Effect of leaded glasses and thyroid shielding on cone beam CT radiation dose in an adult female phantom.

OBJECTIVES: This study aims to demonstrate the effectiveness of leaded glasses in reducing the lens of eye dose and of lead thyroid collars in reducing the dose to the thyroid gland of an adult female from dental cone beam CT (CBCT). The effect of collimation on the radiation dose in head organs is also examined. METHODS: Dose measurements were conducted by placing optically stimulated luminescent dosemeters in an anthropomorphic female phantom. Eye lens dose was measured by placing a dosemeter on the anterior surface of the phantom eye location. All exposures were performed on one commercially available dental CBCT machine, using selected collimation and exposure techniques. Each scan technique was performed without any lead shielding and then repeated with lead shielding in place. To calculate the percent reduction from lead shielding, the dose measured with lead shielding was divided by the dose measured without lead shielding. The percent reduction from collimation was calculated by comparing the dose measured with collimation to the dose measured without collimation. RESULTS: The dose to the internal eye for one of the scans without leaded glasses or thyroid shield was 0.450 cGy and with glasses and thyroid shield was 0.116 cGy (a 74% reduction). The reduction to the lens of the eye was from 0.396 cGy to 0.153 cGy (a 61% reduction). Without glasses or thyroid shield, the thyroid dose was 0.158 cGy; and when both glasses and shield were used, the thyroid dose was reduced to 0.091 cGy (a 42% reduction). CONCLUSIONS: Collimation alone reduced the dose to the brain by up to 91%, with a similar reduction in other organs. Based on these data, leaded glasses, thyroid collars and collimation minimize the dose to organs outside the field of view.

Significant reduction in dental cone beam computed tomography (CBCT) eye dose through the use of leaded glasses.

OBJECTIVE: In light of the increased recognition of the potential for lens opacification after low-dose radiation exposures, we investigated the effect of leaded eyeglasses worn during dental cone-beam computerized tomography (CBCT) procedures on the radiation absorbed dose to the eye and suggest simple methods to reduce risk of radiation cataract development. STUDY DESIGN: Dose measurements were conducted with the use of 3 anthropomorphic phantoms: male (Alderson radiation therapy phantom), female (CIRS), and juvenile male (CIRS). All exposures were performed on the same dental CBCT machine (Imtec, Ardmore, OK) using 2 different scanning techniques but with identical machine parameters (120 kVp, 3.8 mA, 7.8 s). Scans were performed with and without leaded glasses and repeated 3 times. All measurements were recorded using calibrated thermoluminescent dosimeters and optical luminescent dosimetry. RESULTS: Leaded glasses worn by adult and pediatric patients during CBCT scans may reduce radiation dose to the lens of the eye by as much as 67% (from 0.135 ± 0.004 mGy to 0.044 ± 0.002 mGy in pediatric patients). CONCLUSIONS: Leaded glasses do not appear to have a deleterious effect on the image quality in the area of clinical significance for dental imaging.

Doxycycline effects on serum bone biomarkers in post-menopausal women.

We previously demonstrated that subantimicrobial-dose-doxycycline (SDD) treatment of post-menopausal osteopenic women significantly reduced periodontal disease progression, and biomarkers of collagen destruction and bone resorption locally in periodontal pockets, in a double-blind placebo-controlled clinical trial. We now hypothesize that SDD may also improve biomarkers of bone loss systemically in the same women, consistent with previous studies on tetracyclines (e.g., doxycycline) in organ culture and animal models of bone-deficiency disease. 128 post-menopausal osteopenic women with chronic periodontitis randomly received SDD or placebo tablets daily for 2 years adjunctive to periodontal maintenance therapy every 3-4 months. Blood was collected at baseline and at one- and two-year appointments, and sera were analyzed for bone resorption and bone formation/turnover biomarkers. In subsets of the study population, adjunctive SDD significantly reduced serum biomarkers of bone resorption (biomarkers of bone formation were unaffected), consistent with reduced risk of future systemic bone loss in these post-menopausal women not yet on anti-osteoporotic drugs.

Radiation exposure with the NOMAD portable X-ray system.

OBJECTIVES: A new hand-held battery-operated portable X-ray system was tested for possible leakage radiation through the existing heavy metal compounds surrounding the X-ray tube, backscatter radiation through the lead-filled acrylic shield attached at the end of the exit tube and patient exposure. METHODS: Dose measurements were conducted using a DXTRR phantom and a water phantom. All measurements were recorded using calibrated thermoluminescent dosimetry (TLD), calibrated Unfors Model 583L dosemeter, and a calibrated Radcal MDH model 1015 dosemeter. The settings for all exposure were 60 kVp, 2.3 mA and 0.25 s using Kodak Insight (Class F) film. RESULTS: All backscatter measurements, in front of the shield, behind the shield, at the finger of the operator, the operator's chest, eyes and gonads were significantly below the maximum permissible radiation leakage as per the United States Food and Drug Administration regulations (100 mR h(-1)). Our measurements indicate that the exposure would be well within the occupational maximum permissible dose for an occupationally exposed person. Film dose was consistent with the manufacturer's recommendations. As a result of our measurements, the State of New York Bureau of Environmental Radiation Protection granted us a variance to use the NOMAD on a case-by-case basis. CONCLUSIONS: Our data have shown that the NOMAD presents risks that are no greater than with standard dental radiographic units to the patient or operator and the measured doses are well below recommended levels.

Updated quality assurance self-assessment exercise in intraoral and panoramic radiography. American Academy of Oral and Maxillofacial Radiology, Radiology Practice Committee.

This updated self-assessment exercise for the dental team by the Radiology Practice Committee of the American Academy of Oral and Maxillofacial Radiology is intended to produce the highest quality diagnostic radiographs while keeping patient exposure as low as is reasonably achievable. To continue to provide the best radiographic services to patients, those involved in dental radiography need to be aware of the latest changes and advances in dental radiography and need to use them in their practice.

Causes of excessive bitewing exposure: results of a survey regarding radiographic equipment in New York.

OBJECTIVE: The purpose of this study was to identify the causes of excessive exposure in those dental practices that were found to use exceptionably high levels of radiation in bitewing radiography. STUDY DESIGN: Using the parameters of the Dental Exposure Normalization Technique survey, certified radiation equipment safety officers conducted on-site inspections of 186 intraoral x-ray machines in 77 dental facilities. RESULTS: In 23 facilities, the safety officers identified 43 units (23.1%) that delivered entrance exposures greater than 10% in excess of the upper limit of recommended exposures. For each of 27 (63%) of these units, the cause of the elevated exposure was clearly identifiable. CONCLUSIONS: The factors contributing to increased exposure, listed from most frequent to least frequent, were as follows: improper processing, kilovoltage miscalibration, use of D-speed techniques with E-speed film, use of newly installed units with default timer settings that were too high, exposure timer failure, and insufficient half-value layer. Only 18% of the facilities surveyed reported using E-speed film.

Processor quality assurance using digital imaging.

The purpose of this study was to develop and test a computer imaging method for assessing longitudinal processor variability. A technique called adaptive histogram equalization was used to test deviation in automatic processing when a test film is compared with a time-temperature processed standard at two different kVp's and film speeds. In a 14-day study we found that the density ranges for the standard film did not change, while the density range of the automatically processed films changed by a factor of two. These results suggest that if automatic processing is to be used for films taken as part of a longitudinal study-for example, subtraction-then processor variation can potentially lead to incorrect inference of bone gain or loss.

Dental radiographic exposure normalization program (DENT). The experience in Nassau County, NY.

A Federally sponsored program for reducing unnecessary exposures from dental radiographic procedures is monitored over four years. The results are encouraging.

Survey of radiologic practices among dental practitioners.

The purpose of this study was to determine the factors that influence and contribute to patient exposure in radiologic procedures performed in the offices of 132 staff members within the dental department of a teaching hospital. A questionnaire was prepared in which data were requested on brands of film used, type of x-ray unit used, processing, and use of leaded apron, cervical shield, and film holder. Offices were also visited to evaluate performance of existing dental x-ray equipment. Both the Dental Radiographic Normalizing and Monitoring Device and the Dental Quality Control Test Tool were evaluated. The average exposure was equivalent to the class D film (220 mR), but only 13% of those surveyed used the faster class E film, which would reduce patient exposure in half. The survey indicates that dentists are not using the newer low-exposure class E film in their practices.

Effect of beta-amino-propionitrile on the regenerating newt limb evaluated by uptake of 3H-proline and 3H-lysine.

Newt forelimbs were unilaterally amputated and Beta-amino propionitrile (BAPN) was added to the water in which the newts were maintained. Sixty-three days after amputation, animals were injected with either 3H-proline or 3H-lysine. Forelimbs distal to the elbow of both amputated and non-amputated sides were removed 72 hours later. Uptake of 3H-proline and 3H-lysine in whole limbs was assessed by liquid scintillation and in cartilage cells and matrix by autoradiography. Amputation was a potent stimulus to both collagen formation and maturation during regeneration. BAPN reduced the stimulatory effect of amputation on collagen formation but not on its maturation. Collagen synthesis and maturation are independent events and, in intact non-regenerating limbs, BAPN adversely affected collagen maturation while collagen synthesis was unaltered.

Autoradiographic and liquid scintillation assessment of beta-amino-propionitrile-induced inhibition of collagen maturation using 3H-proline and 3H-lysine.

BAPN (0.1 mg/day) was injected into chick embryos for 4 days starting on the 7th day of incubation. On the 11th day, the embryos were administered either 3H-proline or 3H-lysine. 36 h later, the incorporation of each isotope by the periosteal osteogenic cells as well as into bone matrix was investigated by autoradiography. The incorporation of the two isotopes into whole bones was assessed by liquid scintillation counting. 3H-proline incorporation into the cellular or matrical compartments was unaffected by treatment. As compared to the controls, 3H-lysine label in BAPN-treated embryonic bones was significantly higher in the cellular compartment but was reduced over the bone matrix. The data provide the first direct morphological evidence that BAPN probably induces certain changes in the maturation of collagen involving lysyl residues which result in an inhibition of cross-linkage formation in collagen.

Clinical and radiobiologic features of Thorotrast-induced carcinoma of the maxillary sinus. A case report.

This is a case of Thorotrast-induced carcinoma of the maxillary sinus which was detected inadvertently in the course of investigation of associated dental pain and labial paresthesia. Clinical and radiobiologic features are presented. It is likely that similar cases remain undetected and at large in the community.

The effects of induced lathyrism on Sr85 uptake in rats during late prenatal development.

During the last one-third of their gestational period, lathyritic rats incorporate significantly lower amounts of Sr85 as revealed by whole body counting techniques. This difference was maximum at term. The study provides evidence for lathyritic disturbance in the initial phases of mineralization of hard tissue matrices.