Mendonça Rafael Pereira de, Estrela Carlos, Bueno Mike Reis, Carvalho Teresa Cristina Alves Silva Gonzalez, Estrela Lucas Rodrigues de Araújo, Chilvarquer Israel
Universidade de São Paulo, School of Dentistry, Oral Diagnosis, Dental Radiology, and Imaging Department, São Paulo, Brazil.
Universidade Federal de Goiás - UFG, School of Dentistry, Stomatologic Science Department, Goiânia, GO, Brazil.
Braz Oral Res. 2025 Feb 7;39:e14. doi: 10.1590/1807-3107bor-2025.vol39.014. eCollection 2025.
This study carried out a critical review of the principles of radioprotection, including the ALARA, ALADA, and ALADAIP principles. The Google Scholar and PubMed databases were the search resources, and the following keywords were searched: Linear No-Threshold (LNT); Biologic Effects of Ionizing Radiation (BEIR VII); As Low As Reasonably Achievable (ALARA); As Low As Diagnostically Acceptable (ALADA); As Low As Diagnostically Acceptable, being Indication-oriented and Patient-specific (ALADAIP). This critical review included studies with historical references, reviews, position papers, and clinical and experimental studies. Regarding data extraction, only original articles were selected after the screening process. Much of the current evolution of X-ray machines and radioprotection protocols has stemmed from legitimate concerns about this topic. This development has grown out of the relevant work of organizations like ICRP, UNSCEAR, and other renowned international organizations. Low doses of radiation, such as those used for diagnosis, also occur naturally and are present in everyday life. Although there is no agreement on the actual risk involving low doses, the recommendations of ALARA, ALADA, and ALADAIP prevail, in line with the trend to uphold principles that balance the importance of X-ray diagnostic imaging with the intention of keeping the doses as low as possible. The benefits of X-ray exams, when justified, tend to outweigh the low risks attributed to them.
本研究对辐射防护原则进行了批判性综述，包括尽可能合理达到低水平（ALARA）、诊断可接受的最低水平（ALADA）以及针对特定指征和患者的诊断可接受的最低水平（ALADAIP）原则。以谷歌学术和PubMed数据库作为检索资源，并检索了以下关键词：线性无阈（LNT）；电离辐射的生物学效应（BEIR VII）；尽可能合理达到低水平（ALARA）；诊断可接受的最低水平（ALADA）；针对特定指征和患者的诊断可接受的最低水平（ALADAIP）。该批判性综述纳入了具有历史参考文献的研究、综述、立场文件以及临床和实验研究。关于数据提取，在筛选过程后仅选择原始文章。当前X射线机和辐射防护协议的许多发展都源于对该主题的合理关注。这种发展源于国际辐射防护委员会（ICRP）、联合国原子辐射效应科学委员会（UNSCEAR）等组织以及其他知名国际组织的相关工作。低剂量辐射，如用于诊断的辐射，也自然存在于日常生活中。尽管对于低剂量辐射的实际风险尚无定论，但ALARA、ALADA和ALADAIP的建议仍然适用，这与秉持平衡X射线诊断成像重要性与尽可能降低剂量意图的原则的趋势一致。在合理的情况下，X射线检查的益处往往超过其带来的低风险。
