Metoda imagistica cu fascicul conic – “De ce atata agitatie in legatura cu doza de radiatii?”

Introducere

Cea mai noua metoda imagistica disponibila medicilor dentisti isi exercita rapid impactul. Medicii dentisti generalisti, parodontologii, ortodontii, chirurgii buco-maxilo-faciali si alti specialisti au facut cu entuziasm primii pasi in faza de adoptare a noii metode. 

Evaluarea locului de implantare, a articulatiei temporomandibulare, a problemelor parodontale cu afectarea osului alveolar, a sinusurilor paranazale si aprecierea statusului cailor aeriene sunt doar catev adintre cele mai cunoscute aplicatii curente. Aproape continuu sunt gasite noi aplicatii. Ortodontii folosesc aceasta metoda pentru a identifica „locurile de ancorare” potrivite pentru dispozitivele de ancorare temporara, astfel incat sa li se faciliteze aditional actiunea de deplasare a dintilor sau de captare a dintilor inclusi si aducere a acestora intr-o pozitie favorabila eruptiei. Peste 5 ani, acest tip de metoda imagistica va fi folosit de majoritatea dentistilor. Daca va deveni atat de populara si omniprezenta, ar trebui sa intelegem raportul risc/beneficiu in privinta dozei de radiatii pentru un pacient, in functie de procedura stomatologica pentru care ne este necesara o cantitate atat de mare de informatie radiologica. Prin acest articol imi propun sa clarific cateva „nelamuriri” cu privire la doza de radiatii la care expunem pacientul, pentru a va ajuta pe dumneavoastra, colegii mei, sa luati decizia corecta in legatura cu utilizarea fasciculului conic.

Ghidurile Europene pentru CBCT - partea I

RADIATION PROTECTION: CONE BEAM CT FOR DENTAL AND MAXILLOFACIAL RADIOLOGY
Evidence based guidelines , a report prepared by the SEDENTEXCT project 2011

www.sedentexct.eu

 

The SEDENTEXCT project (2008-2011) is supported by The Seventh Framework Programme of the European Atomic Energy Community (Euratom) for nuclear research and training activities (2007 to 2011) http://cordis.europa.eu/fp7/euratom/.

Neither the European Commission nor any person acting on behalf of the Commission is responsible for the use that might be made of the following information. The views expressed in this publication/document/guidelines are the sole responsibility of the author and do not necessarily reflect the views of the European Commission.

PREFACE 

SEDENTEXCT was a collaborative project that aimed to acquire key information necessary for sound and scientifically based clinical use of Cone Beam Computed Tomography (CBCT) in dental and maxillofacial imaging. In order that safety and efficacy are assured and enhanced in the “real world”, a parallel aim was to use this information to develop evidence-based guidelines dealing with justification, optimisation and referral criteria for users of dental CBCT. The aim of this document is to provide such evidence-based guidelines to professional groups involved with CBCT in dental and maxillofacial imaging, including:

• Dental and Maxillofacial Radiologists
• Dentists working in primary care and their assistants
• Radiographers/ Imaging technicians
• Medical Physicists
• Equipment manufacturers and suppliers

The core guidance in preparing the document has been from the two relevant Council Directives of the European Union:

• Directive 96/29/Euratom, of 13 May 1996, laying down the basic safety standards for the protection of the health of workers and the general public against the dangers arising from ionising radiation (Basic Safety Standards Directive)

• Directive 97/43/Euratom, of 3 June 1997, on health protection of individuals against the dangers of ionising radiation in relation to medical exposure (Medical Exposures Directive).

Beyond these sources, the detailed guidelines have been prepared by systematic review of the currently available literature. No exposure to X-rays can be regarded as completely free of risk, so the use of dental CBCT by practitioners implies a responsibility to ensure appropriate protection. 

This document supersedes the Provisional Guideline document published in May 2009, incorporating new research, including work carried out within the SEDENTEXT project itself. 

Guidelines are not a rigid constraint on clinical practice. Local variations will be required according to national legislation, healthcare provision and practice and the unique clinical circumstances of patients.

I hope that the document will be of help to professional groups and contribute to optimizing the use of ionizing radiation in dental imaging. 

K. HORNER

SEDENTEXCT project Co-ordinator