臺灣牙醫診所放射線設備及攝影技術之調查

Investigation into Radiographic Equipment and Imaging Techniques of Dental Clinics in Taiwan

陳木熊(Mu-Hsiung Chen)；高誌廷(Chih-Ting Kao)；茅美貞(Men-Chen Mao)；林淑琦(Shu-Chi Lin)；戴美華(Mei- Hua Tai)；徐春仕(Chun-Shih Hsu)

輻射防護 ； 牙醫師 ； 長方形準直儀 ； 長錐體 ； 平行法技術 ； Radiation Protection ； Dentists ； Rectangular Collimation ； Long Cone ； Paralleling Technique

台灣應用輻射與同位素雜誌

14卷4期（2018 / 12 / 01）

1647 - 1652

繁體中文

放射線攝影是牙科重要的診斷工具之一。雖然牙科患者所接受的輻射線劑量較低，但如果因設備或攝影技術選擇不適當而曝露於過高的照射條件，可能造成不必要的輻射曝露。因此，輻射防護的三大原則－正當化(justification)、最適化(optimization)和限制化(limitation)對於牙醫師來說是一個重要的議題。這項研究蒐集國內335位開業牙醫師所使用之放射線設備及放射線攝影技術之數據。調查結果顯示，有8.4%的牙醫師使用長方形準直儀(rectangular collimation)、12.2%牙醫師使用長錐體(long cone)。口內放射線攝影中，有19.4%的牙醫師使用平行法技術(paralleling technique)。國內開業的牙醫師對於降低病患輻射劑量的做法並不令人滿意，大多數牙醫師沒有選擇合適的設備和攝影技術，造成患者在牙科放射線攝影時接受不必要的輻射曝露。未來，應將牙科的輻射防護列為專業教育的必要課程，讓牙醫師充分了解有關輻射安全知識和更新放射線儀器設備的可行性，如果可以說服更多的牙醫師使用長方形準直儀、長錐體及以平行法攝影技術，除了提升影像品質外也將會大幅度降低病患輻射劑量。

Radiographic imaging is one of the important diagnostic tools in clinical dentistry. Although dental patients receive relatively lower radiation dose, there might still be unnecessary exposure if the practitioners choose inappropriate equipment or radiographic imaging techniques. Therefore, the three guiding principles in radiation protection-justification, optimization and limitation, are crucial issues to dentists. This research collected data about the radiographic equipment and imaging techniques used by 335 dentists owning dental clinics in Taiwan. The outcome of investigation revealed that 8.4% of the dentists used rectangular collimation, 12.2% of them used long cones, and 19.4% of them used paralleling technique in intraoral radiography. Most of the investigated dentists didn’t choose these proper equipment and techniques to reduce the radiation dose received by patients, resulting in unnecessary radiation exposure to them, which is unsatisfying. In the future, dental radiation protection education should be included in obligatory professional courses, in order to fully inform the dentists about radiation safety knowledge and the availability of renewing radiographic equipment. If more dentists are convinced to use rectangular collimation, long cone and paralleling technique in dental radiography, not only the image quality will be improved, but the radiation dose received by patients will also decrease significantly.

1. 衛生福利部中央健康保險署全民健康保險研究資料庫。
2. Aps, JK(2010).Flemish general dental practitioners’ knowledge of dental radiology.Dentomaxillofac Radiol,39,113-118.
3. Araki, K,Kanda, S(1992).Radiological characteristics of lead foils in dental film packets: analysis of components and shielding effect.Dentomaxillofac Radiol,21,21-25.
4. Aroua, A.,Buchillier-Decka, I.,Dula, K.,Nedjadi, Y.,Perrier, M.,Vader, J.-P.,Valley, J.-F.(2004).Radiationexposure in dental radiology: a 1998 nationwide survey in Switzerland.Dentomaxillofac Radiol,33,211-219.
5. Bohay, RN,Kogon, SL,Stephens, RG(1994).A survey of radiographic techniques and equipment used by a sample of general dental practitioners.Oral Surg Oral Med Oral Pathol,78,806-810.
6. Cederberg, RA,Frederiksen, NL,Benson, BW,Sokolowski, TW(1997).Benson BW, Sokolowski TW. Effect of geometry of the intraoral position-indicating device on effective dose.Oral Surg Oral Med Oral Pathol Oral Radiol Endod,84,101-109.
7. Geist, JR,Katz, JO(2002).The use of radiation dose-reduction techniques in the practices of dental faculty members.J Dent Education,66,697-702.
8. Horner, K,Hirschmann, PN(1990).Dose reduction in dental radiography.Journal of Dentistry,18,171-184.
9. İlgüy, D,İlgüy, M,Dinçer, S,Bayırlı, G(2005).Survey of dental radiological practice in Turkey.Dentomaxillofac Radiol,34,222-227.
10. Jacobs, R,Vanderstappen, M,Bogaerts, R,Gijbels, F(2004).Attitude of the Belgian dentist population towards radiation protection.Dentomaxillofac Radiol,33,334-339.
11. Lee, BD,Ludlow, JB(2013).Attitude of the Korean dentists towards radiation safety and selection criteria.Imaging Sci Dent,43,179-184.
12. Mutyabule, TK,Whaites, EJ(2002).Survey of radiography and radiation protection in general dental practice in Uganda.Dentomaxillofac Radiol,31,164-169.
13. Parrott, LA,Ng, SY(2011).A comparison between bitewing radiographs taken with rectangular and circular collimators in UK military dental practices: a retrospective study.Dentomaxillofac Radiol,40,102-109.
14. Platin, E,Janhom, A,Tyndall, D(1998).A quantitative analysis of dental radiography quality assurance practices among North Carolina dentists.Oral Surg Oral Med Oral Pathol Oral Radiol Endod,86,115-120.
15. Praveen, BN,Shubhasini, AR,Bhanushree, R,Sumsum, PS,Sushma, CN(2013).Radiation in Dental Practice: awareness, protection and recommendations.The Journal of Contemporary Dental Practice,14(1),143-148.
16. Rushton, VE,Horner, K(1995).The impact of quality control on radiography in general dental practice.British Dental Journal,179,254-261.
17. Salti, L,Whaites, EJ(2002).Survey of dental radiographic services in private dental clinics in Damascus, Syria.Dentomaxillofac Radiol,31,100-105.
18. Shahab, S,Kavosi, A,Nazarinia, H,Mehralizadeh, S,Mohammadpour, M,Emami, M(2012).Compliance of Iranian dentists with safety standards of oral radiology.Dentomaxillofac Radiol,41,159-164.
19. Sheikh, S,Pallagatti, S,Singla, I,Gupta, R,Aggarwal, A,Singh, R(2014).Survey of dental radiographical practice in States of Punjab and Haryana in India.Journal of Investigative and Clinical Dentistry,5,72-77.
20. Svenson, B,Petersson, A(1995).Questionnaire survey on the use of dental X-ray film and equipment among general practitioners in the Swedish Public Dental Health Service.Acta Odontol Scand,53,230-235.
21. Svenson, B,Söderfeldt, B,Gröndahl, HG(1996).Attitudes of Swedish dentists to the choice of dental X-ray film and collimator for oral radiology.Dentomaxillofac Radiol,25,157-161.
22. Syriopoulos, K,Velders, XL,Sanderink, GC,Van der Stelt, PF,Van Ginkel, FC,Tsiklakis, K(1998).Mail survey of dental radiographic techniques and radiation doses in Greece.Dentomaxillofac Radiol,27,321-328.
23. Tugnait, A,Clerehugh, V,Hirschmann, PN(2003).Radiographic equipment and techniques used in general dental practice. A survey of general dental practitioners in England and Wales.J Dent,31,197-203.
24. UNSCEAR(2008).Sources and effects of ionizing radiation.
25. Whaites, E.(2002).Essentials of dental radiography and radiology.London:Churchill Livingstone.
26. White, SC,Pharoah, MJ(2009).Oral radiology: principles and interpretation.St Louis:Mosby.