Abstract
<h3>Background</h3> There is substantial evidence for a cumulative dose-related response to ionizing radiation in the form of cancer development years after initial exposure. Therefore, this study focused on effective dose, a quantity with direct correlations to biologic risk from dental x-ray exposures. <h3>Objective</h3> The purpose of this study was to measure doses and to calculate the effective doses (E) resulting from exposure parameters that are used for stationary intraoral tomosynthesis (s-IOT) and conventional imaging for adult posterior bitewing examinations of the dentition. Additionally, this study sought to evaluate the effect of sensor attenuation on patient dose. <h3>Materials and Methods</h3> To meet these aims, a human tissue equivalent adult phantom and optically stimulated luminescent (Landauer, Inc., Glenwood, IL) dosimeters were used to measure dose produced during simulated posterior bitewing examinations (n = 4). Optically stimulated luminescent dosimeters were used to measure x-ray dose at 24 head and neck tissue/organ sites of interest. Dosimetry was acquired by using a tissue equivalent phantom simulating the anatomy of an average adult male (AtomMax Model 711 HN,CIRS Inc., Norfolk, VA). Exposure parameters used were 70 kV/7 mA (0.7 mAs) and 0.12 mAs for s-IOT and conventional (KaVo FOCUS, Charlotte, NC), respectively. Analysis of variance (ANOVA) and Tukey's HSD ("honest significant difference") statistics on dose were utilized to demonstrate significant data relationships. <h3>Results</h3> Effective dose by modality (μSv)ModalityDose (μSv)Rectangular Conventional with Sensor1.1Rectangular Conventional without sensor4.6s-IOT with sensor5.9s-IOT without sensor11.9Circular Conventional with sensor8.2Circular Conventional without sensor15.7 Sensor-present doses were significantly lower than sensor-absent for all modalities (<i>P</i> = .0001). Significant differences in E were found for all modality combinations with the exception of s-IOT sensor-present modalities vs conventional rectangular sensor-absent modalities (<i>P</i> = .0482). <h3>Discussion</h3> Unadjusted s-IOT dose was 26% less than conventional-circular exposures and 61% greater than conventional-rectangular for sensor-absent exposures. Unadjusted sensor-present s-IOT dose was 28% less than conventional-circular exposures and 81% greater than conventional-rectangular exposures. Despite a 4-fold increase in mAs for s-IOT imaging compared with conventional imaging, E from s-IOT imaging was at least 26% less than the current most commonly implemented bitewing technique, conventional-circular, while providing substantially greater diagnostic yield in the form of 3-dimensional (3-D) information.
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