Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents

Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed t...

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Main Authors: Ina Manuela Schüler, Christoph-Ludwig Hennig, Rika Buschek, Rebecca Scherbaum, Collin Jacobs, Marcel Scheithauer, Hans-Joachim Mentzel
Format: Article
Language:English
Published: MDPI AG 2023-04-01
Series:Journal of Personalized Medicine
Subjects:
Online Access:https://www.mdpi.com/2075-4426/13/4/692
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author Ina Manuela Schüler
Christoph-Ludwig Hennig
Rika Buschek
Rebecca Scherbaum
Collin Jacobs
Marcel Scheithauer
Hans-Joachim Mentzel
author_facet Ina Manuela Schüler
Christoph-Ludwig Hennig
Rika Buschek
Rebecca Scherbaum
Collin Jacobs
Marcel Scheithauer
Hans-Joachim Mentzel
author_sort Ina Manuela Schüler
collection DOAJ
description Dental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate the radiation dose values and underlying justifications of dental, bitewing and occlusal X-rays in children and adolescents. Data from routinely executed intraoral radiographs between 2002 and 2020 with conventional and digital tube-heads were extracted from the Radiology Information System. The effective exposure was calculated from technical parameters and statistical tests performed. A total number of 4455 intraoral (3128 dental, 903 bitewing and 424 occlusal) radiographs were investigated. For dental and bitewing radiographs, the dose area product (DAP) was 2.57 cGy × cm<sup>2</sup> and the effective dose (ED) 0.77 µSv. For occlusal radiographs, the DAP was 7.43 cGy × cm<sup>2</sup> and the ED 2.22 µSv. Overall, 70.2% of all intraoral radiographs were dental, 20.3% bitewing and 9.5% occlusal radiographs. The most frequent indication for intraoral radiographs was trauma (28.7%), followed by caries (22.7%) and apical diagnostics (22.7%). Moreover, 59.7% of all intraoral radiographs were taken in boys, especially for trauma (66.5%) and endodontics (67.2%) (<i>p</i> ≤ 0.00). Girls were significantly more frequently X-rayed for caries diagnostics than boys (28.1% vs. 19.1%, <i>p</i> ≤ 0.00). The average ED of 0.77 µSv for intraoral dental and bitewing radiographs in this study was within the range of other reported values. The technical parameters of the X-ray devices were found at the lowest recommended levels to best limit the radiation exposure and to assure acceptable diagnostic efficacy. Intraoral radiographs were performed predominantly for trauma, caries and apical diagnostics—reflecting general recommendations for the use of X-rays in children. For improved quality assurance and radiation protection, further studies are necessary to determine the meaningful dose reference level (DRL) for children.
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spelling doaj.art-af391661ab1a4d5fac92c37ae11eefe22023-11-17T20:00:49ZengMDPI AGJournal of Personalized Medicine2075-44262023-04-0113469210.3390/jpm13040692Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and AdolescentsIna Manuela Schüler0Christoph-Ludwig Hennig1Rika Buschek2Rebecca Scherbaum3Collin Jacobs4Marcel Scheithauer5Hans-Joachim Mentzel6Section Preventive Dentistry and Pediatric Dentistry, Department of Orthodontics, Jena University Hospital, 07743 Jena, GermanyDepartment of Orthodontics, Jena University Hospital, 07743 Jena, GermanySection of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, GermanySection of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, GermanyDepartment of Orthodontics, Jena University Hospital, 07743 Jena, GermanyRadiation Protection, Centre for Health and Safety Management, Jena University Hospital, 07747 Jena, GermanySection of Pediatric Radiology, Department of Radiology, Jena University Hospital, 07747 Jena, GermanyDental radiographs are valuable diagnostic aids for oral healthcare, but exposure to ionizing radiation carries health risks, especially in children due to their high radio-sensitivity. Valid reference values for intraoral radiographs in children and adolescents are still missing. This study aimed to investigate the radiation dose values and underlying justifications of dental, bitewing and occlusal X-rays in children and adolescents. Data from routinely executed intraoral radiographs between 2002 and 2020 with conventional and digital tube-heads were extracted from the Radiology Information System. The effective exposure was calculated from technical parameters and statistical tests performed. A total number of 4455 intraoral (3128 dental, 903 bitewing and 424 occlusal) radiographs were investigated. For dental and bitewing radiographs, the dose area product (DAP) was 2.57 cGy × cm<sup>2</sup> and the effective dose (ED) 0.77 µSv. For occlusal radiographs, the DAP was 7.43 cGy × cm<sup>2</sup> and the ED 2.22 µSv. Overall, 70.2% of all intraoral radiographs were dental, 20.3% bitewing and 9.5% occlusal radiographs. The most frequent indication for intraoral radiographs was trauma (28.7%), followed by caries (22.7%) and apical diagnostics (22.7%). Moreover, 59.7% of all intraoral radiographs were taken in boys, especially for trauma (66.5%) and endodontics (67.2%) (<i>p</i> ≤ 0.00). Girls were significantly more frequently X-rayed for caries diagnostics than boys (28.1% vs. 19.1%, <i>p</i> ≤ 0.00). The average ED of 0.77 µSv for intraoral dental and bitewing radiographs in this study was within the range of other reported values. The technical parameters of the X-ray devices were found at the lowest recommended levels to best limit the radiation exposure and to assure acceptable diagnostic efficacy. Intraoral radiographs were performed predominantly for trauma, caries and apical diagnostics—reflecting general recommendations for the use of X-rays in children. For improved quality assurance and radiation protection, further studies are necessary to determine the meaningful dose reference level (DRL) for children.https://www.mdpi.com/2075-4426/13/4/692dental X-raysdental radiologyeffective doseX-ray in childrenradiographradiation exposure
spellingShingle Ina Manuela Schüler
Christoph-Ludwig Hennig
Rika Buschek
Rebecca Scherbaum
Collin Jacobs
Marcel Scheithauer
Hans-Joachim Mentzel
Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents
Journal of Personalized Medicine
dental X-rays
dental radiology
effective dose
X-ray in children
radiograph
radiation exposure
title Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents
title_full Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents
title_fullStr Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents
title_full_unstemmed Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents
title_short Radiation Exposure and Frequency of Dental, Bitewing and Occlusal Radiographs in Children and Adolescents
title_sort radiation exposure and frequency of dental bitewing and occlusal radiographs in children and adolescents
topic dental X-rays
dental radiology
effective dose
X-ray in children
radiograph
radiation exposure
url https://www.mdpi.com/2075-4426/13/4/692
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