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Maintaining Image Quality of Pediatric Dental Intra-Oral X-Rays at Substantially Reduced Radiation Dose: Results of a Randomized Trial

E Somasundaram , R Campbell , S Brady , E Gosnell , J Cully , S Specht , K Strauss*, Cincinnati Childrens Hospital Med Ctr, Cincinnati, OH


(Monday, 7/15/2019) 3:45 PM - 4:15 PM

Room: Exhibit Hall | Forum 8

Purpose: The objective of this study was to maintain intra-oral image quality while reducing pediatric patient dose to the lowest level achievable. A longer cone, additional beam filtration, a rectangular collimator, and an appropriately adjusted radiographic technique were investigated to reduce patient dose. For each step of the dose reduction process, an observer study analyzed the impact of dose reduction techniques on image quality.

Methods: This study was designed to objectively score bite-wing intra-oral dental images from patient data based on five relevant image features. The study involved three phases and established: (1) optimal image post-processing settings to display reconstructed bitewing images; (2) the optimal thickness of x-ray filtration; and (3) the optimal acquisition time. Pediatric patient images from a dental clinic in a large academic pediatric hospital were prospectively acquired and randomly chosen for each phase of the observer study. Two-way ANOVA and Tukey’s HSD post-hoc tests were used to analyze the results from the observer studies.

Results: The results from the observer study indicated optimal image quality parameters to display bitewing images acquired using an added Al filter thickness of 1.02 mm with an acquisition time at 250 ms. This resulted in a patient dose reduction of 77% without significant effect to the diagnostic quality of the image.

Conclusion: This observer study verified that image quality was maintained during intra-oral dental imaging while reducing patient KAP to < 25% of its original value.


Dental Radiography, Dose, Observer Performance


IM- X-ray: Radiation dosimetry & risk

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