Department of Radiology and Physical Medicine, Faculty of Medicine and Dentistry, University of Murcia, Campus de Espinardo, 30100-Murcia, Spain.
Dentomaxillofac Radiol. 2010 Dec;39(8):468-74. doi: 10.1259/dmfr/20362385.
The aim of this study was to assess the influence of European Union legislation on dental radiology practice in Spain and the reduction in doses administered in dental radiological installations 11 years after its introduction.
A total of 19 079 official reports on dental surgeries from 16 Spanish autonomous regions published between 1996 and 2007 were studied. We analysed the physical characteristics of the X-ray units, anomalies, film processing, exposure times and mean radiation doses administered in clinical situations.
The dose applied to obtain a radiograph of an upper second molar had decreased by 37% up until 2007, the mean dose being 2.7 mGy, with 81.1% of installations using a dose of less than 4 mGy, with a reference dose for the 3(rd) quartile of 3.6 mGy. Of note was the incorporation of digital systems (50.1%), which are gradually replacing manual processing systems (45.3%). There were significant differences between the systems: direct digital radiology < indirect digital radiology = Insight = Ektaspeed = Ultraspeed (P < 0.001). In installations with digital systems, 6.3% used more than 4 mGy (20.5% with direct radiology and 3.2% with indirect radiology) and 7.4% a dose of less than 0.5 mGy, with a mean dose of 1.8 mGy and a reference dose for the 3(rd) quartile of 2.3 mGy.
There has been a gradual improvement in dental radiology practices; however, the incorporation of digital systems has not resulted in all the benefits hoped for, and mistakes are frequent. Besides the physical parameters that have been established, anatomical and clinical image quality criteria should be established to convince dentists of the real benefits of incorporating quality guarantee procedures in their practices.
本研究旨在评估欧盟法规对西班牙牙科放射实践的影响，以及在该法规引入 11 年后，牙科放射设备中剂量的减少。
共研究了 1996 年至 2007 年间西班牙 16 个自治区公布的 19079 份官方牙科手术报告。我们分析了 X 射线设备的物理特性、异常情况、胶片处理、曝光时间和临床情况下的平均辐射剂量。
截至 2007 年，获得上颌第二磨牙射线照片的应用剂量减少了 37%，平均剂量为 2.7 mGy，81.1%的设备使用的剂量低于 4 mGy，第三四分位数的参考剂量为 3.6 mGy。值得注意的是，数字系统（50.1%）的引入正在逐渐取代手动处理系统（45.3%）。系统之间存在显著差异：直接数字化放射学<间接数字化放射学=Insight=Ektaspeed=Ultraspeed（P<0.001）。在使用数字系统的设备中，6.3%使用的剂量超过 4 mGy（直接放射学为 20.5%，间接放射学为 3.2%），7.4%使用的剂量低于 0.5 mGy，平均剂量为 1.8 mGy，第三四分位数的参考剂量为 2.3 mGy。
牙科放射实践逐渐得到改善；然而，数字系统的引入并没有带来预期的所有好处，而且错误经常发生。除了已建立的物理参数外，还应建立解剖学和临床图像质量标准，以使牙医相信在其实践中纳入质量保证程序的真正好处。
