Reinhilde Jacobs1,2, Ruben Pauwels3,4, William C Scarfe5, Carl De Cock3, Karl Dula6, Guy Willems7, An Verdonck7, Constantinus Politis3. 1. OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals of Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium. reinhilde.jacobs@uzleuven.be. 2. Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden. reinhilde.jacobs@uzleuven.be. 3. OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals of Leuven, Kapucijnenvoer 33, 3000, Leuven, Belgium. 4. Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand. 5. Radiology and Imaging Science, Department of Surgery and Hospital Dentistry, University of Louisville School of Dentistry, Louisville, KY, USA. 6. Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland. 7. Orthodontics, Department of Oral Health Sciences, Faculty of Medicine, University of Leuven, Leuven, Belgium.
Abstract
OBJECTIVE: The objective of the study was to compare estimates of pediatric cumulative exposure and lifetime attributable risk (LAR) of radiation-induced cancer from dental radiology between cleft palate (CP) subjects and age- and gender-matched controls (non-CP), with and without orthodontic treatment. MATERIALS AND METHODS: The radiation exposure frequency of CP subjects and non-CP controls with and without orthodontic treatment was compared for two-dimensional radiography (intra-oral, panoramic and cephalometric radiography), computed tomography (CT), and cone-beam CT (CBCT) using cumulative radiation dose as an estimate. From this dose estimate, the age- and gender-dependent risk for radiation-induced stochastic effects was calculated for each patient group. RESULTS: CP patients received more radiographic examinations than non-CP controls, with the exception of intra-oral radiographs. The cumulative dose to CP patients was considerably higher (1963 μSv at the age of 20 years) than non-CP patients with (597 μSv) and without (383 μSv) orthodontic treatment, primarily due to the higher frequency of CT scanning. Accordingly, CP patients had a three to five times higher LAR than non-CP patients. CONCLUSIONS: This study suggests a significantly higher lifetime radiation exposure to CP patients than non-CP controls from dental radiographic procedures. Diagnostic benefits from the use of CT and CBCT in children must be justified and appropriate dose optimization strategies implemented. CLINICAL RELEVANCE: The present study indicates the need for proper justification and optimization of pediatric exposures in dentistry, with a special focus on high-risk groups.
OBJECTIVE: The objective of the study was to compare estimates of pediatric cumulative exposure and lifetime attributable risk (LAR) of radiation-induced cancer from dental radiology between cleft palate (CP) subjects and age- and gender-matched controls (non-CP), with and without orthodontic treatment. MATERIALS AND METHODS: The radiation exposure frequency of CP subjects and non-CP controls with and without orthodontic treatment was compared for two-dimensional radiography (intra-oral, panoramic and cephalometric radiography), computed tomography (CT), and cone-beam CT (CBCT) using cumulative radiation dose as an estimate. From this dose estimate, the age- and gender-dependent risk for radiation-induced stochastic effects was calculated for each patient group. RESULTS: CP patients received more radiographic examinations than non-CP controls, with the exception of intra-oral radiographs. The cumulative dose to CP patients was considerably higher (1963 μSv at the age of 20 years) than non-CP patients with (597 μSv) and without (383 μSv) orthodontic treatment, primarily due to the higher frequency of CT scanning. Accordingly, CP patients had a three to five times higher LAR than non-CP patients. CONCLUSIONS: This study suggests a significantly higher lifetime radiation exposure to CP patients than non-CP controls from dental radiographic procedures. Diagnostic benefits from the use of CT and CBCT in children must be justified and appropriate dose optimization strategies implemented. CLINICAL RELEVANCE: The present study indicates the need for proper justification and optimization of pediatric exposures in dentistry, with a special focus on high-risk groups.
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