National guidelines for dental diagnostic imaging in the developmental age

Abstract

Introduction Work Group Bibliographical Research Current regulations Considerations on radiological risks and containment strategies in x-ray examinations Diagnostic imaging for caries and periodontal disease Diagnostic imaging in orthodontics and gnathology Diagnostic imaging in cranio-maxillofacial malformations Ministry of Health Secretariat General Office 2 National Guidelines for Dental Diagnostic Imaging in the Developmental Age Diagnostic imaging in dental anomalies Diagnostic imaging in dental traumatology Table of Recommendations Glossary This document aims to support the dental professional in choosing the adequate diagnostic technique, minimising the radiation dose in observance of the As Low As Reasonably Achievable (ALARA) principle (7). This principle states that the biological cost can only be justified when the benefit, that is, the diagnosis, outweighs the risk related to radiation exposure. In this guideline paper, we report recommendations for radiologists, medical physicists, paediatrician, dentists and maxillofacial surgeons, with reference to the specific fields. The diagnostic techniques considered in this paper are intraoral X-ray, orthopantomography (OPT), cephalometric (Ceph) x-ray and cone beam computed tomography (CBCT). This work considers the Methodological Manual for National Guidelines System (2011), titled "How to produce, spread, and update Public Health Guidelines". Bibliographical research A systematic analysis of existing literature was carried out using PubMed, Embase and The Cochrane Library databases, with the following restrictions:

Image quality of a portable X-ray device (Nomad Pro 2) compared to a wall-mounted device in intraoral radiography

“…In this study, the HH Nomad Pro 2 (Kavo Kerr, Biberach, Germany) was used to conduct fully hand-guided dental X-ray images by means of a digital dental X-ray sensor (GXS 700, size 1 and 2, Gendex, Kavo Kerr, Biberach, Germany). X-ray image quality parameters (according to the current statutes of the German Dental Association; [9]) of the Nomad Pro 2 were then compared to a typical WM X-ray unit (Heliodent Plus, Sirona Dental Systems, Bensheim, Germany) with the same digital dental X-ray sensors (GXS 700, size 1 and 2, Gendex, Kavo Kerr, Biberach, Germany). Quality parameters were distortion, level of detail, image size, overlay, resolution, radiation field, and technical parameters, such as distance from tube end to focus and receiver dose (see Table 1).…”

“…The guidelines of the German Federal Medical Association for quality assurance in radio diagnostics require dental X-ray images to fully capture the examined tooth from crown to apex, the periodontal bony structure as well as the border of the inner alveolar cortex to the periodontal space [8]. Furthermore, standards for dental X-ray diagnostics authored by the German Federal Association of Dentists dictate imaging voltages of ≥ 60 kilovolts (kV), a resolution of ≥ 5 line pairs per millimeter (mm) as well as a distance between the focus and the end of the X-ray tube of ≥ 200 mm [9]. The average radiation effective dose determined for analogue dental X-ray images is approximately 0.005 millisieverts (mSv) and 0.003 mSv for digital dental X-ray imaging.…”

“…Compared variables between the Nomad Pro 2 and the Heliodent Plus (according to[9]; mandatory criteria for bite wing images a )…”

Short‐term effects of the Sander bite‐jumping appliance on the pharyngeal airways in subjects with skeletal Class II malocclusion: A retrospective case‐control study

“…Even if 3D imaging seems to be very accurate for the assessment of the upper airways, 48 a CBCT presents high biological costs because patients are exposed to a massive radiation dose before and after treatment 49 while, although, an MRI is radiation free, it is expensive and requires good collaboration due to the time length of the acquisition 50 . Hence, lateral cephalogram still presents significant advantages since it is a low‐dose record that is routinely acquired in patients needing an orthodontic treatment 51 . Furthermore, these images are easy to achieve, and they produce less radiation than 3D imaging.…”

“…50 Hence, lateral cephalogram still presents significant advantages since it is a low-dose record that is routinely acquired in patients needing an orthodontic treatment. 51 Furthermore, these images are easy to achieve, and they produce less radiation than 3D…”