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分段牙科全景体层摄影术在儿童中的应用:辐射防护继续教育的积极效果

Application of segmented dental panoramic tomography among children: positive effect of continuing education in radiation protection.

作者信息

Pakbaznejad Esmaeili Elmira, Waltimo-Sirén Janna, Laatikainen Tuula, Haukka Jari, Ekholm Marja

机构信息

1 Department of Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.

2 Department of Social Services and Health Care, City of Helsinki, Helsinki, Finland.

出版信息

Dentomaxillofac Radiol. 2016 Jul;45(6):20160104. doi: 10.1259/dmfr.20160104. Epub 2016 May 23.

Abstract

OBJECTIVES

: Dental panoramic tomography is the most frequent examination among 7-12-year olds, according to the Radiation Safety and Nuclear Authority of Finland. At those ages, dental panoramic tomographs (DPTs) are mostly obtained for orthodontic reasons. Children's dose reduction by trimming the field size to the area of interest is important because of their high radiosensitivity. Yet, the majority of DPTs in this age group are still taken by using an adult programme and never by using a segmented programme. The purpose of the present study was to raise the awareness of dental staff with respect to children's radiation safety, to increase the application of segmented and child DPT programmes by further educating the whole dental team and to evaluate the outcome of the educational intervention.

METHODS

: A five-step intervention programme, focusing on DPT field limitation possibilities, was carried out in community-based dental care as a part of mandatory continuing education in radiation protection. Application of segmented and child DPT programmes was thereafter prospectively followed up during a 1-year period and compared with our similar data from 2010 using a logistic regression analysis.

RESULTS

: Application of the child programme increased by 9% and the segmented programme by 2%, reaching statistical significance (odds ratios 1.68; 95% confidence interval 1.23-2.30; p-value < 0.001). The number of repeated exposures remained at an acceptable level. The segmented DPTs were most frequently taken from the maxillary lateral incisor-canine area.

CONCLUSIONS

: The educational intervention resulted in improvement of radiological practice in respect to radiation safety of children during dental panoramic tomography. Segmented and child DPT programmes can be applied successfully in dental practice for children.

摘要

目的

根据芬兰辐射安全与核管理局的数据,牙科全景体层摄影术是7至12岁儿童中最常进行的检查。在这个年龄段,大多数牙科全景体层摄影(DPT)是出于正畸原因进行的。由于儿童对辐射的高敏感性,通过将照射野大小调整到感兴趣区域来降低儿童的辐射剂量非常重要。然而,这个年龄组的大多数DPT仍然采用成人程序进行拍摄,从未使用过分段程序。本研究的目的是提高牙科工作人员对儿童辐射安全的认识,通过进一步培训整个牙科团队来增加分段和儿童DPT程序的应用,并评估教育干预的效果。

方法

作为辐射防护强制性继续教育的一部分,在社区牙科护理中开展了一项五步干预计划,重点是DPT照射野限制的可能性。此后,在1年期间前瞻性地跟踪分段和儿童DPT程序的应用情况,并使用逻辑回归分析将其与我们2010年的类似数据进行比较。

结果

儿童程序的应用增加了9%,分段程序的应用增加了2%,达到统计学显著性(优势比1.68;95%置信区间1.23 - 2.30;p值<0.001)。重复照射的次数保持在可接受水平。分段DPT最常拍摄的区域是上颌侧切牙 - 尖牙区域。

结论

教育干预在牙科全景体层摄影术中改善了儿童辐射安全方面的放射学实践。分段和儿童DPT程序可以在儿童牙科实践中成功应用。

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