Abstract
Radiation doses in dentomaxillofacial imaging are typically very low. However, diagnostic
and follow-up protocols in orthognathic surgery result in a patient-specific risk
in effective dose. Estimating the cancer risks from these exposures remains abstract
for many maxillofacial surgeons. In this study, 40 orthognathic patients were randomly
sampled and their cumulative effective dose (ED) calculated. The lifetime attributable
risk of cancer (LAR) was calculated based on the standard radiological protocol for
orthognathic surgery follow-up using methods described in the BEIR VII report and
RadRAT. The mean cumulative ED of the 40 sampled patients at the end of their 2-year
follow-up period was 1.91 ± 0.58 mSv. The LAR at the end of follow-up was 17.65 (90%
confidence interval 6.46–32.90) per 100,000 person-years for male orthognathic patients
and 13.93 (90% confidence interval 6.27–25.24) per 100,000 person-years for female
orthognathic patients. This represents 0.70% and 0.68%, respectively, of the baseline
cancer risk for oral, thyroid, and brain cancer combined. Although theoretical, these
results provide a framework for interpreting radiation doses and cancer risks in patients
undergoing orthognathic surgery. Considering the increased radiation sensitivity in
children and adolescents, indication-oriented and patient-specific imaging protocols
should be advised.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to International Journal of Oral and Maxillofacial SurgeryAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Three-dimensional planning accuracy and follow-up protocol in orthognathic surgery: a validation study.Int J Oral Maxillofac Surg. 2019; 48: 71-76https://doi.org/10.1016/J.IJOM.2018.07.011
- Layered deep learning for automatic mandibular segmentation in cone-beam computed tomography.J Dent. 2021; 114103786https://doi.org/10.1016/J.JDENT.2021.103786
- Comparison between effective radiation dose of CBCT and MSCT scanners for dentomaxillofacial applications.Eur J Radiol. 2009; 71: 461-468https://doi.org/10.1016/J.EJRAD.2008.06.002
- Dosimetry of digital panoramic imaging. Part I: patient exposure.Dentomaxillofac Radiol. 2005; 34: 145-149https://doi.org/10.1259/DMFR/28107460
- Radiobiological risks following dentomaxillofacial imaging: should we be concerned.Dentomaxillofac Radiol. 2021; 5020210153https://doi.org/10.1259/DMFR.20210153
- DIMITRA Research Group. Irradiation provided by dental radiological procedures in a pediatric population.Eur J Radiol. 2018; 103: 112-117https://doi.org/10.1016/J.EJRAD.2018.04.021
- Dental diagnostic X-ray exposure and risk of benign and malignant brain tumors.Ann Oncol. 2013; 24: 1675-1679https://doi.org/10.1093/ANNONC/MDT016
- Dental X-rays and the risk of intracranial meningioma: a population-based case–control study.Cancer. 2004; 100: 1026-1034https://doi.org/10.1002/CNCR.20036
- Dental X-rays and risk of meningioma.Cancer. 2012; 118: 4530-4537https://doi.org/10.1002/CNCR.26625
- A prospective study of medical diagnostic radiography and risk of thyroid cancer.Am J Epidemiol. 2013; 177: 800-809https://doi.org/10.1093/AJE/KWS315
- Dental X-rays and the risk of thyroid cancer: a case–control study.Acta Oncol. 2010; 49: 447-453https://doi.org/10.3109/02841861003705778
- Health risks from exposure to low levels of ionizing radiation.BEIR VII Phase 2. The National Academies Press, Washington, DC2006
- RadRAT: a radiation risk assessment tool for lifetime cancer risk projection.J Radiol Prot. 2012; 32: 205-222https://doi.org/10.1088/0952-4746/32/3/205
- Lifetime attributable risk as an alternative to effective dose to describe the risk of cancer for patients in diagnostic and therapeutic nuclear medicine.Phys Med Biol. 2017; 62: 9177-9188https://doi.org/10.1088/1361-6560/AA959C
- Pediatric cleft palate patients show a 3- to 5-fold increase in cumulative radiation exposure from dental radiology compared with an age- and gender-matched population: a retrospective cohort study.Clin Oral Investig. 2018; 22: 1783-1793https://doi.org/10.1007/S00784-017-2274-0
- Two examples of indication specific radiation dose calculations in dental CBCT and Multidetector CT scanners.Phys Med. 2017; 41: 71-77https://doi.org/10.1016/J.EJMP.2017.03.027
- Absorbed organ and effective doses from digital intra-oral and panoramic radiography applying the ICRP 103 recommendations for effective dose estimations.Br J Radiol. 2016; 8920151052https://doi.org/10.1259/BJR.20151052
Belgian Cancer Register. 〈http://kankerregister.org/〉 [Accessibility verified December 26, 2021].
Eurostat. 〈https://ec.europa.eu/eurostat/〉 [Accessibility verified December 26, 2021].
- Berekening van de Jaarlijkse Gemiddelde Blootstelling Aan Ioniserende Straling in België: Methodologie en Evolutie.Federal Agency for Nuclear Control (FANC/AFCN), Brussels, Belgium2018
- Radiation-related new primary solid cancers in the childhood cancer survivor study: comparative radiation dose response and modification of treatment effects.Int J Radiat Oncol Biol Phys. 2016; 94: 800-807https://doi.org/10.1016/J.IJROBP.2015.11.046
- Estimation of effective dose of dental X-ray devices.Radiat Prot Dosimetry. 2019; 183: 418-422https://doi.org/10.1093/RPD/NCY159
- Linear no-threshold model vs. radiation hormesis.Dose Response. 2013; 11: 480-497https://doi.org/10.2203/dose-response.13-005.Doss
- Automatic 3D dense phenotyping provides reliable and accurate shape quantification of the human mandible.Sci Rep. 2021; 118532https://doi.org/10.1038/s41598-021-88095-w
- Condylar resorption after orthognathic surgery.J Craniofac Surg. 2019; 30: 169-174https://doi.org/10.1097/SCS.0000000000004837
- How accurate is digital-assisted Le Fort I maxillary osteotomy? A three-dimensional perspective.Int J Oral Maxillofac Surg. 2020; 49: 69-74https://doi.org/10.1016/J.IJOM.2019.06.010
- Cone-beam CT in paediatric dentistry: DIMITRA project position statement.Pediatr Radiol. 2018; 48: 308-316https://doi.org/10.1007/S00247-017-4012-9
- Agreement between cone beam computed tomography images and panoramic radiographs for initial orthodontic evaluation.Oral Surg Oral Med Oral Pathol Oral Radiol. 2014; 117: 111-119https://doi.org/10.1016/J.OOOO.2013.10.016
- An in vitro comparison of subjective image quality of panoramic views acquired via 2D or 3D imaging.Clin Oral Investig. 2013; 17: 293-300https://doi.org/10.1007/S00784-012-0698-0
- An optimized imaging protocol for orofacial cleft patients.Clin Exp Dent Res. 2018; 4: 152-157https://doi.org/10.1002/CRE2.123
- ALADAIP, beyond ALARA and towards personalized optimization for paediatric cone-beam CT.Int J Paediatr Dent. 2021; 31: 676-678https://doi.org/10.1111/IPD.12797
Article info
Publication history
Published online: February 15, 2023
Accepted:
February 2,
2023
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2023 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.
