Manual on Radiation Protection in Hospitals and in General Pract[1]

8/13/2019 Manual on Radiation Protection in Hospitals and in General Pract[1]

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Manual on Radiation Protection

in Hospitals and in General

PracticeVolume 3. Dentistry

Jointly sponsored by CEC / IAEA / ILO/ PAHO/ WHO

Edited by IAEA

VOL 3 JULY 24 vers I!AL A" #ECO!$ P%&e "Co'pressed()*(IAEA(*e'pl%te+do,


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EDITORIAL NOTE

*-e '%teri%l in t-is do,.'ent %s s.pplied by t-e %.t-ors %nd t-e ,ontrib.tors %nd it -%s

been edited+ *-e vies e0pressed re'%in t-e responsibility o1 t-e n%'ed %.t-ors %nd

,ontrib.tors %nd t-e editor %nd do not ne,ess%rily re1le,t t-ose o1 t-e Joint #ponsors+ In

p%rti,.l%r neit-er t-e IAEA nor %ny ot-er or&%ni%tion or body ,o(sponsorin& t-is do,.'ent

,%n be -eld responsible 1or %ny '%teri%l reprod.,ed in t-is do,.'ent+

VOL 3 JULY 24 vers I!AL A" #ECO!$ P%&e 2Co'pressed()*(IAEA(*e'pl%te+do,


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FOREWORD

*-eManual on Radiation Protection in Hospitals and General Practice is 1or

p-ysi,i%ns spe,i%lists .sin& r%di%tion 1or di%&nosis or t-er%py r%dio&r%p-ers or r%diolo&i,%l

te,-nolo&ists 'edi,%l p-ysi,ists 'edi,%l %ssist%nts n.,le%r 'edi,ine te,-nolo&ists r%di%tion

prote,tion o11i,ers %nd s.pervisors %nd %d'inistr%tive personnel orin& -ere t-ey '%y be

e0posed to ioniin& r%di%tion or '%y be responsible 1or t-e e0pos.re o1 ot-ers+ It ill %lso be% .se1.l pr%,ti,%l &.ide 1or p.bli, se,tor %.t-orities %nd t-ose responsible 1or t-e or&%ni%tion

o1 &overn'ent%l servi,es e'ployers %nd orers spe,i%lied r%di%tion prote,tion bodies %nd

s%1ety %nd -e%lt- ,o''ittees+ It is envisioned t-%t e%,- re%der ill need to %,5.ire %t le%st to

vol.'es in t-e series6 Vol.'e " on b%si, r%di%tion prote,tion re5.ire'ents pl.s t-e Vol.'e

de%lin& it- % spe,i1i, %re% o1 interest s.,- %s dentistry di%&nosti, r%diolo&y n.,le%r

'edi,ine or r%diot-er%py+

*-is )%n.%l is % pro1o.nd revision o1 t-e previo.s edition p.blis-ed by WHO d.rin&

t-e period "784("787 in ,o(sponsors-ip it- IAEA %nd ILO+ *-e p.bli,%tion o1 t-is revised

edition %s i'per%tive in vie o1 t-e "779 :e,o''end%tions o1 t-e Intern%tion%l

Co''ission on :%diolo&i,%l Prote,tion %nd t-e p.bli,%tion o1 t-e Intern%tion%l ;%si, #%1ety#t%nd%rds 1or Prote,tion %&%inst Ioniin& :%di%tion %nd 1or t-e #%1ety o1 :%di%tion #o.r,es

ointly sponsored by t-e ood %nd A&ri,.lt.re Or&%ni%tion o1 t-e

United !%tions t-e Intern%tion%l Ato'i, Ener&y A&en,y t-e Intern%tion%l L%bo.r

Or&%ni%tion t-e !.,le%r Ener&y A&en,y o1 t-e Or&%ni%tion 1or E,ono'i, Co(oper%tion

%nd $evelop'ent t-e P%n A'eri,%n He%lt- Or&%ni%tion %nd t-e World He%lt- Or&%ni%tion+

*-e ,ontent o1 e%,- vol.'e is not e0-%.stive b.t is s.11i,ient to provide essenti%l

in1or'%tion+ Vol.'e " provides ne,ess%ry in1or'%tion ,o''on to t-e ot-er 1o.r ,lini,%lly

oriented vol.'es+ Addition%l in1or'%tion spe,i1i, 1or e%,- ,lini,%l %re% is ,ont%ined in t-e

relev%nt vol.'es+ *-e in1or'%tion %s or&%nied syste'%ti,%lly %nd t-e s.b>e,ts -%ve been

presented in t-e s%'e lo&i,%l se5.en,e in e%,- vol.'e+

Volume 1,Basic Protection Requirements bro%dly ,overs s.b>e,ts s.,- %s b%si, prin,iples

o1 r%di%tion prote,tion pl%nnin& %nd or&%ni%tion o1 r%di%tion prote,tion %nd r%di%tion

prote,tion re5.ire'ents in -e%lt- ,%re -e%lt- s.rveill%n,e %nd individ.%l %nd orpl%,e

'onitorin& potenti%l e0pos.res %nd %,,idents %nd ed.,%tion %nd tr%inin&+ In %ddition it

,overs sever%l 1.nd%'ent%l s.b>e,ts t-%t %re t-e s,ienti1i, b%sis 1or r%di%tion prote,tion

e11orts? b%si, r%di%tion p-ysi,s biolo&i,%l e11e,ts o1 ioniin& r%di%tion %nd r%di%tion riss+

Volume 2,Diagnostic Radiology provides spe,i1i, det%ils ,on,ernin& pl%nnin& o1 di%&nosti,

r%diolo&y 1%,ilities r%diolo&i,%l e5.ip'ent desi&n %nd oper%tion roo' desi&n %nd str.,t.r%l

s-ieldin& prote,tion o1 t-e p%tient t-e st%11 %nd t-e p.bli,+ In %ddition it provides det%ils,on,ernin& ed.,%tion %nd tr%inin& typi,%l r%di%tion doses 1or ,o''on e0%'in%tions

esti'%tion o1 p%tient dose 5.%lity %ss.r%n,e %nd &.id%n,e 1or &ood pr%,ti,e %nd lo,%l r.les+

Volume 3, Dentistry provides spe,i1i, in1or'%tion %bo.t dent%l r%diolo&y %nd dent%l

r%di%tion prote,tion+ In,l.ded %re d%t% ,on,ernin& dent%l @(r%y e5.ip'ent desi&n oper%tion

%nd 5.%lity %ss.r%n,e roo' desi&n %nd s-ieldin& prote,tion o1 t-e st%11 t-e p%tient %nd t-e

p.bli,+ Also in,l.ded %re &.id%n,e 1or ed.,%tion %nd tr%inin& %s ell %s 1or &ood pr%,ti,e %nd

lo,%l r.les+

Volume 4, Nuclear medicine provides det%ils ,on,ernin& prote,tion relev%nt to t-e .se o1

r%dion.,lides %nd r%diop-%r'%,e.ti,%ls 1or di%&nosti, i'%&in& %s ell %s 1or r%dion.,lide



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t-er%py+ #pe,i1i, det%ils %re provided %bo.t t-e desi&n %nd or&%ni%tion o1 n.,le%r 'edi,ine

1%,ilities r%dion.,lides %nd e5.ip'ent in di%&nosti, n.,le%r 'edi,ine 5.%lity %ss.r%n,e %nd

r%dion.,lide t-er%py s%1ety iss.es prote,tion o1 p%tients t-e st%11 %nd t-e p.bli,+ *opi,s %lso

in,l.ded %re r%dio%,tive %ste '%n%&e'ent individ.%l %nd orpl%,e 'onitorin&

de,ont%'in%tion potenti%l e0pos.res %nd %,,idents %nd ed.,%tion %nd tr%inin& %s ell %s

&.id%n,e 1or &ood pr%,ti,e %nd lo,%l r.les+

Volume 5,Radiotherapyprovides det%ils ,on,ernin& t-e .se o1 r%dion.,lides %nd r%di%tion

prod.,in& '%,-ines 1or tre%t'ent o1 p%tients by telet-er%py %nd br%,-yt-er%py+ #pe,i1i,

det%ils %re provided %bo.t pl%nnin& %nd or&%ni%tion o1 r%di%tion on,olo&y servi,es

e5.ip'ent desi&n %nd oper%tion roo' desi&n %nd str.,t.r%l s-ieldin& 5.%lity %ss.r%n,e

prote,tion o1 p%tients t-e st%11 %nd t-e p.bli, %nd &.id%n,e 1or &ood pr%,ti,e %nd lo,%l r.les+

;e,%.se quality assuranceis so ,losely lined to r%di%tion prote,tion t-e se,tions on

.%lity Ass.r%n,e e,t+ A is %n indispens%ble p%rt o1 t-e tot%l r%di%tion prote,tion %,tivity in %ll t-e s.b>e,t

%re%s+ :e,o&niin& t-is 1%,t &.idelines 1or 5.%lity %ss.r%n,e in t-e s.b>e,t %re%s o1 t-e

)%n.%l %lso -%ve been p.blis-ed by t-e ,o(sponsors %nd ot-er or&%ni%tions+



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CONTENT

"+ I!*:O$UC*IO! ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7

"+"+ Use o1 dent%l r%dio&r%p-y+ An overvie b%,&ro.nd %nd .pd%ted

in1or'%tion+ +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7

"+2+ *-e !eed 1or :%di%tion Prote,tion in $entistry+++++++++++++++++++++++++++++++++++++++++++""

"+3+ Bener%l or&%ni%tion pl%nnin& %nd 1%,ility desi&n ,onsider%tions o1 $ent%l:%di%tion #ervi,es+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"2

2+ $E!*AL @(:AY EUIP)E!* PE:O:)A!CE A!$ OPE:A*IO!++++++++++++++++"

2+"+ Bener%l ,onsider%tions++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"

2+2+ @(r%y prod.,tion+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"

2+2+"+ $ent%l @(r%y *.bes Bener%tors %nd A,,essories+++++++++++++++++++++++"

2+3+ $ent%l @(r%y e5.ip'ent %nd A,,essories+++++++++++++++++++++++++++++++++++++++++++++++++++++"7

2+3+"+ Intr%or%l


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4+4+ Assess'ent %nd 'et-ods o1 red.,in& p%tient dose+++++++++++++++++++++++++++++++++++++++D

4+4+"+ Pro,ed.res 1or 'ini'iin& dose to p%tients+++++++++++++++++++++++++++++++++D

4+4+2+ #,ope %nd li'it%tions o1 dent%l r%dio&r%p-y


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A!!E@ I+ AVE:ABE A!!UAL !U);E: O $E!*AL @(:AY

E@A)I!A*IO!# A!$ *YPICAL $O#E#++++++++++++++++++++++++++++++++++++++++++72

A!!E@ II+ BUI$A!CE O: BOO$ P:AC*ICE A!$ LOCAL :ULE#++++++++++++++73

II+"+ B.id%n,e 1or $ent%l :%diolo&y in Bener%l Pr%,ti,e++++++++++++++++++++++++++++++++++++73

II+2+ Contin&en,y Pl%n? Bener%l Pr%,ti,e+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++73

II+3+ B.id%n,e 1or % $ent%l @(r%y :oo' in % Hospit%l++++++++++++++++++++++++++++++++++++++++74II+4+ Contin&en,y Pl%n? Hospit%l++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++74

A!!E@ III+ LI#* O PA:A)E*E:# P:OCE$U:E# A!$ EUIP)E!*

:EUI:E$ O: ACCEP*A!CE *E#*I!B O $E!*AL @(:AY

EUIP)E!* A!$ ACILI*IE#++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7

III+"+ Intr%or%l dent%l .nit+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7

III+2+ P%nor%l r%dio&r%p-y .nit+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7

III+3+ Cep-%lost%t++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7

A!!E@ IV+ #HIEL$I!B CALCULA*IO!# *:A!#)I##IO! $A*A A!$ LEA$

EUIVALE!CE O P:O*EC*IVE ;A::IE:# ++++++++++++++++++++++++++++++++78IV+"+ #-ieldin& C%l,.l%tion E0%'ple+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++78

IV+2+ *r%ns'ission $%t%++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"92

IV+3+ Le%d E5.iv%len,e o1 Co''on ;.ildin& )%teri%ls++++++++++++++++++++++++++++++++++"92

A!!E@ V+ :A$IA*IO! P:O*EC*IO! EUIP)E!*+++++++++++++++++++++++++++++++++++++++++"94

A!!E@ VI+ *ECH!IUE AC*O:# A!$ :A$IA*IO! $O#E# O:

I!*:AO:AL :A$IOB:APHY++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"9

A!!E@ VII+ *:AI!I!B *OPIC# A!$ O;JEC*IVE# +++++++++++++++++++++++++++++++++++++++++"98

VII+"+ ;%si, noled&e++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"98VII+2+ #pe,i%l tr%inin& re5.ire'ents in dent%l r%diolo&y+++++++++++++++++++++++++++++++++++"98

:EE:E!CE# O: VOLU)E 3+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"3

CO!*:I;U*O:# *O $:A*I!B A!$ :EVIEW++++++++++++++++++++++++++++++++++++++++++++++++++"3D

:ELA*E$ IAEA PU;LICA*IO!#++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"49



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1! "NTROD#CT"ON

1!1! #se o$ %ental ra%io&ra'(y! )n o*er*ie+, ac-&roun% an% u'%ate% in$ormation!

*-e .se o1 ioniin& r%di%tion in dentistry lie t-%t in &ener%l 'edi,ine %s initi%ted

soon %1ter t-e dis,overy o1 @(r%ys by :oent&en in "D7+ A r%pid &rot- o1 t-is ne i'%&in&

'od%lity by dentists ,%n be d%ted 1ro' "7"3 t-e ye%r o1 Coolid&es invention o1 t-e -ot(,%t-ode @(r%y t.be+ ;y t-e de,%de 1olloin& "739 @(r%ys -%d ,o'e into &ener%l .se in

dentistry


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$ent%l @(r%y e0pos.re red.,tion -%s been do,.'ented in t-e UF %nd in U#A '%inly d.e to

in,re%se .sed o1 re%r e%rt- intensi1yin& s,reens %nd -e%vy 'et%l 1iltr%tion+

#.,- v%st in,re%se in t-e .se o1 @(r%ys in dentistry de'onstr%tes t-e needs 1or t-e

.pd%tin& o1 %lre%dy p.blis-ed %nd develop'ent o1 ne &.idelines %nd re,o''end%tions to

prote,t t-e p%tients p.bli, %nd dentists 1ro' possible -%r'1.l e11e,ts o1 ioniin& r%di%tion %nd

to 'ini'ie t-e r%di%tion e0pos.re o1 t-e individ.%l %nd t-e pop.l%tion %s % -ole+

U!#CEA: 2999

In so'e ,o.ntries t-e %.t-orities s.,- %s E.rope%n Co''ission 1or EC


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$e,isions re&%rdin& t-e .se o1 dent%l r%dio&r%p-y s-o.ld be b%sed on t-e deter'in%tion

o1 need %risin& 1ro' ,lini,%l e0%'in%tion %nd t-e dent%l %nd 'edi,%l -istory o1 t-e p%tient+

*-e de,ision to t%e % dent%l @(r%y depends on t-e pro1ession%l >.d&'ent o1 t-e dentist+ #.,-

>.d&'ent is developed t-ro.&- so.nd tr%inin& e0perien,e %nd ,ontin.in& ed.,%tion+

$i%&nosti, r%dio&r%p-y s-o.ld be li'ited to t-ose inst%n,es in -i,- t-e in1or'%tion is liely

to ,ontrib.te to proper di%&nosis tre%t'ent or prevention o1 dise%se+

:e,o''end%tions 1or pres,ribin& dent%l r%dio&r%p-s -%ve been p.blis-ed e,t to ,lini,%l >.d&'ent %nd '%y not %pply to every p%tient+ *-ey s-o.ld be .sed by

dentists only %1ter reviein& t-e p%tients -e%lt- -istory %nd ,o'pletin& % ,lini,%l

e0%'in%tion+ *-e re,o''end%tions do not need to be %ltered be,%.se o1 pre&n%n,y+

A 5.%lity %ss.r%n,e pro&r%''e s-o.ld be est%blis-ed to ens.re -i&- 5.%lity

r%dio&r%p-i, i'%&es+ *-is ne,ess%rily in,l.des ro.tine 'onitorin& o1 @(r%y &ener%tors

pro,essin& e5.ip'ent %nd pro,essin& sol.tions %nd ,onditions s.,- %s ti'e %nd te'per%t.re

%s ell %s %ll pro,ed.res+ )%inten%n,e s-o.ld be per1or'ed %t re&.l%r interv%ls+

Pr%,titioners s-o.ld st%y in1or'ed o1 ne develop'ents in e5.ip'ent '%teri%ls %ndte,-ni5.es to i'prove r%dio&r%p-i, pr%,ti,es+ !e $ire,t $i&it%l I'%&in& #yste's it-

%de5.%te i'%&e 5.%lity %nd si&ni1i,%tively loer r%di%tion dose ,o'p%red to ,onvention%l

te,-ni5.es %re be,o'in& 'ore %nd 'ore %v%il%ble 1or bot- Intr%or%l %nd P%nor%l

r%dio&r%p-y+

$entists %nd dent%l %ssist%nts s-o.ld p%rti,ip%te in ,ontin.in& ed.,%tion in t-e '%ny

%spe,ts o1 di%&nosti, i'%&in& in dentistry %nd te,-nolo&y+

$eliber%te e0pos.re o1 %n individ.%l to t-e .se1.l be%' in dent%l r%diolo&y 1or tr%inin&

or de'onstr%tive p.rposes s-%ll not be per'itted .nless t-ere is % di%&nosti, need 1or t-e

e0pos.re %nd t-e e0pos.re is pres,ribed by % dentist or p-ysi,i%n+

1!2! T(e Nee% $or Ra%iation .rotection in Dentistry

As 'entioned in vol.'e " t-e p.rpose o1 r%di%tion prote,tion is to prevent t-e

o,,.rren,e o1 deter'inisti, e11e,ts %nd to li'it t-e ris o1 sto,-%sti, e11e,ts+

*-e '%in ob>e,tive is to present % pr%,ti,%l &.ide %s ell %s 'et-ods %nd pro,ed.res 1or

r%di%tion prote,tion in dent%l 1%,ility+

Prote,tion o1 p%tients 1ro' .nne,ess%ry r%di%tion prote,tion o1 dent%l st%11 %ndprote,tion o1 ot-er persons


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3+ $ose li'it%tion

"+ J.sti1i,%tion o1 t-e pr%,ti,e is to prove t-%t t-e net bene1it o1 r%di%tion e0pos.re

o.tei&-s %ny %,,o'p%nyin& ris+

2+ Opti'i%tion o1 t-e prote,tion is to ens.re t-%t t-e tot%l r%di%tion e0pos.re re'%ins %s

lo %s re%son%bly %,-iev%ble t%in& into %,,o.nt so,i%l %nd e,ono'i, 1%,tors Espe,i%lly in dentistry t-e '%in ,on,ern is t-e prote,tion o1 t-e p%tient+ *-e pri'%ry

ob>e,tive is to ens.re t-%t t-e -e%lt- bene1it override t-e p%tient ris 1ro' r%di%tion e0pos.re

%pplyin& 1irst to prin,iples+

or dent%l st%11


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Wit- re&%rd to occu'ational e'osure t-e ;%si, #%1ety #t%nd%rds re5.ire t-e

,l%ssi1i,%tion o1 orpl%,es %s controlle% areasor %nd %s su'er*ise% areas or uncontrolle%

areas e,t to re&.l%tory oversi&-t r%t-er t-%n to

stip.l%te v%l.es+ Hoever dent%l pr%,titioners o1ten or in 'ore t-%n one 1%,ility t-.s it

'%y be %ppropri%te to .se % so.r,e rel%ted dose ,onstr%int %t % level o1 -%l1 t-e dose li'it+

*o b%si, prin,iples '.st be observed -en deter'inin& t-e s-ieldin& re5.ire'ents 1or

% roo' .sed ro.tinely 1or dent%l r%diolo&y+ *-ese %re?

"+ *-e r%di%tion levels in ,ontrolled %re%s %nd s.pervised %re%s t-%t %re o,,.pied

ro.tinely by r%di%tion orers '.st 'eet t-e re5.ire'ents 1or occu'ational

e'osures.,- t-%t no r%di%tion orer re,eives % dose o1 'ore t-%n 29 '#v per

ye%r t%in& in %,,o.nt %ll t-e relev%nt so.r,es+ *-e s.&&ested v%l.e 1or %ose

constraintsis "9 '#v per ye%r+

2+ *-e r%di%tion levels o.tside o1 ,ontrolled or s.pervised %re%s '.st 'eet t-e

re5.ire'ents 1or 'ulic e'osure %nd t-e esti'%ted %ver%&e doses to relev%nt

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,riti,%l &ro.ps o1 'e'bers o1 t-e p.bli, s-%ll not e0,eed " '#v per ye%r+ *-e

s.&&ested v%l.e 1or %ose constraintsis 9+ '#v per ye%r+

In &ener%l r%di%tion levels in t-e i''edi%te vi,inity o1 @(r%y e5.ip'ent %re s.,- t-%t

t-e %bove li'its o.ld be e0,eeded+ :ed.,tion in r%di%tion e0pos.re ,%n be %,,o'plis-ed by

t-e .se o1 % s.it%ble ,o'bin%tion o1 dist%n,e 1ro' t-e so.r,es o1 r%di%tion %nd s-ieldin&

b%rriers+ *-e s-ieldin& re5.ired to red.,e r%di%tion levels to it-in t-e %,,ept%ble li'its '%ybe ,o'p.ted on t-e b%sis o1 dist%n,e '%0i'.' t.be potenti%l


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( be %%re o1 t-e r%di%tion -%%rds %sso,i%ted it- t-eir or %nd o1 t-eir d.ty to prote,t

t-e'selves %nd ot-ers espe,i%lly p%tients

( -%ve % noled&e o1 .se o1 proper te,-ni5.es %nd pro,ed.res to eli'in%te or red.,e to

loest pr%,ti,%l v%l.es %ll .nne,ess%ry p%tient e0pos.res

( be "D ye%rs o1 %&e or older+

Pre&n%nt orers


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2! DENT)7 R) E8#".ENT .ERFOR)NCE )ND O.ER)T"ON

2!1! /eneral consi%erations

All @(r%y i'%&in& syste's -%ve ,ert%in ,o''on 1e%t.res+ @(r%ys %re prod.,ed in %n

@(r%y t.be by %,,eler%tin& ele,trons %,ross % v%,..' %nd %re restri,ted e,t %re re1erred to %

te0tboo on t-e s.b>e,t


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Figure 2.1 Schematic diagram and phtgraph! f a t!pica" statinar! ande #$ra! tu%e.

*-e potenti%l di11eren,e beteen t-e %node %nd ,%t-ode is prod.,ed by %n @(r%y

&ener%tor -i,- is % type o1 tr%ns1or'er+ A tr%ns1or'er ,onsists o1 to sets o1 indin& it-

% ,o''on ,ore+ One o1 t-ese indin&s e,tive o1 1re5.en,y ,onverter '.lti(p.lse


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)ost intr%or%l dent%l @(r%y .nits oper%te %t only one t.be ,.rrent+ Conse5.ently t-e

ti'e %ver%&ed intensity o1 t-e @(r%y be%' is ,onst%nt t-ro.&-o.t t-e @(r%y e0pos.re+ *-.s

t-e only 'e%ns o1 v%ryin& t-e n.'ber o1 @(r%y p-otons in,ident on t-e 1il' is to %d>.st t-e

e0pos.re ti'e


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Figure 2.* T!pes f denta" #$ra! %eam c""imatrs.

*-e ot-er p.rpose o1 t-e ,olli'%tor is to ens.re t-%t dent%l r%diolo&y is per1or'ed %t %

&iven so.r,e


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Focuss-in %istance 29 ,'

"rra%iate% $iel%

2D ,'2

ro.nd N,'

*od%ys 1ield sie vis.%li%tion is per1or'ed by '%n.1%,t.rin& %n open(ended position

indi,%tin& devi,e .st t-e '%ins volt%&e

,o'pens%tion to t-e desired v%l.e indi,%ted on t-e volt 'eter displ%y+

*-e potenti%l di11eren,e .s.%lly ,%lled ilovolt%&e ,ontrols t-e @(r%y ener&ies in t-e

@(r%y be%'+ Loer &ives loer @(r%y ener&y o.tp.t b.t -i&-er sin doses to t-e p%tient %s

ell %s t-e lon&er e0pos.re ti'es %s needed 1or -i&-er ilovolt%&e


21/141

%lloy &ivin& t-e s%'e %tten.%tion %s t-e '%teri%l in 5.estion+ *-e %ddition%l 1iltr%tion in

dent%l e5.ip'ent is .s.%lly %n %l.'ini.' 1ilter %dded to t-e in-erent 1ilter %nd pl%,ed in t-e

p%t- o1 t-e '%in @(r%y be%'+ *-e tot%l per'%nent 1iltr%tion in t-e .se1.l be%' 1or

,onvention%l dent%l @(r%y e5.ip'ent it- % '%0i'.' t.be volt%&e not e0,eedin& s-%ll be

e5.iv%lent to not less t-%n "+ '' Al+ At -i&-er t.be volt%&es %s 1or re&.l%r di%&nosti,

i'%&in& t-e tot%l 1iltr%tion o1 t-e .se1.l be%' s-%ll be e5.iv%lent to not less t-%n 2+ '' o1

Al+ o1 -i,- "+ '' s-%ll be per'%nent+


22/141

C+ ;ite Win&

Figure 2.++ ,htgraphs f intrara" denta" fi"ms. Department f Denta" Radi"g!- Natina"

ni&ersit! /hn F. 0enned!- uens Aires- Argentina

In % 'odern 1re5.en,y ,onverter '.lti(p.lse


23/141

At one ti'e dent%l @(r%y e5.ip'ent %s .sed in -i,- t-e @(r%y t.be %s %,t.%lly

positioned inside t-e 'o.t-+ E0perien,e -%s s-on t-%t t-e .se o1 t-ese intr%or%l t.bes to %n

%ir er'% o1 9+ "+9 By per sin&le e0pos.re %t t-e s.r1%,e o1 t-e t.be

,o'pleted t-e 1.l,r.' position is t-en ,-%n&ed %nd t-e t.be %nd 1il' 'ove %bo.t t-is ne0t

1.l,r.' point+ All t-ree 1.l,r.' points %re .sed in t-e t-ree ,ir,.l%r 'ove'ent e5.ip'ent

-ere%s only to 1.l,r.' points %re .sed 1or to ,ir,.l%r 'ove'ents+

A s,-e'%ti, di%&r%' o1 % rot%tion%l p%nor%l r%dio&r%p-y .nit is &iven in i&.re 2+00+



24/141

Figure 2.++Diagram i""ustrating rtatina" panra" radigraph!.

In %n ellipti,%l p%nor%l r%dio&r%p-y .nit t-e position o1 t-e 1.l,r.' point is

,ontin.o.sly ,-%n&ed t-ro.&-o.t t-e rot%tion o1 t-e @(r%y t.be %nd 1il'+ *-e lo,.s o1 t-e

position o1 t-e 1.l,r.' points 1ollo %n ellipti,%l s-%pe -i,- ,losely 1ollos t-e

%ppro0i'%te position o1 t-e dent%l %r,-es


25/141

Figure 2.++ E""iptica" ,anramic Radigraph!. Institute fr ,anramic Imaging in

Dentistr!- La ,"ata- Argentina

Figure 2.++,htgraphs shing a digita" e""iptica" panra" radigraph! unit. Institute fr

,anramic Imaging in Dentistr!- La ,"ata- Argentina



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Figure 2.++ Digita" ,anramic Radigraph!. Institute fr ,anramic Imaging in Dentistr!-

La ,"ata- Argentina

Us.%lly t-e e0posed %re% is '.,- l%r&er t-%t t-%t o1 t-e di%&nosti, interest+ *-e 'odern

p%nor%'i, e5.ip'ent is no o11erin& %.to'%ti, pro&r%''ed 1ield sie ,%p%bilities+ *-e be%'

-ei&-t %t t-e re,eivin& slit

2.'.2.2. 3epha"metric Denta" #$ra! equipment and Accessries.

Cep-%lo'etri, r%dio&r%p-y %lso non %s teler%dio&r%p-y .s.%lly provides t-e i'%&es

o1 t-e -e%d %nd 1%,i%l str.,t.res %nd p%rt o1 t-e ,ervi,%l spine+ *-e '%in %ppli,%tion is 1or

ort-odonti, tre%t'ent+



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In % ,ep-%lo'etri, @(r%y .nit t-e p%tient is %,,.r%tely %nd reprod.,ibly positioned in %

,r%neost%t+ *-e dist%n,e o1 t-e t.be %nd @(r%y 1il' ,%ssette rel%tive to t-e ,r%neost%t is

st%nd%rdied %nd is typi,%lly "+9 ' or 'ore to %ss.re 'ini'%l &eo'etri,%l distortion to t-e

i'%&e+ :%dio&r%p-s %re t%en .sin& % ,onvention%l @(r%y t.be lined to % &ener%tor+ *-e @(

r%y 1il' ,%ssette is pl%,ed in % -older %t % 1i0ed dist%n,e %%y 1ro' t-e p%tient on t-e side

opposite to t-e @(r%y t.be t-ereby ,%.sin& % s'%ll de&ree o1 '%&ni1i,%tion on t-e r%dio&r%p-+

*o o.tline so1t tiss.e 1%,i%l ,onto.rs 1ilters to red.,e e0pos.re %re re5.ired+

*-e @(r%y be%' 1or ,ep-%lo'etri, r%dio&r%p-y s-%ll be ,olli'%ted o t-e %re% o1 ,lini,%l

interest espe,i%lly l%ter%l ,ep-%lo&r%'s to s-o t-e '%0ill% %nd '%ndible only+

)%n.1%,t.rers '.st in,orpor%te li'itin& devi,e in t-e desi&n to %,,o'plis- t-is re5.ire'ent+

Figure 2.++ ,htgraphs f a mdern and "d 3epha"metric denta" unit.



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Figure 2.++ ,htgraphs and radigraphies f 3epha"metric denta" unit

Figure 2.++ ,htgraph f a Digita" 3epha"metric denta" unit. Institute fr ,anramic

Imaging in Dentistr!- La ,"ata- Argentina.

2.'.2.'. F"urscp! fr denta" use

In dentistry t-e .se o1 1l.oros,opy re%l ti'e i'%&in& is li'ited 1or ev%l.%tion o1

'ovin& %n%to'i, str.,t.re o1 te'poro'%ndib.l%r >oint e,tion o1 ,ontr%sts 1l.ids

1or si%lo&r%p-y+ It re5.ires ele,troni, i'%&e intensi1i,%tion %nd *V 'onitorin& to red.,e

p%tient e0pos.re+ *-is dent%l @(r%y e5.ip'ent is very e0pensive %nd not .s.%lly 1o.nd in

re&.l%r dent%l ,lini,s+

2.'.2.*. Denta" 3T scanner

C* %s ell %s ,onvention%l to'o&r%p-y is ro.tinely .sed in dento('%0illo(1%,i%l

r%dio&r%p-y+ *-e re%l pl%nnin& o1 dent%l i'pl%nt s.r&ery re5.ires to'o&r%p-i, i'%&in& to

ev%l.%te t-e di'ensions o1 t-e potenti%l i'pl%nt sites %nd t-e lo,%tion o1 %n%to'i,%l

str.,t.res+ *-e dose to r%diosensitive or&%ns s.,- %re sin %nd p%rotid &l%nd 1ro' C*

s,%nners is ,onsider%bly -i&-er t-%n t-%t 1ro' ,onvention%l to'o&r%p-y+ *-e dose 1ro' %

VOL 3 JULY 24 vers I!AL A" #ECO!$ P%&e 2DCo'pressed()*(IAEA(*e'pl%te+do,


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ne vol.'etri, C* s,%nner '%n.1%,t.red espe,i%lly 1or dent%l i'pl%nt s.r&ery i'%&in& %s

1o.nd to be %ppro0i'%tely one si0t- o1 t-%t 1ro' tr%dition%l spir%l C*+


30/141


31/141

*-e de&ree to -i,- t-e spe,i1i,%tions %re 'et t-e &.%r%ntees %nd t-e %bility to provide

'%inten%n,e servi,e 1or t-e e5.ip'ent %s ell %s to %ss.re t-e %v%il%bility o1 sp%re p%rts

d.rin& t-e entire .se1.l li1e o1 t-e e5.ip'ent %re %lso very i'port%nt 1%,tors to t%e into

%,,o.nt+

*-e s.pplier s-o.ld %ss.'e t-e responsibility 1or delivery %nd inst%ll%tion o1 t-e

e5.ip'ent %s ell %s -is '%inten%n,e %nd servi,e response poli,y+ *-e vendor s-o.ld&.%r%ntee t-%t t-e %v%il%bility o1 ,riti,%l p%rts t-%t o.ldnt t%e 'ore t-%n one or to d%ys to

re,eive+ All syste' ,o'ponents s-o.ld be ,overed .nder % ,o'pre-ensive one(ye%r %rr%nty+

*r%inin& o1 personnel prior its .se s-o.ld be provided+

2.3.3. &cceptance testing% pre*enti*e and routine maintenance

&cceptance testing

A,,ept%n,e testin& is one o1 t-e 'ost i'port%nt steps o1 t-e p.r,-%sin& pro,ess+ Prior to

t-e e5.ip'ent bein& introd.,ed into ,lini,%l .se %n %,,ept%n,e test s-o.ld be ,%rried o.t+ *-e

essenti%l p%rt o1 t-e %,,ept%n,e test is to deter'ine t-%t t-e e5.ip'ent oper%tes properly

it-in '%n.1%,t.rers te,-ni,%l %&reed per1or'%n,e p%r%'eters


32/141

:o.tine '%inten%n,e or tests s-o.ld be per1or'ed %t desi&n%ted interv%ls %nd 1olloin&

%ny si&ni1i,%nt '%inten%n,e pro,ed.re+ Ide%lly t-is s-o.ld be per1or'ed %t le%st every t-ree

ye%rs


33/141


34/141

A neer type o1 &ro.p(E 1il' e'ploys % ne &r%in te,-nolo&y %lso e'ployed in s,reen(

1il' e'.lsions+ In ,o'p%r%tive st.dies t-is ne &ro.p(E 1il' displ%yed si'il%r ,ontr%st to

&ro.p($ 1il' %nd less v%ri%bility .nder di11erin& pro,essin& ,onditions t-%n t-e initi%l &ro.p(

E 1il' types


35/141

te,-nolo&y+ :e,ently so'e sensors -%ve been developed it- s'%ller pi0el sie %nd it- t-e

.se o1 t-e so(,%lled A,tive Pi0el #ensor e,tions t-e i'%&e re,eptor is positioned intr%or%lly %nd e0posed .sin&

,onvention%l @(r%y di%&nosti, te,-ni5.es+ On,e 1in%lied t-e @(r%y e0pos.re t-e i'%&e is

i''edi%tely di&itied %nd displ%yed on % PC 'onitor %s ell %s stored in 'e'ory+

*-e p-otosti'.l%ble stor%&e p-osp-or pl%te is si'il%r to %n intensi1yin& s,reen+ It is

inserted in % li&-t(ti&-t ,%ssette %nd e0posed .sin& ,onvention%l @(r%y di%&nosti, te,-ni5.es


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Figure 2.## Diagram f 3.3.D. and ,.S.,. Department f Denta" Radi"g!- Natina"

ni&ersit! /hn F. 0enned!- uens Aires- Argentina

2!5! "ma&e acquisition! Film 'rocessin& *ersus %i&ital ima&in&

2... /ilm processing

Attention s-o.ld be p%id to %de5.%te %nd ,onsistent 1il' pro,essin& so %s to prod.,e&ood 5.%lity r%dio&r%p-s %nd to %void t-e repetition o1 t-e e0pos.res+ I'%&e 5.%lity %nd

'ini'.' p%tient e0pos.re depend on proper 1il' pro,essin&+ il' '%n.1%,t.rers indi,%te or

re,o''end t-e pro,essin& ,-e'i,%ls or its e5.iv%lent %nd pro,ed.res '%t,-ed to t-e 1il'

e'.lsion+ Pro,essin& ,-e'i,%ls s-o.ld be 'i0ed to t-e ,orre,t stren&t- re,o''ended by t-e

'%n.1%,t.rers+ P%rti,.l%r %ttention s-o.ld be p%id to t-e pro,essin& ti'e %nd te'per%t.re to

prevent over( or .nder(develop'ent o1 t-e 1il's+ Pro,essin& sol.tions s-o.ld be 1re5.ently

,-%n&ed dependent on t-e 1il' orlo%d+ Pr%,ti,es it- lo 1il' orlo%ds -%ve to 'onitor

t-e developer sol.tion on % re&.l%r b%sis %s .n.sed developer o0idies over % period o1 ti'e

%nd its %,tivity de,re%ses+ I1 it is noti,ed t-%t si&ni1i,%ntly lon&er developer ti'es %re re5.ired

to prod.,e % dent%l 1il' it- %n %,,ept%ble r%n&e o1 densities t-en it is indi,%tive o1 % need to

repl%,e or replenis- t-e developer sol.tion+ *-e develop'ent ti'e re5.ired 1or i'%&e%,5.isition is inversely proportion%l to te'per%t.re %nd need to be %d>.sted 1or e%,- sol.tion+

*-e in%ppropri%te ,o'bin%tion o1 in,re%sed e0pos.re %nd in,o'plete develop'ent res.lts in

p%tient overe0pos.re %s ell %s in de,re%sed i'%&e ,ontr%st %nd 5.%lity+

)%n.%l 1il' pro,essin& s-o.ld be per1or'ed in % &ood d%rroo'+ il' s-o.ld not be

stored in %re%s -ere it '%y be e0posed to ioniin& r%di%tion or ,-e'i,%l 1.'es+ In order to

prevent 1o&&in& o1 t-e e0posed 1il's t-ere s-o.ld be no e0tr%neo.s li&-t enterin& t-e roo'

%nd t-e s%1eli&-t s-o.ld -%ve t-e ,orre,t 1ilter %tt%,-ed+ It is s.&&ested t-%t t-e b%t-s

,ont%inin& t-e v%rio.s ,-e'i,%l sol.tions %re l%id o.t in % lo&i,%l order %nd % ti'er is pl%,ed

,lose to -%nd+ I1 it is not possible to -%ve % roo' dedi,%ted 1or .se %s % d%rroo' t-en it is

possible to .se &love bo0 type '%n.%l 1il' pro,essors -i,- per'it 1il' p%,ets to be

opened in % li&-t proo1 environ'ent+

$edi,%ted dent%l %.to'%ti, 1il' pro,essors %re %v%il%ble %nd re,o''ended+ *-ese

pro,essors -%ve % series o1 t%ns ,ont%inin& t-e sol.tions re5.ired d.rin& pro,essin& in %

se5.enti%l order+ *-e dent%l 1il' is ,onveyed t-ro.&- t-ese t%ns vi% % syste' o1 rollers+

*-ese rollers %lso serve to provide % ,ontrolled %'o.nt o1 %&it%tion+ :eplenis-'ent o1

developer %nd 1i0er sol.tions '%y %lso be per1or'ed %.to'%ti,%lly+ *-ese %.to'%ti, 1il'

pro,essors %re intended 1or .se in % d%rroo'+ Hoever i1 one is not %v%il%ble t-en % &love

bo0 '%y be %tt%,-ed to t-e entr%n,e o1 t-e pro,essor so t-%t 1il' p%,ets '%y be opened in %

d%rened environ'ent+ *-e per1or'%n,e o1 dent%l %.to'%ti, 1il' pro,essors s-o.ld be

'onitored+ It is %lso i'port%nt to ,le%n %nd servi,e t-ese pro,essors on % re&.l%r b%sis+



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il's -i,- '%y be pro,essed in t-eir p%,ets -%ve been re,ently introd.,ed+ In t-ese

so ,%lled 'onob%t- 1il's % ,o'bined developer %nd 1i0er sol.tion is in>e,ted into t-e

e0posed 1il' p%,et+ *-e ,-e'istry is '%n.%lly %&it%ted 1or % spe,i1ied ti'e+ W-ile t-ese

'onob%t- 1il's ,%n be pro,essed it-o.t dedi,%ted d%rroo's or pro,essin& 1%,ilities t-e

pro,essed 1il's 5.i,ly deterior%te -en e0posed to %ir+ *-e sensitivity o1 t-is type o1 1il' is

loer t-%n t-%t 1or E/$(speed 1il' %nd res.lts in -i&-er r%di%tion doses+ *-e i'%&e 5.%lity

%lso '%y not be %s &ood+

il' pro,essin& vers.s di&it%l r%dio&r%p-y+ *-ere %re sever%l %dv%nt%&es o1 dire,t

di&it%l r%dio&r%p-y+ *-e i'%&e '%y be r%pidly %,5.ired %nd in t-e ,%se o1 CC$ re,eptors

displ%yed i''edi%tely+ *-ere is no d%rroo' re5.ire'ent+ *-e i'%&e '%y be ele,troni,%lly

'%nip.l%ted to en-%n,e t-e per,eption o1 ,ert%in 1e%t.res6 -oever t-ere is no in,re%se in

di%&nosti, in1or'%tion ,ontent+ I'%&es %re e%sily stored %nd tr%ns'itted in di&it%l 1or'+

P%tient dose '%y be less t-%n it- ,onvention%l 1il'

( A,,ordin& to previo.sly %,,epted proto,ols

( ;y %de5.%tely tr%ined personnel

( Wit- properly sele,ted %nd 1.n,tionin& e5.ip'ent

( *o s%tis1%,tion o1 p%tient %nd re1err%l dentist

( At s%1e ,onditions %nd %t t-e 'ini'.' ,ost+



38/141

.%lity Control


39/141

vis.%l ,o'p%rison beteen t-e res.lt%nt i'%&e %nd % re1eren,e 1il' ,%n dete,t v%ri%tions in

pro,essin& 5.%lity be1ore t-ey %11e,t p%tient 1il's+ #.,- ,-e,s s-o.ld be '%de %t le%st %1ter

every ,-%n&e o1 pro,essin& sol.tions to ens.re t-%t ,onditions %re s%tis1%,tory be1ore p%tients

1il's %re pro,essed+ )ore 1re5.ent ,-e,s %re pre1er%ble .sted in %,,ord%n,e+

( 1or %.to'%ti, pro,essin& t-e pro,essor s-o.ld be properly ,le%ned %nd '%int%ined+

( pro,essin& sol.tions s-o.ld be ,-%n&ed %t re&.l%r interv%ls %s indi,%ted by ro.tine

( 'onitorin& tests+

(

Ens.rin& r%dio&r%p-s o1 ,onsistently %,,ept%ble 5.%lity


40/141

'ore re%listi, %nd %,-iev%ble st%nd%rd o.ld be 1or e%,- dentist to %,-ieve % 9K red.,tion

in .n%,,ept%ble 1il's %t e%,- s.bse5.ent %.dit session

p.bli,%tions on A %nd C test 'et-ods %nd it is s.&&ested t-%t t-e re%der re1ers to t-ese

'%n.%ls 1or 1.rt-er &.id%n,e


41/141

*-eNatinide,&a"uatin f!$ra! #rends


42/141

3! ROO DE"/N )ND TR#CT#R)7


43/141

O.tside t-ese %re%s t-e r%di%tion levels '.st 'eet t-e re5.ire'ents 1or p.bli,

e0pos.re+ W-en deter'inin& t-e bo.nd%ries o1 %ny ,ontrolled %re% li,ensees %nd re&istr%nts

s-%ll t%e into %,,o.nt t-e '%&nit.de o1 e0pe,ted nor'%l e0pos.res t-e lieli-ood %nd

'%&nit.de o1 potenti%l e0pos.res %nd t-e n%t.re %nd e0tent o1 t-e re5.ired prote,tion %nd

s%1ety pro,ed.res+


44/141

Hoever it is e'p-%sied t-%t t-e %dvi,e o1 % S5.%li1ied e0pert s-o.ld be so.&-t in

de1inin& ,ontrolled %re%s+ #.,- %dvi,e is essenti%l 1or -i&-er orlo%d sit.%tions or 1or

,ep-%lo'etry .nits+

Prote,tive b%rriers ,%n be ,onstr.,ted 1ro' %ny s.it%ble '%teri%l t-i, eno.&- to

provide t-e re5.ired de&ree o1 %tten.%tion+ Le%d is % pop.l%r '%teri%l 1or .se in prote,tive

b%rriers in di%&nosti, r%diolo&y %s it -%s % -i&- %to'i, n.'ber %nd density %nd -en,e is verye11e,tive 1or s-ieldin& @(r%ys in t-e di%&nosti, ener&y r%n&e+ Prote,tive b%rriers ,%n be '%de

1ro' le%d 1%,ed '%teri%ls or le%d s-eet+ ;%ri.' pl%ster '%y %lso be .sed b.t t-ere %re ,ert%in

dis%dv%nt%&es?

( b%ri.' pl%ster ,%nnot be re.sed .nlie le%d6

( it is di11i,.lt to %pply b%ri.' pl%ster to % s.bst%nti%l dept- d.e to s%&&in& o1 t-e pl%ster

.nder its on ei&-t+

)ost b.ildin& '%teri%ls '%y be .sed 1or prote,tive b%rriers+ E0istin& %lls '%y be

in,orpor%ted into prote,tive b%rriers %nd t-e prote,tion %11orded '%y be in,re%sed bys.pple'ent%ry '%teri%ls+ Hoever ,%.tion is re5.ired %s so'e %lls '%y be ,onstr.,ted

1ro' -ollo or lo density b.ildin& '%teri%ls+ *-e le%d e5.iv%len,e o1 e0istin& str.,t.res 1or

t-e @(r%y ener&ies o1 interest s-o.ld be deter'ined i1 t-ere is %ny do.bt %bo.t t-e %de5.%,y

o1 t-e ,onstr.,tion '%teri%ls .sed


45/141


46/141


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#-ieldin& desi&n &o%ls %re e0pressed %s eely v%l.es sin,e t-e orlo%d 1or % 'edi,%l 0(r%y

i'%&in& so.r,e -%s tr%dition%lly .tilied % eely 1or'%t+

In t-e p%st 'ost r%di%tion s-ieldin& desi&ners -%ve .sed !C:P p.bli,%tions &.id%n,e

E11e,tive $ose


48/141

*-e ,%l,.l%tions o1 re,o''ended b%rrier t-i,ness %l%ys %ss.'e perpendi,.l%r

in,iden,e o1 t-e r%di%tion+ I1 not %ss.'ed t-e e11e,t o.ld v%ry in '%&nit.de b.t o.ld

%l%ys be % red.,tion in t-e tr%ns'ission t-ro.&- t-e b%rrier 1or 0 r%ys t-%t -%ve non(

perpendi,.l%r in,iden,e+

#,%ttered r%di%tion is ,re%ted by Co'pton %nd ,o-erent inter%,tions in ob>e,ts str., by

t-e pri'%ry p-otons p%rti,.l%rly t-e p%tient+ #,%ttered r%di%tion is %n .n%void%ble,onse5.en,e o1 t-e pri'%ry be%'+ *-e %ir(er'% r%te d.e to s,%ttered r%di%tion is

proportion%l to t-e pri'%ry be%' %ir(er'% r%te %nd t-e %n&.l%r bre%dt- o1 t-e pri'%ry be%'

%nd inversely proportion%l to t-e s5.%re o1 t-e dist%n,e 1ro' t-e s,%tterin& 'edi.' to t-e

o,,.pied %re%+ *-e dire,tion o1 t-e s,%ttered 0 r%ys is 1%irly r%ndo' it- so'e pre1eren,e to

b%,s,%tterin&+ W-ile t-e s,%ttered p-oton ener&y spe,tr.' is s-i1ted to loer ener&ies %s %

res.lt o1 Co'pton inter%,tions 1or r%di%tion prote,tion p.rposes t-e s,%ttered r%di%tion

spe,tr.' '%y be %ss.'ed to '%t,- t-%t o1 t-e pri'%ry be%'+

*-e s-ieldin& desi&n ,%l,.l%tion o1ten i&nores t-e presen,e o1 '%teri%ls


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ne0t %v%il%ble &re%ter st%nd%rd t-i,ness ill typi,%lly be spe,i1ied+ *-is %dded t-i,ness

provides %n in,re%sed 'e%s.re o1 prote,tion+

*-e 'ini'.' dist%n,e to t-e o,,.pied %re% 1ro' % s-ielded %ll is %ss.'ed to be 9+3

'+ *-is is typi,%lly % ,onserv%tively s%1e esti'%te 1or 'ost %lls %nd espe,i%lly 1or doors+ I1 %

v%l.e 9+3 ' ere %ss.'ed t-e e11e,t o.ld v%ry b.t r%di%tion levels de,re%se r%pidly it-

in,re%sin& dist%n,e+

*-e ,onserv%tively s%1e 1%,tors dis,.ssed %bove ill &ive % si&ni1i,%nt 'e%s.re o1

%ss.r%n,e to t-e s-ieldin& desi&ner t-%t t-e %,t.%l %ir er'% tr%ns'itted t-ro.&- % b%rrier

desi&ned it- t-e 'et-odolo&y &iven in t-is :eport ill be '.,- less t-%n t-e %ppli,%ble

s-ieldin& desi&n &o%l

:%dio&r%p-i, 1il' .sed in dent%l 0(r%y i'%&in& is less sensitive to dire,t r%di%tion

e0pos.re tod%y t-%n in t-e p%st e,ts s.,-

%s t-e i'%&in& -%rd%re %nd le%%&e r%di%tion 1ro' t-e prote,tive -o.sin& o1 t-e 0(r%y t.be+

Asecndar! %arrier is % %ll ,eilin& 1loor or ot-er str.,t.re t-%t ill inter,ept %nd %tten.%te

le%%&e %nd s,%ttered r%di%tions to t-e %ppropri%te s-ieldin& desi&n &o%l+ *-e %ir er'% 1ro'

le%%&e r%di%tion ,%n be esti'%ted by 1irst %ss.'in& t-%t t-e le%%&e r%di%tion intensity it-

no -o.sin& '%t,-es t-%t o1 t-e pri'%ry be%'+ *-e '%&nit.de o1 t-e %ir er'% d.e to s,%ttered

r%di%tion is % 1.n,tion o1 t-e s,%tterin& %n&le t-e n.'ber %nd ener&y o1 pri'%ry p-otons

in,ident on t-e p%tient lo,%tion o1 t-e be%' on t-e p%tient %nd t-e sie %nd s-%pe o1 t-e

p%tient+ It is %ss.'ed t-%t s,%ttered r%di%tion intensity is proportion%l to t-e pri'%ry be%'

%re% %t % dist%n,e 1ro' t-e 1o,%l spot+ *-ese p%r%'eters %re ,onveniently t%en %s t-e i'%&e(

re,eptor %re% %nd t-e so.r,e(to(i'%&e(re,eptor dist%n,e


50/141


51/141

4! .ROTECT"ON OF T


52/141

p%tients sin+ $i%&nosti, re1eren,e levels


53/141

E5.ip'ent %nd %,,essories rel%ted re5.ire'ents %re o1 spe,i%l i'port%n,e in dosered.,tion+ *-e pointed ,one ,olli'%tor -i,- no is not re,o''ended %s ,o''only

s.pplied it- '%ny types o1 old dent%l @(r%y e5.ip'ent+ An open ended ,olli'%tor is

re5.ired by intern%tion%l st%nd%rds %nd s-o.ld be re5.ired no % d%y by %ny re&.l%tory

%.t-orities+ A 1il' -oldin& ,%p%bility is -i&-ly re,o''ended+ *ypi,%l devi,es '%ny o1

-i,- %re ,o''er,i%lly %v%il%ble 1or -oldin& 1il's %re s-on in i&.re 4+"+

i&.re 4+" *ypes o1 1il' -oldin& devi,es+

Figure *.1 T!pes f fi"m h"ding de&ices.

Intr%or%l r%dio&r%p-i, vies %re s-on s,-e'%ti,%lly in i&.re 4+2+

i&.re 4+2 #,-e'%ti, di%&r%'s o1 intr%or%l r%dio&r%p-i, vies+

Figure *.2 Schematic diagrams f intrara" radigraphic &ies.

*%bles


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$osi'etry te,-ni5.es .sin& t-er'ol.'ines,ent dosi'eters in post%l p%,s


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Hoever t-e n.'ber o1 vies re5.ested '%y be 'ore t-%n is needed %nd on ,loser

%n%lysis it '%y be 1o.nd t-%t % n.'ber o1 t-e vies t%en did not ,ontrib.te to t-e di%&nosis

or %11e,t t-e ,o.rse o1 tre%t'ent+ *-is %pplies p%rti,.l%rly to t-e @(r%y e0%'in%tions 1or

1%,i%l in>.ries6 so by ,%re1.l %ssess'ent o1 ,riteri% 1or re5.estin& 1%,i%l vies % syste' o1

sele,tion ,riteri%X ,%n be est%blis-ed+

#ele,tion ,riteri% 1or ,%ries s,reenin& %re e0tre'ely i'port%nt sin,e t-e peri%pi,%l %ndbitein& e0%'in%tions %re prob%bly t-e 'ost 1re5.ent dent%l @(r%y pro,ed.res ,%rried o.t in

&ener%l dent%l pr%,ti,e+ C%ries ris '.st be %ssessed 1or %ll ne p%tients %nd t-en

s.bse5.ently %t re,%ll %ppoint'ent %s ris 1%,tors '%y ,-%n&e in t-e intervenin& period+ ;y

identi1yin& p%tients -o %re %t t-e &re%test ris o1 dent%l de,%y ,lini,i%ns ,%n i'ple'ent

prevention te,-ni5.es to '%int%in lo ,%ries ris st%t.s+

*-e in1or'%tion needed to est%blis- s.,- sele,tion ,riteri% is?

( t-e p%tients ,%ries -istory6

( t-e r%te o1 pro&ression o1 ,%ries in en%'el %nd dentine6

( t-e presen,e or %bsen,e o1 1l.oride in t-e diet or toot-p%ste+

:%dio&r%p-s %re .sed 1re5.ently to 'onitor t-e steps d.rin& t-e pro&ress o1 ,ert%in

tre%t'ents s.,- %s root ,%n%l t-er%py+ @(r%y e0%'in%tion is %lso .sed to 'onitor t-e pro&ress

o1 t-e -e%lin& pro,ess %1ter root ,%n%l tre%t'ent or t-e re'ov%l o1 % lesion it-in t-e >%s+

*-e dentist s-o.ld ,onsider %t -%t st%&e @(r%y e0%'in%tion ill reve%l ,-%n&es t-%t 'i&-t

%lter t-e ,o.rse o1 tre%t'ent+ #pe,i%l ,%re need to be t%en 1or ,-ildren+

#o'e e0%'ples o1 sele,tion ,riteri% %nd iss.es t-%t s-o.ld be ,onsidered -en ,onsiderin&

t-e need 1or % dent%l r%dio&r%p- %re 'entioned belo+

Or%l #.r&ery

Is t-ere %ny bene1it in t-e tr.e o,,l.s%l vie o1 i'p%,ted isdo' teet-6

Vies 1or i'p%,ted isdo' teet-6

Vies 1or .ner.pted '%0ill%ry ,%nines6

Is t-ere %ny bene1it in t-e verte0 o,,l.s%l vie o1 t-e '%0ill%6

ollo(.p o1 -e%lin& ,rypt ,%vities+ Ho o1ten to r%dio&r%p-6

re5.en,y o1 r%dio&r%p-i, e0%'in%tion 1or lesions t-%t tend to re,.r e+&+ er%to,yst

every si0 'ont-s or %nn.%lly

%,i%l In>.ries ( e0%'in%tion in e'er&en,ies

.ll 1%,i%l %nd s.ll s.rvey or >.st one initi%l vie .ntil or%l s.r&eon or ot-er spe,i%list-%s seen t-e p%tient

*e'poro()%ndib.l%r Joints


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Ho o1ten do yo. t%e r%dio&r%p-i, vies to deter'ine pro&ress o1 periodont%l

tre%t'ent

Ort-odonti,s

At -%t %&e do yo. t%e r%dio&r%p-s to deter'ine need 1or ort-odonti,s

$o yo. %l%ys need % r%dio&r%p- to deter'ine t-e need 1or ort-odonti, tre%t'ent

Are ,ep-%lost%t vies %l%ys needed

Are ,ep-%lost%t vies needed %t t-e end o1 tre%t'ent$o yo. need to see t-e -ole s.ll on % ,ep-%lo&r%'

4!3! ?usti$ication an% o'timi0ation o$ 'rotection

a+ 6ustiication o a dental practice

A,,ordin& to t-e ;%si, #%1ety #t%nd%rds .sti1ied by

ei&-in& t-e di%&nosti, bene1its t-ey prod.,e %&%inst t-e r%di%tion detri'ent t-ey 'i&-t

,%.se t%in& into %,,o.nt t-e bene1its %nd riss o1 %v%il%ble %ltern%tive te,-ni5.es t-%t do not

involve r%di%tion e0pos.re+ All @(r%y e0%'in%tions '.st be >.sti1ied on %n individ.%l p%tient

b%sis by de'onstr%tin& t-%t t-e bene1its to t-e p%tient o.tei&- t-e potenti%l detri'ent+

Any @(r%y e0pos.re ent%ils % ris to t-e p%tient+ Under nor'%l ,ir,.'st%n,es t-e ris

1ro' dent%l r%dio&r%p-y is very lo+ !onet-eless it is essenti%l t-%t %ny @(r%y e0%'in%tion

s-o.ld s-o % net bene1it to t-e p%tient ei&-in& t-e tot%l potenti%l di%&nosti, bene1its it

prod.,es %&%inst t-e individ.%l detri'ent t-%t t-e e0pos.re 'i&-t ,%.se+ *-e e11i,%,y

bene1its %nd ris o1 %v%il%ble %ltern%tive te,-ni5.es -%vin& t-e s%'e ob>e,tive b.t involvin&

no or less e0pos.re to @(r%ys s-o.ld be t%en into %,,o.nt+

In order t-%t t-e >.sti1i,%tion pro,ess ,%n be ,%rried o.t it is essenti%l t-%t sele,tion o1

%ppropri%te r%dio&r%p-y is b%sed on t-e individ.%l p%tients -istory %nd % ,lini,%l

e0%'in%tion+ *-e Sro.tine .se o1 r%dio&r%p-y on p%tients b%sed on % &ener%lied %ppro%,-r%t-er t-%n individ.%l pres,ription is .n%,,ept%ble+ A Sro.tine or Ss,reenin& e0%'in%tion is

de1ined %s one in -i,- % r%dio&r%p- is t%en re&%rdless o1 t-e presen,e or %bsen,e o1 ,lini,%l

si&ns %nd sy'pto's+

*-e dentist s-o.ld?

( .estion %ny e0%'in%tion -i,- '%y not be o1 dire,t relev%n,e to t-e p%tientSs ,ondition+

( Consider t-e possibility o1 .sin& %ltern%tive te,-ni5.es -i,- do not involve ioniin&

r%di%tion++

#o'e %ltern%tive 'et-ods to ioniin& r%di%tion it- -i,- to di%&nose ,%ries -%ve %lsobeen developed+ *-ese in,l.de est%blis-ed te,-ni5.es s.,- %s 1ibreopti, tr%nsill.'in%tion


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*-e i'port%n,e o1 >.sti1i,%tion 1or ,-ildren r%dio&r%p-y is espe,i%lly .nderlined+

C-ildren %re s.b>e,t to -i&-er riss 1ro' @(r%y e0pos.re t-%n %re %d.lts+ )%ny ,-ildren see

ort-odonti, tre%t'ent+ W-en s.,- tre%t'ent is ,lini,%lly re5.ired 'ost ,-ildren %re

%ppropri%tely tre%ted %t %ro.nd "2("3 ye%rs o1 %&e %nd ill re5.ire r%dio&r%p-s to ,on1ir' t-e

presen,e %nd ,ondition o1 %ll teet-+

O,,%sion%lly t-ere ill be % need 1or % r%dio&r%p-i, e0%'in%tion %t %n e%rlier %&e-ere t-ere is % serio.s dep%rt.re 1ro' nor'%l dent%l develop'ent or -en % ,-ild %ttends in

p%in or %1ter tr%.'%+

$+ 7ptimi8ation o patient protection in dental !"ray e-posures

Opti'i%tion '%y be s.b(divided into to '%in p%rts t-%t o1 opti'%lly sele,tin& t-e

'ost %ppropri%te e0%'in%tion 1or t-e p%tient %nd t-e opti'i%tion o1 t-e e0%'in%tion itsel1+

*-ere %re % n.'ber o1 %ys to opti'ie e5.ip'ent %nd pro,ed.re oint -en %n i'%&e o1 t-is re&ion

-%s not been sele,ted ,%n -%lve t-e e11e,tive dose+ I'%&in& t-e re&ion o1 ,lini,%l interest %nd

not t-e -ole 'o.t- ill t-ere1ore opti'ie t-is e0%'in%tion+

*-e pro&r%'s %nd e0pos.re p%r%'eters 1or to typi,%l p%nor%l dent%l @(r%y .nits %re

s-on in *%ble 4+"+ *-e res.ltin& or&%n doses %re s-on in *%ble 4+2 %nd t-e e11e,tive doses

%re s-on in *%ble 4+3


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Ta%"e *.2 Organ dses frm panramic radigraph! ('1).

*%ble 4+3 C%l,.l%ted e11e,tive doses 1ro' p%nor%'i, r%dio&r%p-y e,ted to .nne,ess%ry r%diolo&i,%l

e0%'in%tions %nd -en % r%diolo&i,%l e0%'in%tion is re5.ired6 p%tients s-o.ld be prote,ted

1ro' .nne,ess%ry e0pos.re d.rin& t-e e0%'in%tion+

In %ddition to t-e eli'in%tion o1 .nne,ess%ry @(r%y e0%'in%tions it is i'port%nt t-%t %

ne,ess%ry e0%'in%tion be per1or'ed it- &ood te,-ni5.e+ It is possible 1or e0%'ple to

obt%in % series o1 di%&nosti,%lly(%,,ept%ble r%dio&r%p-s %nd -%ve t-e p%tient e0pos.re v%ry

idely be,%.se o1 di11eren,es in te,-ni5.e 1%,tors %nd 1il's .sed+ It is t-e responsibility o1

t-e oper%tor %nd dent%l pr%,titioner to be %%re o1 t-is %nd to no -o to ,%rry o.t %

pres,ribed e0%'in%tion it- t-e loest possible e0pos.re to t-e p%tient+ P%rti,.l%r ,%re

s-o.ld be t%en d.rin& e0%'in%tions o1 ,-ildren -o %re ,onsidered to be 'ore %t ris

be,%.se o1 lon&er li1e e0pe,t%n,y %nd -ose ,riti,%l or&%ns %re ,loser to t-e r%di%tion so.r,e+

4.4.2. 5cope and limitations o dental radiography (32+.

An @(r%y &ener%tor '%y be desi&ned to per1or' 'ore t-%n one o1 t-e b%si, types o1

dent%l r%dio&r%p-y+ $ent%l @(r%y e0%'in%tions %re 1re5.ently re1erred to %s intr%or%l


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r%dio&r%p-y %nd ,ep-%lo'etry=+ #o'e types o1 @(r%y &ener%tors intended pri'%rily 1or

'edi,%l r%dio&r%p-y %re %lso .sed 1or dent%l r%dio&r%p-y+ *-is is espe,i%lly tr.e 1or st%tion%ry

s.ll(vie r%dio&r%p-y %nd spe,i%l p.rpose to'o&r%p-i, r%dio&r%p-y %s ell %s C* s,%nners

it- spe,i%l so1t%re+

'ntraoral radiography

*-e @(r%y so.r,e is positioned e0tr%or%lly %nd t-e i'%&e re,eptor is positionedintr%or%lly 1or % st%tion%ry pro>e,tion+ *-is type o1 e5.ip'ent is .sed 1or peri%pi,%l bitein&

%nd o,,l.s%l r%dio&r%p-y+

*-e p.rpose o1 intr%or%l r%dio&r%p-y is to %,-ieve %n i'%&e o1 % toot- %nd its s.rro.ndin&

%lveol%r bone it- t-e loest possible r%di%tion dose t-%t does not %dversely %11e,t t-e

di%&nosis+ *-e p%r%llelin& te,-ni5.e s-o.ld be pre1erred to t-e bise,tin& %n&le te,-ni5.e 1or

'ost di%&nosti, t%ss+ #o'e %dv%nt%&es %re?

( 'ore %,,.r%te reprod.,tion o1 t-e '%r&in%l bone level

( 'ore %,,.r%te ,%ries di%&nosis p%rti,.l%rly re,.rrent ,%ries

( less distortion o1 t-e i'%&e( less &eo'etri, .ns-%rpness

( 1%,ilit%tes periodi, identi,%l e0pos.res

( -e%d post.re irrelev%nt

( no 1in&er dose -en 1il'(-olders .sed less sin dose+

,-traoral radiography

.anoral equi'ment

*-e @(r%y so.r,e %nd t-e i'%&e re,eptor 'ove e0tr%or%lly %bo.t t-e p%tients -e%d to

,re%te % ,o'bined to'o&r%p-i, %nd s,%no&r%p-i, pro>e,tion o1 t-e or%l(1%,i%l re&ion+

*-e 'ost ,o''on e0tr% or%l r%dio&r%' in dentistry is t-e p%nor%'i, r%dio&r%p-+ *-is

p%nor%'i, r%dio&r%p- o11ers % &ood s.rvey o1 teet- %nd >%s b.t its de1inition is in1erior to

re&.l%r dent%l 1il's+ :e,ent te,-nolo&y in t-is 1ield -%s i'proved 5.%lity b.t in p%rti,.l%r in

t-e in,isor re&ion i'%&e 5.%lity is o1ten poor+ A,,ordin& to t-e i'%&in& prin,iples o1

p%nor%'i, r%dio&r%p-y % l%yer it- % li'ited t-i,ness is depi,ted+ #tr.,t.res %t % dist%n,e

1ro' t-e ,entr%l pl%ne s-o % ,ert%in %'o.nt o1 bl.r %nd distortion+

or better di%&nosti, v%l.e t-e p%nor%'i, r%dio&r%p-s '%y need to be s.pple'ented

it- intr%or%l 1il's 1or 1iner det%ils %nd spe,i1i, e0tr% or%l pro>e,tions+

Ce'(alometric equi'ment

*-e @(r%y so.r,e %nd t-e i'%&e re,eptor %re positioned e0tr%or%lly 1or % st%tion%ry

pro>e,tion+ *-is type o1 pro>e,tion '%y in,l.de t-e ,o'plete s.ll or '%y only i'%&e %

li'ited re&ion o1 interest+ *-e need 1or spe,i%l e0%'in%tions lie ,ep-%lo'etri, r%dio&r%p-s

spe,i1i, te'poro('%ndib.l%r >%s


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4.4.3. ,quipment and accessories technical parameters in patient dose reduction

*.*.'.1. #$ra! generatin and set parameters (5;- mA- time)

*-e t.be potenti%l


61/141

*-e e0pos.re s-o.ld be ter'in%ted %.to'%ti,%lly -en % predeter'ined ,ondition s.,-

%s % pre(set ti'e -%s been %tt%ined+ or ,onvention%l dent%l r%dio&r%p-y t-e '%0i'.' r%n&e

o1 t-e e0pos.re ti'er s-o.ld not e0,eed 1ive se,onds+ *-e ti'er s-%ll be ,%p%ble o1

,onsistently reprod.,in& t-e s-ort e0pos.re ti'es needed 1or -i&-(speed 1il'+ *-e e0pos.re

sit,- s-%ll -%ve % ,ir,.it(,losin& ,ont%,t -i,- ,%n be '%int%ined only by ,ontin.o.s

press.re+ It s-%ll not be possible to '%e repe%t e0pos.res it-o.t rele%se o1 t-e e0pos.re

sit,- e,t o1

interest is %n obvio.s 'e%ns o1 li'itin& dose to p%tients+ Li'itin& be%' %re% on t-e sin

VOL 3 JULY 24 vers I!AL A" #ECO!$ P%&e "Co'pressed()*(IAEA(*e'pl%te+do,


62/141

s.r1%,e %lso li'its t-e vol.'e o1 t-e p%tient t-%t is irr%di%ted+ As ell %s S1ield sie on t-e

p%tients sin bein& i'port%nt t-e @(r%y so.r,e to sin dist%n,e pl%ys % role in li'itin& doses+

;e,%.se o1 t-e diver&en,e o1 t-e @(r%y be%' in,re%sin& t-is dist%n,e red.,es t-e diver&en,e

it-in t-e p%tient %nd t-ere1ore red.,es t-e vol.'e irr%di%ted+

*-e %li&n'ent is depend%nt .pon oper%tor sill+ or ,onvention%l dent%l r%dio&r%p-y %

1ield(de1inin& sp%,er ,one provides % 'ini'.' 1o,.s sin dist%n,e o1 29,' 1or e5.ip'entoper%tin& %bove 9V %nd "9,' 1or e5.ip'ent oper%tin& %t 9V or belo+ Open(ended

,ylinders or diver&ent ,ones %nd re,t%n&.l%r ,ones %re pre1er%ble to pointed ,ones -i,-

prod.,e s,%tter r%di%tion+

#-ort pointed sp%,er ,ones ere on,e 1%vored be,%.se t-e ,oni,%l s-%pe %lloed % less

obstr.,ted vie o1 1il'/teet- rel%tions-ip %nd provided % vis.%l indi,%tion o1 t-e ,entr%l r%y+

Hoever in t-e l%st 29 ye%rs 'ost dent%l intr%or%l sets -%ve been '%n.1%,t.red it- %n open(

ended PI$ o1 9 '' di%'eter+ A ,ir,.l%r be%' o1 t-is sie is "3K l%r&er in %re% t-%n %

,onvention%l dent%l 1il'


63/141

i&.re 4+3 E11e,t on sin e0pos.re o1 %lterin& t-e 1o,.s(1il' dist%n,e %s %nd

t-e teet-+ Hoever t-e e0posed %re% is 1re5.ently 1%r in e0,ess o1 t-%t o1 di%&nosti, interest+

$entists -%d no 1%,ility 1or red.,in& t-e %re% irr%di%ted+ Hoever sever%l .nits no o11er

pro&r%''ed 1ield(sie tri''in& %s % 'e%ns o1 red.,in& p%tient dose+ ield li'it%tion ,%n

si&ni1i,%ntly red.,e p%tient e0pos.re -en spe,i1i, di%&nosti, in1or'%tion is re5.ired+

!e e5.ip'ent s-o.ld be provided it- %.to'%ti, sele,tion o1 be%' li'it%tion%lt-o.&- '%n.%l sele,tion is %,,ept%ble+ *-e be%' -ei&-t %t t-e re,eivin& slit or se,ond%ry

,olli'%tor s-o.ld be restri,ted to no &re%ter t-%n t-%t re5.ired to e0pose t-e %re% o1 di%&nosti,

interest %nd ,ert%inly no &re%ter t-%n t-e 1il' e,t %s % tot%l intr%or%l e0%'in%tion .d&'ent %s to t-e ind %nd e0tent o1 @(r%y e0%'in%tion

needed to prod.,e t-e re5.ired in1or'%tion to di%&nose or tre%t % p%rti,.l%r dent%l p%tient+

Cep-%lo'etry or teler%dio&r%p-y prod.,es i'%&es o1 t-e entire -e%d %nd '.,- o1 t-e

,ervi,%l spine+ Hoever t-e %re% o1 interest to ort-odontists .s.%lly stops %t t-e level o1 t-e

b%se o1 t-e s.ll+ L%ter%l ,ep-%lo&r%'s s-o.ld be ,olli'%ted to li'it t-e 1ield to t-e %re%

re5.ired 1or di%&nosis+



64/141

E5.ip'ent 1or ,ep-%lo'etry s-o.ld -%ve % li&-t be%' di%p-r%&' or ot-er s.it%ble

'e%ns 1or ,on1inin& t-e .se1.l be%' to t-e %re% o1 di%&nosti, interest+

A ;ritis- Ort-odonti, #o,iety orin& p%rty s.pported t-e ,on,ept o1 red.,tion o1

l%ter%l ,ep-%lo&r%' dose by t-e .se o1 'odi1ied ed&e ,olli'%tion to re'ove p%rt o1 t-e s.ll

1ro' di%&nosti, %re%


65/141

#tri,t %ttention s-o.ld be p%id to ,orre,t %nd ,onsistent 1il' pro,essin& so %s to prod.,e

&ood 5.%lity r%dio&r%p-s %nd %void t-e ne,essity 1or e0%'in%tions to be repe%ted+ *-e

te'per%t.re o1 t-e developer s-o.ld be ,-e,ed prior to 1il' pro,essin& %nd t-e develop'ent

ti'e %d>.sted in %,,ord%n,e it- t-e 1il' '%n.1%,t.rers instr.,tions+ *-e developer s-o.ld

be ,-%n&ed %t le%st on,e per 'ont-+ .%lity ,ontrol .stin& t-e ,ontr%st %nd bri&-tness to opti'ie t-e visibility o1 t-e re&ion

o1 interest e,t r%te


66/141

be%' d.rin& dent%l r%dio&r%p-y+ ;e,%.se people .nder %&e 39 %re %t &re%ter ris o1 r%di%tion

ind.,ed t-yroid ,%n,er t-%n older individ.%ls so'e -%ve %r&.ed t-%t t-yroid s-ieldin&


67/141

i'%&in& espe,i%lly in ,%ses involvin& bone &r%1ts %nd in t-ose in -i,- t-ere %re '.ltiple

potenti%l i'pl%nt sites+ In t-ese ,%ses C* -%s been re,o''ended+

Wit- t-e e0,eption o1 re1or'%tted ,o'p.ted to'o&r%p-y e,tions %re '%&ni1ied+ *-e '%&ni1i,%tion 1%,tor '.st be derived %nd %ny %ssess'ents o1

%v%il%ble bone -ei&-t '.st be ,%l,.l%ted -%vin& t%en t-is 1%,tor into ,onsider%tion+

)%&ni1i,%tion 1%,tors ,%n be derived by .se o1 % re1eren,e ob>e,t in t-e s%'e pl%ne %s t-e%lveol.s+

W-en i'%&in& .sin& eit-er ,onvention%l or ,o'p.ted to'o&r%p-y to &ener%te ,ross(

se,tion%l i'%&es proposed i'pl%nts sites %nd/or to'o&r%p-i, l%nd'%rs s-o.ld be identi1ied

.sin& s.r&i,%l stents ,onsistin& o1 'et%l rods b%lls or r%diop%5.e '%rers+

Convention%l to'o&r%p-y is obt%ined eit-er 1ro' dedi,%ted so1t%re in,orpor%ted into

p%nor%'i, e5.ip'ent or 1ro' spe,i1i,%lly desi&ned @(r%y '%,-ines 1or i'pl%ntolo&y+ *-e

l%tter ,o'prises '.lti'od%l syste's .sin& n%rro be%' r%dio&r%p-y %nd spir%l to'o&r%p-y+

Usin& -ypo,y,loid%l or spir%l ,onvention%l to'o&r%p-y t-e %bsorbed doses tor%diosensitive or&%ns %re belo 9+2 'By+ $oses 1ro' C* ,%n be ,onsider%bly -i&-er it-

1or e0%'ple '%0i'.' doses o1 3D 'By %nd 3"'By bein& 'e%s.red %t t-e sin s.r1%,e %nd

t-e p%rotid &l%nd respe,tively %lt-o.&- 'et-ods 1or red.,ed doses 1ro' -eli,%l C* -%ve %lso

been de'onstr%ted


68/141

*-e dentist .s.%lly sees eit-er verb%l or i'plied ,onsent 1ro' t-e p%tient+ *-e l%tter

relies .pon % p%tient not %,tively re1.sin& t-e r%dio&r%p-+ I'plied ,onsent is not s%tis1%,tory

%s it does not %llo 1or t-e &%t-erin& o1 in1or'%tion t-%t 'i&-t in1l.en,e -et-er t-e

r%dio&r%p- is ne,ess%ry


69/141

'%0i'%lly e0posed individ.%ls ill nor'%lly be e'ployees o1 t-e 1%,ility itsel1 or residents or

e'ployees o1 %n %d>%,ent 1%,ility+ O,,.p%tion%lly e0posed st%11 '%y be %ss.'ed to spend

t-eir entire or period in ,ontrolled or s.pervised %re%s+ *-ere1ore %re%s s.,- %s 0(r%y

roo's %nd ,ontrol boot-sshu"dbe desi&ned it- %n o,,.p%n,y 1%,tor o1 one+

*-e interior sp%,es o1 .nrel%ted o11i,es or b.ildin&s %d>%,ent to t-e 0(r%y 1%,ility t-%t

%re not .nder t-e ,ontrol o1 t-e %d'inistr%tor o1 t-e 0(r%y 1%,ility shu"d nor'%lly be,onsidered %s 1.lly o,,.pied %,ent roo' %nd 'y t-ere1ore be 'ore i'port%nt in s-ieldin&

desi&n despite t-e l%r&er dist%n,es involved+

4..4. :se actors

*-e .se 1%,tor


70/141

*%ble +2

;%rrier Use %,tor


71/141

'.ltiplied by %ver%&ed 'illi%'pere(se,onds per 1il' %nd t-%n divided by 9 ill yield t-e

orlo%d in 'illi%'pere('in.tes per ee+

In p%nor%'i, r%dio&r%p-y % n%rro slit(lie .se1.l be%' irr%di%tes % rel%tively s'%ll

p%rt o1 t-e -e%d %t %ny one ti'e+ *-e %'o.nt o1 s,%ttered r%di%tion o1 t-e p%tient is rel%tively

less t-%n t-%t o1 '.ltiple peri%pi,%l 1.ll 'o.t- e0%'in%tions+ *-e dire,tion o1 t-e be%' is

1i0ed to point t-e %pert.re o1 t-e i'%&e(re,eptor -oldin& devi,e t-%t -%s % pri'%ry b%rrierbe-ind t-e i'%&e re,eptor+ *-e .se1.l be%' tresp%sses only t-e p%tient %re% to be e0%'ined

%nd doesnt strie ot-er ob>e,t t-%n only se,ond%ry b%rriers to be t%in& into %,,o.nt+ #o'e

%.t-ors


72/141

Vol.'e

Intr%or%l

89

79

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399 9

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79

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p%nor%'i,

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p%nor%'i,

9 9

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p%nor%'i,

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%*-e intr%or%l orlo%d %ss.'es % sin&le(p-%se %ve1or' %nd t-%t % 49 ,' ,one is .sed+ I1 i'%&e

re,eptors -%vin& % speed di11erent 1ro' t-ose &iven in *%ble +3 %re .sed t-e orlo%d s-o.ld be

s,%led by t-e r%tio o1 t-e 1il' or i'%&e re,eptor speeds+ or inst%n,e orlo%d s-o.ld be do.bled 1or

$(speed 1il'+ or % ,onst%nt(potenti%l %ve1or' t-e te,-ni5.e 1%,tor


73/141

A r%di%tion b%rrier o1 t-i,ness acco1 '%teri%l m is %,,ept%ble -en t-e tot%l %ir

er'% %t % point beyond t-e b%rrier is e5.%l to or less t-%n t-e %ppropri%te s-ieldin& desi&n

&o%l

be-ind % b%rrier o1 t-i,ness + to t-e %ir er'% %t t-e s%'e lo,%tion it- no intervenin&

r%di%tion b%rrier+ An %,,ept%ble b%rrier t-i,ness


74/141

Figure *. ++. ,rimar! and secndar! %arriers prtecting a persn at , (,) frm direct and

scattered radiatin frm patien

*r%ns'ission ;


75/141

*%bles 3++2+" to 3++2+4 1ro' !C:P "4 1or sin&le(p-%se %nd ,onst%nt potenti%l .nits

%re t-e res.lts o1 t-ese ,%l,.l%tions b%sed on ,onserv%tive %ss.'ptions+ or le%%&e r%di%tion

t-e t.be ,.rrent is %ss.'ed to be "9 'A re&%rdless o1 V res.ltin& o1 %n e11e,tive le%%&e

,.rrent o1 9+ 'A+ Ho.sin& le%%&e is %ss.'ed to 'eet t-e st%nd%rd %t t-e -i&-est V+ *-e

s,%ttered r%di%tion %re% is %ss.'ed to be 4 ,'2 %nd -e dist%n,e to s,%ttered vol.'e is

%ss.'ed to be 49 ,'+ *-e s,%ttered %n&le is %ss.'ed to be 79 de&rees+

*-ese *%bles s-o t-e t-i,ness re5.ired 1or pri'%ry %nd se,ond%ry


76/141

re,eive % r%di%tion e0pos.re in e0,ess o1 % relev%nt dose ,onstr%int+ In %ddition 'onitorin& o1

,ert%in ,riti,%l &ro.ps '%y be re5.ired+

Co'pre-ensive r%di%tion s.rveys %t v%rio.s ti'es s-o.ld be per1or'ed by % 5.%li1ied

e0pert in r%di%tion prote,tion -o ill .s.%lly be % 'edi,%l p-ysi,ist or % -e%lt- p-ysi,ist+

*-ese s.rveys ill ,onsist o1 % ,o'bin%tion o1 % vis.%l inspe,tion o1 t-e 1%,ility %nd r%di%tion

'e%s.re'ents+ *-e r%di%tion prote,tion s.rveys '.st be ,ond.,ted it- %ppropri%te,%libr%ted r%di%tion 'e%s.rin& e5.ip'ent prior to t-e ,o''issionin& %nd ,lini,%l .se o1 ne

%nd 'odi1ied @(r%y 1%,ilities+

Approv%l ill be b%sed on ,o'pli%n,e it- relev%nt le&isl%tive re&.l%tions %nd desi&n

,riteri%+ A st%te'ent o1 %pprov%l s-o.ld be ritten %nd % re,ord o1 t-e r%di%tion prote,tion

s.rvey res.lts '%int%ined+ Any ite' o1 non(,o'pli%n,e it- t-e re&.l%tions or desi&n

,onstr%ints s-o.ld be noted+ I1 ne,ess%ry t-e 5.%li1ied e0pert s-o.ld re,o''end %ppropri%te

,orre,tive 'e%s.res s.,- %s %n in,re%se in t-e t-i,ness o1 % prote,tive b%rrier %nd % res.rvey

s-o.ld be per1or'ed to veri1y t-%t t-e ,orre,tive 'e%s.res %re %de5.%te+

:%di%tion prote,tion s.rveys d.rin& t-e pl%nnin& %nd ,onstr.,tion st%&e

At t-e pl%nnin& st%&e t-e 5.%li1ied e0pert in r%di%tion prote,tion s-o.ld be provided

it- t-e %r,-ite,t.r%l det%ils o1 t-e @(r%y 1%,ility to&et-er it- %n indi,%tion o1 t-e orlo%d+

*-e e0pert '%y need to visit t-e ne @(r%y 1%,ility d.rin& its ,onstr.,tion+ *-e e0pert ,%n

'onitor t-e ,onstr.,tion o1 t-e roo' %nd veri1y t-%t no de1e,ts in s-ieldin& -%ve been

introd.,ed d.rin& t-e or+ or e0%'ple essenti%l servi,e d.,ts ill be visible d.rin&

,onstr.,tion %nd t-eir i'p%,t on r%di%tion prote,tion ,%n be %ssessed+ Also t-e overl%p

beteen le%d s-eets %nd ot-er ,onstr.,tion '%teri%ls t-e prote,tion provided %t re,esses in

s-ieldin& %nd ot-er ,onstr.,tion det%ils ,%n be inspe,ted+ I1 %ny r%di%tion prote,tion

proble's %re dis,overed it is .s.%lly '.,- e%sier to re,ti1y t-e' d.rin& ,onstr.,tion r%t-er

t-%n l%ter+

It '%y be desir%ble to ,-e, p-ysi,%lly t-e le%d e5.iv%len,e o1 prote,tive b%rriers %s

b.ildin& pl%ns


77/141

*-e r%di%tion prote,tion s.rvey s-o.ld reve%l %ny potenti%l proble's+ Hoever it is

not %l%ys possible to predi,t r%di%tion doses to individ.%ls 1ro' t-e res.lts o1 t-is s.rvey+ It

is t-ere1ore i'port%nt to .ndert%e %n environ'ent%l or

'odi1i,%tions s-o.ld be tre%ted %s % ne inst%ll%tion+ *-e 5.%li1ied e0pert ill be %ble to

provide de1initive &.id%n,e on t-e need %nd type o1 %ddition%l s.rveys+

V%rio.s e5.ip'ent(rel%ted %spe,ts o1 r%di%tion prote,tion s-o.ld be ,-e,ed on %n

%nn.%l b%sis %s t-e e5.ip'ent '%y develop de1e,ts+ Ite's s.,- %s interlo,s or %rnin&

li&-ts s-o.ld be in,l.ded in t-is ,%te&ory+ Also % ne environ'ent%l s.rvey o.ld be

%rr%nted i1 t-ere ere si&ni1i,%nt ,-%n&es in r%diolo&i,%l pro,ed.res or % s.bst%nti%l in,re%se

in p%tient orlo%d+



78/141

5! .ROTECT"ON OF T)FF )ND /ENER)7 .#67"C

5!1! /eneral consi%erations

*-e ;%si, #%1ety #t%nd%rds


79/141

*-e !C:P 1ro' U#A %lso reports t-%t t-e 'e%n dose re,eived by dent%l orers is 9+2

'#v/ye%r

"imits %e nt e+ceededB

(a) an effecti&e dse f 2C mS& per !ear a&eraged &er fi&e cnsecuti&e !ears

(%) an effecti&e dse f 6C mS& in an! sing"e !ear

(c) an equi&a"ent dse t the "ens f the e!e f 16C mS& in a !ear and

(d) an equi&a"ent dse t the e+tremities (hands and feet) r the s5in1f 6CC mS& in a!ear.

Pre&n%nt orers

In dent%l r%diolo&y it is liely t-%t t-e '%>ority o1 dent%l %ssist%nts ill be 1e'%le %

si&ni1i,%nt proportion o1 -o' ill be o1 ,-ildbe%rin& %&e+ Conse5.ently t-e e0pos.re o1

pre&n%nt orers '.st be &iven spe,i%l ,onsider%tion+

A,,ordin& to t-e ;%si, #%1ety #t%nd%rds


80/141

Bood r%di%tion prote,tion oper%tion%l pro,ed.res %nd e5.ip'ent desi&n s-o.ld ens.re

t-%t t-e r%di%tion doses re,eived by st%11 orin& in dent%l r%diolo&y %re ell belo %ny dose

li'it+ An%lysis o1 personnel 'onitorin& res.lts in 'ost 1%,ilities ill .s.%lly indi,%te t-%t

st%11


81/141

s-eets &yps.' %llbo%rd ,on,rete steel or ot-er s.it%ble '%teri%l+ As it %s 'entioned

be1ore it is in t-e e,ono'i, best interest o1 t-e dentists to obt%in s-ieldin& desi&n by %

5.%li1ied e0pert %t t-e e%rly be&innin&+

;%rriers s-%ll be ,onstr.,ted in t-e %y t-%t oper%tor ,%n '%int%in vis.%l ,ont%,t %nd

,o''.ni,%tion it- p%tients t-ro.&-o.t t-e pro,ed.re+

In dent%l r%diolo&y e'p-%sis is pl%,ed on t-e provision o1 s-ieldin& %t t-e so.r,e o1 @(

r%ys+ *-.s dent%l @(r%y t.be -o.sin& -%s -i&- %tten.%tion '%teri%ls pl%,ed %ro.nd it %nd

in,orpor%ted in t-e t.be -e%d desi&n+ :ed.,tion o1 st%11 doses in t-is '%nner is very e11i,ient+

#t%11 per1or'in& dent%l r%diolo&y '%y be iss.ed le%d %prons to e%r i1 t-ere is no le%d

prote,tive s-ield


82/141

(Fig.6.2 (TITLEGGG))

*i'e

#t%11 s-o.ld %lso be %%re t-%t t-ey '%y red.,e t-eir r%di%tion dose i1 t-ey ,%n

'ini'ie t-e ti'e to -i,- t-ey %re e0posed to r%di%tion+ Bood orin& pr%,ti,e ens.res t-%t

bot- t-e n.'ber o1 persons e0posed to r%di%tion %nd t-e ti'e o1 t-eir e0pos.re is ept to %

'ini'.'+ *-e %void%n,e o1 repe%t r%dio&r%p-s ill %lso 'ini'ie e0pos.re+

5!4! Ra%iation 'rotection sur*ey

*-is is %n ev%l.%tion done by 5.%li1ied e0pert o1 potenti%l r%di%tion e0pos.re 1ro' t-e

.se o1 dent%l 0(r%y e5.ip'ent .nder spe,i1i, ,onditions o1 p%rti,.l%r inst%ll%tion+ *-e p.rpose

o1 1%,ility s.rvey is to %sses t-e r%di%tion prote,tion 1e%t.res provided in t-e desi&n %nd

,onstr.,tion o1 t-e roo' it- dent%l 0(r%y e5.ip'ent+ *-e st%rtin& point is t-e revie o1 t-e

ori&in%l desi&n+ *-e 1%,ility s.rvey s-o.ld indi,%te t-e lo,%tion o1 t-e 0(r%y e5.ip'ent

p-ysi,%l s%1e&.%rds s.,- %s ,ontrol boot-s 'ov%ble s-ields t-e de&ree o1 o,,.p%n,y o1 %ll

%re% %d>%,ent to 0(r%y roo' %nd ,l%ssi1i,%tion o1 individ.%l e0posed o,,.p%tion%lly or

nono,,.p%tionlly+ *-e res.lts o1 t-ese 'e%s.re'ents %t v%rio.s lo,%tions t-%n need to be,o'p%red it- e0pe,tin& or li'it levels+ Appropri%te r%di%tion dete,tion instr.'ent%tion need

to be sele,ted 1or t-e dent%l 0(r%y 1%,ility+ *-ese s.rveys '%y be per1or'ed it- % sensitive

ele,troni,%lly re%d instr.'ent s.,- %re l%r&e vol.'e -i&-(press.re &%s ioni%tion s.rvey

'eters


83/141

t-e p%tients


84/141

Cep-%lo'etri, r%dio&r%p-y prod.,es i'%&es o1 t-e entire -e%d %nd '.,- o1 t-e ,ervi,%l

spine+ *-e %re% o1 interest .s.%lly stops %l t-e level o1 t-e b%se o1 t-e s.ll %nd is .s.%lly

'.,- s'%ller t-%n t-e i'%&e re,eptor+ L%ter%l ,ep-%lo&r%'s s-o.ld be ,olli'%ted to li'it t-e

1ield to t-e %re% re5.ired 1or di%&nosis+ Cep-%lost%t is b%sed on % 1i0ed 0(r%y so.r,e(p%tient(

i'%&e re,eptor rel%tions-ip typi,%lly %t t-e dist%n,e o1 "+9 'eters or 'ore+ #o only

se,ond%ry b%rrier s-ieldin& is re5.ired+

5!;! O'timi0ation o$ ra%iation 'rotection

#t%11 doses '%y be 'ini'ied by t-e %ppli,%tion o1 t-e pro,ess o1 ,onstr%ined

opti'i%tion+ + *-e dose ,onstr%int ill be dependent on lo,%l ,ir,.'st%n,es %nd ill be

in1l.en,ed by t-e type o1 e0%'in%tions per1or'ed e5.ip'ent prote,tive devi,es %v%il%ble

%nd t-e orlo%d+ In &ener%l st%11 doses in dent%l r%diolo&y '%y be red.,ed by %ppli,%tion o1

si'ple r%di%tion prote,tion 'e%s.res+

Bood orin& pr%,ti,es s.,- %s t-ose des,ribed in t-e &.id%n,e 1or &ood pr%,ti,e %nd

lo,%l r.les


85/141

to be orn %t t-e -e%d or on t-e -%nds or .nderne%t- prote,tive ,lot-in& so t-%t t-e dose to

,riti,%l or&%ns or t-e e11e,tive dose '%y be %ssessed+

!o sin&le te,-ni5.e is %ppli,%ble in %ll inst%n,es o1 individ.%l 'onitorin&+ It is

i'port%nt t-%t te,-ni5.e ,-osen be ,%p%ble o1 re&isterin& % ide r%n&e o1 doses it- %n

%,,ept%ble %,,.r%,y+

*-ere %re 1o.r '%in types o1 personnel dosi'etry syste's?

"= il' ;%d&e

2= *-er'ol.'ines,ent dosi'etry


86/141

e11e,tive dose+ )et-ods 1or %ssess'ent o1 e11e,tive dose %re dis,.ssed in det%il in


87/141

%s % dent%l s.r&ery+ In t-e l%tter inst%n,e t-e %lls ill not -%ve been desi&ned 1or .se %s

r%di%tion b%rriers+ I1 it is possible t-e pri'%ry be%' s-o.ld be dire,ted %t e0istin& s.bst%nti%l

%lls


88/141

t-e %nn.%l p.bli, dose li'it 1or e0%'ple by %pplyin& % dose ,onstr%int -i,- is belo t-e

dose li'it !


89/141

;! ED#C)T"ON )ND TR)"N"N/

;!1! Dental 'ro$essional e%ucation an% trainin&! /eneral remar-s

All personnel involved it- t-e o,,.p%tion%l .se o1 r%di%tion so.r,es re5.ire b%si, %nd

,ontin.in& ed.,%tion %s ell %s tr%inin& in r%di%tion prote,tion %nd s%1ety+ #.,- tr%inin&

s-o.ld be %n inte&r%ted p%rt o1 t-eir &ener%l pro1ession%l ed.,%tion+

A,,ordin& to t-e ;%si, #%1ety #t%nd%rds %s+ *-e re'%inin&

spe,i%lties %re pedodonti,s


90/141

*-e r%n&e o1 topi,s to be tre%ted in tr%inin& ,o.rses v%ries idely %,,ordin& to t-e type

o1 tr%inees t-eir level o1 noled&e %nd t-e 1.t.re d.ties+ A b%si, tr%inin& pro&r%''e is

des,ribed in Anne0 8


91/141

;!4! .ost&ra%uate trainin& an% researc(

#t.dents o1 dentistry %s ell %s pr%,ti,in& dentists s-o.ld be &ener%lly noled&e%ble

%bo.t '%tters pert%inin& to dent%l r%diolo&y %nd p%rti,.l%rly ell in1or'ed %bo.t t-ose

%spe,ts o1 dent%l r%diolo&y relev%nt to t-e spe,i%lty t-ey -%ve ,-osen to pr%,ti,e+ ;ot-

te,-ni,%l %nd interpret%tive sills '%y be %,5.ired %s % '%tter o1 ne,essity 1ro' %ny %v%il%ble

so.r,e+ Br%d.%te st.dents -o -%ve ,-osen to spe,i%lie in dent%l r%diolo&y itsel1 s-o.ld be%%re t-%t t-is %re% o1 st.dy interrel%tes it- '%ny ,lini,%l %nd b%si, s,ien,e %re%s+ In

%ddition to % -i&- de&ree o1 ,o'peten,e in dent%l r%diolo&y t-e &r%d.%te st.dent s-o.ld -%ve

% re%son%bly t-oro.&- .nderst%ndin& o1 t-e perip-er%l ,lini,%l %nd b%si, s,ien,e s.b>e,ts 'ost

,losely %llied it- t-e te,-ni,%l %nd interpret%tive p-%ses o1 dent%l r%diolo&y+

Addition%lly it is -i&-ly desir%ble t-%t t-e &r%d.%te in dent%l r%diolo&y s-o.ld be

1%'ili%r it- rese%r,- desi&n 'et-odolo&y %nd investi&%tion %nd -%ve p%rti,ip%ted %t le%st to

% li'ited de&ree in rese%r,- %,tivity+

A b%si, r%di%tion s%1ety ,o.rse 1or st%11 o.ld in,l.de t-e 1olloin& topi,s?

"+ Introd.,tion ( *-e n%t.re o1 r%di%tion !%t.r%l %nd )%n('%de so.r,es o1 ioniin&

r%di%tion

2+ :%di%tion .nd%'ent%ls ( C-%r%,teristi,s o1 ioniin& r%di%tion Inter%,tion o1 r%di%tion

it- '%tter

3+ ;%si, prin,iples o1 Person%l %nd #.rvey Instr.'ents ( $oe/dose r%te 'e%s.re'ents (

Instr.'ent ,%libr%tion

4+ :%di%tion E0pos.re ( )%&nit.des %nd Units o1 r%di%tion e0pos.re %nd dose

+ ;iolo&i,%l e11e,ts o1 ioniin& r%di%tion ( #to,-%sti, %nd $eter'inisti, E11e,ts :is

rel%ted to e0pos.re in t-e orpl%,e

+ O,,.p%tion%l %nd P.bli, E0pos.re $ose Li'its ( O,,.p%tion%l r%di%tion e0pos.re %nd

ris+ e00pos.re o1 o'en o1 reprod.,tive ,%p%,ity t-e ALA:A Prin,iple8+ :%di%tion Prote,tion ( ;%si, prin,iples o1 r%di%tion prote,tion? ti'e dist%n,e %nd

s-ieldin& :esponsibilities o1 e'ployees %nd o1 t-e instit.tion W%rnin& si&ns %nd

l%bellin& :e&.l%tory %nd li,ens.re re5.ire'ents

#o'e o1 t-ese topi,s %lso ,o.ld be .sed %s % b%sis 1or % tr%inin& pro&r%' 1or %n,ill%ry st%11

%nd ot-er in,ident%l orers+

VOL 3 JULY 24 vers I!AL A" #ECO!$ P%&e 7"Co'pressed()*(IAEA(*e'pl%te+do,


92/141

)NNE "! )VER)/E )NN#)7 N#6ER OF DENT)7 R) E)"N)T"ON

)ND T."C)7 DOE

In1or'%tion ,on,ernin& %ver%&e %nn.%l n.'ber o1 dent%l @(r%y e0%'in%tions per "999

pop.l%tion %nd t-e esti'%tes o1 'e%n %bsorbed dose %nd e11e,tive dose e5.iv%lent -i,- ere

p.blis-ed by U!#CEA: in its 2999 report


93/141

)NNE ""! /#"D)NCE FOR /OOD .R)CT"CE )ND 7OC)7 R#7E

#ee EC A!!E@ 2

*-e 1olloin& e0%'ples o1 lo,%l r.les -i,- -%ve been .pd%ted %nd revised 1ro' t-e

previo.s version o1 t-is )%n.%l .sti1i,%tion+

2= *-e dire,t be%' '.st not irr%di%te %ny person ot-er t-%n t-e p%tient bein& r%dio&r%p-ed+

3= W-enever possible t-e dent%l 1il' s-o.ld be 'e,-%ni,%lly 1i0ed in position ot-erise it

s-o.ld be -eld by t-e p%tient+ It s-o.ld never be -eld by t-e dentist or st%11+ I1 %nyone is

re5.ired to s.pport % p%tient or 1il' d.rin& %n e0pos.re?

%= % prote,tive %pron '.st be orn %nd t-e dire,t be%' %voided by st%ndin& to one side

%%y 1ro' t-e @(r%y t.beb= A re,ord s-o.ld be '%de in t-e noteboo provided o1 t-e individ.%ls n%'e t-e

d%te t-e n.'ber o1 e0pos.res %nd t-e r%dio&r%p-i, te,-ni5.e .sed+

4= W-en '%in& %n e0pos.re t-e st%11 s-o.ld st%nd %s 1%r %%y 1ro' t-e p%tient %s possible

to %void t-e r%di%tion t-%t is s,%ttered in %ll dire,tions+ I1 it is ne,ess%ry to be %s ne%r %s

one 'etre % prote,tive %pron s-o.ld be orn+

= *-e p%tient s-o.ld be prote,ted by % prote,tive %pron


94/141

*-e oper%tor is %dvised to est%blis- t-e lo,%tion o1 t-e ele,tri,%l poer sit,- be1ore .sin& %

&ener%tor+

""!3! /ui%ance $or a Dental ray Room in a


95/141

)NNE """! 7"T OF .)R)ETER, .ROCED#RE )ND E8#".ENT

RE8#"RED FOR )CCE.T)NCE TET"N/ OF DENT)7 R) E8#".ENT

)ND F)C"7"T"E

"""!1! "ntraoral %ental unit

.arameters Frequency

"+ *.be potenti%l ,%libr%tion A/3A/!

2+ *.be o.tp.t %nd ,onsisten,y A/3A/!

3+ E0pos.re or te,-ni5.e sele,tor ti'er %,,.r%,y A/3A/!

4+ H%l1 v%l.e l%yer !

+ ;e%' sie %nd %li&n'ent A/3A/!

+ o,.s sin dist%n,e A/3A/!

8+ Le%%&e r%di%tion A/3A/!

D+ Pro,essin& $/A/!

7+ o,%l spot sie !

"9+ I'%&e 5.%lity A/3A/!

E5.ip'ent? $ent%l post p%,

( !on(inv%sive t.be potenti%l divider %nd os,illos,ope+

( Penetr%'eter+

( Ele,tro'eter %nd ioni%tion ,-%'ber+

( Ali&n'ent/1o,.s sin dist%n,e >i&+

( E0pos.re ti'er


96/141

E5.ip'ent? Penetr%'eter+

( !oninv%sive t.be potenti%l divider %nd os,illos,ope+

( Ele,tro'eter %nd ioni%tion ,-%'ber+

( E0pos.re ti'er


97/141

)NNE "V!


98/141

W-en t-is v%l.e is .sed %s t-e ordin%te in i&.re A4+2


99/141

*-.s in t-e e0%'ple sin,e t-e ne%rest sie o1 ,o''er,i%lly %v%il%ble le%d is 9+87 ''


100/141

Usin& t-e v%l.es &iven %bove in t-e 1or'.l% s.&&ested by IC:P yields % v%l.e 1or ;

o1 2+ "9(2'By/'A 'in+

"99 tr%ns'ission o1 % b%rrier is &iven by?

!T;T lo&"9WL*

d2P

* is t-e o,,.p%n,y 1%,tor+ P is t-e dose ,onstr%int %nd d is t-e dist%n,e in 'etres 1ro' t-e

so.r,e o1 le%%&e


101/141

Usin& % v%l.e o1 'A 1or t-e '%0i'.' r%ted ,ontin.o.s t.be ,.rrent %s s-on in

*%ble A4+3


102/141

#in,e t-e le%%&e r%di%tion is %t le%st %s -i&- %n ener&y %s t-e pri'%ry be%' t-e pri'%ry

be%' %tten.%tion ,.rve o1 i&.re A4+2 '%y be .sed to obt%in t-e b%rrier t-i,ness -i,- in

t-is ,%se is 9+2 '' o1 le%d+

W-en s-ieldin& 1or s,%tter %nd le%%&e r%di%tion ,o'bined < -i,- is t-e .s.%l

sit.%tion= t-e IC:P re,o''end%tion is t-%t i1 t-e b%rrier t-i,nesses 1or s,%tter %nd le%%&e

di11er by t-ree tent-( v%l.e t-i,nesses or 'ore only t-e t-i,er b%rrier v%l.e s-o.ld be .sed6i1 -oever t-ey di11er by less t-%n one tent-(v%l.e t-i,ness t-e t-i,er b%rrier v%l.e s-o.ld

be .sed %nd one -%l1(v%l.e t-i,ness s-o.ld be %dded to it+

In t-is e0%'ple b%rrier ,%l,.l%tion % v%l.e o1 9+2 '' o1 le%d is needed 1or prote,tion

%&%inst s,%tter %nd 9+2 '' o1 le%d is needed 1or prote,tion %&%inst le%%&e+ *-ese di11er by

less t-%n one tent-(v%l.e t-i,ness %nd t-.s %,,ordin& to t-e IC:P re,o''end%tion one -%l1(

v%l.e t-i,ness


103/141

*%ble A4+ t%en 1ro' IC:P


104/141

)NNE V! R)D")T"ON .ROTECT"ON E8#".ENT

Person%l Prote,tion

Le%d r.bber prote,tive %prons+

Le%d r.bber &loves+

W-ole body dosi'eters


105/141

)NNE V"! TEC


106/141

*%ble A+ *ypi,%l e0pos.re ti'es


107/141

)NNE V""! TR)"N"N/ TO."C )ND O6?ECT"VE

*-e r%n&e o1 topi,s to be tre%ted in tr%inin& ,o.rses v%ries idely %,,ordin& to t-e types

o1 tr%inee t-eir level %nd re5.ired %ppli,%tion o1 noled&e %nd t-eir 1.t.re d.ties+ A

syll%b.s o1 % b%si, tr%inin& pro&r%''e is listed belo?

V""!1! 6asic -no+le%&e

%= :%diolo&i,%l p-ysi,s

b= :%di%tion dete,tors

,= :%di%tion dose %nd dosi'etry

d= :%di%tion biolo&y

e= :%di%tion p%t-olo&y

1= In,idents = .%lity %ss.r%n,e %nd 5.%lity ,ontrol

= .%lity ,riteri% 1or t-e r%dio&r%p-i,

Documents

Manual on Radiation Protection in Hospitals and in General Pract[1]