic control with the prevalence of apical periodontitis or root canal treatment in diabetic patients. Key words: Apical periodontitis, diabetes mellitus, endodontic medicine, glycated haemoglobin.

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“…Based on phantom studies, CBCT scans of a 10-yearold result in 15 to 140 times higher organ doses compared to conventional dental radiography [14], and the received equivalent dose is significantly higher in children than in adults during CBCT examinations especially in maxillary regions [15,16]. Based on dosimetry of patients during CBCT, and conversion of skin doses to organ dose, the lifetime attributed cancer risk has been estimated as 9.8 per million for 8-to 11-year-olds and 2.7 per million for older than 60 years, the risk being 40% higher for females [17].…”

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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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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Radiation dose from X-ray examinations of impacted canines: cone beam CT vs two-dimensional imaging

Abstract: The effective dose from CBCT ranged from 140 times higher dose (NewTom5G compared to two periapical radiographs) to 15 times higher dose (ProMax3D compared to three periapical and one panoramic radiograph) than a 2D examination.

Cited by 34 publications

References 31 publications

Impact of CBCT image quality on the confidence of furcation measurements

Impact of CBCT image quality on the confidence of furcation measurements

Apical periodontitis and glycemic control in type 2 diabetic patients: Cross-sectional study

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

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