Department of Pediatric Dentistry, Faculty of Dentistry, Tokat Gaziosmanpaşa University, Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, Ali Sevki Erek Yerleskesi Dis Hekimligi Fakültes, Merkez, Tokat, 60030, Turkey.
Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Tokat Gaziosmanpaşa University. Kaleardi Mahallesi, Muhittin Fisunoglu Caddesi, Omcalik Sokak, Ali Sevki Erek Yerleskesi, Dis Hekimligi Fakültes, Merkez, Tokat, 60030, Turkey.
BMC Oral Health. 2024 Sep 11;24(1):1068. doi: 10.1186/s12903-024-04813-6.
The use of cone beam computed tomography (CBCT) for dentomaxillofacial diagnostics in pediatric dentistry is expanding and concerns have been raised about the radiation risks associated with this imaging modality, especially for children. Dentomaxillofacial paediatric imaging: an investigation towards low-dose radiation induced risks (DIMITRA) is a multidisciplinary project focused on optimizing CBCT exposure for children and adolescents. This study aims to clarify the indications behind CBCT scans in children aligned with DIMITRA's recommendations.
For each CBCT examination, data were collected on patient age at the time of the CBCT examination, gender, reason for request, referring department, CBCT-requested region, and the field of view (FOV) dimension of imaging. The CBCT indications were categorized under six headings according to an adaptation of the DIMITRA project recommendations: impacted teeth, dentoalveolar trauma, orofacial clefts, dental anomalies, bone pathology, syndromes. Indications not categorized in DIMITRA were recorded below the heading "other".
The most common indication was the "other" category (34.8%), which included implant, temporomandibular joint dysfunction, orofacial anomalies, foreign object and root canal morphology. The least common indication was "orofacial cleft" (1.9%) and no requests were made for cases related to syndromes. Detection of supernumerary tooth in dental anomalies (68.6%) was the most common CBCT indication, while dentigerous cysts (37.6%) were among the most common CBCT indication in bone pathologies and orofacial anomalies (68.1%) in the other category. The most common size was External Center (15 × 15 cm) (27%) and the least common size was Both Arches/small (8 × 8 cm) (0.4%) when the CBCT FOV was analysed.
Although the option of a smaller FOV size was available, the larger FOV size that included the both jaws were most frequently used. When justifying CBCT requests, patient-specific radiation dose risks should be considered and specific guidelines should be followed.
锥形束计算机断层扫描（CBCT）在儿童牙科中的牙颌面诊断中的应用正在扩大，人们对这种成像方式的辐射风险表示担忧，尤其是对儿童而言。牙颌面儿科影像学：针对低剂量辐射诱导风险的研究（DIMITRA）是一个多学科项目，专注于优化儿童和青少年的 CBCT 辐射暴露。本研究旨在阐明与 DIMITRA 建议一致的儿童 CBCT 扫描的适应证。
对于每一次 CBCT 检查，均收集患者 CBCT 检查时的年龄、性别、请求原因、转诊科室、请求 CBCT 扫描的区域以及成像的视野（FOV）尺寸等数据。CBCT 适应证根据 DIMITRA 项目建议进行改编，分为六个标题：阻生牙、牙牙槽外伤、口面裂、牙齿异常、骨病变、综合征。未归类于 DIMITRA 中的适应证记录在“其他”标题下。
最常见的适应证是“其他”类别（34.8%），包括种植体、颞下颌关节功能障碍、口面畸形、异物和根管形态。最不常见的适应证是“口面裂”（1.9%），且没有关于综合征相关病例的请求。在牙齿异常中，发现额外牙（68.6%）是最常见的 CBCT 适应证，而在骨病变和“其他”类别中的口面畸形中，牙源性囊肿（37.6%）是最常见的 CBCT 适应证之一。当分析 CBCT 的 FOV 时，最常见的尺寸是外部中心（15×15 cm）（27%），最小的尺寸是双弓/小（8×8 cm）（0.4%）。
尽管可以选择较小的 FOV 尺寸，但最常使用的是包括上下颌骨的较大 FOV 尺寸。在证明 CBCT 请求时，应考虑患者特定的辐射剂量风险，并遵循特定的指南。
