Lower radiation possible when X-raying children with cleft palates
Radiation dose can be reduced when X-raying children with special healthcare needs, such as congenital cleft palate, according to a thesis by a researcher at Malmö University.
In his thesis, Radiographic Examinations in Dental Care for Paediatric Patients with Special Needs, António Vicente at the Faculty of Odontology, started with the idea that children are more sensitive than adults to ionising radiation.
... it turned out that the images with a lower radiation dose were of sufficiently high quality to be able to conduct these post-operative assessments.
António Vicente
This is because children's organs and tissues are still growing and their smaller head size means that, for example, the thyroid gland is more likely to be exposed. In addition, as part of the optimisation process, there is an EU legal requirement to use as little ionising radiation as possible in connection with examinations.
"Children with special care needs often undergo many X-ray examinations, so it is important that we try to minimise the amount of radiation for these patients.”
Vicente took a close look at two groups of paediatric patients – children and adolescents – with the aim of finding ways to reduce radiation in X-ray examinations of the mouth and face. This applies to children born with cleft lip and palate (CLP), and premature babies.
Lower radiation dose than standard
CLP is one of the most common congenital facial malformations (approximately two per 1,000 births) and affected children usually undergo surgery between the ages of nine and twelve – often entailing three-dimensional X-rays (CBCT) both before and after the operation.
In part of his thesis, Vicente developed and tested a CBCT protocol with a lower radiation dose than the standard. This was then used in examinations of patients who had undergone this corrective surgery.
“The higher the radiation dose, the better the image quality. But it turned out that the images with a lower radiation dose were of sufficiently high quality to be able to conduct these post-operative assessments.”
Developed an AI tool
Vicente has also developed an AI tool that, based on CBCT images, can accurately delineate and display the patients' gap area and estimate the amount of bone for future bone grafting; this saves time compared to the same task being performed manually by a dentist.
“This helps to ensure that operations can be performed with greater precision and, in the long run, means better care for these patients,” he says.
Vicente has also reviewed several hundred dental records for premature babies as part of his work. The results showed that these children were not exposed to more radiation in dental care than children born after a full-term pregnancy.
“It is positive that dental care does not contribute to increased radiation exposure for these children. Not least considering that premature babies often undergo many X-ray examinations in healthcare,” says Vicente.
