Pakbaznejad Esmaeili Elmira, Ekholm Marja, Haukka Jari, Waltimo-Sirén Janna
*Oral Radiology, Department of Oral and Maxillofacial Diseases, University of Helsinki,
**Oral Healthcare Department of City of Helsinki.
Eur J Orthod. 2016 Feb;38(1):96-102. doi: 10.1093/ejo/cjv033. Epub 2015 May 14.
Numbers of dental panoramic tomographs (DPTs) and lateral cephalometric radiographs (LCRs) outweigh other radiographic examinations in 7- to 12-year-old Finns. Orthodontists and general practitioners (GPs) involved in orthodontics hold therefore the highest responsibility of the exposure of children to ionising radiation with its risks. Against this background, lack of reports on the quality of orthodontic radiography is surprising. The purpose of our study was to shed some light and draw the awareness of the orthodontic community on the subject by analyzing the quality of orthodontic radiography in Oral Healthcare Department of City of Helsinki, in the capital of Finland.
We analyzed randomly selected 241 patient files with DPTs and 118 patient files with LCRs of 7- to 12-year-olds for the indications of radiography, quality of referrals, status of interpretation, and number of failed radiographs.
The majority of DPTs (95%) and all LCRs had been ordered for orthodontic reasons. Of the DPTs, 60% were ordered by GPs, and of the LCRs, 64% by orthodontists. The referrals were adequate for most DPTs (78%) and LCRs (73%), orthodontists being responsible for the majority of inadequate referrals. Of the DPTs, 80% had been interpreted. Of the LCRs, 65% lacked interpretation, but 67% had been analysed cephalometrically. Failed radiographs, leading to repeated exposure, were found in 2-3%.
The quality assessment revealed that orthodontic radiography may not completely fulfill the criteria of good practice. Our results stress further need of continuing education in radiation protection among both orthodontists and GPs involved in orthodontics.
在7至12岁的芬兰人中，牙科全景体层摄影（DPT）和头颅侧位X线片（LCR）的数量超过其他放射检查。因此，从事正畸工作的正畸医生和全科医生（GP）对儿童遭受电离辐射及其风险负有最高责任。在此背景下，正畸放射摄影质量缺乏相关报告令人惊讶。我们研究的目的是通过分析芬兰首都赫尔辛基市口腔保健部门的正畸放射摄影质量，来阐明这一问题并引起正畸界的关注。
我们随机分析了241份7至12岁儿童的DPT患者档案和118份LCR患者档案，以了解放射摄影的指征、转诊质量、解读情况以及放射照片不合格数量。
大多数DPT（95%）和所有LCR都是因正畸原因开具的。在DPT中，60%是由全科医生开具的，在LCR中，64%是由正畸医生开具的。大多数DPT（78%）和LCR（73%）的转诊是充分的，正畸医生应对大多数不充分的转诊负责。在DPT中，80%已得到解读。在LCR中，65%缺乏解读，但67%已进行头影测量分析。发现2%至3%的放射照片不合格，导致再次曝光。
质量评估显示，正畸放射摄影可能未完全符合良好实践的标准。我们的结果进一步强调了从事正畸工作的正畸医生和全科医生都需要继续接受辐射防护教育。
