Radiation dose and image quality in pediatric bitewing imaging

Raheis Rajalingam; Karen Brage; Louise Kjærby Nielsen; Freja Bøgh Eriksen; Helene Hviid Jørgensen; Anne Sofie Mikkelsen; Gitte Schøler; Nejc Mekiš; Maja Bruvo; Helle Precht

doi:10.1093/rpd/ncae227

Radiation dose and image quality in pediatric bitewing imaging

Radiat Prot Dosimetry. 2024 Dec 16:ncae227. doi: 10.1093/rpd/ncae227. Online ahead of print.

Authors

Affiliations

¹ UCL University College, Education of Radiography, Niels Bohrs Allé 1, Odense M 5230, Denmark.
² UCL University College, Health Sciences Research Centre, Niels Bohrs Allé 1, Odense M 5230, Denmark.
³ Varde municipality, Department of Pediatric Dentistry, Lerpoetvej 50b, Varde 6800, Denmark.
⁴ University of Ljubljana, Medical imaging and radiotherapy department, Zdravstvena pot 5, Ljubljana 100, Slovenia.
⁵ University College Absalon, Centre for Engineering and Science, Department of Radiography, Parkvej 190, Naestved 4700, Denmark.
⁶ Lillebelt Hospital, University Hospitals of Southern Denmark, Kolding, Radiology Department, Sygehusvej 1, Kolding 6000, Denmark.
⁷ University of Southern Denmark, Institute of Regional Health Research, Campusvej 55, Odense M 5230, Denmark.

PMID: 39679813
DOI: 10.1093/rpd/ncae227

Abstract

Introduction: Bitewing examinations are used to examine the pediatric dental status. The aim of this study was to compare the image quality and radiation dose between two different X-ray systems used for pediatric bitewing imaging.

Materials and methods: Data were obtained from both pediatric in vivo bitewing studies and phantom studies. Two X-ray systems were used: Trophy CCX digital (TCCX) (Trophy Irix 70, Marne-la-Vallee, France) and Planmeca Pro X (PPX) (Planmeca, Helsinki, Finland). An Unfors dosimeter (Unfors EDD-30, Billdal, Sweden) was used to measure the skin dose. Image quality was evaluated blindly by three experienced dentists using a Likert scale of 1-5 based on the visual representation of the anatomical structures with emphasis on caries.

Results: The highest scoring in vivo bitewing images were obtained with TCCX, but the skin dose was 36% higher (mean 3029 ± 613 μGy) and 113% higher (mean 1364 ± 276 μGy) with standard settings than with compared to PPX. The evaluation of image quality revealed a higher median value for all ratings of TCCX compared to PPX for both the patient and phantom studies, meaning that the images of TCCX were rated as higher quality than the images from PPX. No correlation was found between the median score and the skin dose or between the median score and the exposure times.

Conclusion: A significant difference in radiation dose and image quality was found between TCCX and PPX in bitewing imaging. TCCX generally produced higher doses and better graded images, although all images were suitable for diagnosis.