Dental radiology plays an important role in diagnosis but also exposes patients and staff to radiation risks. New dental imaging technologies like CBCT provide more effective 3D imaging but also increase radiation exposure levels. It is important to use the minimum radiation dose needed for quality images and to follow standard protocols to minimize risks from dental radiography.

1. Dose radiation concern in dental applications from new imaging
technologies
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2. Introduction
• In dentistry, diagnosis is usually carried out with the help of X-rays, especially for the
clinical issues that cannot be effectively diagnosed with a traditional dental checkup
• radiographic techniques main role is to enhance the clinical examination and diagnosis
• As technology advances, a growing number of dental radiology equipment are available for
the diagnosis more effectively.
• The routine use of dental radiographs might result in unintentional exposure of dentists or
the staff of dental clinics and patients, resulting in biological hazards for both parties.
• In comparison to conventional radiography, CBCT provides an overview of three-
dimensional imaging and has been shown to be beneficial in imaging hard tissues in
dentistry
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3. Background on Dental
Radiation
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4. Dental Radiology
• Different parameters
• Standardization of quality of radiology
• Devastating outcomes in medical use of radiations
• Specific measures regarding quality assurance of radiology
• Image quality
• Level of exposure
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5. Medical Image
• Images impacted by noise and other interfering sources
• Less suitable results due to reduced visibility and contrast
• Image segregation
• Morphology
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6. Dental Radiology
• Dental radiology as an important tool in dentistry
• Periapical Radiographic
• Occlusal Radiographic:visualize floor of mouth or palate
• Panoramic Radiographic: is a full mandibular image in one film and this can help in the reduction of time used in scanning
• For dental implant, combine panoramic and periapical radiography
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7. Factors which control X-ray
• Exposure time
• Amount of radiation a patient receive
• Tube current
• Tube voltage (Kavitha, Muthulakshmi & Latha,2019)
• Photoelectric absorption
• Bremsstrahlung interactions hand (Aps, 2019)
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9. History
• Initial discovery by William Rontgen in 1895
• William Morgan and Michael Faraday generated x-rays during 1795 to 1800
• Philip Lenard studied cathode rays in the 1890s
• Arthur Goodspeed and William Jennings created radiograph accidentally
• After William Rontgen discovery, Otto Walkhoff, a German dentist, got a
radiograph of his own teeth with assistance from Fritz Giesel
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10. History
• An English dentist, Frank Harrison experiments in dental radiography in 1896
• Walter Konig tests on radiography applications on upper and lower jaws
• In 1896 the American dentist Edmund Kells demonstrating new techniques of
radiography. He proposed simultaneous use of two films
• Weston Price labelled radiographs using thin copper wire in 1904
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11. History
• Franklin McCormack focused on the paralleling technique
• In Turkey, Esat Feyzi and Trifat Osman utilize this technology in 1896
• In 1924, Hasan Hayri Bey and his workmates recommended Turkey Ministry
of Health establishing a dentistry school
• In 1913, the first hand wrapped dental film marketed by Kodak
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12. History
• In 1921 there was a production of machine-made dental film packets
• In 1924 fine grain dental film was created
• In 1941, ultra speed film was created
• In 1981, the idea of e-speed film was introduced which officially launched in
2000
• In 1987, introduction of a digital charge coupled device known as Intra-oral
detector
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13. Doses in Dental Radiology
• Preferred doses for better results
• Excess dosage, devastative results
• Some commonly used quantities of doses
• Diagnostic Reference Level for adult 0.65 to 3.7 mGy
• For entrance surface dose 3.3 to 4,2 mGy
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14. Doses in Dental Radiology
• For adults 41 to 146 mGy.cm2
• For children 25 to 21 mGy.cm2
• In adults effective dosage 0,005mSv, panoramic x-ray 0.025 mSv and for
cone beam CT scan 0,18 mSv.
• Radiation weighting factor (Tuan et al., 2018)
• From natural background radiation 3.2 mSv per year
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15. Doses in Dental Radiology
• From artificial sources 3.0 mSv from artificial sources
• x-ray spectral sensitivity of the dental x-ray film
• 60-70 kvp for intraoral radiography
• Diagnostic reference levels
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16. References
• Aps, J. (2019). Imaging in Pediatric Dental Practice: A Guide to Equipment, Techniques and Clinical Considerations. Springer.
• Behling, R. (2018). X-ray tubes development–IOMP history of medical physics. Med. Phys. Int, 1, 8-55.
• Chen, M. C., Chen, C. H., & Chen, M. H. (2019, April). Artificial intelligence (AI) for dental intraoral film mounting. In International Conference on Biomedical and Health
Informatics (pp. 1-8). Springer, Cham.
• Guo, T. (2018). X-ray Nanochemistry. Springer.
• Iannucci, J., & Howerton, L. J. (2021). Dental radiography-E-book: principles and techniques. Elsevier Health Sciences.
• Kavitha, G., Muthulakshmi, M., & Latha, M. (2019). Image Segmentation Using Contour Models: Dental X-Ray Image Segmentation and Analysis. In Computational
Techniques for Dental Image Analysis (pp. 62-85). IGI Global.
• Maier, C., & Heinichen, C. (2018). Dental x-ray in companion animals: correct positioning and radiographic technique. Praktische Tierarzt, 99(2), 144-158.
• Niemiec, B. A. (2017). Dental Radiography Equipment. In Practical Veterinary Dental Radiography (pp. 31-41). CRC Press.
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17. References
• Pauwels, R. (2020). History of dental radiography: Evolution of 2D and 3D imaging modalities. Med. Phys. Int, 8, 235-277.
• Qiang, W., Qiang, F., & Lin, L. (2019). Estimation of effective dose of dental x-ray devices. Radiation protection dosimetry, 183(4), 418-422.
• Russo, P. (Ed.). (2017). Handbook of X-ray imaging: physics and technology. CRC press.
• Stabulas-Savage, J. J. (2018). Frommer's Radiology for the Dental Professional-E-Book. Elsevier Health Sciences.
• Tuan, T. M., Fujita, H., Dey, N., Ashour, A. S., Ngoc, V. T. N., & Chu, D. T. (2018). Dental diagnosis from X-ray images: an expert system based on
fuzzy computing. Biomedical Signal Processing and Control, 39, 64-73.
• Whaites, E., & Drage, N. (2020). Essentials of Dental Radiography and Radiology E-Book. Elsevier Health Sciences.
• White, S. C., & Pharoah, M. J. (2018). White and pharoah's oral radiology e-book: principles and interpretation. Elsevier Health Sciences.
• IAEA (2017). Radiation Protection and Safety in Medical Uses of Ionizing Radiation. SSG 46 (to be published)
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18. Literature Review
• Dental cone beam CT: An updated review.
• Application of three-dimensional computed tomography in craniofacial clinical practice and research.
• Effects of radiation doses from different dental imaging modalities on cell-implant interaction: A comparison with cell culture study.
• Dose assessment in dental cone-beam computed tomography: Comparison of optically stimulated luminescence dosimetry with
Monte Carlo method.
• Radiation dose and protection in dentistry.
• Ultralow Dose MSCT Imaging in Dental Implantology.
• Assessment of dental radiation dose reduction utilizing mathematical pediatric phantom models: applications in clinical practice.
• The growing concern of radiation dose in paediatric dental and maxillofacial CBCT: an easy guide for daily practice.
• Organ dose and radiogenic risk in dental cone-beam computed tomography examinations.
• Estimated radiation risk of cancer from dental cone-beam computed tomography imaging in orthodontics patients.
• Radiation Load Exerted by the PARDUS Portable Dental x-ray Apparatuses.
• Radiation protection in dental radiology – Recent advances and future directions.
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