A comparison of two radiographic assessment protocols for patients with periodontal disease.

Objective: Radiographic assessment of patients with generalised severe periodontitis may be undertaken with a panoramic view and supplementary periapicals. The purpose of this study was to estimate the effective radiation dose from this form of radiographic assessment, and to compare it with an estimate of the dose from a series of periapicals of all the affected teeth.

Design: Cross-sectional observational study.

Setting: Departments of Periodontology and Radiology, Glasgow Dental Hospital and School.

Method: Fifty consecutive patients [were recruited] with sufficiently widespread advanced periodontitis to require at least seven periapical radiographs. [Following new local guidelines, a panoramic view was taken.] The adequacy of the image of every affected tooth and the number of supplementary periapicals required was determined by a panel of four examiners who also calculated the number of periapicals which would have been taken if panoramic radiography had not been available. An effective dose of 0.001 mSv for one periapical and 0.007 mSv for a panoramic view was assumed.

Results: The panoramic-plus-periapicals approach delivered an estimated additional effective dose to 86% of patients, in the order of 0.001-0.007 mSv.

Conclusions: Within the parameters of this investigation, the anticipated effective radiation dose from a series of periapical radiographs of all selected teeth would, for the great majority of patients, have been less than the dose from a panoramic-plus-periapicals approach.