Radiation exposure during orthodontic treatment: risk to children and adolescents
DOI:
https://doi.org/10.2340/aos.v83.40571Keywords:
dental radiography, indication, orthodontic treatment, panoramic, radiation riskAbstract
Objectives: To estimate radiation risk to children and adolescents during orthodontic treatment by retrieving number and type of radiographs from the patient records.
Material and methods: Radiographs, along with justifications for radiation exposure, were obtained retrospectively from the patient records of 1,790 children and adolescents referred to two Swedish orthodontic clinics. Data were grouped according to treatment stage: treatment planning, treatment, and follow-up. Estimated risk was calculated using the concept of effective dose.
Results: Each patient had received around seven radiographs for orthodontic purposes. The most common exposures during treatment planning were one panoramic, one lateral, and three intraoral periapical radiographs. A small number of patients received a tomographic examination (8.2%). Few justifications for treatment planning and follow-up, but more in the actual treatment stage, had been recorded. The most common examinations were to assess root resorption and the positions of unerupted teeth, or simply carry out an unspecified control. The estimated risk of developing fatal cancer was considered low. The radiation risk from orthodontic treatment was equivalent to about 5–10 days of natural background radiation.
Conclusions: Children and adolescents sometimes undergo multiple radiographic examinations, but despite the low radiation burden, accumulated radiation exposure should be considered and justified in young patients.
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SBU. Bettavvikelser och tandreglering i ett hälsoperspektiv. En systematisk litteraturöversikt. Stockholm: Statens beredning för medicinsk utvärdering (SBU); 2005. SBU-rapport nr 176.
Mohlin B, Domgaard P, Egermark I, et al. Hälsorisker vid obehandlade malocklusioner. Tandläkartidningen. 2007:99(2):40–5. DOI: https://doi.org/10.56373/2007-1-7
Statistics Sweden. (Statistiska Centralbyrån (SCB)) [Inteernet]. Available from: https://www.statistikdatabasen.scb.se/pxweb/sv/ssd/START__BE__BE0101__BE0101A/BefolkningNy/ [cited 2023 Nov 28]
Isaacson KG, Thom AR, Atack NE, et al. Guidelines for the use of radiographs in clinical orthodontics [Internet]. 2015. Available from: https://www.bos.org.uk/wp-content/uploads/2022/03/Orthodontic-Radiographs-2016-2.pdf [cited 2023 Nov 28]
Bruks A, Enberg K, Nordqvist I, et al. Radiographic examinations as an aid to orthodontic diagnosis and treatment planning. Swed Dent J. 1999;23(2–3):77–85.
Stervik C, Lith A, Westerlund A, et al. Choice of radiography in orthodontic treatment on children and adolescents: a questionnaire‐based study performed in Sweden. Eur J Oral Sci. 2021;129(4):e12796. https://doi.org/10.1111/eos.12796 DOI: https://doi.org/10.1111/eos.12796
European Commission. Radiation protection No.136. European guidelines in dental practice. 2004. Office for Official Publications of the European Communities, 2004. Luxemburg. ISBN 92-894-5958-1
Mattsson Granlund CM, Lith A, Molander B, et al. Frequency of errors and pathology in panoramic images of young orthodontic patients. Eur J Orthodontics. 2012;34(4):452–7. https://doi.org/10.1093/ejo/cjr035 DOI: https://doi.org/10.1093/ejo/cjr035
ICRP. The 2007 recommendation of the International Commission on Radiological Protection. Ann ICRP. 2007;37:1–332. https://doi.org/10.1016/j.icrp.2008.07.001 DOI: https://doi.org/10.1016/j.icrp.2008.07.001
The National Board of Health and Welfare. (Socialstyrelsen), Nationella riktlinjer för tandvård. Stöd för styrning och ledning 2022 [Interenet]. 2022. Available from: https://www.socialstyrelsen.se/globalassets/sharepoint-dokument/artikelkatalog/nationella-riktlinjer/2022-9-8114.pdf [cited 2023 Nov 28]
Granlund C, Thilander-Klang A, Ylhan B, et al. Absorbed organ and effective doses from digital intra-oral and panoramic radiography applying the ICRP 103 recommendations for effective dose estimations. Br J Radiol. 2016;89(1066):20151052. https://doi.org/10.1259/bjr.20151052 DOI: https://doi.org/10.1259/bjr.20151052
Ludlow JB, Davies-Ludlow LE, White SC. Patient risk related to common dental radiographic examinations: the impact of 2007 International Commission on Radiological Protection recommendations regarding dose calculation. J Am Dent Assoc. 2008;139(9):1237–43. https://doi.org/10.14219/jada.archive.2008.0339 DOI: https://doi.org/10.14219/jada.archive.2008.0339
European Commission. Radiation protection No. 172. Cone beam CT for dental and maxillofacial radiology [Internet]. 2012 [cited 05-05-2021]. Available from: https://www.sedentexct.eu/content/guidelines-cbct-dental-and-maxillofacial-radiology
ICRP. The 1990 Recommendations of the International Commission on Radiological Protection. ICRP publicatio 60. Ann ICRP. 1990;21:1–212.
Raelson CA, Kanal KM, Vavilala MS, et al. Radiation dose and excess risk of cancer in children undergoing neuroangiography. AJR Am J Roentgenol. 2009;193(6):1621–8. https://doi.org/10.2214/AJR.09.2352 DOI: https://doi.org/10.2214/AJR.09.2352
United Nations Scientific Committee on the Effects of Atomic Radiation. UNSCEAR. Effects of ionizing radiation 2006 Report, Volume 1 – Report to the General Assembly, with Scientific Annexes A and B. United Nations Publication. New York 2008. ISBN 978-92-1-142263-4
Svenson B, Ståhlnacke K, Karlsson R, et al. Dentists’ use of digital radiographic techniques: Part I – intraoral X-ray: a questionnaire study of Swedish dentists. Acta Odontol Scand. 2018;76(2):111–118. https://doi.org/10.1080/00016357.2017.1387930 DOI: https://doi.org/10.1080/00016357.2017.1387930
Swedish Radiation Safety Authority (Strålsäkerhetsmyndigheten). Granskning av berättigandeprocessen inom barn-och ungdomstandvården. Katrineholm, Sweden. SSM; 2022, p. 12.
Poppe B, Looe HK, Pfaffenberger A, et al. Radiation exposure and dose evaluation in intraoral dental radiology. Radiat Prot Dosimetry. 2007;123(2):262–7. https://doi.org/10.1093/rpd/ncl113 DOI: https://doi.org/10.1093/rpd/ncl113
Sameshima GT, Asgarifar KO. Assessment of root resorption and root shape: periapical vs panoramic films. Angle Orthod. 2001;71(3):185–9.
Durao AR, Pittayapat P, Rockenbach MI, et al. Validity of 2D lateral cephalometry in orthodontics: a systematic review. Progress Orthodontics. 2013;14:31. https://doi.org/10.1186/2196-1042-14-31 DOI: https://doi.org/10.1186/2196-1042-14-31
Lund H, Gröndahl K, Gröndahl HG. Cone beam computed tomography evaluations of marginal alveolar bone before and after orthodontic treatment combined with premolar extractions. Eur J Oral Sci. 2012;120(3):201–11. https://doi.org/10.1111/j.1600-0722.2012.00964.x DOI: https://doi.org/10.1111/j.1600-0722.2012.00964.x
Lund H, Gröndahl K, Hansen K, et al. Apical root resorption during orthodontic treatment. A prospective study using cone beam CT. Angle Orthod. 2012;82(3):480–7. https://doi.org/10.2319/061311-390.1 DOI: https://doi.org/10.2319/061311-390.1
United Nations Scientific Committee on the Effects of Atomic Radiation. UNSCEAR. Sources and effects of ionizing radiation. Report to the General Assembly, with Scinetific Annexes. 2000. United Nations Publication. New York 2000. ISBN 92-1-142238-8
Swedish Radiation Safety Authority (Strålsäkerhetsmyndigheten). Bakgrundsstrålning [Internet]. Available from: https://www.stralsakerhetsmyndigheten.se/om-stralning/bakgrundsstralning/ [cited 2023 Nov 28]
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Copyright (c) 2024 Christina Stervik, Agneta Lith, Annika Ekestubbe
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Acta Odontologica Scandinavica publishes original research papers as well as critical reviews relevant to the diagnosis, epidemiology, health service, prevention, aetiology, pathogenesis, pathology, physiology, microbiology, development and treatment of diseases affecting tissues of the oral cavity and associated structures including papers on cause and effect or explanatory/associative relationships for experimental or observational studies.
