Use of the Hand-Held Dental X-Ray Machine during Joint Operation, NATO Exercise Display Determination-92

Coy, Jim; Vandre, Robert H.; Davidson, William R.K.

doi:10.1093/milmed/162.8.575

Cited by 12 publications

(10 citation statements)

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“…However, most of the studies were performed in the USA 1,2,4,[7][8][9][10][11][12][13][14] with only a few studies in other countries, for example, Italy, 5 Belgium 3,15 and Korea. 16 To date, there are no reports from the UK although the device is available in the country.…”

Section: Discussionmentioning

confidence: 99%

“…In the past, the majority of handheld, portable X-ray units are modified machines, for use in military medicine, humanitarian missions and training exercises. 1,2 They are also used in archaeological excavation sites, crime scene/disaster areas for forensic dentistry imaging and veterinary applications. The advantages of these devices extend to dental patients who are homebound or institutionalized with limited mobility and patients undergoing general anaesthesia, [3][4][5] where conventional fixed or mobile X-ray units are not easily available.…”

Section: Introductionmentioning

confidence: 99%

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The effects of device position on the operator's radiation dose when using a handheld portable X-ray device

Makdissi

Pawar

Johnson

et al. 2016

Dentomaxillofacial Radiology

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Introduction: Handheld X-ray devices are now offered in dental practice. Handheld X-ray units challenge the concept of a restricted access to the "controlled area" as they are held by the operator. Although an integral lead shield is provided, the distance from the body is variable, dependent on how the device is held. The aim of this article was to investigate the level of operator dose when using a handheld X-ray device in various positions. Material and Methods: A NOMAD ProÔ Handheld X-ray system (Aribex Inc., Charlotte, NC) fitted with a remote control and mounted on a tripod was used in this study. A maxillofacial phantom ATOM ® Max Dental and Diagnostic Phantom, model 711 HN (CIRS Inc., Norfolk, VA) was used to simulate the patient's head position. A mannequin was used to represent the operator. Pre-calibrated thermoluminescent dosemeters (TLDs) (Qados, Agar Scientific, Stansted, UK) were placed on the mannequin close to the eyes and at the level of thyroid, trunk, waist, hand (right finger 1 left palm) and feet, and three TLDs were used for background radiation. Three test scenarios were investigated; Position 1, close to operators' body and parallel to the ground; Position 2, away from the body with the arms fully extended (approximately 40 cm distance) and parallel to the ground; Position 3, perpendicular to the ground while the arms are partially extended. 30 exposures each of 1 s were performed in each test. Results: Background radiation was measured at 0.0110 mGy. The highest exposure after subtracting background radiation was recorded on the palm of the left hand (0.0310 mGy) at Position 3. The estimated dose to the operator was calculated based on an average workload of 100 intraoral radiographs weekly for a dental practitioner working 46 weeks a year. Conclusions: There is a negligible increase in operator exposure levels using handheld X-ray devices which remain well below the recommended levels of the Ionizing Radiation Regulations 1999. They could however represent an increase from what should be a nil exposure when using a wall-mounted machine. The position of the device relative to the operator has a significant effect on the overall operator's radiation exposure. The use of personal dosemeters is highly recommended to ensure a continuity of low radiation dose exposure. Furthermore, guidance, training and protocols on usage must be in place, strictly adhered to and regular audits are necessary to ensure compliance.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The effects of device position on the operator's radiation dose when using a handheld portable X-ray device

Makdissi

Pawar

Johnson

et al. 2016

Dentomaxillofacial Radiology

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“…Work in remote areas without dental facilities, such as military operations abroad. 9 vi. Dental support in rural areas in developing countries or isolated areas without dental facilities.…”

Section: Objectivementioning

confidence: 99%

Justification and good practice in using handheld portable dental X-ray equipment: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology (EADMFR)

Berkhout¹,

Suomalainen²,

Brüllmann³

et al. 2015

Dentomaxillofacial Radiology

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Handheld portable X-ray devices are increasingly used for intraoral radiography. This development introduces new challenges to staff and patient safety, for which new or revised risk assessments must be made and acted upon prior to use. Major issues might be: difficulties in using rectangular collimation with beam aiming devices, more complex matching of exposure settings to the X-ray receptor used (e.g. longer exposure times), movements owing to the units' weight, protection of the operator and third persons, and the use in uncontrolled environments. These problems may result in violation of the "as low as reasonably achievable'', that is, ALARA principle by an increase in (re)exposures compared with the other available intraoral X-ray devices. Hence, the use of handheld portable X-ray devices should be considered only after careful and documented evaluation (which might be performed based on medical physics support), when there is evidence that handheld operation has benefits over traditional modalities and when no new risks to the operators and/or third parties are caused. It is expected that the use of handheld portable X-ray devices will be very exceptional, and for justified situations only. Special attention should be drawn to beamaiming devices, rectangular collimation, the section of the X-ray receptor, focus-skin distance, and backscatter shielding, and that the unit delivers reproducible dose over the full set of environmental conditions (e.g. battery status and temperature).

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“…The use of handheld x-ray devices in dentistry has increased over the last 25 years and the development of and marketing for these devices is also growing 6 . Early handheld x-ray devices were designed for use by military dental personnel in deployment and field operations 7 . In 1992, the handheld dental x-ray machine (HDX) was developed by the United States Army Research and Development Command and tested in a NATO joint exercise.…”

Section: Review Of Literaturementioning

confidence: 99%

“…The HDX incorporated a 4.5-pound medical collimator for limited medical examinations. The total weight of the HDX, medical collimator and carrying case with battery pack was about 35 pounds 7 . In 2003, Aribex (Aribex Inc., Charlotte, NC) introduced the first light weight handheld x-ray device to incorporate the power source in the same enclosure as the x-ray head and the development of similar devices followed 8 .…”

Section: Review Of Literaturementioning

confidence: 99%

A Comparison of Contemporary Portable X-Ray Systems

Dillon

Johnson

Broome

et al. 2020

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

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Jessica Ruth Dillon: A Comparison of Contemporary Portable X-ray Systems (Under the direction of Brandon Johnson) Using optically stimulated luminescent (OSL) dosimetry, full mouth series (FMX) effective dose (E) and operator dose were calculated for adult and child anthropomorphic phantoms using a wall-mounted source with circular collimation (Cir) and rectangular collimation (RC), the NOMAD Pro 2 TM handheld with Cir and RC, and the Xray2go handheld with Cir. To assess the impact of RC on exposure, an exploratory device positioning technique was evaluated. Technique errors and line pair resolution (LP) were also assessed. Dosimetry differences were analyzed using Analysis of Variance. Adult handheld E with Cir was significantly lower than conventional Cir for both handheld devices (p<.0001). Child handheld E with Cir was similar to conventional Cir for the NOMAD TM (p=.0984). RC E was significantly lower than all Cir (p<.0001). Operator groin dose was significantly higher than thyroid, chest and trigger hand for all handheld modalities (p<.0001). Prevalence of technique errors was not different between devices (p=.07). Mean LP resolution was similar for all modalities. iv PREFACE LCDR Jessica R. Dillon, Dental Corps, Navy Medicine Education, Training and Logistics Command, is a resident at the University of North Carolina at Chapel Hill Adams School of Dentistry, training in Oral and Maxillofacial Radiology.

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Use of the Hand-Held Dental X-Ray Machine during Joint Operation, NATO Exercise Display Determination-92

Cited by 12 publications

References 0 publications

The effects of device position on the operator's radiation dose when using a handheld portable X-ray device

The effects of device position on the operator's radiation dose when using a handheld portable X-ray device

Justification and good practice in using handheld portable dental X-ray equipment: a position paper prepared by the European Academy of DentoMaxilloFacial Radiology (EADMFR)

A Comparison of Contemporary Portable X-Ray Systems

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