Evaluation of Radiation Exposure Due to Dental Radiographs Taken during Endodontic Treatment Sessions in Young Permanent Teeth

Abstract

Background and Objectives: The aim of this study was to retrospectively analyze the duration of treatment and the number of dental radiographs taken during endodontic treatment (endo-t) of young permanent teeth (YPT). Materials and Methods: Age, gender, affected tooth number, apex status, duration of treatment and dental radiographs taken during this period were retrospectively evaluated in pediatric patients aged 6–15 years who presented to the pedodontic department for endo-t of anterior YPT. Data were analyzed with Kruskal Wallis H, Dunn and Pearson chi-square tests. p < 0.05 was accepted as statistically significant in all analyses. Results: Anterior endo-t was initiated in 471 of 9,200 pedodontic patients between the ages of 6 and 15 years who applied to our university. The reason for seeking treatment was caries (8.1%) and trauma (91.9%). It was observed that 59% of the teeth had an open apex and 45.7% had a closed apex. A total of 1893 periapical radiographs (Per-R) and 245 panoramic radiographs (Pan-R) were taken from 471 pediatric patients during the treatment period. Total number of dental radiographs was 2138 with 4.5 per patient. Number of Per-R was lower in patients whose treatment was completed in a single session (p < 0.001). There was no difference in the number of Pan-R with respect to duration of treatment (p = 0.560). Conclusions: In children, the number of Per-R significantly increased with prolonged duration of treatment encompassing multiple sessions for endo-t procedures of anterior YPT, decided based on the apex and lesion status of the affected tooth. Especially in long-term traditional apexification treatments, treatment should be carried out in children with the ALADAIP (As Low As Diagnostically Achievable being Indication-oriented and Patient-specific) principle in mind.

Associated risks with periodontal x‐rays or CBCT scans: Are there any?

“…The ALADAIP principles are fundamentally designed for pediatric patients 25 and are further validated in endodontic imaging as well. 26 When translating these principles to periodontal practice, several key points should be borne in mind. This mainly includes utilization of previously available radiographs, following general safety guidelines and last, if available and possible, using non-ionizing tools (such as ultrasonography) to determine whether periodontal tissues should be prioritized.…”

“…A more recent modification to the ALADA concept, “as low as diagnostically acceptable being indication oriented and patient‐specific” (ALADAIP), 24 was introduced in 2018 that takes into account the patient‐specific factors and follows an indication‐ and age‐oriented concept. The ALADAIP principles are fundamentally designed for pediatric patients 25 and are further validated in endodontic imaging as well 26 . When translating these principles to periodontal practice, several key points should be borne in mind.…”