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Manual on Radiation Protection in Hospitals and in General Practice

Volume 3. Dentistry

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

Edited by IAEA

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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 vie/s 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%r2 neit-er t-e IAEA nor %ny ot-er or&%ni3%tion or body ,o(sponsorin& t-is do,.'ent ,%n be -eld responsible 1or %ny '%teri%l reprod.,ed in t-is do,.'ent+

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FOREWORD *-e Manual on Radiation Protection in Hospitals and General Practice is 1or p-ysi,i%ns2 spe,i%lists .sin& r%di%tion 1or di%&nosis or t-er%py2 r%dio&r%p-ers or r%diolo&i,%l te,-nolo&ists2 'edi,%l p-ysi,ists2 'edi,%l %ssist%nts2 n.,le%r 'edi,ine te,-nolo&ists2 r%di%tion prote,tion o11i,ers %nd s.pervisors %nd %d'inistr%tive personnel /or4in& /-ere t-ey '%y be e0posed to ioni3in& 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&%ni3%tion o1 &overn'ent%l servi,es2 e'ployers %nd /or4ers2 spe,i%li3ed 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 t/o vol.'es in t-e series6 Vol.'e " on b%si, r%di%tion prote,tion re5.ire'ents2 pl.s t-e Vol.'e de%lin& /it- % spe,i1i, %re% o1 interest s.,- %s2 dentistry2 di%&nosti, r%diolo&y2 n.,le%r 'edi,ine or r%diot-er%py+ *-is )%n.%l is % pro1o.nd revision o1 t-e previo.s edition2 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 Ioni3in& :%di%tion %nd 1or t-e #%1ety o1 :%di%tion #o.r,es <;##=+ *-e ;## /ere >ointly sponsored by t-e ood %nd A&ri,.lt.re Or&%ni3%tion o1 t-e United !%tions2 t-e Intern%tion%l Ato'i, Ener&y A&en,y2 t-e Intern%tion%l L%bo.r Or&%ni3%tion2 t-e !.,le%r Ener&y A&en,y o1 t-e Or&%ni3%tion 1or E,ono'i, Co(oper%tion %nd $evelop'ent2 t-e P%n A'eri,%n He%lt- Or&%ni3%tion %nd t-e World He%lt- Or&%ni3%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'%tion2 spe,i1i, 1or e%,- ,lini,%l %re%2 is ,ont%ined in t-e relev%nt vol.'es+ *-e in1or'%tion /%s or&%ni3ed 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 Requirements2 bro%dly ,overs s.b>e,ts s.,- %s b%si, prin,iples o1 r%di%tion prote,tion2 pl%nnin& %nd or&%ni3%tion o1 r%di%tion prote,tion %nd r%di%tion prote,tion re5.ire'ents in -e%lt- ,%re2 -e%lt- s.rveill%n,e %nd individ.%l %nd /or4pl%,e 'onitorin&2 potenti%l e0pos.res %nd %,,idents2 %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,s2 biolo&i,%l e11e,ts o1 ioni3in& r%di%tion %nd r%di%tion ris4s+ Volume 2, Diagnostic Radiology2 provides spe,i1i, det%ils ,on,ernin& pl%nnin& o1 di%&nosti, r%diolo&y 1%,ilities2 r%diolo&i,%l e5.ip'ent desi&n %nd oper%tion2 roo' desi&n %nd str.,t.r%l s-ieldin&2 prote,tion o1 t-e p%tient2 t-e st%11 %nd t-e p.bli,+ In %ddition it provides det%ils ,on,ernin& ed.,%tion %nd tr%inin&2 typi,%l r%di%tion doses 1or ,o''on e0%'in%tions2 esti'%tion o1 p%tient dose2 5.%lity %ss.r%n,e %nd &.id%n,e 1or &ood pr%,ti,e %nd lo,%l r.les+ Volume 3, Dentistry2 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&n2 oper%tion %nd 5.%lity %ss.r%n,e2 roo' desi&n %nd s-ieldin&2 prote,tion o1 t-e st%112 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 medicine2 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&%ni3%tion o1 n.,le%r 'edi,ine 1%,ilities2 r%dion.,lides %nd e5.ip'ent in di%&nosti, n.,le%r 'edi,ine2 5.%lity %ss.r%n,e2 %nd r%dion.,lide t-er%py s%1ety iss.es2 prote,tion o1 p%tients2 t-e st%11 %nd t-e p.bli,+ *opi,s %lso in,l.ded %re r%dio%,tive /%ste '%n%&e'ent2 individ.%l %nd /or4pl%,e 'onitorin&2 de,ont%'in%tion2 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, Radiotherapy provides 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&%ni3%tion o1 r%di%tion on,olo&y servi,es2 e5.ip'ent desi&n %nd oper%tion2 roo' desi&n %nd str.,t.r%l s-ieldin&2 5.%lity %ss.r%n,e2 prote,tion o1 p%tients t-e st%11 %nd t-e p.bli,2 %nd &.id%n,e 1or &ood pr%,ti,e %nd lo,%l r.les+ ;e,%.se quality assurance is so ,losely lin4ed to r%di%tion prote,tion2 t-e se,tions on A.%lity Ass.r%n,e <AA= provide det%iled in1or'%tion re1le,tin& t-e i'port%n,e o1 t-is s.b>e,t+ AA 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&ni3in& t-is 1%,t2 &.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&%ni3%tions+

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CONTENT "+ I!*:O$UC*IO! ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7 "+"+ Use o1 dent%l r%dio&r%p-y+ An overvie/2 b%,4&ro.nd %nd .pd%ted in1or'%tion+ +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7 "+2+ *-e !eed 1or :%di%tion Prote,tion in $entistry+++++++++++++++++++++++++++++++++++++++++++"" "+3+ Bener%l or&%ni3%tion2 pl%nnin& %nd 1%,ility desi&n ,onsider%tions o1 $ent%l :%di%tion #ervi,es+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"2 2+ $E!*AL @(:AY EAUIP)E!* PE: O:)A!CE A!$ OPE:A*IO!++++++++++++++++"C 2+"+ Bener%l ,onsider%tions++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"C 2+2+ @(r%y prod.,tion+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"C 2+2+"+ $ent%l @(r%y *.bes2 Bener%tors %nd A,,essories+++++++++++++++++++++++"C 2+3+ $ent%l @(r%y e5.ip'ent %nd A,,essories+++++++++++++++++++++++++++++++++++++++++++++++++++++"7 2+3+"+ Intr%or%l <Convention%l or Peri%pi,%l= $ent%l @(r%y e5.ip'ent %nd A,,essories++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"7 2+3+2+ E0tr%or%l <P%nor%l %nd Cep-%lo'etri,= $ent%l @(r%y e5.ip'ent %nd A,,essories++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++23 2+3+2+"+ PA!O:A)IC $E!*AL @(:AY EAUIP)E!* A!$ ACCE##O:IE#++++++23 2+3+2+2+ CEPHALO)E*:IC $E!*AL @(:AY EAUIP)E!* A!$ ACCE##O:IE#+ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++2C 2+3+2+3+ LUO:O#COPY O: $E!*AL U#E+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++2D

2+3+2+4+ $E!*AL C* #CA!!E:++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++2D 2+3+3+ A,,ept%n,e testin&2 preventive %nd ro.tine '%inten%n,e++++++++++++3" 2+4+ I'%&e re,eptors %nd displ%ys+ il'(s,reen ,o'bin%tions %nd $i&it%l $ete,tors++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++32 2+E+ I'%&e %,5.isition+ il' pro,essin& vers.s di&it%l i'%&in&++++++++++++++++++++++++++3C 2+E+"+ il' pro,essin&++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++3C 2+C+ A.%lity Ass.r%n,e <AA= %nd A.%lity Control <AC=+++++++++++++++++++++++++++++++++++++38 3+ :OO) $E#IB! A!$ #*:UC*U:AL #HIEL$I!B++++++++++++++++++++++++++++++++++++++++++++++42 3+"+ Bener%l ,onsider%tions++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++42 3+2+ :oo' desi&n %nd l%yo.t++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++42 3+3+ #-ieldin& desi&n &o%ls+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++4C 3+3+"+ ;%si, ,on,epts++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++4C 3+3+2+ :%di%tion p%r%'eters+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++48 3+3+3+ Air(Fer'% Li'its 1or :%dio&r%p-i, il's++++++++++++++++++++++++++++++++++47 3+4+ P%r%'eters .sed in ,%l,.l%tion o1 s-ieldin& b%rriers 1or $ent%l @(r%y roo'+ ++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++47 3+4+"+ Pri'%ry %nd se,ond%ry b%rriers+++++++++++++++++++++++++++++++++++++++++++++++++++47 4+ P:O*EC*IO! O *HE PA*IE!*++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++E" 4+"+ Bener%l ,onsider%tions++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++E" 4+2+ :%dio&r%p-i, sele,tion <re1err%l= ,riteri%++++++++++++++++++++++++++++++++++++++++++++++++++++++E4 4+2+"+ #ele,tion ,riteri%++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++E4 4+3+ J.sti1i,%tion %nd opti'i3%tion o1 prote,tion++++++++++++++++++++++++++++++++++++++++++++++++++EC
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4+4+ Assess'ent %nd 'et-ods o1 red.,in& p%tient dose+++++++++++++++++++++++++++++++++++++++ED 4+4+"+ Pro,ed.res 1or 'ini'i3in& dose to p%tients+++++++++++++++++++++++++++++++++ED 4+4+2+ #,ope %nd li'it%tions o1 dent%l r%dio&r%p-y <32=++++++++++++++++++++++++ED 4+4+3+ E5.ip'ent %nd %,,essories te,-ni,%l p%r%'eters in p%tient dose red.,tion+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++C9 4+4+3+"+ @(:AY BE!E:A*IO! A!$ #E* PA:A)E*E:# <FV2 )A2 *I)E=++++++++C9 4+4+3+2+ U#E UL ;EA) IL*:A*IO!++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++C" 4+4+3+3+ 4+4+3+4+ COLLI)A*IO!2 IEL$ #IGE A!$ PO#I*IO!I!B <I!*:AO:AL A!$ E@*:AO:AL=++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++C" IL) P:OCE##I!B A!$ $IBI*AL I)ABI!B I! PA*IE!* $O#E :E$UC*IO!++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++C4

4+4+3+E+ *HY:OI$ A!$ BO!A$ E@PO#U:E#+++++++++++++++++++++++++++++++++++++++++++++++++++++++CE 4+4+3+C+ :A$IOB:APHY I! I)PLA!*OLOBY+++++++++++++++++++++++++++++++++++++++++++++++++++++++CC 4+4+3+8+ I! O:)A*IO! A!$ CO!#E!* O: PA*IE!*#++++++++++++++++++++++++++++++++++++C8 4+E+ !e/ i'%&in& 'od%lities+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++CD 4+E+"+ Bener%l Aspe,ts+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++CD 4+E+2+ $ist%n,e to t-e o,,.pied %re%+++++++++++++++++++++++++++++++++++++++++++++++++++++++CD 4+E+3+ O,,.p%n,y 1%,tors++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++CD OCCUPA!CY AC*O: <*=+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++C7 4+E+4+ Use 1%,tors+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++C7 4+E+E+ Wor4lo%d++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++89 4+C+ #-ieldin& ,%l,.l%tion 'et-ods 1or dent%l @(r%y roo'++++++++++++++++++++++++++++++++++82 4+C+"+ ;%rrier *-i,4ness C%l,.l%tions +++++++++++++++++++++++++++++++++++++++++++++++++++82 4+C+2+ Appro0i'%te s-ieldin& ,%l,.l%tions+++++++++++++++++++++++++++++++++++++++++++++84 4+8+ I'ple'ent%tion o1 s%1ety 'e%s.res+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++8E E+ P:O*EC*IO! O #*A A!$ BE!E:AL PU;LIC+++++++++++++++++++++++++++++++++++++++++++++8D

E+"+ Bener%l ,onsider%tions++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++8D E+2+ $ose li'its++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++87 E+3+ Prote,tive 'e%s.res+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++D9 E+4+ :%di%tion prote,tion s.rvey++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++D2 E+E+ #pe,i%l proble's+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++D3 E+C+ Opti'i3%tion o1 r%di%tion prote,tion+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++D4 E+8+ Individ.%l <person%l= 'onitorin&++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++D4 E+D+ #pe,i%l Co'pens%tory %rr%n&e'ents++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++DC E+7+ Prote,tion o1 t-e &ener%l p.bli,++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++DC E+"9+ Helpin& in t-e ,%re2 s.pport or ,o'1ort o1 p%tients <000=+++++++++++++++++++++++++++DD C+ E$UCA*IO! A!$ *:AI!I!B++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++D7 C+"+ C+2+ C+3+ C+4+ $ent%l pro1ession%l ed.,%tion %nd tr%inin&+ Bener%l re'%r4s++++++++++++++++++++++D7 Contin.in& le%rnin& pro&r%''es 1or pro1ession%ls++++++++++++++++++++++++++++++++++++++79 A,,redit%tion %nd ,erti1i,%tion++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++79 Post&r%d.%te tr%inin& %nd rese%r,-++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7"
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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 % $ent%l @(r%y :oo' in % Hospit%l++++++++++++++++++++++++++++++++++++++++74 II+4+ Contin&en,y Pl%n? Hospit%l++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++74 A!!E@ III+ LI#* O PA:A)E*E:#2 P:OCE$U:E# A!$ EAUIP)E!* :EAUI:E$ O: ACCEP*A!CE *E#*I!B O $E!*AL @(:AY EAUIP)E!* A!$ ACILI*IE#++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7E III+"+ Intr%or%l dent%l .nit+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7E III+2+ P%nor%l r%dio&r%p-y .nit+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7E III+3+ Cep-%lost%t++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++7C A!!E@ IV+ #HIEL$I!B CALCULA*IO!#2 *:A!#)I##IO! $A*A A!$ LEA$ EAUIVALE!CE O P:O*EC*IVE ;A::IE:# ++++++++++++++++++++++++++++++++78 IV+"+ #-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! EAUIP)E!*+++++++++++++++++++++++++++++++++++++++++"94 A!!E@ VI+ *ECH!IAUE AC*O:# A!$ :A$IA*IO! $O#E# O: I!*:AO:AL :A$IOB:APHY++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"9E A!!E@ VII+ *:AI!I!B *OPIC# A!$ O;JEC*IVE# +++++++++++++++++++++++++++++++++++++++++"98 VII+"+ ;%si, 4no/led&e++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"98 VII+2+ #pe,i%l tr%inin& re5.ire'ents in dent%l r%diolo&y+++++++++++++++++++++++++++++++++++"98 :E E:E!CE# O: VOLU)E 3+++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++"3C 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 ioni3in& r%di%tion in dentistry2 li4e t-%t in &ener%l 'edi,ine /%s initi%ted soon %1ter t-e dis,overy o1 @(r%ys by :oent&en in "D7E+ A r%pid &ro/t- o1 t-is ne/ i'%&in& 'od%lity by dentists ,%n be d%ted 1ro' "7"32 t-e ye%r o1 Coolid&eHs invention o1 t-e -ot( ,%t-ode @(r%y t.be+ ;y t-e de,%de 1ollo/in& "7392 @(r%ys -%d ,o'e into &ener%l .se in dentistry <"=+ !o/%d%ys % dent%l r%dio&r%p-i, e0%'in%tion is re&%rded %s %n i'port%nt ele'ent in t-e di%&nosti, pro,ess prior to tre%t'ent+ It is /ell 4no/n t-%t % dent%l r%dio&r%p-y2 espe,i%lly intr%or%l pro,ed.res <Peri%pi,%l r%dio&r%p-y(non s,reen 1il's= is one o1 t-e 'ost 1re5.ent r%diolo&i,%l e0%'s2 %lt-o.&- t-e e0pos.res to individ.%l p%tients %re lo/+ In %ddition2 di&it%l s.btr%,tion r%dio&r%p-y te,-ni5.es %s /ell %s t-e p%nor%'i, r%dio&r%p-y <P%nor%l(e0tern%l 1il' in % ,%ssette /itintensi1yin& s,reen= %re %lso .sed+ *-e 2999 U!#CEA: :eport <2= st%tes t-%t represent%tives 1re5.en,ies o1 '%>or dent%l e0%'in%tions <Intr%or%l %nd P%nor%l= /orld/ide 1or t-e period "77"("77C /ere 3972 "4 %nd 9+2E per t-o.s%nd pop.l%tion 1or -e%lt- ,%re levels I2 II %nd III respe,tively+ <In ,o.ntries o1 -e%lt- ,%re level I2 t-ere is %t le%st " p-ysi,i%n 1or every "999 pop.l%tion6 -e%lt- ,%re level II2 " p-ysi,i%n per "999(3999 pop.l%tion6 -e%lt- ,%re level III2 " 1or 3999("9 999 pop.l%tion2 %nd -e%lt- ,%re level IV2 " 1or 'ore t-%n "9 999 pop.l%tion <Anne0 I=+

$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 li4ely to ,ontrib.te to proper di%&nosis2 tre%t'ent or prevention o1 dise%se+

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$ent%l @(r%y e0pos.re red.,tion -%s been do,.'ented in t-e UF %nd in U#A2 '%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%tients2 p.bli, %nd dentists 1ro' possible -%r'1.l e11e,ts o1 ioni3in& r%di%tion %nd to 'ini'i3e 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 <E.r%to' $ire,tives= %nd t-e ood %nd $r.& Ad'inistr%tion < $A= in t-e U#A -%ve prep%red &.id%n,e ,on,ernin& &ood ,lini,%l %nd r%diolo&i,%l s%1ety in dent%l pr%,ti,es /-i,- %re s.''%ri3ed belo/ <2b= <3= <4=+ Pro1ession%l >.d&'ent s-o.ld be .sed to deter'ine t-e type2 1re5.en,y2 %nd e0tent o1 e%,- r%dio&r%p-i, e0%'in%tion+ @(r%di%tion 1or di%&nosti, p.rposes s-o.ld be .sed only %1ter ,lini,%l e0%'in%tion %nd ,onsider%tion o1 bot- t-e dent%l %nd t-e &ener%l -e%lt- needs o1 t-e p%tient+ *-e n%t.re %nd e0tent o1 di%&nosis 1or re5.ired p%tient ,%re ,onstit.te t-e only r%tion%l b%sis 1or deter'inin& t-e need2 type2 %nd 1re5.en,y o1 r%dio&r%p-i, e0%'in%tions2 not t-e ,on,ept o1 ro.tine .se o1 r%dio&r%p-y %s % p%rt o1 periodi, e0%'in%tions o1 %ll p%tients+ !o pre1erred n.'eri,%l 1re5.en,y ,%n be e0pressed+ It is i'port%nt to re,o&ni3e t-%t %s e%,p%tient is di11erent 1ro' t-e ne0t2 %nd ,onse5.ently r%dio&r%p-i, e0%'in%tions s-o.ld be individ.%li3ed 1or e%,- p%tient+ *-e ro.tine re5.ire'ent o1 post(oper%tive r%dio&r%p-s to s-o/ proo1 o1 servi,e provided2 or ot-er e0,l.sively %d'inistr%tive .ses o1 r%dio&r%p-s2 s-o.ld not be per'itted+ It is desir%ble 1or r%dio&r%p-i, re,ords to be tr%ns1erred /-en % p%tient 'oves 1ro' one dent%l ,%re lo,%tion to %not-er to %void .nne,ess%ry repetitions o1 e0pos.re+ A 1%,ility t-%t desires to '%int%in per'%nent r%dio&r%p-i, re,ords '%y 1.l1ill t-e tr%ns1er o1 re,ords by 'e%ns o1 d.pli,%te r%dio&r%p-s+
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$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%4e % 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&2 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 li4ely to ,ontrib.te to proper di%&nosis2 tre%t'ent2 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=+ *-ese %re s.b>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 revie/in& t-e p%tientHs -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%tors2 pro,essin& e5.ip'ent2 %nd pro,essin& sol.tions %nd ,onditions s.,- %s ti'e %nd te'per%t.re2 %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'ent2 '%teri%ls2 %nd te,-ni5.es to i'prove r%dio&r%p-i, pr%,ti,es+ !e/ $ire,t $i&it%l I'%&in& #yste's2 /it%de5.%te i'%&e 5.%lity %nd si&ni1i,%tively lo/er r%di%tion dose2 ,o'p%red to ,onvention%l te,-ni5.es2 %re be,o'in& 'ore %nd 'ore %v%il%ble 1or bot-2 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'itted2 .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+ I 1!2! T(e Nee% $or Ra%iation .rotection in Dentistry As 'entioned in vol.'e "2 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 ris4 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%tion2 prote,tion o1 dent%l st%11 %nd prote,tion o1 ot-er persons <t-e p.bli,= in ne%rby %re%s ,%n be %ss.red by 1ollo/in& spe,i1i, re,o''end%tions 1or dent%l r%di%tion prote,tion+ Ho/ever2 t-e re,o''end%tions &iven -ere %re not intended to e0,l.de t-e .se o1 %ltern%te 'et-ods provided t-%t t-ese %,-ieve t-e r%di%tion prote,tion ob>e,tives *-e syste' o1 r%diolo&i,%l prote,tion 1or dent%l r%diolo&y is b%sed on t-ree 1.nd%'ent%l prin,iples <4=+ "+ 2+ J.sti1i,%tion o1 t-e pr%,ti,e Opti'i3%tion o1 prote,tion %nd
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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.t/ei&-s %ny %,,o'p%nyin& ris4+ 2+ Opti'i3%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%ble2 t%4in& into %,,o.nt so,i%l %nd e,ono'i, 1%,tors <ALA:A P:I!CIPLE= 3+ $ose li'it%tion is to ens.re t-%t no one is e0posed to %n .n%,,ept%ble -i&- ris42 %pplyin& $ose Li'its <!ot %ppli,%ble to p%tient=

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 ris4 1ro' r%di%tion e0pos.re2 %pplyin& 1irst t/o prin,iples+ or dent%l st%11 <o,,.p%tion%l e0pos.re= %nd 1or ot-er persons <p.bli, e0pos.re= %ll o1 t-ese t-ree prin,iples %re %pplied %nd t-e %ppropri%te dose li'its %re est%blis-ed %nd /ill be dis,.ssed 1.rt-er'ore+ #pe,i%l ,onsider%tions %re %lso t%4in& into %,,o.nt 1or st.dents .nder "D ye%rs o1 %&e %nd pre&n%nt /or4ers+ 1!3! /eneral or&ani0ation, 'lannin& an% $acility %esi&n consi%erations o$ Dental Ra%iation er*ices $ent%l r%dio&r%p-y is '%inly intended 1or t-e 1ollo/in& e0%'in%tions %nd pro,ed.res? $i%&nosis2 tre%t'ent pl%nnin& %nd 'onitorin& tre%t'ent or lesion develop'ent+ *-e desi&n o1 dent%l r%diolo&i,%l 1%,ilities is dependent on t-e type o1 pro,ed.res to be per1or'ed %nd t-e /or4lo%d+ #pe,i%li3ed pro,ed.res s.,- %s e0tr% or%l ,ep-%lo'etri, r%dio&r%p-y %nd p%nto'o&r%p-y '%y re5.ire dedi,%ted r%diolo&i,%l e5.ip'ent+ C-%pters 2 %nd 3 dis,.ss in 'ore det%il t-e .se o1 e5.ip'ent spe,i1i,%lly desi&ned 1or r%dio&r%p-y o1 t-e teet- or >%/s %nd str.,t.r%l s-ieldin&+ *-e '%in .se %re 1or I!*:AO:AL <,onvention%l= %nd E@*:AO:AL <p%nor%l J ,ep-%lo'etri, or to'o&r%p-i,= pr%,ti,es+ *-e @(r%y roo' s-o.ld be l%r&e eno.&- to provide s%1e %,,o''od%tion 1or t-ose persons /-o -%ve to be in t-e roo' d.rin& @(r%y e0%'in%tions+ *-is roo'2 /-i,- '%y be 1or dent%l s.r&ery or % sep%r%te e0%'in%tion roo'2 s-o.ld not be .sed 1or ot-er /or4 or %s % p%ss%&e/%y /-ile r%dio&r%p-y is in pro&ress+ All persons /-ose presen,e is .nne,ess%ry s-o.ld be e0,l.ded 1ro' t-e roo' /-ile @(r%ys %re bein& prod.,ed+ $ent%l @(r%y e5.ip'ent s-o.ld be inst%lled so t-%t t-e person oper%tin& it2 ,%n be %t le%st 2 ' 1ro' t-e @(r%y t.be %nd 1ro' t-e p%tient <ot-er/ise prote,tion b%rrier is needed= %nd t-ere1ore /ell o.tside t-e r%di%tion be%'+ W-en pl%nnin& % dent%l @(r%y 1%,ility2 %,,o.nt '.st be t%4en o1 t-e oper%tin& t.be potenti%l2 t-e e0pe,ted '%0i'.' /or4lo%d o1 t-e e5.ip'ent2 t-e .se 1%,tors o1 t-e b%rriers %nd o,,.p%n,y 1%,tors 1or %re%s %d>%,ent to t-e 1%,ility+ Allo/%n,e s-o.ld be '%de 1or possible 1.t.re in,re%ses in t-ese p%r%'eters+
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Wit- re&%rd to occu'ational e1'osure2 t-e ;%si, #%1ety #t%nd%rds re5.ire t-e ,l%ssi1i,%tion o1 /or4pl%,es %s controlle% areas or %nd %s su'er*ise% areas or uncontrolle% areas <C=+ A controlle% area is %ny %re% in /-i,- spe,i1i, prote,tion 'e%s.res %nd s%1ety provisions %re or ,o.ld be re5.ired In &ener%l2 dent%l r%diolo&y roo's %re ,ontrolled %re%s %nd %,,ess s-o.ld be restri,ted to personnel involved /it- t-e e0%'in%tion2 %nd to ot-ers /-ose presen,e is re5.ired+ *-e roo'2 in,l.din& t-e 1loor %nd /indo/s2 s-o.ld be %ppropri%tely s-ielded or prote,ted by restri,tion o1 t-e dire,tion o1 t-e @(r%y be%'+ *-e e5.ip'ent s-o.ld be inst%lled so t-%t t-e .se1.l be%' is dire,ted %/%y 1ro' %ny door or /indo/2 i1 t-e sp%,e i''edi%tely beyond is o,,.pied+ *-ere s-o.ld be % r%di%tion /%rnin& si&n2 to&et-er /it- %ny %ppropri%te /ords on t-e @(r%y roo' door
<23R)4 ROO5, "F 4O# )RE OR 5)4 6E .RE/N)NT )DV" E 4O#R DOCTOR=+

A s.pervised %re% is %ny %re% not desi&n%ted %s % ,ontrolled %re% b.t 1or /-i,- o,,.p%tion%l e0pos.re ,onditions %re 4ept .nder revie/ even t-o.&- spe,i1i, prote,tive 'e%s.res %nd s%1ety provisions %re not nor'%lly needed+ *-e de,ision %s to /-et-er %n %re% is desi&n%ted %s ,ontrolled or s.pervised s-o.ld be b%sed on oper%tion%l e0perien,e %nd >.d&'ent+ A,,o.nt s-o.ld be t%4en bot- o1 t-e e0pe,ted levels o1 e0pos.re %nd o1 t-e li4ely v%ri%tions in t-ese e0pos.res+ *-e intention is to ens.re t-%t in %re%s o.tside t-e desi&n%ted %re% t-%t individ.%ls s-o.ld re,eive t-e s%'e level o1 prote,tion %s i1 t-ey /ere 'e'bers o1 t-e p.bli,+ In dent%l r%diolo&y 1%,ilities /-ere t-e r%diolo&i,%l /or4lo%d is lo/ t-e ,onvention%l b.ildin& '%teri%ls .sed in ,eilin&s2 1loors %nd /%lls /ill nor'%lly provide %de5.%te s-ieldin& %&%inst bot- t-e pri'%ry @(r%y be%' %nd str%y r%di%tion+ W-en e0istin& str.,t.r%l '%teri%l does not provide %de5.%te prote,tion %ddition%l s-ieldin& /ill be re5.ired+ *-is ,%n be %,,o'plis-ed by .sin& &re%ter t-i,4ness o1 t-e b.ildin& '%teri%l or by %ddin& le%d to t-e /%lls2 1loor %nd ,eilin& o1 t-e e0istin& 1%,ility+ *-e s-ieldin& %n%lyst/desi&ner /ill -%ve to ,onsider t-e so.r,e(rel%ted %ppro%,- to ens.re t-e proper opti'i3%tion o1 prote,tion2 in,l.din& t-e sele,tion o1 so.r,e(rel%ted %ose constraints %nd t-e individ.%l(rel%ted %ppro%,to ens.re t-e %de5.%te prote,tion o1 individ.%ls in rel%tion to %ll t-e relev%nt so.r,es+ As % &ener%l r.le it /o.ld be %ppropri%te to t-e re&.l%tor to en,o.r%&e t-e develop'ent o1 dose ,onstr%ints /it-in or&%ni3%tion%l &ro.ps2 s.b>e,t to re&.l%tory oversi&-t2 r%t-er t-%n to stip.l%te v%l.es+ Ho/ever2 dent%l pr%,titioners o1ten /or4 in 'ore t-%n one 1%,ility2 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 /or4ers2 '.st 'eet t-e re5.ire'ents 1or occu'ational e1'osure s.,- t-%t no r%di%tion /or4er re,eives % dose o1 'ore t-%n 29 '#v per ye%r2 t%4in& in %,,o.nt %ll t-e relev%nt so.r,es+ *-e s.&&ested v%l.e 1or %ose constraints is "9 '#v per ye%r+ *-e r%di%tion levels o.tside o1 ,ontrolled or s.pervised %re%s '.st 'eet t-e re5.ire'ents 1or 'u,lic e1'osure %nd t-e esti'%ted %ver%&e doses to relev%nt
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2+

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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 constraints is 9+E '#v per ye%r+ In &ener%l2 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 '%y be ,o'p.ted on t-e b%sis o1 dist%n,e2 '%0i'.' t.be potenti%l <4V=2 /or4lo%d <W=2 .se 1%,tor <U= %nd o,,.p%n,y 1%,tor <*=2 %s des,ribed in C-%pter 3+ Attention s-o.ld be p%id to proper %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+ )%inten%n,e o1 r%di%tion s%1ety 1e%t.res o1 e5.ip'ent s-o.ld be done in %,,ord%n,e /it- t-e %dvi,e o1 t-e '%n.1%,t.rer2 t-e s.pplier %nd2 i1 %ppli,%ble2 t-e re&.l%tory %.t-ority+ Ele,tri,%l %nd 'e,-%ni,%l 1e%t.res s-o.ld be ,-e,4ed periodi,%lly+ A A.%lity Ass.r%n,e pro&r%''e s-o.ld be est%blis-ed %nd % re,ord o1 '%inten%n,e s-o.ld be 4ept 1or e%,- @(r%y '%,-ine <8=+ )%ny @(r%y .nits /-i,- /ere '%n.1%,t.red prior to re,ent st%nd%rds ,%nnot 'eet s.,st%nd%rds %nd need to be .p&r%ded+ #pe,i1i, %spe,ts %re 'entioned belo/6 Inst%ll%tion o1 better ,olli'%tion devi,es2 i+e+ open ended ,olli'%tion2 %re pre1erred to t-ose t-%t -%ve pl%sti, ,losed ends2 be,%.se t-e pl%sti,( ended ,one is % so.r,e o1 s,%ttered r%di%tion+ In,re%sin& t-e %'o.nt o1 .se1.l be%' 1iltr%tion %dded to t-e @(r%y t.be to be ,onsistent /it- t-e 'ini'.' re5.ire'ents o1 relev%nt le&isl%tion+ *-e p.rpose o1 t-e 1ilter is to %bsorb r%di%tion o1 lo/ penetr%tin& ener&y /-i,- does not ,ontrib.te to t-e in1or'%tion on t-e 1il' %nd t-.s i'pose % .seless e0pos.re .pon t-e p%tient+ A,5.irin& i'%&e re,eptors li4e -i&- speed 1il's %nd 1%ster 1il'/s,reen ,o'bin%tions <s.,- %s r%re e%rt- s,reens= %nd .sin& proper 1il' pro,essin&+ Staffing Requirements ;%si, re5.ire'ents 1or '%int%inin& %n %de5.%te level o1 prote,tion in % b%si, dent%l 1%,ility %re?
(

A dentist2 ,o'petent in dent%l r%dio&r%p-y2 /-o -%s re,eived %de5.%te tr%inin& in r%di%tion prote,tion+ %n individ.%l <te,-ni,i%n or n.rse= tr%ined in t-e oper%tion o1 t-e @(r%y .nit %nd in 1il' pro,essin&2 % se,ret%ry 1or v%rio.s %d'inistr%tive d.ties+

All @(r%y oper%tors '.st possess 5.%li1i,%tions re5.ired by relev%nt n%tion%l or lo,%l re&.l%tions or st%t.tes+ All oper%tors '.st?
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be %/%re o1 t-e r%di%tion -%3%rds %sso,i%ted /it- t-eir /or4 %nd o1 t-eir d.ty to prote,t t-e'selves %nd ot-ers2 espe,i%lly p%tients2 -%ve % 4no/led&e o1 .se o1 proper te,-ni5.es %nd pro,ed.res to eli'in%te or red.,e to lo/est pr%,ti,%l v%l.es %ll .nne,ess%ry p%tient e0pos.res2 be "D ye%rs o1 %&e or older+

Pre&n%nt /or4ers <see C-%pter E=

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2! DENT)7 23R)4 E8#".5ENT .ERFOR5)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 <.se1.l be%'= to t-e %re% o1 interest by t-e t.be s-ieldin& %nd % be%' li'itin& devi,e <,olli'%tor=+ *-e .se1.l or pri'%ry @(r%y be%' inter%,ts /it- t-e p%tient2 so'e @(r%y p-otons %re s,%ttered or %bsorbed2 ot-ers bein& tr%ns'itted+ *r%ns'itted @(r%ys i'pin&e on t-e i'%&e re,eptor /-ere %n i'%&e is 1or'ed /-i,- is s.bse5.ently vie/ed by % dentist or ot-er 'edi,%l pr%,titioner+ *-e p.rpose o1 t-e i'%&e re,eptor is to ,onvert t-e ener&y distrib.tion in t-e tr%ns'itted @(r%y be%' into %n i'%&e+ *-e intention o1 t-e @(r%y e0%'in%tion is to '%4e possible % di%&nosis2 %nd to i'prove t-e ,lini,%l '%n%&e'ent or tre%t'ent o1 t-e p%tient+ A brie1 introd.,tion to t-e p-ysi,s o1 dent%l r%diolo&i,%l i'%&in& is &iven in t-is ,-%pter+ :e%ders /-o /%nt % 'ore ,o'pre-ensive tre%t'ent o1 t-e s.b>e,t %re re1erred to % te0tboo4 on t-e s.b>e,t <D=2 <7=+ 2!2! 23ray 'ro%uction 2.2. . Dental !"ray #u$es% Generators and &ccessories In &ener%l2 st%tion%ry %node @(r%y t.bes %re .sed in dent%l intr%or%l r%diolo&y+ i&.re 2+" is % s,-e'%ti, di%&r%' %s /ell %s t-e p-oto&r%p-y o1 % typi,%l st%tion%ry %node @(r%y t.be+ *-e v%rio.s p%rts o1 t-e t.be %re en,losed in %n ev%,.%ted &l%ss envelope+ An ele,tri,%l ,.rrent is p%ssed t-ro.&- % ,oil o1 /ire /-i,- 1or's t-e ,%t-ode 1il%'ent+ *-is prod.,es -e%t %nd ele,trons %re e'itted 1ro' t-e 1il%'ent into t-e v%,..' by t-er'ioni, e'ission+ *-ese t-er'ioni, ele,trons %re %,,eler%ted %,ross t-e v%,..' by %pplyin& % l%r&e potenti%l di11eren,e2 bet/een E9 to 89 4ilovolts <4V= bet/een t-e %node %nd ,%t-ode+ *-e ele,trons %re %ttr%,ted by t-e positive potenti%l+ *-e %,,eler%ted ele,trons i'pin&e on t-e t.n&sten %lloy t%r&et o1 t-e %node+ As t-e ele,trons %re slo/ed do/n /it-in t-e %node2 @(r%ys %re prod.,ed by % p-ysi,%l pro,ess 4no/n %s ;re'str%-l.n&+ #o'eti'es %n in,ident ele,tron ,ollides /itone o1 t-e ele,trons in %n inner orbit %ro.nd one o1 t-e %to's o1 t-e t%r&et %nd t-is orbit%l ele,tron is re'oved+ #.bse5.ently2 %n ele,tron 1ro' %not-er orbit o1 t-e %to' 1ills t-e v%,%n,y le1t by t-e e>e,ted ele,tron2 res.ltin& in t-e e'ission o1 %n @(r%y ,-%r%,teristi, o1 t-e t%r&et '%teri%l <t.n&sten=+

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

P%&e "C

Figure 2.1 Schematic diagram and ph t graph! f a t!pica" stati nar! an de #$ra! tu%e. *-e potenti%l di11eren,e bet/een t-e %node %nd ,%t-ode is prod.,ed by %n @(r%y &ener%tor2 /-i,- is % type o1 tr%ns1or'er+ A tr%ns1or'er ,onsists o1 t/o sets o1 /indin& /it% ,o''on ,ore+ One o1 t-ese /indin&s <t-e pri'%ry= /ill -%ve % s'%ll n.'ber o1 t.rns %ro.nd t-e ,ore2 /-ile t-e se,ond%ry /indin& /ill -%ve % '.,- l%r&er n.'ber <1or e0%'ple2 E99 ti'es 'ore=+

Figure 2.2 Scheme f a c n&enti na" denta" #$ra! generat r W-en % lo/ volt%&e ti'e v%ryin& ,.rrent is p%ssed t-ro.&- t-e pri'%ry ,oil s.rro.ndin& t-e ,o''on ,ore2 % -i&- volt%&e is prod.,ed in t-e se,ond%ry ,oil by ele,tro'%&neti, ind.,tion+ In % dent%l @(r%y &ener%tor it is ,o''on pr%,ti,e to %pply t-e lo,%l sin.soid%l '%in volt%&e /%ve1or' %,ross t-e pri'%ry /indin&s+ *-e r%tio o1 t-e n.'ber o1 t.rns in t-e se,ond%ry /indin& to t-e pri'%ry is &iven by t-e r%tio o1 t-e oper%tin& t.be potenti%l <E9 to 89 4ilovolts= to t-%t o1 t-e '%ins s.pply no'in%l <""9 / 299 V= volt%&e+ )%ny e0istin& dent%l @(r%y .nits -%ve % sin&le p-%se sel1 re,ti1ied /%ve1or'+ A sin&le p-%se /%ve1or' is prod.,ed by t-e &ener%tor %nd t-e @(r%y t.be %,ts %s % re,ti1ier be,%.se it /ill only ,ond.,t /-en t-e %node is positive /it- respe,t to t-e ,%t-ode <i+e+ only 1or -%l1 t-e ti'e=+ Un1ort.n%tely2 @(r%y prod.,tion is less t-%n "K e11i,ient %t C9 4ilovolts <4V= %nd 'ost o1 t-e 4ineti, ener&y o1 t-e ele,trons stri4in& t-e %node is ,onverted into -e%t inste%d o1 @( r%ys+ *-e b%si, p-ysi,%l l%/ des,ribin& t-e oper%tion o1 % tr%ns1or'er st%tes t-%t t-e volt%&e ind.,ed in t-e se,ond%ry ,oils is proportion%l to t-e r%te o1 ,-%n&e o1 '%&neti, 1l.0 in t-e pri'%ry side+ *-.s -i&- o.tp.t @(r%y &ener%tors ,%n be prod.,ed i1 % r%pid r%te o1 ,-%n&e o1 '%&neti, 1l.0 is %,-ieved+ *-is is t-e desi&n ob>e,tive o1 1re5.en,y ,onverter '.lti(p.lse < C)P= @(r%y &ener%tors /-i,- oper%te %t % sever%l t-o.s%nd -ert3+ *-.s s'%ll -i&- o.tp.t @(r%y t.bes %nd &ener%tors '%y be prod.,ed in /-i,- t-e r%di%tion dose(r%te is %l'ost ,onst%nt+ Un1iltered @(r%y spe,tr% -%ve % l%r&e n.'ber o1 lo/ ener&y @(r%y p-otons2 /-i,- %re ,o'pletely %bsorbed by t-e p%tient+ In t-e '%in2 t-ese lo/ ener&y @(r%y p-otons only ,ontrib.te to t-e p%tientHs r%di%tion dose %nd not to t-e i'%&e <1il' density=+ *-.s it is re,o''ended by v%rio.s re&.l%tory bodies t-%t %ddition%l 1iltr%tion be %dded to @(r%y t.bes to sele,tively re'ove t-ese lo/ ener&y @(r%y p-otons /-i,- /o.ld ot-er/ise be %bsorbed by t-e p%tient+
VOL 3 JULY 24 vers I!AL A" #ECO!$ Co'pressed()*(IAEA(*e'pl%te+do,

P%&e "8

)ost intr%or%l dent%l @(r%y .nits oper%te %t only one t.be ,.rrent+ Conse5.ently2 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 <i+e+ t-e ti'e d.rin& /-i,- @(r%ys %re prod.,ed=+ Ad>.st'ent o1 e0pos.re ti'e is .s.%lly ,ontrolled vi% % sele,tor s/it,- lin4ed to eit-er % 'e,-%ni,%l or ele,troni, ti'er+ *-e l%tter type %re &ener%lly 'ore %,,.r%te %nd %re to be pre1erred+ )e,-%ni,%l or ,lo,4/or4 ti'ers '%y be very in%,,.r%te2 p%rti,.l%rly %t lo/ e0pos.re ti'es+ *-e @(r%y t.be %nd &ener%tor %re .s.%lly ,ont%ined in t-e t.be -o.sin& o1 %n intr%or%l dent%l @(r%y .nit2 /-i,- is ill.str%ted in i&.re 2+2 <"=+ *-e t.be -o.sin& ,ont%ins t-e step .p tr%ns1or'er %s /ell %s t-e @(r%y t.be+

Figure 2.' Tu%e h using f an intra ra" denta" #$ra! unit (1).

Li'it%tion o1 t-e @(r%y be%' to t-e %re% o1 di%&nosti, interest is provided by % le%d di%p-r%&' pl%,ed %t t-e o.tp.t port o1 t-e t.be -o.sin&2 %s /ell %s by e0tern%l ,olli'%tion in t-e pointer ,one+ Any r%di%tion o.tside t-e %re% o1 di%&nosti, interest res.lts in .nne,ess%ry r%di%tion e0pos.re o1 t-e p%tient+ *-e di%'eter o1 t-e pri'%ry be%' %t t-e end o1 t-e ,olli'%tor ,one /ill typi,%lly be C ,'2 %nd t-e di%'eter '%y be spe,i1ied in n%tion%l or lo,%l le&isl%tion or ,odes o1 pr%,ti,e+ *-ree types o1 ,olli'%tor %re ill.str%ted in i&.re 2+3+ *-e t-ree types o1 ,olli'%tor ill.str%ted in i&.re 2+3 %,-ieve t-is /it- v%rio.s de&rees o1 s.,,ess+ *-e ,one type o1 ,olli'%tor is not re,o''ended be,%.se o1 t-e si3e o1 t-e pri'%ry be%' %nd t-e %'o.nt o1 s,%ttered r%di%tion+

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

P%&e "D

Figure 2.* T!pes f denta" #$ra! %eam c ""imat rs. *-e ot-er p.rpose o1 t-e ,olli'%tor is to ens.re t-%t dent%l r%diolo&y is per1or'ed %t % &iven so.r,e <1o,.s= to s.r1%,e dist%n,e <##$= %nd t-e 1il' is pl%,ed %t % st%nd%rdi3ed position rel%tive to t-e @(r%y t.be 1o,.s+ *-e 'ini'.' 1o,.s s4in dist%n,e 1or % ,olli'%tor is .s.%lly spe,i1ied in lo,%l/n%tion%l re&.l%tions %nd /ill be typi,%lly not less t-%n "9 ,' 1or % .nit oper%tin& %t E9 4V+ *-e trend to/%rds -i&- r%di%tion o.tp.t @(r%y t.bes %nd &ener%tors 1or dent%l r%diolo&y <C9/89 4Vp= -%s res.lted in t-e develop'ent o1 lon&er 1o,.s s4in dist%n,es <##$ L e+&+ 29 ,'=+ *-e lon& ,one te,-ni5.e -%s potenti%l bene1its in ter's o1 % lo/er s4in dose to t-e p%tient 1or t-e s%'e 1il' dose %nd it %lso red.,es t-e e11e,t o1 bl.rrin& ,%.sed by t-e 1inite si3e o1 t-e @(r%y t.be 1o,.s+ 2!3! Dental 23ray equi'ment an% )ccessories 2.3. . 'ntraoral ()on*entional or Periapical+ Dental !"ray equipment and &ccessories *-e @(r%y t.be -o.sin& o1 %n intr%or%l dent%l .nit typi,%l o1 t-ose '%n.1%,t.red '%ny ye%rs %&o %nd is still /idely .sed in so'e developin& ,o.ntries+ It '%y ,ont%in t-e @(r%y t.be %nd step(.p tr%ns1or'er+ A ;%4elite "99 '' pointer ,one <not re,o''ended no/%d%ys= ,%n be %tt%,-ed to t-e o.tp.t port o1 t-e @(r%y t.be -o.sin&+ E1'osure time Tu,e 'otential Focal s'ot si0e "n(erent $iltration 1ro' C9 's to 2+E s )in+ C9 4V2 M8'A " '' M2 '' Al e5.iv%lent
P%&e "7

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

Focus3s-in %istance

29 ,'

"rra%iate% $iel%

2D ,'22 ro.nd2 NLC ,'

*od%yHs 1ield si3e vis.%li3%tion is per1or'ed by '%n.1%,t.rin& %n open(ended position indi,%tin& devi,e <PI$=+ *-e 1ield di%'eter o1 t-e ,olli'%tor end s-o.ld not e0,eed C9 '' %nd s-%ll not e0,eed 8E '' o1 '%0i'.' di%'eter+ <IC:P 33=+ :e,t%n&.l%r s-%pe ,olli'%tor /ill be pre1erred to t-e ,ir,.l%r one %nd -%s been re,o''ended2 %s t-e ,onvention%l dent%l 1il' si3e is 39 0 49 ''+ *-is is one o1 t-e i'port%nt iss.es to be t%4en into t-e %,,o.nt 1or dose red.,tion to t-e p%tient+ It is %lso i'port%nt to re'ind t-%t t-e re,t%n&.l%r ,olli'%tion re5.ires t-e .se o1 t-e 1il' -oldin& devi,es /it- % be%' %li&n'ent &.ide to %void ,one ,.ts+ It is not di11i,.lt to %dopt t-e e0istin& e5.ip'ent to % ne/ re,t%n&.l%r ,olli'%tion+ As /ell %s t-e 1ield si3e on t-e p%tient s4in is i'port%nt2 t-e @(r%y so.r,e <1o,.s= to s4in dist%n,e <##$= is %lso one o1 t-e i'port%nt p%r%'eters in li'itin& doses to p%tient+ $.e to t-e diver&en,e o1 t-e @(r%y be%'2 in,re%sin& t-is dist%n,e red.,es t-e diver&en,e to t-e p%tient %nd t-ere1ore red.,es t-e irr%di%ted %re%+ A 'ini'.' so.r,e <1o,.s=(to(s4in dist%n,e <##$= s-%ll not be less t-%n 299 ''+ *-e .nit ,%n be ,onne,ted to t-e do'esti, '%ins s.pply+ Un1ort.n%tely2 t-e '%ins volt%&e '%y 1l.,t.%te d.rin& t-e d%y /-i,- /o.ld res.lt in ,orrespondin& ,-%n&es in t-e &ener%ted t.be volt%&e+ It is t-ere1ore ne,ess%ry to ,o'pens%te 1or '%ins volt%&e v%ri%tions+ *-e ,ontrol p%nel o1 t-is intr%or%l dent%l .nit ,ont%ins % volt 'eter /-i,- indi,%tes t-e inp.t volt%&e to t-e step(.p tr%ns1or'er %nd % 4nob ,onne,ted to t-e t.be volt%&e ,o'pens%tion ,ir,.it+ ;e1ore initi%tin& %n e0pos.re t-e oper%tor is re5.ired to %d>.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,e2 .s.%lly ,%lled 4ilovolt%&e2 ,ontrols t-e @(r%y ener&ies in t-e @(r%y be%'+ Lo/er &ives lo/er @(r%y ener&y o.tp.t b.t -i&-er s4in doses to t-e p%tient2 %s /ell %s t-e lon&er e0pos.re ti'es2 %s needed 1or -i&-er 4ilovolt%&e <s%'e 'As=+ Hi&-er 4ilovolt%&e red.,es t-e s4in dose2 b.t not t-e dept- dose %nd prod.,es 'ore s,%ttered @(r%ys+ In intr%or%l dent%l @(r%y .nits t-e volt%&e is .s.%lly 1i0ed or %t le%st -%s t/o di11erent v%l.es+ or t-e ot-er -%nd t-e lo/ 4ilovolt%&e prod.,es -i&-er ,ontr%st t%n -i&-er 4ilovolt%&e+ #o2 1or intr%or%l r%dio&r%p-y t-e re,o''ended 4ilovolt%&e is 1ro' C9 to 89 4V2 t%4in& in %,,o.nt t-e %,,ept%ble s4in dose to t-e p%tient %nd di%&nosti, 5.%lity+ It is %dvis%ble t-%t t-e oper%tin& potenti%l o1 intr%or%l dent%l @(r%y '%,-ines s-o.ld not be 'ore t-%n D9 4V+ *-e %i' o1 t-e 1iltr%tion is to %bsorb lo/er ener&y p-otons 1ro' t-e .se1.l be%'2 /-i,is very i'port%nt to red.,e t-e p%tientHs s4in doses+ *-e tot%l 1iltr%tion ,onsists o1 in-erent %nd %dded 1ilters+ *-e in-erent 1iltr%tion is /it-in t-e @(r%y t.be %nd its -o.sin&6 it in,l.des t-e /indo/ <&l%ss= o1 t-e @(r%y t.be %nd %ny per'%nent en,los.re 1or t-e so.r,e %nd is 'e%s.red in %l.'ini.' e5.iv%lents+ *-e %l.'ini.' e5.iv%lent is t-e t-i,4ness o1 %l.'ini.'
VOL 3 JULY 24 vers I!AL A" #ECO!$ Co'pressed()*(IAEA(*e'pl%te+do,

P%&e 29

%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 "+E '' Al+ At -i&-er t.be volt%&es2 %s 1or re&.l%r di%&nosti, i'%&in&2 t-e tot%l 1iltr%tion o1 t-e .se1.l be%' s-%ll be e5.iv%lent to not less t-%n 2+E '' o1 Al+ o1 /-i,- "+E '' s-%ll be per'%nent+ <IC:P 33= C.rrently t-ere %re investi&%tions on&oin& /it- ot-er t-%n %l.'ini.' '%teri%ls2 s.,- %s r%re(e%rt- 1ilters2 to prove t-e dose red.,tion in intr%or%l dent%l r%dio&r%p-y2 b.t '.st be b%l%n,ed ,ost to i'%&e 5.%lity2 %s /ell %s per1or' t-e ne/ e0pos.re 1%,tors+ *-ere %re %lso t/o di11erent ,olored /%rnin& li&-ts on t-e ,ontrol p%nel2 one indi,%tin& /-et-er t-e .nit is ,onne,ted to t-e '%ins s.pply %nd t-e ot-er /-en @(r%ys %re bein& prod.,ed+ A ,lo,4/or4 'e,-%ni,%l ti'er <not re,o''ended no/%d%ys= is .s.%lly %tt%,-ed to t-e side o1 t-e ,ontrol p%nel+ *-e oper%tor t.rns t-e di%l to sele,t t-e desired e0pos.re ti'e+ @( r%y e0pos.re is initi%ted by depressin& t-e e0pos.re b.tton2 t-ereby rele%sin& t-e ,lo,4/or4 ti'er+ *-e e0pos.re b.tton is o1 t-e de%d '%n type2 @(r%y &ener%tion ,e%sin& on,e t-e b.tton is rele%sed+ or t-e ,onvention%l <peri%pi,%l= dent%l r%dio&r%p-y t-e '%0i'.' r%n&e o1 t-e e0pos.re ti'e s-o.ld not e0,eed E se,onds+ *-e ,lo,4/or4 ti'er is %tt%,-ed to t-e ,ontrol ,onsole vi% % lon& ,%ble <.s.%lly 2 'eters or &re%ter= /-i,- en%bles t-e oper%tor to st%nd /ell b%,4 1ro' t-e p%tient d.rin& %n e0pos.re2 t-ereby red.,in& -is/-er r%di%tion dose+ !o/%d%ys di&it%l ti'ers %re /idely .sed+ *-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's+

A+ Intr%or%l ,onvention%l

;+ O,l.s%l

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

P%&e 2"

C+ ;ite Win& Figure 2.++ ,h t graphs f intra ra" denta" fi"ms. Department f Denta" Radi " g!- Nati na" .ni&ersit! / hn F. 0enned!- 1uen s Aires- Argentina In % 'odern 1re5.en,y ,onverter '.lti(p.lse < C)P= &ener%tor 1or dent%l .nits <intr%or%l %nd e0tr%or%l=2 t-e te,-ni5.e 1%,tor sele,tion is %,-ieved vi% % 'i,ropro,essor ,-ip+ *-e @(r%y prod.,tion is o1 ,onst%nt potenti%l <$C($ire,t C.rrent= type+ *-is .nit '%y be oper%ted %t di11erent t.be potenti%ls2 /-i,- '%y be sele,ted %t t-e ,ontrol p%nel+ *-e t.be ,.rrent is lin4ed to t-e t.be potenti%l+ *-e oper%tor %lso sele,ts t-e e0pos.re ti'e /-i,res.lts in % v%l.e o1 t.be ,.rrent(e0pos.re ti'e prod.,t <or 'As= yieldin& t-e ,orre,t densities on t-e pro,essed intr%or%l dent%l 1il'+

Figure 2.++ ,h t graph f a m dern frequenc! c n&erter mu"ti pu"se intra ra" denta" unit.

*-e r%di%tion intensity prod.,ed by t-is intr%or%l dent%l .nit is '.,- &re%ter t-%n t-%t o1 ,onvention%l dent%l @(r%y .nit 'entioned %bove+ *-e 'e%n @(r%y ener&y o.tp.t 1ro' t-is ,onst%nt potenti%l <$C= .nit is -i&-er2 t-%n t-ose one 1ro' %n %ltern%tin& potenti%l <AC= .nit %t t-e s%'e 4V+ or t-e intr%or%l r%dio&r%p-y ,onst%nt potenti%l <$C= or C)P &ener%tors2 t-e C9 4V is re,o''ended /it- '.,- 'ore %,,.r%te %nd predi,t%ble @(r%y o.tp.t+ It is %lso &ener%lly s.&&ested 1or t-e .se /it- di&it%l re,eptor i'%&in& syste's+ *-ere1ore2 s-orter e0pos.re ti'es '%y be ne,ess%ry 1or ,ert%in ,lini,%l e0%'in%tions /-i,- %re %,-ieved on t-is dent%l .nit by %n ele,troni, <di&it%l= ti'er+ On,e %&%in t-e e0pos.re b.tton is o1 t-e de%d('%n type %nd is %tt%,-ed to % lon& le%d <%t le%st 2 'eters lon&= %lso to 'ini'i3e e0pos.re o1 t-e st%11+ Anot-er %dv%nt%&e o1 1re5.en,y ,onverter '.lti(p.lse < C)P= &ener%tors is t-%t t-e si3e o1 t-e tr%ns1or'er '%y be red.,ed2 res.ltin& in t-e desi&n o1 rel%tively s'%ll t.be -e%ds+ *-e -i&- r%di%tion intensity 'e%ns t-%t lon&er ,olli'%tors '%y be %tt%,-ed to t-e @(r%y t.be <e+&+ 29 ,'=+ *-is type o1 ,olli'%tors in-erently prod.,es i'proved be%' li'it%tion o1 t-e @(r%y o.tp.t+

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At one ti'e2 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-o/n t-%t t-e .se o1 t-ese intr%or%l t.bes to %n %ir 4er'% o1 9+E J "+9 By per sin&le e0pos.re %t t-e s.r1%,e o1 t-e t.be <IC:P 33=+ ort.n%tely t-e .se o1 t-is type o1 e5.ip'ent -%s s.bst%nti%lly de,re%sed %s dis%ppe%red over t-e ye%rs2 t-o.&- t-ere '%y be so'e old .nits still in oper%tion+

2.3.2. ,-traoral (Panoral and )ephalometric+ Dental !"ray equipment and &ccessories 2.'.2.1. ,an ramic Denta" #$ra! equipment and Access ries

Dental panoral radiography


In p%nor%l r%dio&r%p-y t-e %i' is to obt%in %n i'%&e <,.rved(pl%ne to'o&r%'s= o1 t-e ,o'plete p%t-olo&y o1 bot- sets o1 teet- %nd >%/s+ *-e '%in %dv%nt%&e is % r%pid %,5.isition o1 % sin&le i'%&e o1 t-e entire dent%l %r,-es %nd t-eir s.pportin& str.,t.res+ Ho/ever2 t-e b%si, proble' o1 dent%l p%nor%l r%dio&r%p-y is t-%t t-e pl%ne o1 teet- is %ppro0i'%tely ellipti,%l+ *-.s it is not possible to .se % sin&le si'ple 'ove'ent /-i,/o.ld res.lt in %ll t-e teet- bein& ,ont%ined in t-e 1o,%l tro.&-+ It is t-ere1ore ne,ess%ry to .se % series o1 ,o'ple0 to'o&r%p-i, 'ove'ents to i'%&e bot- ro/s o1 teet-+ One sol.tion to t-is proble' is to per1or' rot%tion%l p%nor%l r%dio&r%p-y .sin& t/o or t-ree ,ir,.l%r 'ove'ents+ A s'%ll verti,%l slit %pert.re is pl%,ed %t t-e o.tp.t port o1 t-e @( r%y t.be+ *-e 1il' is lo%ded into eit-er % 1l%t or ,.rved @(r%y ,%ssette /-i,- is rot%ted %s /ell %s bein& 'oved %ro.nd t-e p%tientHs -e%d+ *-ere '%y %lso be % n%rro/ verti,%l slit pl%,ed in 1ront o1 t-e 1il' ,%ssette+ *-e @(r%y t.be %nd 1il' %re rot%ted %ro.nd one point 1or % ,ert%in %n&le+ *-is p%nor%'i, to'o&r%p-i, te,-ni5.e .ses % n%rro/ verti,%l be%'2 e0posin& only % s'%ll portion o1 t-e i'%&e re,eptor %t %ny one ti'e <!C:P "4E=+ On,e t-is initi%l rot%tion -%s been ,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'ent2 /-ere%s only t/o 1.l,r.' points %re .sed 1or t/o ,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+

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Figure 2.++ Diagram i""ustrating r tati na" pan ra" radi graph!.

In %n ellipti,%l p%nor%l r%dio&r%p-y .nit2 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 1ollo/s t-e %ppro0i'%te position o1 t-e dent%l %r,-es <see i&.re 2+00=+

Figure 2.++ ,h t graphs i""ustrating an e""iptica" pan ra" radi graph! unit.

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Figure 2.++

E""iptica" ,an ramic Radi graph!. Institute f r ,an ramic Imaging in Dentistr!- La ,"ata- Argentina

Figure 2.++ ,h t graphs sh 2ing a digita" e""iptica" pan ra" radi graph! unit. Institute f r ,an ramic Imaging in Dentistr!- La ,"ata- Argentina

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Figure 2.++ Digita" ,an ramic Radi graph!. Institute f r ,an ramic 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 si3e ,%p%bilities+ *-e be%' -ei&-t %t t-e re,eivin& slit <se,ond%ry ,olli'%tor= s-o.ld be restri,ted to no &r%ter t-%n t-%t re5.ired to e0pose t-e %re% o1 di%&nosti, interest %nd obvio.sly no &re%ter t-%n t-e 1il'+ #o t-e be%' li'it%tion is nor'%lly o1 "29 or "E9 '' o1 -ei&-t+ *-e be%' n%rro/in& </idt-= s-o.ld nor'%lly be no &re%ter t-%n E ''+ <EB "3C= It is stron&ly en,o.r%&ed in p%nor%'i, r%dio&r%p-y t-e li'it%tion o1 1ield si3e to t-e %re% o1 di%&nosti, interest+ *-e %li&n'ent o1 @( r%y t.be </it- its slit be%'(li'itin& devi,e %nd 1il' s-ield /it- its slit is ,riti,%l2 %nd t-is s-%ll be ,-e,4ed periodi,%lly+<IC:P 33= Irrespe,tive o1 t-e type o1 'ove'ent e'ployed2 t-e e5.ip'ent -%s ,ert%in ,o''on 1e%t.res+ *ypi,%l 1o,%l tro.&- t-i,4nesses %re %ppro0i'%tely "9 '' deep2 t-o.&- it v%ries dependent on t-e type o1 'ove'ent e'ployed by t-e p%nor%l to'o&r%p-i, .nit+ A ,onse5.en,e o1 t-e li'ited e0tent o1 t-e 1o,%l tro.&- is t-%t it is vit%lly i'port%nt to ,orre,tly position t-e p%tient+ V%rio.s positionin& %ides %re in,orpor%ted in t-e e5.ip'ent desi&n+ E11e,tive dose to t-e p%tient 1or % sin&le p%nor%'i, i'%&e is %ppro0i'%tely t-e s%'e %s 1o.r si'ple peri%pi,%l i'%&es+ ;.t 1ro' t-e i'%&e %,5.isition point o1 vie/ t-e verti,%l i'%&e '%&ni1i,%tion is independent o1 t-e -ori3ont%l '%&ni1i,%tion+ *-is i'%&e distortion v%ries /it- %re% to be e0plored in t-e p%tient %s /ell %s 1ro' p%tient to p%tient 1or t-e s%'e p%nor%'i, @(r%y devi,e+ *-e repe%t i'%&es o1 t-e s%'e p%tient %lso '%y di11er be,%.se o1 sli&-t di11eren,es o1 p%tient positionin&2 /-i,- is ,riti,%l+ Anot-er dis%dv%nt%&e is t-e i'%&e resol.tion2 /-i,- is li'ited by t-e i'per1e,t 'ove'ent o1 so.r,e %nd i'%&e re,eptor2 re5.ired by t-e to'o&r%p-i, te,-ni5.e+ *-e 3one o1 s-%rp 1o,.s is li'ited %nd v%ries /it'%n.1%,t.rer %nd 'odel+ <!C:P "4E= 2.'.2.2. 3epha" metric Denta" #$ra! equipment and Access ries.

Cep-%lo'etri, r%dio&r%p-y2 %lso 4no/n %s teler%dio&r%p-y2 .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 .nit2 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%rdi3ed %nd is typi,%lly "+E9 ' or 'ore2 to %ss.re 'ini'%l &eo'etri,%l distortion to t-e i'%&e+ :%dio&r%p-s %re t%4en .sin& % ,onvention%l @(r%y t.be lin4ed 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.be2 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.rs2 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 interest2 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.++ ,h t graphs f a m dern and "d 3epha" metric denta" unit.

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Figure 2.++ ,h t graphs and radi graphies f 3epha" metric denta" unit

Figure 2.++ ,h t graph f a Digita" 3epha" metric denta" unit. Institute f r ,an ramic Imaging in Dentistr!- La ,"ata- Argentina.

2.'.2.'.

F"u r sc p! f r denta" use

In dentistry t-e .se o1 1l.oros,opy2 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 <*)J= or in>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 s4in %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' %
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ne/ vol.'etri, C* s,%nner2 '%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*+ <U!#CEA: 2999=

Fig. 2.## Denta" #$ra! equipment se"ecti n and purchase specificati ns. Acceptance and r utine testing. 4enera" maintenance.

*-is se,tion rel%tes to %,,.r%te sele,tion %nd %,5.isition %s /ell %s testin& %nd '%inten%n,e o1 dent%l @(r%y e5.ip'ent+ $ent%l @(r%y e5.ip'ent s-o.ld be desi&ned2 ,onstr.,ted %nd inst%lled in ,o'pli%n,e /it- re,o&ni3ed Intern%tion%l st%nd%rds pert%inin& to %ll %spe,ts o1 e5.ip'ent 5.%lity per1or'%n,e %nd s%1ety <e+&+ ele,tri,%l2 'e,-%ni,%l %nd r%di%tion o.tp.t %nd prote,tion=+ In %ddition t-e s%1ety o1 st%11 .sin& t-e e5.ip'ent %nd p%tients .nder&oin& t-e di%&nosis is opti'i3ed %s /ell %s need to be ens.red t-%t dose to bot-2 st%11 %nd p%tients is 4ept %s lo/ %s re%son%bly %,-iev%ble+ It is re5.ired t-%t s.ppliers o1 dent%l @(r%y e5.ip'ent provide %de5.%te in1or'%tion pertinent to t-e proper .se2 testin& %nd '%inten%n,e o1 t-e e5.ip'ent+ *-e s.,,ess %,-ieved in t-e pro,.re'ent pro,ess /ill si&ni1i,%ntly in1l.en,e t-e 5.%lity o1 t-e pro,ed.res %s /ell %s t-e ,osts2 %nd % pro1ession%l %ppro%,- '.st t-ere1ore be t%4en to p.r,-%sin&+ It is i'port%nt to point o.t t-%t t-e p.r,-%se o1 t-is type o1 e5.ip'ent ,ons.'es %n i'port%nt %'o.nt o1 t-e b.d&et o1 % dent%l instit.tion+ *-e pro,.re'ent pro,ess is p%rt o1 %n over%ll pl%n t-%t ,o'prises t-e 1ollo/in& st%&es <00=?
( ( ( ( (

An%lysis o1 e5.ip'ent needs2 ,le%rly de1inin& t-e intended .se o1 t-e syste'+ E5.ip'ent spe,i1i,%tions2 o.tlinin& t-e &ener%l re5.ire'ents %nd det%ilin& spe,i1i, 1.n,tion%l p%r%'eters %nd i'%&e 5.%lity 1%,tors in t-e ,%se o1 $i&it%l I'%&in&+ ;id %n%lysis2 /it- e'p-%sis on 'eetin& t-e spe,i1i,%tions+ E5.ip'ent inst%ll%tion2 1ollo/ed by %,,ept%n,e testin&2 prior to t-e e5.ip'entHs .se in ,lini,%l pr%,ti,e %nd on(site tr%inin&+ I'ple'ent%tion o1 % pro&r%' o1 preventive %nd ro.tine '%inten%n,e2 per1or'ed %t re&.l%r
P%&e 27

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interv%ls2 1ollo/in& %ny si&ni1i,%nt '%inten%n,e pro,ed.re+ Est%blis-'ent o1 % qua"it! c ntr " pro&r%' to %ss.re ,onst%n,y o1 per1or'%n,e %nd to dete,t %nd ,orre,t %ny tenden,ies to/%rd syste' '%l1.n,tion+

On,e % p%rti,.l%r need /%s de1ined2 it '.st ,%re1.lly sele,t t-e p%rti,.l%r 'odel %nd br%nd2 sin,e t-is is %n %re% o1 r%pid pro&ress in /-i,- te,-nolo&y be,o'es obsolete very 5.i,4ly+ *-e 'odel s-o.ld be sele,ted %,,ordin& to t-e 1ollo/in& ,riteri%? e11e,tiveness2 s%1ety2 in1r%str.,t.re2 '%inten%n,e2 %nd ,ost+ It is %dvis%bly to ,o'p%re t-e te,-ni,%l spe,i1i,%tions o1 v%rio.s types o1 e5.ip'ent %nd %n%ly3e t-eir %dv%nt%&e on t-e ,lini,%l %ppli,%tion 1or /-i,- t-e e5.ip'ent is bein& sele,ted+ !e0t2 it is ne,ess%ry to %ssess /-%t 4ind o1 %n,ill%ry e5.ip'ent is re5.ired 1or t-e '%in e5.ip'ent to be e11e,tive+ or e0%'ple2 i1 % di&it%l i'%&in& syste' is to be p.r,-%sed2 it is essenti%l to t%4in& in %,,o.nt proper ,o'p.teri3ed e5.ip'ent+ Written e5.ip'ent spe,i1i,%tions s-o.ld indi,%te t-e ,lini,%l pro,ed.res to be per1or'ed <peri%pi,%l or p%nor%l or ,ep-%lo'etri,= o.tlinin& %ny spe,i1i, needs beyond t-e nor'%l ,lini,%l pro,ed.res+ In %ddition2 %n esti'%te o1 t-e n.'ber o1 pro,ed.res per d%y s-o.ld be &iven6 t-e e0pe,ted lo,%tion o1 t-e e5.ip'ent2 /it- t-e roo' di'ensions2 s-o.ld be spe,i1ied6 %nd %ny p%rti,.l%r site proble's s-o.ld be noted+ *-e pl%ns 1or t-e inst%ll%tion o1 % dent%l @(r%y set s-o.ld be ,riti,%lly revie/ed %nd ,onsidered e%rly in t-e pro,ess by % 5.%li1ied e0pert <or ot-er %pproved body dependent on lo,%l %rr%n&e'ents= to ens.re t-%t %ll %spe,ts o1 r%di%tion s%1ety 1or bot- st%11 %nd 'e'bers o1 t-e p.bli, -%ve been ,onsidered+ #%1ety i'plies 4no/led&e o1 'e,-%ni,%l2 ele,tri,%l2 %nd r%diolo&i,%l ris5s+ It is ne,ess%ry to 4no/ /-%t r%di%tion levels %re e'itted by t-e e5.ip'ent %nd to desi&n t-e ne,ess%ry prote,tion <1or e0%'ple2 str.,t.r%l shie"ding= in %,,ord%n,e /it- t-e r%di%tion prote,tion l%/s o1 t-e ,o.ntry+ A'on& t-e 1%,tors to ,onsider in esti'%tin& ,osts %re t-e 1ollo/in&? t-e initi%l p.r,-%se o1 t-e '%in %nd %n,ill%ry e5.ip'ent6 its inst%ll%tion2 in,l.din& shie"ding6 t-e '%inten%n,e pro&r%'2 in,l.din& sp%re p%rts6 %,,essories <1il's2 s,reens2 dosi'eters2 s.pplies in &ener%l=6 t-e ,ost o1 oper%tor tr%inin& %nd ,ontin.in& ed.,%tion+ As p%rt o1 t-e re5.ired spe,i1i,%tions2 it s-o.ld be st%ted t-%t i'ported e5.ip'ent '.st ,o'ply /it- re&.l%tions o1 t-e ,o.ntry o1 ori&in %s /ell %s /it- %ny ot-er n%tion%l or lo,%l nor's2 i1 t-ere %re %ny+ In t-e ,%se o1 non(i'ported e5.ip'ent2 it '.st be de,ided /-i,intern%tion%l st%nd%rds %re to be 1ollo/ed <e+&+2 t-ose o1 t-e IEC2 I#O2 et,+= It is %dvis%ble to ,le%rly de1ine t-e st%nd%rds 1or e5.ip'ent %,,ept%n,e testin& pro,ess+ In so'e instit.tions2 % t-ird p%rty ,ons.lt%nt is re,r.ited to -%ndle e5.ip'ent %,5.isition %s /ell %s t-e %,,ept%n,e testin& in order to 1ree st%11 1ro' t-e tedio.s %nd ti'e(,ons.'in& t%s4 o1 /ritin& spe,i1i,%tions %nd ,%rryin& o.t t-e re5.ired 1ollo/(.p+ or di&it%l i'%&in& t-e ,o'p.ter ,%p%bilities s-o.ld be ,le%rly spe,i1ied+ *-e re5.ire'ents '%y v%ry dependin& on t-e i'%&in& 'od%lity .nder ,onsider%tion+ Ho/ever2 1or %ll 'od%lities i'%&e %,5.isition p%r%'eters '.st be ,le%rly de1ined2 in,l.din& t-e n.'ber o1 i'%&es per .nit ti'e2 '%tri0 si3e2 re,onstr.,tion ti'e2 %nd pi+e" dept-+ #tor%&e 'e'ory devi,es %nd t-eir stor%&e li'its /ill -%ve to be spe,i1ied t%4in& into ,onsider%tion t-e stor%&e ,%p%,ity needed per i'%&e+
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*-e de&ree to /-i,- t-e spe,i1i,%tions %re 'et2 t-e &.%r%ntees %nd t-e %bility to provide '%inten%n,e servi,e 1or t-e e5.ip'ent2 %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'ent2 %re %lso very i'port%nt 1%,tors to t%4e 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'ent2 %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.ldnHt t%4e 'ore t-%n one or t/o 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 .se2 %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.rerHs te,-ni,%l %&reed per1or'%n,e p%r%'eters <e+&+ oper%tin& potenti%l %nd ,.rrent2 @(r%y o.tp.t2 ti'er %,,.r%,y et,++= %nd provide b%seline d%t% 1or ro.tine testin& t-ro.&-o.t t-e .se1.l li1e o1 t-e e5.ip'ent+ *-e %,,ept%n,e test s-o.ld %lso ,onsist o1 'e%s.re'ents to %ssess typi,%l p%tient doses+ It is %dvised t-%t % represent%tive p%tient dose be ,%l,.l%ted %nd ,o'p%red /it- %n %ppropri%te re,o''end%tion level <Intern%tion%l or n%tion%l/lo,%l re,o''end%tions=+ *ests o1 e5.ip'ent 1.n,tion s-o.ld be ,%rried o.t in % ,onsistent '%nner2 'et-ods bein& b%sed on intern%tion%l %nd or n%tion%l proto,ols+ <00=+ *-ro.&- t-ese tests it is possible to veri1y t-%t t-e e5.ip'ent ,o'plies /it- t-e spe,i1i,%tions provided by t-e '%n.1%,t.rer in t-e bid %nd it s-o.ld %lso be possible to dete,t %ny non(,o'pli%n,e or de1e,t+ #-o.ld t-e 1%,ility not -%ve t-e re5.ired instr.'ent%tion %nd/or personnel to per1or' t-e tests2 t-ere s-o.ld be % ,l%.se in t-e s%les ,ontr%,t .nder /-i,- t-e vendor is re5.ired to lend t-e ,%libr%ted e5.ip'ent %nd/or 5.%li1ied personnel+ It is %dvis%ble to -%ve % /ritten st%te'ent in t-e s%les ,ontr%,t det%ilin& t-e n%t.re %nd spe,i1i,%tions o1 t-e %,,ept%n,e testin&+ *-e preventive '%inten%n,e ,onsists o1 periodi, pro,ed.res %nd 'e%s.re'ents per1or'ed on e5.ip'ent to red.,e t-e possibilities o1 % '%l1.n,tion %nd ens.re its ,ontin.o.s2 s%1e2 %nd e,ono'i,%l oper%tion+ It is essenti%l t-%t t-e 1e%t.res o1 dent%l @(r%y e5.ip'ent pert%inin& to t-e r%di%tion s%1ety o1 bot- .sers %nd p%tients is ,orre,tly '%int%ined+ *o ens.re t-is2 t-e e5.ip'ent needs to be in &ood 'e,-%ni,%l %nd ele,tri,%l order+ :e&.l%r '%inten%n,e %nd %sso,i%ted ,-e,4s s-o.ld be per1or'ed in %,,ord%n,e /it- t-e re,o''end%tions o1 t-e '%n.1%,t.rer2 t-e s.pplier2 %nd t-e 5.%li1ied e0pert+ :e&%rdless o1 /-o ,%rries o.t '%inten%n,e %,tivities2 % lo&boo4 s-o.ld be 4ept in /-i,- %ll '%inten%n,e pro,ed.res %nd t-eir ,osts %re re,orded+ *-e e0%,t pro,ed.res %nd 1re5.en,y 1or ,%rryin& o.t t-ese tests on dent%l @(r%y e5.ip'ent %nd t-e ,riteri% 1or re'edi%l %,tion v%ry 1ro' ,o.ntry to ,o.ntry+ A.%li1ied e0perts or 'edi,%l p-ysi,s e0perts s-o.ld nor'%lly be involved+ E.rope%n ,riteri% o1 %,,ept%bility -%ve been est%blis-ed 1or intr%or%l r%dio&r%p-y .nits %nd it is %lso re,o''ended t-%t t-e E.rope%n ,riteri% 1or &ener%l r%dio&r%p-i, .nits ,%n be %pplied to ,ep-%lo'etri, .nits <0=+

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:o.tine '%inten%n,e or tests s-o.ld be per1or'ed %t desi&n%ted interv%ls %nd 1ollo/in& %ny si&ni1i,%nt '%inten%n,e pro,ed.re+ Ide%lly2 t-is s-o.ld be per1or'ed %t le%st every t-ree ye%rs <00= %nd is o1ten % 'ore 1re5.ent re&.l%tory re5.ire'ent <00=+ A ro.tine test is essenti%lly t-e s%'e in ,ontent %s t-e %,,ept%n,e test %bove2 b.t /it- % di11erent e'p-%sis+ *-e intention is to est%blis- t-%t t-e e5.ip'ent ,ontin.es to oper%te opti'%lly /it- respe,t to st%11 %nd p%tient s%1ety %s deter'ined %t t-e %,,ept%n,e test+ Hen,e2 it /ill only be ne,ess%ry to ,on1ir' t-%t t-ere -%ve been no si&ni1i,%nt ,-%n&es to t-e e5.ip'entHs lo,%tion %nd its 1.n,tion+ Ann.%l testin& s-o.ld %l/%ys be ,onsidered /-en? "+ ( *-e %ssessed typi,%l p%tient dose e0,eeds t-e re1eren,e level <see 00= 2+ ( I'%&e 5.%lity is ro.tinely poor <see 00= 3+ ( *-e A.%lity Ass.r%n,e pro&r%''e indi,%tes % si&ni1i,%nt per1or'%n,e /e%4ness Ann.%l interv%ls s-o.ld be '%int%ined .ntil 1.ll ,on1iden,e is restored t-%t %,,ept%ble per1or'%n,e is bein& '%int%ined+ *-e d%t% ,olle,ted s-o.ld be ret%ined %s % per'%nent re,ord 1or ,o'p%rison /it- s.bse5.ent tests+ :e,o''end%tions s-o.ld be '%de to re,ti1y %ny identi1ied de1i,ien,ies+ :o.tine tests s-o.ld ,over %ll 'e,-%ni,%l %nd ele,tri,%l syste's /-ose '%l1.n,tion ,o.ld res.lt in in%dvertent r%di%tion e0pos.re+ A re,ord o1 '%inten%n,e2 in,l.din& %ny de1e,ts 1o.nd %nd t-eir rep%ir s-o.ld be 4ept 1or e%,- ite' o1 @(r%y e5.ip'ent+ ollo/in& '%inten%n,e t-e en&ineer s-o.ld provide % s%tis1%,tory /ritten report prior to t-e e5.ip'ent bein& .sed on,e 'ore 1or ,lini,%l pr%,ti,e+ Any '%inten%n,e lo&s s-o.ld be .p(to(d%te %nd 1or' p%rt o1 t-e AA pro&r%''e+

Fig. 2. ++

Fig. 2. ++1

2!4! "ma&e rece'tors an% %is'lays! Film3screen com,inations an% Di&ital Detectors

'mage receptors
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I'%&e re,eptor syste's /ill be ,l%ssi1ied in Intr%or%l il's2 #,reen il's %nd Intensi1yin& #,reens 1or E0tr%or%l i'%&in& %nd $ire,t $i&it%l :%dio&r%p-y re,eptors+ *-e per1or'%n,e o1 i'%&e re,eptor syste's ,%n be ,-%r%,teri3ed by t-ese 1ive p%r%'eters? 1il' speed2 1il' or ot-er i'%&e re,eptor ,ontr%st2 r%n&e l%tit.de2 i'%&e resol.tion %s % line p%irs per 'illi'eter <lp '' ("= %nd noise %s % presen,e o1 r%ndo' 1l.,t.%tion in i'%&e intensity+ <00=+ In % ,onvention%l intr%or%l dent%l 1il' % bl%,4 pie,e o1 p%per is /r%pped %ro.nd t-e @( r%y 1il' to e0,l.de li&-t+ *-e 1il' %nd prote,tive p%per %re pl%,ed in % li&-t ti&-t pl%sti, p%,4et2 to&et-er /it- % pie,e o1 le%d 1oil+ *-is t-in s-eet o1 le%d 1oil is pl%,ed to t-e re%r o1 t-e pl%sti, p%,4et on t-e side 1.rt-est %/%y 1ro' t-e @(r%y t.be+ *-e le%d 1oil serves to %tten.%te t-e @(r%ys tr%ns'itted t-ro.&- t-e 1il'2 t-ereby red.,in& t-e r%di%tion dose to t-e p%tient+ It %lso red.,es t-e %'o.nt o1 s,%ttered r%di%tion re%,-in& t-e 1il' %nd -en,e 1il' 1o&&in&+ It is dire,t e0pos.re 1il'2 /-ere t-e l%tent i'%&e is prod.,ed by t-e dire,t e0pos.re o1 1il' e'.lsion by t-e 0(r%y be%'+ Intr%or%l 1il's %re ,-%r%,teri3ed by speed &ro.ps C t-ro.&- <A$A2 "7896 A!#I2 "77C= <*%ble 00=+ #peed &ro.ps $2 E %nd %re %v%il%ble 1or .se in intr%or%l r%dio&r%p-y < %r'%n %nd %r'%n2 29996 *-.nt-y2 2999=+ Ad>%,ent &ro.ps di11er in speed by 1%,tors o1 %ppro0i'%tely t/o+ *-.s2 speed &ro.p E is %ppro0i'%tely t/i,e t-e speed o1 &ro.p $2 i.e.- E( speed 1il's per'it p%tient e0pos.re to be red.,ed by %bo.t -%l1 o1 t-%t re5.ired 1or $(speed 1il's <L.dlo/ %nd Pl%tin2 "77E6 Pri,e2 "77E=+ #peed &ro.p is %ppro0i'%tely t/i,e t-e speed o1 &ro.p E+ *A;LE 00 (Intr%or%l 1il'(speed ,l%ssi1i,%tion+ % Film 'ee% /rou' C $ E 'ee% Ran&e 9R3l:a C("2 "2 ( 24 24 ( 4D 4D ( 7C
%

$%t% 1ro' A'eri,%n $ent%l Asso,i%tion <A$A2 "789=2 &iven in t-e 5.%ntity .tili3ed %t t-e ti'e o1 p.bli,%tion Oinverse o1 e0pos.re in roent&en <:(l=P+

Over t-e ye%rs dent%l @(r%y 1il' '%n.1%,t.rers -%ve red.,ed p%tient e0pos.res by t-e introd.,tion o1 1%ster intr%or%l dent%l 1il's+ *-e .se o1 E4t%speed <E speed= 1il' -%s been in,re%sin& sin,e its introd.,tion+ *-e introd.,tion o1 1%ster 1il' speeds does not res.lt in de,re%sed i'%&e 5.%lity or di%&nosti, yield d.e to %lter%tions in 1il' e'.lsion+ E%rly &ro.p(E 1il' /it- ,onvention%l e'.lsion te,-nolo&y -%d % .se1.l density r%n&e si'il%r to &ro.p($ 1il'2 b.t de'onstr%ted % sli&-t de,re%se in ,ontr%st %nd /%s 'ore sensitive to pro,essin& ,onditions <$ie-l et ai.- "7DC6 *-.nt-y %nd Weinber&2 "7D2=+ In ,lini,%l tri%ls2 -o/ever2 &ro.p(E %nd &ro.p($ 1il' de'on( str%ted ,o'p%r%ble di%&nosti, 5.%lity < ro''er %nd J%in2 "7D86 Fleier et ai.- "7D86 W-ite %nd P-%r%o-2 2994=+
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A ne/er 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.dies2 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 <L.dlo/ %nd Pl%tin2 "77E6 Pri,e2 "77E=+ P%tient e0pos.re ,%n be si&ni1i,%ntly red.,ed by .tili3%tion o1 E(speed or (speed 1il' /it-o.t ,o'pro'isin& di%&nosti, 5.%lity+ .rt-er develop'ents in e'.lsion te,-nolo&y '%y res.lt in 1.t.re i'prove'ents+ *-ere %re t/o possible proble's %sso,i%ted /it- t-e .se o1 intr%or%l dent%l @(r%y 1il'+ One is t-%t o1 positionin& t-e dent%l 1il'+ *-e se,ond proble' is t-%t t-e 1il' is re,t%n&.l%r in ,ross(se,tion /-ere%s t-e @(r%y be%' '%y be ,ir,.l%r+ *-.s not only is it di11i,.lt to %,,.r%tely position t-e @(r%y t.be /it- respe,t to t-e 1il'2 t-e r%di%tion be%' '%y -%ve % '.,- l%r&er %re% t-%n t-e 1il'2 t-ereby ,%.sin& %n in,re%se in p%tient dose+ #pe,i%li3ed intr%or%l dent%l 1il' -olders -%ve been developed /-i,- in,orpor%te %ddition%l ,olli'%tion to red.,e r%di%tion dose+ Ot-er positionin& %ides %re %v%il%ble 1or t-e re,t%n&.l%r ,olli'%tors .sed on so'e dent%l .nits+ E0tr%or%l e0pos.res 1or p%nor%'i, %nd ,ep-%lo'etri, r%dio&r%p-y2 .tili3e li&-t( sensitive 1il' in ,o'bin%tion /it- proper intensi1yin& s,reens /it-in % ,%ssette+ *-e intensi1yin& s,reens ,onsist o1 t-in l%yers o1 p-osp-or ,ryst%ls t-%t 1l.ores,e /-en e0posed to 0 r%ys+ *-e 1il' is e0posed by li&-t e'itted by t-e intensi1yin& s,reens+ Absorption o1 li&-t e'itted 1ro' t-e intensi1yin& s,reens is in,re%sed by t-e %ddition o1 dyes to t-e 1il' e'.lsion+ *-e spe,tr.' o1 li&-t 'ost re%dily %bsorbed by t-e 1il' is '%t,-ed to t-e spe,tr.' o1 li&-t e'itted by t-e intensi1yin& s,reens+ <00=+ :%re(e%rt- intensi1yin& s,reens2 .sed in ,on>.n,tion /it- properly '%t,-ed s,reen 1il's2 %re t-e 1%stest s,reen(1il' ,o'bin%tions %v%il%ble %s o1 t-e d%te o1 t-is :eport+ <00= :%re(e%rt- s,reens t-%t e'it &reen or bl.e li&-t %re 'ore e11i,ient %t %bsorbin& r%di%tion t-%t e0its t-e p%tient %nd ,onvertin& 0(r%y ener&y to li&-t ener&y t-%n t-e bl.e(e'ittin& ,%l,i.' t.n&st%te s,reens+ P%tient e0pos.re in p%nor%'i, %nd ,ep-%lo'etri, r%dio&r%p-y '%y be red.,ed by %bo.t E9 K .sin& 1%st r%re(e%rt- vers.s slo/er ,%l,i.' t.n&st%te s,reen(1il' ,o'bin%tions /it- no si&ni1i,%nt di11eren,e in per,eived di%&nosti, 5.%lity <Br%tt et a".- "7D46 F%.&%rs %nd %to.ros2 "7D2=+ Use o1 s,reen 1il' /it- ne/ &r%in te,-nolo&y res.lts in in,re%sed 1il' speed /it-o.t % loss o1 i'%&e s-%rpness+ :%re(e%rt- i'%&in& syste's .sin& t-is 1il' -%ve been s-o/n to be "+3 ti'es 1%ster t-%n % ,o'p%r%ble syste' .sin& ,onvention%l 1il' e'.lsion te,-nolo&y /it-o.t ,o'pro'isin& di%&nosti, 5.%lity <$QA'brosio et a".- "7DC6 *-.nt-y %nd Weinber&2 "7DC6 W-ite %nd P-%r%o-2 2994=+ Co''er,i%lly #,reen(1il's %re /idely %v%il%ble /it- v%ryin& speed2 ,ontr%st %nd l%tit.de ,-%r%,teristi,s2 dependin& on spe,i1i, i'%&in& needs+ #,reen(1il' ,o'bin%tions %re 'ore sensitive to 0 r%ys t-%n nons,reen 1il'2 t-.s red.,in& t-e level o1 e0pos.re to t-e p%tient+ I'%&e s-%rpness2 -o/ever2 is de,re%sed %s % res.lt o1 di11.sion o1 li&-t e'itted 1ro' t-e intensi1yin& s,reens to e0pose t-e 1il'+

Digital detectors
$ire,t $i&it%l :%dio&r%p-y is t-e repl%,e'ent o1 % 1il'(b%sed i'%&e by % di&it%l i'%&e ,onsistin& o1 % t/o(di'ension%l %rr%y o1 pi0els+ In dire,t di&it%l r%dio&r%p-y2 t-e l%tent i'%&e is dire,tly re,orded by % s.it%ble sensor+ :e,eptors .sed in dire,t di&it%l r%dio&r%p-y %re p-otosti'.l%ble stor%&e p-osp-or <P#P= pl%tes or solid st%te ele,troni, devi,es ,ont%inin& eit-er ,-%r&e(,o.pled devi,e <CC$= or ,o'ple'ent%ry 'et%l(o0ide se'i,ond.,tor <C)O#=
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te,-nolo&y+ :e,ently so'e sensors -%ve been developed /it- s'%ller pi0el si3e %nd /it- t-e .se o1 t-e so(,%lled A,tive Pi0el #ensor <AP#=+ In indire,t di&it%l r%dio&r%p-y2 t-e i'%&e is initi%lly re,orded on ,onvention%l 1il'2 %nd l%ter di&it%lly pro,essed to prod.,e %n ele,troni, i'%&e+ *-e ele,troni, i'%&e '%y be displ%yed on % ,o'p.ter devi,e2 ,onverted to % -%rd ,opy2 or tr%ns'itted ele,troni,%lly %nd no pro,essin& ,-e'i,%ls or e5.ip'ent is ne,ess%ry+ *-e di&it%l i'%&es %re s.pposed to %,-ieve i'%&es o1 -i&- di%&nosti, 5.%lity2 %t le%st e5.%l to t-%t o1 ,onvention%l r%dio&r%p-i, 1il'+ One o1 t-e 'ost ,o''on intr%or%l di&it%l re,eptor /it- % si'il%r si3e o1 % re&.l%r intr%or%l dent%l 1il' introd.,ed in "7D7 is % t/o(di'ension%l CC$ %rr%y2 /-i,- is ,onne,ted by ,%ble to PC+ )ost o1 CC$Rs %re '%de o1 p.re sili,on %nd %re sensitive to 0 r%ys or to visible li&-t+ *-e CC$ re,eptor is eit-er dire,tly e0posed to 0 r%ys or 0(r%y ener&y is previo.sly ,onverted by %n intensi1yin& s,reen to li&-t /-i,- is tr%ns'itted to t-e CC$ %rr%y+ An ele,troni, ,-%r&e2 proportion%l to t-e %'o.nt o1 0(r%y e0pos.re2 is %,,.'.l%ted in t-e CC$+ or intr%or%l pro>e,tions2 t-e i'%&e re,eptor is positioned intr%or%lly %nd e0posed .sin& ,onvention%l @(r%y di%&nosti, te,-ni5.es+ On,e 1in%li3ed t-e @(r%y e0pos.re2 t-e i'%&e is i''edi%tely di&iti3ed %nd displ%yed on % PC 'onitor %s /ell %s stored in 'e'ory+ *-e p-otosti'.l%ble stor%&e p-osp-or pl%te is si'il%r to %n intensi1yin& s,reen+ It is inserted in % li&-t(ti&-t ,%ssette %nd e0posed .sin& ,onvention%l @(r%y di%&nosti, te,-ni5.es <Wen3el %nd Brond%-l2 "77E=+ W-en+ t-e devi,e is e0posed6 it stores t-e l%tent i'%&e in % 5.%si(st%ble st%te+ *-e ,%ssette ,ont%inin& t-e e0posed pl%te is pl%,ed in % pro,essor t-%t re'oves t-e pl%te %nd positions it on % st%&e so it ,%n be s,%nned by % l%ser2 /-i,- sti'.l%tes p-otol.'ines,ent e'ission o1 t-e i'%&e t-%t ,%n be re,orded di&it%lly or tr%ns1erred to % 1il' <;.s-ber& et a".- 299"=+ *-e i'%&in& pl%tes %re re.s%ble %nd do not need ,%ble ,onne,tion to t-e PC+ Pl%tes s-o.ld not be 4ept in t-e prote,tive envelope 1or % lon& period be1ore bein& .sed+ Cos'i, r%di%tion /ill re%,- t-e p-osp-or s.r1%,e %nd tr%ns1er ener&y to ele,trons+ *-is /ill res.lt in SnoiseH visible in t-e 1in%l i'%&e %s bl%,4 spots+ A1ter t-e pl%tes %re e0posed2 t-ey s-o.ld be re%d %s soon %s possible+ W-en t-e pl%tes %re 4ept 1or % lon&er2 espe,i%lly /-en t-ey %re e0posed to %'bient li&-t2 t-e l%tent i'%&e /ill 1%de %nd t-e res.ltin& i'%&e /ill l%,4 ,ontr%st %nd be noisier+ E%,- o1 t-ese t/o types o1 intr%or%l di&it%l syste's -%s %dv%nt%&es %nd dis%dv%nt%&es+ ;e,%.se i'%&e %,5.isition is 'ore r%pid /it- CC$ syste's t-%n /it- P#P2 t-e 1or'er '%y be 'ore .se1.l /-en Sinst%ntH r%dio&r%p-s %re desir%ble+ In ,ontr%st2 P#P syste's %re /ireless %nd .se % l%r&er si3e i'%&e pl%te2 %ppro0i'%tely t-e si3e o1 % !o+2 peri%pi,%l 1il'+ One o1 t-e 'ost i'port%nt %dv%nt%&es o1 di&it%l r%dio&r%p-y is t-e red.,tion o1 r%di%tion dose+ V%rio.s st.dies -%ve s-o/n t-%t t-e %'o.nt o1 r%di%tion needed to ,re%te %n i'%&e 1or bot- types o1 intr%or%l syste' is lo/er t-%n /it- 1il'+

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Figure 2.## Diagram f 3.3.D. and ,.S.,. Department f Denta" Radi " g!- Nati na" .ni&ersit! / hn F. 0enned!- 1uen s 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&ed2 dependent on t-e 1il' /or4lo%d+ Pr%,ti,es /it- lo/ 1il' /or4lo%ds -%ve to 'onitor t-e developer sol.tion on % re&.l%r b%sis2 %s .n.sed developer o0idi3es 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 densities2 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%r4roo'+ il' s-o.ld not be stored in %re%s /-ere it '%y be e0posed to ioni3in& r%di%tion or ,-e'i,%l 1.'es+ In order to prevent 1o&&in& o1 t-e e0posed 1il's2 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%r4roo'2 t-en it is possible to .se &love bo0 type '%n.%l 1il' pro,essors2 /-i,- per'it 1il' p%,4ets to be opened in % li&-t proo1 environ'ent+ $edi,%ted dent%l %.to'%ti, 1il' pro,essors %re %v%il%ble %nd re,o''ended+ *-ese pro,essors -%ve % series o1 t%n4s ,ont%inin& t-e sol.tions re5.ired d.rin& pro,essin&2 in % se5.enti%l order+ *-e dent%l 1il' is ,onveyed t-ro.&- t-ese t%n4s vi% % syste' o1 rollers+ *-ese rollers %lso serve to provide % ,ontrolled %'o.nt o1 %&it%tion+ :eplenis-'ent o1 developer %nd 1i0er sol.tions '%y %lso be per1or'ed %.to'%ti,%lly+ *-ese %.to'%ti, 1il' pro,essors %re intended 1or .se in % d%r4roo'+ Ho/ever2 i1 one is not %v%il%ble t-en % &love bo0 '%y be %tt%,-ed to t-e entr%n,e o1 t-e pro,essor2 so t-%t 1il' p%,4ets '%y be opened in % d%r4ened environ'ent+ *-e per1or'%n,e o1 dent%l %.to'%ti, 1il' pro,essors s-o.ld be 'onitored+ It is %lso i'port%nt to ,le%n %nd servi,e t-ese pro,essors on % re&.l%r b%sis+
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il's /-i,- '%y be pro,essed in t-eir p%,4ets -%ve been re,ently introd.,ed+ In t-ese2 so ,%lled 'onob%t- 1il's2 % ,o'bined developer %nd 1i0er sol.tion is in>e,ted into t-e e0posed 1il' p%,4et+ *-e ,-e'istry is '%n.%lly %&it%ted 1or % spe,i1ied ti'e+ W-ile t-ese 'onob%t- 1il's ,%n be pro,essed /it-o.t dedi,%ted d%r4roo's or pro,essin& 1%,ilities2 t-e pro,essed 1il's 5.i,4ly deterior%te /-en e0posed to %ir+ *-e sensitivity o1 t-is type o1 1il' is lo/er t-%n t-%t 1or E/$(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 %nd2 in t-e ,%se o1 CC$ re,eptors2 displ%yed i''edi%tely+ *-ere is no d%r4roo' 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 -o/ever2 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' <$.nn %nd F%ntor2 "7736 Wen3el %nd Brond%-l2 "77E=+ #ensitivity o1 di&it%l re,eptors to 0 r%di%tion '%y res.lt in e0pos.re red.,tions &re%ter t-%n E9 per,ent ,o'p%red to E(speed 1il'+ In '%ny syste's2 -o/ever2 t-e %,tive %re% o1 t-e re,eptor is s'%ller t-%n ,onvention%l 1il'+ *-.s2 'ore e0pos.res '%y be re5.ired to i'%&e % spe,i1ied re&ion+ In %ddition2 'ost CC$ re,eptors %re t-i,4er t-%n ,onvention%l 1il'2 /-i,- '%y '%4e so'e intr%or%l positionin& di11i,.lt %nd res.lt in 'ore ret%4es+ I'%&e resol.tion is sli&-tly de,re%sed in di&it%l i'%&es ,o'p%red /it- ,onvention%l 1il'+ #p%ti%l resol.tion 1or dire,t di&it%l syste's r%n&es 1ro' C to "9 lp '' (l <line p%irs per 'illi'eter= ,o'p%red to "2 to "4 lp '' (l 1or r%dio&r%p-i, 1il' <$.nn %nd F%ntor2 "7736 Wen3el %nd Brond%-l2 "77E=+ )ost ,.rrent dire,t di&it%l syste's provide 2EC s-%des o1 &r%y6 -o/ever2 ,ontr%st resol.tion is li'ited by '%ny PC 'onitors t-%t ,%n only displ%y C4 s-%des o1 &r%y si'.lt%neo.sly <Wen3el %nd Brond%-l2 "77E=+ *-e PC 'onitor s-o.ld -%ve eno.&resol.tion to %,,o''od%te t-e ,.rrent si3e o1 di&it%l i'%&es+ :esol.tion o1 "924 0 8CD pi0els is t-e 'ini'.'2 b.t l%r&er is pre1er%ble+ *-e s,reen si3e o1 t-e 'onitor s-o.ld be %t le%st "8 in,- 1or % ,onvention%l 'onitor %nd % "E in,- 1or % 1l%t p%nel 'onitor+ !evert-eless2 ,o'p%r%tive st.dies -%ve s-o/n t-%t t-e di%&nosti, 5.%lity o1 dire,t di&it%l i'%&es %ppro%,-es r%pidly t-%t o1 t-e ,onvention%l 1il' in dete,tin& o,,l.s%l %nd %ppro0i'%l ,%ries2 periodont%l bone lesions2 peri%pi,%l bone lesions %nd root ,%n%l syste's < .r4%rt et a".- "7726 Hint3e et a".- "7746 F.llendor1 et a".- "77C6 #%nderin4 et a".- "7746 #-e%rer et a".- "7796 #v%n%es et a".- "77C=+ 2!;! 8uality )ssurance 98): an% 8uality Control 98C: *-e ter' A.%lity Ass.r%n,e <AA= des,ribes % pro&r%''e 1or periodi, %ssess'ent o1 t-e per1or'%n,e o1 %ll p%rts o1 t-e r%diolo&i,%l pro,ed.res <!C:P "7DD=+ It is t-e '%n%&e'ent tool /-i,-2 t-ro.&- t-e develop'ent t-e poli,ies %nd t-e est%blis-'ent o1 revie/ pro,ed.res2 %i's to ens.re t-%t every e0%' in dent%l r%diolo&y dep%rt'ent is ne,ess%ry %nd %ppropri%te to dent%l pr%,ti,e %nd t-%t it is per1or'ed <Or&%ni3%tion2 $evelop'ent T++PAHO "778=?
( ( ( ( (

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+
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A.%lity Control <AC= is p%rt o1 AA %nd is .s.%lly re1erred %s t-e spe,i1i, tests to ens.re t-e %,,.r%,y o1 t-e di%&nosis t-ro.&- t-e e11e,tive %nd s%1e e5.ip'ent per1or'%n,e2 1il' pro,essin& ,-e'istry %nd pro,ed.res2 i'%&e re,eptor per1or'%n,e ,-%r%,teristi,s %nd d%r4roo' inte&rity %nd need to be ev%l.%ted %t %ppropri%te interv%ls %nd /it-in spe,i1i, proto,ols+ *-e responsibilities 1or per1or'in& t-e v%rio.s AA %nd AC pro,ed.res %re dele&%ted to @(r%y oper%tors2 r%dio&r%p-ers2 %nd 'edi,%l or -e%lt- p-ysi,ists dependin& on t-e si3e o1 t-e 1%,ility+ A /ritten lo& o1 t-is pro&r%''e s-o.ld be '%int%ined by st%11 to ens.re %d-eren,e to t-e pro&r%''e %nd to r%ise its i'port%n,e %'on& st%11+ A spe,i1i, person s-o.ld be n%'ed %s le%der 1or t-e pro&r%''e+ Espe,i%l %ttention need to be p%id to d%r4roo'2 1il'2 ,%ssettes %nd pro,essin&+ or d%r4roo' t-e ro.tine ,-e,4s s-o.ld be '%de to ens.re t-%t d%r4roo's re'%in li&-t ti&-t %nd t-%t s%1eli&-ts do not prod.,e 1o&&in& o1 1il's+ $es4top .nits s-o.ld be si'il%rly ,-e,4ed 1or li&-t(ti&-tness+ *-is ,%n be done .sin& % si'ple S,oinH test+ :o.tine ,-e,4s s-o.ld be ,%rried o.t every "2 'ont-s or i1 %ny %lter%tions to d%r4roo' or e5.ip'ent -%ve been per1or'ed+ A /ritten lo& o1 s.,- ,-e,4s -elps in '%int%inin& t-e pro&r%''e+ *-e 5.%lity o1 r%dio&r%p-s ,%n be red.,ed by in%de5.%te stor%&e o1 1il'+ *-e '%n.1%,t.rers /ill l%y do/n t-e st%nd%rds+ Poor stor%&e e+&+ %t e0,essive te'per%t.re2 in ,lose pro0i'ity to @(r%y e5.ip'ent or poor -%ndlin& ,%n %ll le%d to %rte1%,ts+ il' s-o.ld not be .sed %1ter its e0piry d%te %nd t-e pro&r%''e s-o.ld in,l.de sto,4 ,ontrol 'e%s.res+ or e0tr%or%l r%dio&r%p-y ,%ssettes in,orpor%tin& intensi1yin& s,reens %re .sed+ *-e ,%ssettes '%y be,o'e d%'%&ed le%din& to li&-t le%4s %nd poor 1il'/s,reen ,ont%,t+ It is i'port%nt to re,o&ni3e t-e 1%.lts t-%t t-ese prod.,e %nd to ,-e,4 on ,%ssettes %s p%rt o1 t-e AA pro&r%''e+ *-e intensi1yin& s,reens '.st be ,le%n %nd .nd%'%&ed to '%int%in &ood i'%&e 5.%lity+ S#,reen %rte1%,tsH %re very ,o''on+ *o ,o'b%t t-ese2 s,reens s-o.ld be prote,ted by 4eepin& t-e ,%ssette ,losed2 e0,ept /-en lo%din& or .nlo%din& 1il's+ *-e s,reens s-o.ld be ,le%ned .sin& t-e %ppropri%te s,reen ,le%ner on % re&.l%r re&i'e det%iled in t-e AA pro&r%''e+ In%de5.%te pro,essin& %l/%ys ,o'pro'ises di%&nosti, in1or'%tion+ AA st%nd%rds /ill be l%id do/n by '%n.1%,t.rers o1 pro,essin& sol.tions %nd e5.ip'ent %nd /ill in,l.de?
( ( (

Pro,essin& ,onditions <ti'e %nd te'per%t.res= C-%n&in& 1re5.en,y 1or pro,essin& sol.tions Cle%nin& instr.,tions 1or %.to'%ti, pro,essors *-e AA pro&r%''e s-o.ld ens.re t-%t t-ese st%nd%rds %re %d-ered to by 'e%ns o1?

( (

:e,ords to ,ontrol %nd v%lid%te t-e ,-e'i,%l ,-%n&es Cle%nin& pro,ed.res 1or %.to'%ti, pro,essors

*-e over%ll per1or'%n,e o1 t-e pro,essin& %lso needs to be 'onitored+ One o1 t-e si'plest 'e%ns o1 %,-ievin& t-is is /it- t-e .se o1 % test ob>e,t s.,- %s % step /ed&e <00=+ *-is ob>e,t is ro.tinely r%dio&r%p-ed2 %l/%ys .sin& t-e s%'e e0pos.re p%r%'eters+ A si'ple
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vis.%l ,o'p%rison bet/een 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,4s 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%tientsH 1il's %re pro,essed+ )ore 1re5.ent ,-e,4s %re pre1er%ble <every 2(3 d%ys=2 to ens.re ,onsistent pro,essin&+ l.,t.%tions in @(r%y e5.ip'ent o.tp.t /ill %lso '%ni1est %s %n %lter%tion in step /ed&e densities+ I1 ,-%n&es o,,.r in t-e %bsen,e o1 %ny identi1i%ble pro,essin& proble's t-en %n e5.ip'ent 1%.lt s-o.ld be ,onsidered+ or $i&it%l #yste's t-e errors in 1il' positionin& %nd be%' %li&n'ent %re si'il%r to t-ose 1or ,onvention%l 1il' b%sed r%dio&r%p-y <see 00=+ *-e si3e o1 t-e di&it%l sensor %nd t-e l%,4 o1 1le0ibility2 espe,i%lly in ,%se o1 % solid st%te sensor2 ,%n '%4e t-e positionin& 'ore di11i,.lt2 %nd t-ere1ore 'ore prone to 'is%li&n'ent %nd t-e need 1or ret%4es <00= #olid(st%te sensors <CC$2 C)O#= %re prote,ted inside % pl%sti, ,%sin&+ *-is prote,ts t-e sensor s.r1%,e %&%inst d%'%&e+ P#P sensors on t-e ot-er -%nd2 %re '.,- 'ore v.lner%ble to s,r%t,-es o1 t-e p-osp-or l%yer+ *-ese %re visible %s /-ite lines %nd spots in t-e i'%&e /-en t-e pl%te -%s been re%d+ #'%ll s,r%t,-es '%y 'i'i, r%diop%5.e ob>e,ts s.,- %s endodonti, 1illin&s+ Pl%tes /-i,- %re d%'%&ed s-o.ld be repl%,ed+ A AA pro&r%'s 1or 'onitorin& d%r4roo' %nd pro,essin& ,onditions s-o.ld be instit.ted in e%,- dent%l 1%,ility+ As % 'ini'.'?
( ( ( ( ( (

t-e te'per%t.re o1 t-e developer s-o.ld be ,-e,4ed prior to 1il' pro,essin& %nd t-e develop'ent ti'e %d>.sted in %,,ord%n,e+ 1or %.to'%ti, pro,essin&2 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 <I'%&e 5.%lity %ssess'ent= is obvio.sly o1 bene1it to p%tient %nd dentist %li4e+ Ho/ever t-ere is %'ple rese%r,- eviden,e s-o/in& t-%t i'%&e 5.%lity is o1ten less t-%n ide%l in pri'%ry dent%l ,%re <00=+ It is essenti%l t-%t i'%&e 5.%lity be 'onitored on % re&.l%r b%sis+ *-is s-o.ld be done in t/o /%ys+ irst2 t-e dentist %t t-e ,-%ir side ,%n be vi&il%nt in e0%'inin& r%dio&r%p-s %s %nd /-en t-ey %re prod.,ed+ *o 1%,ilit%te t-is2 re1eren,e i'%&es o1 &ood 5.%lity ,%n be 4ept %v%il%ble 1or ,o'p%r%tive p.rposes+ #e,ond2 t-e dentist %nd st%11 ,%n ,ond.,t periodi, %.dits o1 i'%&e 5.%lity+ Clini,%l %.dit re5.ires %ssess'ent %&%inst % ,le%rly de1ined set o1 A.%lity #t%nd%rds+ I'%&e 5.%lity ,%n be si'ply %ssessed %s SE0,ellentH <no 1%.lts=2 SA,,ept%bleH <so'e 1%.lts b.t not %11e,tin& i'%&e interpret%tion= %nd SUn%,,ept%bleH <1%.lts le%din& to t-e r%dio&r%p- bein& .ns.it%ble 1or interpret%tion=+ *-e pr%,titioner ,%n i'ple'ent % Sre>e,t 1il' %n%lyses+ Assess'ent o1 re>e,ted 1il's %llo/s t-e dentist to identi1y t-e ,%.se o1 poor i'%&es+ Un%,,ept%ble 1il's %re t-ose in /-i,1il' 5.%lity dep%rts si&ni1i,%ntly 1ro' t-e %,,epted A.%lity #t%nd%rd2 t-ereby2 ,o'pro'isin& or preventin& di%&nosis %nd2 in 'ore e0tre'e ,%ses2 ne&%tin& t-e p.rpose 1or /-i,- t-e 1il' /%s t%4en+ *-ere ,%n be no toler%ble level o1 Q.n%,,ept%bleQ r%dio&r%p-s+ Obvio.sly2 %s t-ere /ill be /ide inter(pr%,titioner v%ri%tion in t-e level o1 .n%,,ept%ble 1il's in pri'%ry dent%l ,%re2 %
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'ore re%listi, %nd %,-iev%ble st%nd%rd /o.ld be 1or e%,- dentist to %,-ieve % E9K red.,tion in .n%,,ept%ble 1il's %t e%,- s.bse5.ent %.dit session <00=+ As % 'ini'.' t%r&et2 no &re%ter t-%n "9K o1 r%dio&r%p-s s-o.ld be o1 .n%,,ept%ble 5.%lity+ *-e %i' s-o.ld be to red.,e t-e proportion o1 .n%,,ept%ble r%dio&r%p-s by E9K %t e%,- s.,,essive %.dit ,y,le+ It is di11i,.lt to be pres,riptive %bo.t AA %nd AC test 'et-ods %nd 1re5.en,ies t-%t %re %ppli,%ble in %ll sit.%tions in dent%l r%diolo&y+ An %.to'%ti, 1il' pro,essor '%y re5.ire 'onitorin& on % d%ily b%sis2 /-ere%s %n intr%or%l @(r%y .nit in % s.r&ery '%y be ,-e,4ed on %n %nn.%l b%sis+ In % '%n.%l o1 t-is 4ind it is i'pr%,ti,%l to des,ribe %ll AA %nd AC tests t-%t s-o.ld be per1or'ed 1or di11erent types o1 dent%l r%dio&r%p-i, .nits+ Ho/ever2 s.&&ested %nd re,o''ended b%si, AA %nd AC Proto,ol 1or % typi,%l priv%te dent%l o11i,e2 /it- % brie1 list o1 1.n,tions to be tested is &iven in Anne0 3 <!C:P "4E=+ *-ere -%ve been n.'ero.s p.bli,%tions on AA %nd AC 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 <00=2 <00=2 <00=2 <00= <00=+ #o'e n%tion%l %.t-orities %lso re5.ire 1re5.ent i'%&e 5.%lity in1or'%tion %s /ell %s /or4in& pro,ed.res2 tr%inin& %nd %.dits <UF(!:P; 299"=

Dental postal pac0s


In so'e ,o.ntries %nd re&ions o1 t-e /orld2 % dent%l post%l p%,4 is .sed to per1or' 5.%lity ,ontrol %nd r%di%tion prote,tion s.rveys o1 intr% or%l dent%l .nits in re'ote lo,%tions+ *-e desi&n %nd ,onstr.,tion o1 one s.,- p%,4 is des,ribed else/-ere <00=+ An%lyses o1 t-e res.lts o1 dent%l post%l p%,4 s.rveys -%ve been p.blis-ed <00= <00=+ *-e dent%l p%,4 is sent to t-e dentist /-o is %s4ed to 1ollo/ % series o1 si'ple instr.,tions to per1or' t-e test+ Us.%lly t/o e0pos.res %t di11erent e0pos.re ti'es %re per1or'ed .sin& t/o l%r&e %re% dent%l 1il's+ It is possible to ded.,e ti'er errors 1ro' t-e opti,%l densities on t-e t/o pro,essed 1il's+ Ot-er 1e%t.res o1 t-e post%l p%,4 %ssess t-e tr%ns'ission o1 t-e @(r%y be%' t-ro.&- % series o1 %tten.%tin& 1ilters+ Assess'ent o1 t-is %re% o1 t-e p%,4 &ives %n indi,%tion o1 t.be potenti%l %nd t.be 1iltr%tion+ *-e post%l p%,4 '%y %lso deter'ine ,olli'%tor di%'eter2 1o,.s s4in dist%n,e %nd %li&n'ent o1 t-e ,olli'%tor <see i&.re 2+E=+ i&.re 2+E Post%l p%,4 .sed 1or dent%l 5.%lity ,ontrol 'e%s.re'ents+

Figure 2.6 , sta" pac5 used f r denta" qua"it! c ntr " measurements.

#o'e ,enters %lso %ssess t-e 1il' pro,essin& in dist%nt dent%l s.r&ery s.ites+ */o dent%l 1il's %re e0posed .nder identi,%l ,onditions2 one is pro,essed .nder ide%l ,onditions in t-e %ssess'ent ,entre2 %nd t-e ot-er is pro,essed in t-e dent%l s.r&ery+ A ,o'p%rison o1 t-e t/o 1il' densities %nd % vis.%l inspe,tion o1 t-e s.r&ery pro,essed 1il' ,%n yield in1or'%tion %bo.t in%de5.%te 1il' pro,essin&+ I'port%nt ,o'ponents o1 %ny 5.%lity %ss.r%n,e pro&r%''e %re i'%&e 5.%lity %nd p%tient dose+ )et-ods o1 %ssessin& %nd red.,in& p%tient dose %re des,ribed in C-%pter 4+

N,!#
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*-e Nati n2ide ,&a"uati n f !$ra! #rends <N,!#= is % s.rvey pro&r%' per1or'ed by t-e $A Center 1or $evi,es %nd :%diolo&i,%l He%lt- <C$:H= in ,oll%bor%tion /it- t-e Con1eren,e o1 :%di%tion Control Pro&r%' $ire,tors <C:CP$=+ It sele,ts % p%rti,.l%r r%diolo&i,%l di%&nosti, e0%'in%tion 1or st.dy %nd ,%pt.res r%di%tion e0pos.re d%t% 1ro' % n%tion%lly represent%tive s%'ple o1 U+#+ A+ ,lini,%l 1%,ilities+ *-e NE#T pro&r%' %nn.%lly s.rveyed 1%,ilities per1or'in& t/elve ,o''on di%&nosti, 0(r%y e0%'in%tions2 in,l.din& dent%l+ E0pos.re d%t% %re ,olle,ted .sin& '%n.%l te,-ni5.es sele,ted 1or % st%nd%rd re1eren,e p%tient+ It is ne,ess%ry to develop 'et-ods %nd p-%nto's si'il%r to t-%t 1or % re%l p%tient 1or % /ide r%n&e o1 pr%,ti,%l 0(r%y ,onditions <be%' 4ilovolt%&e pe%42 be%' 5.%lity=2 yet %lso -%d to be e,ono'i,%l2 e%sily tr%nsport%ble2 %nd 'ost i'port%ntly prod.,e ,onsistent2 ,lini,%lly represent%tive res.lts+ *-e 1irst p-%nto's developed by C$:H /ere t-e %d.lt ,-est %nd t-e %d.lt %bdo'en(l.'bos%,r%l spine p-%nto's+ *-ere %re no/ seven p-%nto's in t-e NE#T 1%'ily2 in,l.din& dent%l p-%nto's2 /-i,- %re no/ %lso ,o''er,i%lly %v%il%ble+ *-e NE#T s.rveys ,%pt.re ,o'pre-ensive d%t% on t-e pr%,ti,e o1 di%&nosti, r%diolo&y in,l.din& t-e ev%l.%tion o1 1il' pro,essin& 5.%lity2 t-e inte&rity o1 t-e 1il' pro,essin& d%r4roo' environ'ent2 0(r%y 1il' i'%&e 5.%lity2 %nd in1or'%tion %bo.t t-e 1%,ilityHs &ener%l pr%,ti,e+ Wit- di&it%l 0(r%y i'%&in& te,-nolo&y no/ %v%il%ble2 t-e est%blis-ed rel%tions-ip bet/een p%tient e0pos.re %nd 1il' i'%&e 5.%lity /ill no lon&er -old 1or s.,- syste's+ *-e i'p%,t on p%tient e0pos.re ,%n be si&ni1i,%nt be,%.se t-ere is no 1il' to .nder(or overe0pose+ NE#T is 1indin& its /%y %,ross t-e U+#+ A+ borders2 /it- % n.'ber o1 intern%tion%l or&%ni3%tions %nd ,o.ntries re5.estin& NE#T pro&r%' in1or'%tion %s /ell %s p-%nto's 1or .se in v%rio.s pro>e,ts+ Or&%ni3%tions e0pressin& s.,- interest in,l.de t-e Intern%tion%l Ato'i, Ener&y A&en,y <IAEA=2 /-i,- is developin& re,o''end%tions 1or t-e deter'in%tion o1 p%tient doses in ,o''on 0(r%y e0%'s2 %nd t-e A'eri,%n Asso,i%tion o1 P-ysi,ists in )edi,ine <AAP)=2 /-i,- is /or4in& to develop re1eren,e e0pos.re v%l.es 1or ,o''on di%&nosti, e0%'s.

Fig. 2.++ NE#T ,hant m f r Dentistr!

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3! ROO5 DE "/N )ND TR#CT#R)7 <"E7D"N/ 3!1! /eneral consi%erations A,tivities s.,- %s di%&nosti, r%diolo&y /-i,- in,re%se t-e e0pos.re to r%di%tion %re 4no/n %s pr%,ti,es+ *-ese e0pos.res '%y be li'ited by v%rio.s 'e%ns s.,- %s t-e %ppli,%tion o1 dose li'its %nd dose ,onstr%ints+ One 'et-od o1 %,-ievin& dose li'it%tion is by t-e %ppropri%te desi&n o1 roo's in /-i,- r%diolo&i,%l pro,ed.res %re per1or'ed+ *-is ,-%pter des,ribes -o/ s.,- % roo' is desi&ned 1or dent%l @(r%y e0%'in%tions+ In prep%rin& t-e spe,i1i,%tion 1or r%di%tion prote,tion b%rriers2 desi&ners /ill o1ten %pply % ,onstr%int t-%t doses to individ.%ls o.tside o1 t-e roo' %re /ell belo/ t-e p.bli, dose li'it+ *-is te,-ni5.e is %n e11i,ient 'e%ns o1 li'itin& p.bli, e0pos.re+ In di%&nosti, r%diolo&y2 t-e red.,tion o1 e0pos.re 1ro' dent%l @(r%y e5.ip'ent '%y be %,-ieved by % ,o'bin%tion o1 t-ree 1%,tors? "+= #-ieldin&6 2+= $ist%n,e6 3+= *i'e+ *-e .se o1 s-ieldin& is %n i'port%nt 'e%ns o1 red.,in& t-e e0pos.re to personnel in % di%&nosti, r%diolo&y 1%,ility %s /ell %s to p.bli, in t-e vi,inity+ #-ieldin& involves pl%,in& %tten.%tin& '%teri%l s.,- %s le%d bet/een t-e so.r,e o1 r%di%tion %nd %ny individ.%ls e0posed+ In %n @(r%y roo'2 prote,tive b%rriers %re pl%,ed %ro.nd t-e so.r,e o1 r%di%tion %nd in,orpor%ted in t-e /%lls2 ,eilin& %nd 1loor o1 t-e @(r%y roo'+ or e0%'ple2 le%d s-ieldin& is in,l.ded in t-e desi&n o1 %n @(r%y t.be -o.sin&2 %nd str.,t.r%l s-ieldin& in t-e ,onstr.,tion o1 t-e roo'2 sin,e bot- red.,e t-e r%di%tion e0pos.re to t-e s.rro.ndin& environ'ent+ $ist%n,e is p%rti,.l%rly .se1.l 'et-od o1 red.,in& r%di%tion e0pos.res2 espe,i%lly i1 t-e roo' is o1 l%r&e si3e2 %s % res.lt o1 t-e inverse s5.%re l%/+ *-is is not .s.%lly t-e ,%se o1 t-e dentist roo'2 /-i,- .sed to be o1 red.,ed si3e+ I1 t-e dist%n,e 1ro' t-e so.r,e o1 r%di%tion is do.bled2 t-e dose %nd dose(r%te %re red.,ed by % 1%,tor o1 1o.r+ At t-e s%'e ti'e i1 t-e dist%n,e is red.,ed to % -%l12 t-e e0pos.re %nd -en,e t-e dose to t-e person is 1o.r ti'es &re%ter+ W-ile t-e inverse s5.%re l%/ rel%tions-ip is stri,tly %ppli,%ble only to .n%tten.%ted pri'%ry r%di%tion2 in,re%sin& t-e dist%n,e 1ro' t-e so.r,e o1 s,%ttered r%di%tion </-i,- in dent%l r%diolo&y is t-e p%tientHs -e%d= /ill %lso red.,e t-e dose(r%te si&ni1i,%ntly+ Also e0pos.res to individ.%ls '%y be red.,ed2 by red.,in& t-e ti'e t-e so.r,e o1 r%di%tion is present2 or by red.,in& t-e ti'e t-e individ.%l is e0posed to t-e so.r,e+ 3!2! Room %esi&n an% layout *-e ;## re5.ires 1or o,,.p%tion%l e0pos.res t-e ,l%ssi1i,%tion o1 /or4pl%,es %s controlle% an% su'er*ise% or uncontrolle% areas + Controlled %re%s %re t-ose /-ere e'ployees -%ve si&ni1i,%nt potenti%l 1or e0pos.re to r%di%tion in t-e ,o.rse o1 t-eir %ssi&n( 'ents2 or /-ere t-e e'ployees %re dire,tly responsible 1or or involved /it- t-e .se %nd ,ontrol o1 r%di%tion+ *-ese individ.%ls &ener%lly -%ve tr%inin& in r%di%tion '%n%&e'ent %nd %re s.b>e,t to ro.tine person%l 'onitorin&+ #.pervised or .n,ontrolled %re%s %re t-ose o,,.pied by individ.%ls s.,- %s p%tients2 visitors to t-e 1%,ility2 %nd e'ployees /-o do not /or4 ro.tinely /it- or %ro.nd r%di%tion so.r,es+ Are%s %d>%,ent to2 b.t not p%rts o1 t-e 0(r%y 1%,ility2 %re %lso s.pervised %re%s+
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O.tside t-ese %re%s2 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%2 li,ensees %nd re&istr%nts s-%ll t%4e into %,,o.nt t-e '%&nit.de o1 e0pe,ted nor'%l e0pos.res2 t-e li4eli-ood %nd '%&nit.de o1 potenti%l e0pos.res2 %nd t-e n%t.re %nd e0tent o1 t-e re5.ired prote,tion %nd s%1ety pro,ed.res+ <;##T+= *-e de,ision /-ere to inst%ll dent%l @(r%y e5.ip'ent needs to be b%sed %'on& ot-er 1%,tors in ter's o1 r%di%tion dose to st%11 %nd 'e'bers o1 t-e p.bli, in %d>%,ent %re%s+ *-is is very i'port%nt i1 e5.ip'ent is lo,%ted ,lose to % p%rtition /%ll <i+e+ /it-in "+E ' 1or lo/ /or4lo%d sit.%tions=2 1or %ny /%lls or 1loor in t-e dire,tion o1 t-e pri'%ry be%' <intr%or%l %nd ,ep-%lo'etry= %nd 1or -i&- /or4lo%d .se+ *o %,-ieve s.,- levels o1 prote,tion2 it is .s.%lly s.11i,ient to ens.re t-%t /%lls %nd 1loors in dent%l r%dio&r%p-y %re o1 solid ,onstr.,tion2 e+&+ ,on,rete blo,4/or4 or bri,4 ,onstr.,tion+ Altern%tively le%d lined ply/ood or pl%sterbo%rd ,%n be .sed to obt%in t-e desired prote,tion+ or t-e %ver%&e dent%l 1%,ility2 str.,t.r%l prote,tion ,%n re%dily be %,-ieved .sin& tr%dition%l b.ildin& '%teri%ls+ Consider%tion needs to be &iven to t-e l%yo.t o1 t-e roo' so t-%t r%di%tion prote,tion is opti'i3ed+ *-e roo' s-o.ld be o1 %de5.%te si3e to %llo/ %ll st%11 t-%t needs to re'%in /it-in t-e roo' to position t-e'selves o.tside t-e ,ontrolled %re% d.rin& e0pos.re+ It is essenti%l t-%t t-e oper%tor o1 t-e e5.ip'ent ,%n position -i'sel1 so t-%t -e -%s % vie/ o1 p%tient2 o1 ,ontrolled %re% %nd S@(r%ys onH indi,%tor li&-t+ I1 t-e roo' si3e is li'ited2 it 'i&-t be ne,ess%ry 1or st%11 to position t-e'selves o.tside t-e roo'2 in /-i,- ,%se % 'irror 'i&-t be re5.ired to ens.re t-%t % ,le%r vie/ o1 t-e roo' in,l.din& p%tient is '%int%ined+ *-e e5.ip'ent s-o.ld be pl%,ed so t-%t t-e ,ontrolled %re% does not e0tend to %ny entr%n,es %nd so t-%t t-e pri'%ry be%' /ill not be dire,ted to/%rds %ny door/%ys or &ro.nd 1loor /indo/s+ *-e e0pos.re s/it,- s-o.ld be lo,%ted so t-%t t-%t t-e oper%tors ,%n eit-er re'%in o.tside o1 t-e ,ontrolled %re% or be be-ind % prote,tive b%rrier+ In %ddition2 %ttention s-o.ld be &iven to t-e lo,%tion o1 t-e '%ins on s/it,-+ *-is s-o.ld be pl%,ed so t-%t2 in t-e .nli4ely event o1 1%il.re to ter'in%te e%sily t-e e0pos.re+ All dent%l pro,ed.res s-o.ld -%ve /ritten instr.,tions 1or st%11 r%di%tion s%1ety+ C ontrolled %nd s.pervised %re%s s-o.ld be deline%ted by %ppropri%te 'e%ns <e+&+ p-ysi,%l 'e%ns=+ Approved si&ns s-o.ld be .sed %t %ll %ppropri%te %,,ess points to indi,%te t-e desi&n%tion o1 t-e r%di%tion %re%+ O,,.p%tion%l prote,tion %nd s%1ety 'e%s.res <in,l.din& 'onitorin& e5.ip'ent %nd prote,tive ,lot-in&=2 instr.,tions 1or .se %nd lo,%l r.les s-o.ld be %v%il%ble %nd present in t-e ,ontrolled %re%+ *-e proper desi&n%tion o1 %re%s s-o.ld be revie/ed periodi,%lly+ or t-e lo/ /or4lo%d dent%l sit.%tion2 UF &.id%n,e <00= -%s t%4en % pr%&'%ti, vie/ o1 t-is re5.ire'ent %nd %dvises t-%t t-e ,ontrolled %re% be de1ined %s t-e %re% %ro.nd t-e @(r%y e5.ip'ent t-%t st%11 s-o.ld be 'ovin& d.rin& e0pos.re+ Conse5.ently2 in t-e UF it is re,o''ended t-%t 1or p%nor%'i, <no 'ore t-%n E9 e0pos.res t%4en per /ee4= %nd intr%or%l .nits <no 'ore t-%n "99 e0pos.res t%4en per /ee4= t-e ,ontrolled %re% is de1ined d.rin& @(r%y e0pos.re %s? /it-in "+E ' o1 t-e @(r%y t.be %nd p%tient %nd /it-in t-e pri'%ry @(r%y be%' .ntil s.11i,iently %tten.%ted by dist%n,e or s-ieldin&+ #t%11 s-o.ld ens.re t-%t t-ey %re /ell o.t o1 t-is %re%2 i+e+ bet/een 2(3 ' %/%y or o.t o1 t-e roo'2 d.rin& r%dio&r%p-y+
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Ho/ever2 it is e'p-%si3ed t-%t t-e %dvi,e o1 % S5.%li1ied e0pertH s-o.ld be so.&-t in de1inin& ,ontrolled %re%s+ #.,- %dvi,e is essenti%l 1or -i&-er /or4lo%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,4 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 very e11e,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 .sed2 b.t t-ere %re ,ert%in dis%dv%nt%&es?
( (

b%ri.' pl%ster ,%nnot be re.sed2 .nli4e le%d6 it is di11i,.lt to %pply b%ri.' pl%ster to % s.bst%nti%l dept-2 d.e to s%&&in& o1 t-e pl%ster .nder its o/n /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%rriers2 %nd t-e prote,tion %11orded '%y be in,re%sed by s.pple'ent%ry '%teri%ls+ Ho/ever2 ,%.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 <i=+ Vie/in& /indo/s in t-e ,ontrol ,onsole need to be l%r&e eno.&- %nd tr%nsp%rent+ Le%d &l%ss or le%d %,ryli, '%teri%ls %re bot- s.it%ble+ In so'e inst%n,es pl%te &l%ss '%y be .sed /-ere prote,tive re5.ire'ents %re rel%tively lo/ s.,- %s 1or '%''o&r%p-y <ii=+ Addition%l d%t% ,on,ernin& t-e ,onstr.,tion o1 b%rriers2 in,l.din& %r,-ite,t.r%l s4et,-es2 %tten.%tion d%t% 1or prote,tive b%rriers %nd t-e le%d e5.iv%len,e o1 v%rio.s types o1 ,o''only .sed b.ildin& '%teri%ls %re provided in Anne0 *%ble "" + !C:P "4E dis,.sses t-e prote,tion %11orded by ,on,rete <li&-t/ei&-t %nd st%nd%rd= %nd &yps.' /%llbo%rd2 %nd ,%.tions %bo.t t-e presen,e o1 voids in t-eir 1%bri,%tion+ It %lso des,ribes t-e best '%teri%ls 1or e0terior /%lls <%r,-ite,t to be ,ons.lted=2 doors <le%d(lined i1 s-ieldin& needed=2 /indo/s <le%d &l%ss2 pl%te &l%ss %nd/or le%d %,ryli,=2 %nd 1loors %nd ,eilin&s <,on,rete=+ *-e r%di%tion %tten.%tion e11e,tiveness o1 t-ese '%teri%ls depends on t-eir t-i,4ness2 density %nd ,o'position+ *-e desi&n o1 % ne/ @(r%y 1%,ility is %n i'port%nt %nd o1ten ,o'ple0 t%s4 /-i,re5.ires inp.t 1ro' % /ide r%n&e o1 pro1ession%l st%11+ *-e sitin& o1 %n @(r%y roo'2 its di'ensions %nd lo,%tion %s /ell %s t-e provision %nd rel%tions-ip to s.pport servi,es %re vit%l %nd s-o.ld be t-oro.&-ly ,onsidered+ In desi&nin& t-e r%di%tion prote,tion 1or % ne/ dent%l @(r%y 1%,ility2 v%rio.s 1%,tors -%ve to be ,onsidered2 s.,- %s?
( (

( (

*-e type o1 e5.ip'ent %nd in p%rti,.l%r its position /it-in t-e roo'+ *-e r%n&e o1 dent%l r%diolo&i,%l pro,ed.res+ or e0%'ple /ill only intr%or%l dent%l r%dio&r%p-y be per1or'ed or /ill t-ere be % dent%l to'o&r%p-y <p%nor%l= .nit2 per-%ps /it- % ,ep-%lost%t %tt%,-'ent+ *e,-ni5.e 1%,tors <4V2 'As=+ Lo,%tion o1 t-e roo' %nd t-e p.rpose o1 %d>%,ent %re%s <%ro.nd2 %bove %nd belo/ @(r%y
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roo'=+ Unless intr%or%l dent%l r%dio&r%p-y is to be per1or'ed %t % lo/ /or4lo%d2 t-en it is s.&&ested t-%t t-e %dvi,e o1 % ,ons.lt%nt be so.&-t <i+e+ % 5.%li1ied e0pert in r%di%tion prote,tion=+ ;.ildin& '%teri%ls <,onvention%l or espe,i%l=

*-e r%di%tion prote,tion %spe,ts o1 ne/ or 'odi1ied inst%ll%tions s-o.ld be spe,i1ied or revie/ed by % 5.%li1ied e0pert in r%di%tion prote,tion be1ore ,onstr.,tion <iii=+ *-e 5.%li1ied e0pert s-o.ld -%ve %,,ess to t-e b.ildin& pl%ns+ Any 'odi1i,%tions to t-e b.ildin& desi&n s-o.ld be re,orded on t-e pl%ns %nd % ,opy 4ept by t-e li,ensee or re&istr%nt o1 t-e 1%,ility+ *-e spe,i%list %nd t-e %r,-ite,t need to be %/%re2 1or e0%'ple2 t-%t t-e .se o1 e0terior /%lls %nd %d>%,ent sp%,es2 bot- -ori3ont%l %nd verti,%l2 ,%n o1ten be ,ost(e11e,tive ele'ents in t-e desi&n o1 r%di%tion s-ieldin&+ As s-o/n in i&.re 00 % ,orridor ,%n be .sed to sep%r%te o11i,es %nd s.pport roo's 1ro' t-e 0(r%y e0%'in%tion roo's r%t-er t-%n le%vin& t-ese roo's %d>%,ent to one %not-er+ *-is str%te&y /ill o1ten red.,e t-e %'o.nt o1 s-ieldin& re5.ired to 'eet t-e s-ieldin& desi&n &o%l+ *-e ,orridor is % lo/ o,,.p%n,y %re% %nd t-e o,,.pied sp%,es <o11i,es %nd lo.n&es= %re %t le%st 2+E ' 1.rt-er 1ro' t-e so.r,e o1 0 r%ys+ *-e s%'e str%te&y %pplies 1or sp%,es %bove %nd belo/ <i.e+2 lo,%tin& %n 0(r%y roo' %bove or belo/ % ,orridor or 'e,-%ni,%l roo' r%t-er t-%n %n o,,.pied o11i,e is %n e11e,tive str%te&y 1or red.,in& s-ieldin& re5.ire'ents=+ Cert%in /%ll %nd door '%teri%ls re5.ired 1or b.ildin& %nd li1e s%1ety ,odes '%y provide ,ost(e11e,tive %ltern%tives to le%d s-ieldin&+

Fig. '.++

7! a8% (a) T!pica" denta" #$ra! r (%) T!pica" denta" #$ra! r m 2

In &ener%l2 @(r%y e5.ip'ent -%s % s-orter /or4in& .se1.l li1eti'e t-%n t-%t o1 t-e roo'+ *-.s /-en pl%nnin& t-e desi&n o1 % ne/ @(r%y 1%,ility2 t-ere s-o.ld be ,onsider%tion o1 t-e possible ,-%n&es in .se %t so'eti'e in t-e 1.t.re+ It is .s.%lly '.,- ,-e%per to in,orpor%te r%di%tion s-ieldin& in t-e roo' desi&n %t t-e pl%nnin& st%&e <1.t.re pl%nnin&= r%t-er t-%n to -%ve to %dd it l%ter+ *-e desi&n o1 % r%diolo&i,%l 1%,ility s-o.ld %lso in,l.de % ,onsider%tion o1 %ny potenti%l e0pos.res %risin& 1ro' %n %,,ident %sso,i%ted /it- % pr%,ti,e+ Any in,re%se in e0pos.re to p%tients2 st%11 or t-e &ener%l p.bli, /-i,- '%y res.lt 1ro' %n in,ident '.st be t-ere1ore be ,onsidered %t t-e pl%nnin& st%&e <iv=+ *-e prin,iple o1 t-e desi&n o1 %ny r%diolo&i,%l 1%,ility '.st -%ve t-e t/o ob>e,tives o1 red.,in& t-e prob%bility o1 %,,idents %nd %lso o1 'ini'i3in& e0pos.res in t-e event t-%t one o,,.rs+ *-is is s.''%ri3ed by t-e ,on,epts o1 prevention %nd
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'iti&%tion+ *-e e'p-%sis in t-e desi&n o1 t-e prote,tion o1 % r%diolo&i,%l 1%,ility '.st be on &ood pl%nnin& %nd desi&n2 in pre1eren,e to pro,ed.r%l 'et-ods+ *o t-e e0tent t-%t it is possible2 prote,tion s-o.ld be desi&ned into % 1%,ility2 r%t-er t-%n -%vin& to /rite it into t-e r%di%tion prote,tion oper%tion%l pro,ed.res or lo,%l r.les+ 3!3! (iel%in& %esi&n &oals

3.3. . Basic concepts It is possible to ,%l,.l%te t-e %'o.nt o1 r%di%tion prote,tion re5.ired in % &iven b%rrier+ V%rio.s p.bli,%tions '%y be ,ons.lted %nd di11erent '%t-e'%ti,%l %l&orit-'s '%y be .sed <Error? :e1eren,e so.r,e not 1o.nd=2 <v=2<vi=2 <vii=2 <viii=2 <i0=2 <0=+ <!C:P "4E=+ Ho/ever2 irrespe,tive o1 t-e 'et-od ,-osen2 t-e p.rpose o1 prote,tive s-ieldin& is to red.,e t-e e0pe,ted e0pos.re o1 individ.%ls to % %,,ept%ble level+ *-e ;%si, #%1ety #t%nd%rds re5.ire t-%t prote,tion %nd s%1ety s-%ll be opti'i3ed %nd t-%t doses delivered to individ.%ls be s.b>e,t to ,onstr%ined opti'i3%tion+ *-e re,o''ended 5.%ntity 1or s-ieldin& desi&n ,%l,.l%tions 1or 0 r%ys is air 5erma <0=2 de1ined %s t-e s.' o1 t-e initi%l 4ineti, ener&ies o1 %ll t-e ,-%r&ed p%rti,les liber%ted by .n,-%r&ed p%rti,les per .nit '%ss o1 %ir2 'e%s.red %t % point in %ir <IC:U2 "77D%=+ In t-is )%n.%l2 t-e sy'bol 0 %l/%ys re1ers to t-e 5.%ntity %ir 4er'% <in pl%,e o1 t-e sy'bol 0%=2 1ollo/ed by %n %ppropri%te s.bs,ript to 1.rt-er des,ribe t-e 5.%ntity <e.g+2 0P2 %ir 4er'% 1ro' pri'%ry r%di%tion=+ *-e .nit o1 %ir 4er'% is >o.le/4ilo&r%' <J 4& J"=2 /it- t-e spe,i%l n%'e &r%y <By=+ As dis,.ssed in Vol.'e "2 t-e re,o''ended r%di%tion prote,tion 5.%ntity 1or t-e li'it%tion o1 e0pos.re to people 1ro' so.r,es o1 ioni3in& r%di%tion is effecti&e d se <E=2 de1ined %s t-e s.' o1 t-e /ei&-ted e5.iv%lent doses to spe,i1i, or&%ns or tiss.es O i.e+2 e%,e5.iv%lent dose is /ei&-ted by t-e ,orrespondin& tissue 2eighting fact r 1or t-e or&%n or tiss.e <2*=P <IC:P C9 =+ *-e v%l.e o1 2* 1or % p%rti,.l%r or&%n or tiss.e represents t-e 1r%,tion o1 detri'ent <i.e+2 1ro' ,%n,er %nd -eredit%ry e11e,ts= %ttrib.ted to t-%t or&%n or tiss.e /-en t-e /-ole body is irr%di%ted .ni1or'ly+ *-e equi&a"ent d se to % spe,i1i, or&%n or tiss.e <9*= is obt%ined by /ei&-tin& t-e 'e%n %bsorbed dose in % tiss.e or or&%n < D*= by % radiati n 2eighting fact r <2:= to %llo/ 1or t-e rel%tive biolo&i,%l e11e,tiveness o1 t-e ioni3in& r%di%tion or r%di%tions o1 interest+ or t-e type o1 r%di%tion ,onsidered in t-is )%n.%l < i.e+2 0 r%ys= 2: is %ssi&ned t-e v%l.e o1 one+ *-e rel%tions-ip o1 E to in,ident 0 is ,o'ple02 %nd depends on t-e %tten.%tion o1 t-e 0 r%ys in t-e body in penetr%tin& to t-e r%diosensitive or&%ns %nd -en,e on t-e 0(r%y ener&y spe,tr.'2 %nd %lso on t-e post.re o1 t-e e0posed individ.%l /it- respe,t to t-e so.r,e+ :ot%tion%l e0pos.re s-o.ld be %ss.'ed2 sin,e it is prob%ble t-%t %n individ.%l is 'ovin& %bo.t %nd /o.ld not be e0posed 1ro' one dire,tion only+ It is not pr%,ti,%l to b%se s-ieldin& desi&n dire,tly on E2 sin,e E ,%nnot be 'e%s.red dire,tly+ *-ere1ore2 1or t-e p.rposes o1 t-is )%n.%l2 t-e s-ieldin& desi&n &o%ls %re st%ted in ter's o1 0 <in 'illi&r%y= %t t-e point o1 ne%rest o,,.p%n,y beyond t-e b%rrier+ or e0%'ple2 %s dis,.ssed belo/2 t-e dist%n,e o1 ,losest %ppro%,- to %n 0(r%y roo' /%ll ,%n be %ss.'ed ,onserv%tively <on t-e s%1e side= to be not less t-%n 9+3 '+ #-ieldin& desi&n &o%ls < ,= %re pr%,ti,%l v%l.es2 1or % sin&le 'edi,%l 0(r%y i'%&in& so.r,e or set o1 so.r,es2 t-%t %re ev%l.%ted %t % re1eren,e point beyond % prote,tive b%rrier+ W-en .sed in ,on>.n,tion /it- ,onserv%tively s%1e %ss.'ptions2 s.,- t-ose re,o''ended in !C:P :eport "4E2 t-e s-ieldin& desi&n &o%ls /ill ens.re t-%t t-e respe,tive %nn.%l v%l.es 1or E re,o''ended 1or o,,.p%tion%l %nd p.bli, e0pos.re %re not e0,eeded+
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#-ieldin& desi&n &o%ls %re e0pressed %s /ee4ly v%l.es sin,e t-e /or4lo%d 1or % 'edi,%l 0(r%y i'%&in& so.r,e -%s tr%dition%lly .tili3ed % /ee4ly 1or'%t+ In t-e p%st2 'ost r%di%tion s-ieldin& desi&ners -%ve .sed !C:P p.bli,%tions &.id%n,e <!C:P 47 /%s de 1%,to t-e st%nd%rd 'et-od .sed intern%tion%lly=2 t-e desi&n &o%ls .sed in t-is )%n.%l %re t-ose b%sed on t-e ne/ !C:P :eports <!C:P "4E2 !C:P "48=+ *-ey %re listed in *%ble 000+ *%ble 3+@@ <Provide title= E0pos.re O,,.p%tion%l P.bli, $ose Li'it2 E E11e,tive $ose <'#v/ye%r= 29 " #-ieldin& desi&n Bo%l2 P Air Fer'% <'By/ye%r= 9m/y=+ee-: E >!1 " >!>2

or o,,.p%tion%l e0pos.re2 t-e s-ieldin& desi&n &o%l in %ir(4er'% is E 'By per ye%r2 %s t-e e'ployees /-o /or42 espe,i%lly in ,ontrolled %re%s2 -%ve si&ni1i,%nt potenti%l 1or e0pos.re to r%di%tion in t-e ,o.rse o1 t-eir %ssi&n'ents or %re dire,tly responsible 1or or involved /it- t-e .se %nd ,ontrol o1 r%di%tion+ On t-e ot-er -%nd2 t-e desi&n &o%l 1or p.bli, e0pos.re is " 'By/ye%r+ *-e r%tion%le 1or %doptin& t-is v%l.e is b%sed on t-e ,onserv%tis' %ss.'ed in t-e s-ieldin& desi&n 'et-odolo&y .sed+ #ever%l e0%'ples o1 t-is ,onserv%tis' %nd t-e rel%tive i'p%,t o1 e%,-2 %d%pted 1ro' !C:P "4E %re &iven in A!!E@ 000? #-ieldin& desi&n &o%ls 1or dent%l 0(r%y .nits %re pr%,ti,e v%l.es <Air Fer'% in 'By//ee4= t-%t res.lt in t-e respe,tive li'its 1or e11e,tive dose in % ye%r to /or4ers %nd t-e p.bli, not bein& e0,eeded2 /-en ,o'bined /it- ,onserv%tively s%1e %ss.'ptions in t-e str.,t.r%l s-ieldin& desi&n ,%l,.l%tions+ 3.3.2. Radiation parameters An 0(r%y t.be in % dent%l r%diolo&y 1%,ility provides t-ree so.r,es o1 0 r%di%tion2 e%,- o1 /-i,- re5.ires %n%lysis 1or proper r%di%tion s-ieldin& re5.ire'ents+ *-ese %re pri'%ry2 s,%ttered %nd le%4%&e r%di%tion+ #,%ttered %nd le%4%&e r%di%tion %re s%id to be se,ond%ry r%di%tion+ Pri'%ry r%di%tion is t-%t &ener%ted in t-e %node o1 t-e 0(r%y t.be2 e'%n%tin& 1ro' t-e 0( r%y t.be port%l2 %nd dire,ted to/%rd t-e p%tient %nd i'%&e re,eptor+ *-e ener&ies o1 t-e pri'%ry p-otons r%n&e 1ro' %ppro0i'%tely 1ro' C9 to 79 4V 1or intr%or%l dent%l r%dio&r%p-y+ *-e dose r%te 1ro' pri'%ry r%di%tion is dependent on t-e oper%tin& potenti%l <4V=2 dire,t pro( portion%l to t-e 0(r%y t.be ,.rrent <'A=2 %nd inversely proportion%l to t-e s5.%re o1 t-e dist%n,e 1ro' t-e 0(r%y t.be 1o,%l spot to t-e o,,.pied %re% <i+e+2 1ollo/s t-e inverse s5.%re l%/=+ *-e si&ni1i,%nt %tten.%tion o1 t-e pri'%ry be%' by t-e p%tient is ne&le,ted+ *-e p%tient %tten.%tes t-e pri'%ry be%' by % 1%,tor o1 "9 to "99+

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*-e ,%l,.l%tions o1 re,o''ended b%rrier t-i,4ness %l/%ys %ss.'e perpendi,.l%r in,iden,e o1 t-e r%di%tion+ I1 not %ss.'ed2 t-e e11e,t /o.ld v%ry in '%&nit.de2 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.,4 by t-e pri'%ry p-otons2 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(4er'% r%te d.e to s,%ttered r%di%tion is proportion%l to t-e pri'%ry be%' %ir(4er'% r%te %nd t-e %n&.l%r bre%dt- o1 t-e pri'%ry be%'2 %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'2 /it- so'e pre1eren,e to b%,4s,%tterin&+ W-ile t-e s,%ttered p-oton ener&y spe,tr.' is s-i1ted to lo/er ener&ies %s % res.lt o1 Co'pton inter%,tions2 1or r%di%tion prote,tion p.rposes2 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 <e.g+2 personnel /e%rin& le%d %prons2 e5.ip'ent ,%binets2 et,+= in t-e p%t- o1 t-e r%di%tion ot-er t-%n t-e spe,i1ied s-ieldin& '%teri%l+ I1 t-e %ddition%l '%teri%ls /ere in,l.ded2 t-e e11e,ts /o.ld v%ry in '%&nit.de2 b.t t-e net e11e,t /o.ld be % red.,tion in tr%ns'ission d.e to t-e %ddition%l '%teri%ls+ *-e 1ield si3e %nd p-%nto' .sed 1or s,%ttered r%di%tion ,%l,.l%tions yield ,onserv%tively -i&- v%l.es o1 s,%ttered r%di%tion+ I1 % 'ore li4ely 1ield si3e %nd p-%nto' /ere .sed2 t-e ,ontrib.tion to s,%ttered r%di%tion /o.ld be red.,ed by % 1%,tor o1 %ppro0i'%tely 1o.r+ Le%4%&e r%di%tion is &ener%ted in t-e 0(r%y t.be %node %nd is tr%ns'itted t-ro.&- t-e prote,tive -o.sin&+ *-is -%rdens t-e tr%ns'itted r%di%tion to t-e point t-%t only t-e 'ost ener&eti, p-otons %re %ss.'ed to ,onstit.te le%4%&e r%di%tion+ *-e %ir(4er'% r%te d.e to le%4%&e r%di%tion &ener%ted .nder p%rti,.l%r ,onditions <0(r%y t.be oper%ted %t its le%4%&e te,-ni5.e 1%,tors= is li'ited by re&.l%tion+ *-e intern%tion%l le%4%&e r%di%tion st%nd%rd is %n %ir(4er'% r%te o1 9+2E 'By - (l 1or intr%or%l '%,-ines %nd " 'By - (l 1or %ll ot-er '%,-ines <IEC2 "774=+ In t-e U+#+A+ st%nd%rd < $A2 "77E= t-e le%4%&e r%di%tion %t " ' 1ro' t-e so.r,e is li'ited to %n e0pos.re r%te o1 9+" : -(l <e5.iv%lent to %n %ir(4er'% r%te o1 9+D8C 'By -(l=+ *-e e'ission o1 le%4%&e p-otons is %ss.'ed to be r%ndo'ly dire,ted 1ro' t-e 0(r%y t.be+ *-e le%4%&e r%di%tion 1ro' 0(r%y e5.ip'ent is %ss.'ed to be %t t-e '%0i'.' v%l.e %llo/ed by t-e IC:P re,o''end%tion 1or t-e le%4%&e r%di%tion te,-ni5.e 1%,tors 1or t-e 0(r%y devi,e+ In ,lini,%l pr%,ti,e2 le%4%&e r%di%tion is '.,- less t-%n t-is v%l.e2 sin,e t-e te,-ni5.e 1%,tors .sed to est%blis- t-e '%0i'.' le%4%&e r%di%tion %re not typi,%lly e'ployed 1or e0%'in%tion o1 p%tients+ I1 t-e '%0i'.' v%l.e /ere not %ss.'ed2 t-e e11e,t /o.ld be % red.,tion in le%4%&e r%di%tion %nd its ,ontrib.tion to se,ond%ry r%di%tion+ *-e re,o''ended o,,.p%n,y 1%,tors 1or .n,ontrolled or s.pervised %re%s %re ,onserv%tively -i&-+ or e0%'ple2 very 1e/ people spend "99 per,ent o1 t-eir ti'e in t-eir o11i,e+ I1 'ore li4ely o,,.p%n,y 1%,tors /ere .sed2 t-e e11e,t /o.ld v%ry in '%&nit.de2 b.t /o.ld %l/%ys res.lt in % red.,tion in t-e %'o.nt o1 e0pos.re re,eived by %n individ.%l lo,%ted in %n .n,ontrolled %re%+ Le%d 1or s-ieldin& is '%n.1%,t.red in s-eets o1 spe,i1i, st%nd%rd t-i,4nesses2 9+E2 "+92 "+E '' o1 le%d2 I1 s-ieldin& ,%l,.l%tions re5.ire % v%l.e &re%ter t-%n % st%nd%rd t-i,4ness2 t-e
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ne0t %v%il%ble &re%ter st%nd%rd t-i,4ness /ill typi,%lly be spe,i1ied+ *-is %dded t-i,4ness 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 U9+3 ' /ere %ss.'ed2 t-e e11e,t /o.ld v%ry2 b.t r%di%tion levels de,re%se r%pidly /itin,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 4er'% 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 <!C:P "4E=+ 3.3.3. &ir"1erma 2imits 3or Radiographic /ilms :%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 <#.lei'%n et a"+2 "77E=+ il' stored in d%r4roo's sh u"d n t be e0posed to %n %ir 4er'% U9+" 'By d.rin& t-e period it is in stor%&e+ *-is stor%&e period is typi,%lly on t-e order o1 one 'ont- or t/o+ In %ddition2 1il' stored in ,%ssettes /itintensi1yin& s,reens 1or ,ep-%lo'etry sh u"d be stored so t-%t t-e opti,%l density o1 t-e b%se( pl.s(1o& /ill not be in,re%sed by U9+9E+ A '%0i'.' %ir 4er'% o1 9+E VBy is re,o''ended 1or lo%ded ,%ssettes d.rin& t-e stor%&e period in t-e d%r4roo'2 /-i,- is .s.%lly on t-e order o1 % 1e/ d%ys <#.lei'%n et a"+2 "77E=+ 3!4! .arameters use% in calculation o$ s(iel%in& ,arriers $or Dental 23ray room! 3.4. . Primary and secondary $arriers As it /%s 'entioned be1ore2 in dent%l %s /ell %s 'edi,%l 0(r%y i'%&in& %ppli,%tions2 t-e r%di%tion ,onsists o1 pri'%ry %nd se,ond%ry r%di%tion+ ,rimar! radiati n2 %lso ,%lled t-e .se1.l be%'2 is r%di%tion e'itted dire,tly 1ro' t-e 0(r%y t.be t-%t is .sed 1or p%tient i'%&in&+ A primar! %arrier is % /%ll2 ,eilin&2 1loor or ot-er str.,t.re t-%t /ill inter,ept r%di%tion e'itted dire,tly 1ro' t-e 0(r%y t.be+ Its 1.n,tion is to %tten.%te t-e .se1.l be%' to %ppropri%te s-ieldin& desi&n &o%ls+ A le%d 1oil %t t-e b%,4 o1 t-e 1il' p%,4et ,overs % si&ni1i,%nt 1r%,tion o1 t-e ,olli'%ted r%di%tion 1ield+ *-e ,o'bin%tion o1 p%tient -e%d %nd i'%&e re,eptor si&ni1i,%ntly %tten.%te t-e pri'%ry be%'+ Sec ndar! radiati n ,onsists o1 0 r%ys s,%ttered 1ro' t-e p%tient %nd ot-er ob>e,ts s.,%s t-e i'%&in& -%rd/%re %nd le%4%&e r%di%tion 1ro' t-e prote,tive -o.sin& o1 t-e 0(r%y t.be+ A sec ndar! %arrier is % /%ll2 ,eilin&2 1loor or ot-er str.,t.re t-%t /ill inter,ept %nd %tten.%te le%4%&e %nd s,%ttered r%di%tions to t-e %ppropri%te s-ieldin& desi&n &o%l+ *-e %ir 4er'% 1ro' le%4%&e r%di%tion ,%n be esti'%ted by 1irst %ss.'in& t-%t t-e le%4%&e r%di%tion intensity /itno -o.sin& '%t,-es t-%t o1 t-e pri'%ry be%'+ *-e '%&nit.de o1 t-e %ir 4er'% d.e to s,%ttered r%di%tion is % 1.n,tion o1 t-e s,%tterin& %n&le2 t-e n.'ber %nd ener&y o1 pri'%ry p-otons in,ident on t-e p%tient2 lo,%tion o1 t-e be%' on t-e p%tient2 %nd t-e si3e %nd s-%pe o1 t-e p%tient+ It is %ss.'ed t-%t s,%ttered r%di%tion intensity is proportion%l to t-e pri'%ry be%' %re% %t % dist%n,e 1ro' t-e 1o,%l spot+ *-ese p%r%'eters %re ,onveniently t%4en %s t-e i'%&e( re,eptor %re% %nd t-e so.r,e(to(i'%&e(re,eptor dist%n,e <#I$=2 respe,tively+ *-e s,%tter 1r%,tion <a"= is de1ined %s t-e r%tio o1 t-e s,%ttered %ir 4er'% " ' 1ro' t-e ,enter o1 t-e pri'%ry be%' %re% %t t-e p%tient to t-e pri'%ry %ir 4er'% " ' 1ro' t-e 0(r%y t.be 1or % &iven pri'%ry be%' %re%+ *-e %ir 4er'% 1or s,%ttered r%di%tion is %ss.'ed to s,%le line%rly /itVOL 3 JULY 24 vers I!AL A" #ECO!$ Co'pressed()*(IAEA(*e'pl%te+do,

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pri'%ry 1ield %re%+ *-is re1eren,e 1ield si3e is ,onveniently t%4en %s t-e i'%&e(re,eptor %re% %t t-e #I$+ *-e pri'%ry2 s,%ttered %nd le%4%&e <se,ond%ry= r%di%tion t-ere1ore di11er in t-eir intensity2 point o1 ori&in2 %nd p-oton ener&y distrib.tion+ $.e to t-ese di11eren,es2 t-ey %lso di11er in tr%ns'ission t-ro.&- % b%rrier+ i&.re 00 ill.str%tes pri'%ry be%' %nd s,%ttered tr%ns'itted r%di%tion 1or % typi,%l dent%l intr%or%l e0pos.re+

Fig. '.++ ,rimar! %eam and scattered transmitted radiati n f r a t!pica" denta" intra ra" e+p sure

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4! .ROTECT"ON OF T<E .)T"ENT 4!1! /eneral consi%erations It is i'per%tive t-%t @(r%y e0%'in%tions o1 p%tients s-%ll only be done on t-e b%sis o1 p%tient -istory %nd ,lini,%l2 p-ysi,%l %nd ot-er l%bor%tory st.dies+ In dent%l r%dio&r%p-y2 t-e &re%test ,on,ern in r%di%tion prote,tion is t-e r%di%tion dose to t-e p%tient2 espe,i%lly to p%tient t-yroid %nd lens o1 t-e eye+ *-e '%&nit.de o1 p%tient doses in &ener%l di%&nosti, %s /ell %s dent%l r%diolo&y 1or % p%rti,.l%r pro,ed.re v%ries ,onsider%bly d.e to di11eren,es in e5.ip'ent2 te,-ni5.e 1%,tors .sed2 sensitivity o1 t-e i'%&in& syste'2 %nd t-e s4ill2 tr%inin& %nd e0perien,e o1 t-e dent%l r%diolo&i,%l st%11+ *-e 'ost ,o''on dent%l r%dio&r%p-i, te,-ni5.es involve intr%or%l non(s,reen 1il's eit-er to provide %n i'%&e o1 t-e .pper %nd lo/er teet- to&et-er2 ,%lled bite/in& r%dio&r%p-y2 or to de'onstr%te 1.ll toot- str.,t.re2 in,l.din& p.lp2 root2 %nd &.' %n%to'y2 ,%lled peri%pi,%l or ,onvention%l r%dio&r%p-y+ Altern%tively2 n%rro/(be%' rot%tion%l to'o&r%p-y is .sed to vie/ t-e teet- %nd >%/ bones in % sin&le i'%&e6 s.,- p%nor%'i, r%dio&r%p-y .ses %n e0tern%l 1il' in % ,%ssette /it- intensi1yin& s,reens %nd %n 0(r%y t.be t-%t rot%tes %ro.nd t-e -e%d to provide % to'o&r%p-i, i'%&e o1 t-e /-ole 'o.t-+ Ort-odonti, %n%lysis in t-e di%&nosis %nd tre%t'ent o1 '%lo,,l.sion disorders .se ,ep-%lo'etri, r%dio&r%p-y /itst%nd%rd i'%&in& te,-ni5.e2 to &ener%te reprod.,ible i'%&es o1 t-e s4.ll2 dentition2 %nd 1%,i%l pro1ile so1t tiss.es+ Convention%l to'o&r%p-y %nd C* %re ro.tinely .sed in dento( '%0illo1%,i%l r%dio&r%p-y+ $ent%l :%diolo&y %lso re5.ires p%rti,.l%r ,onsider%tions be,%.se it is ,%rried o.t /idely by non(r%diolo&ists2 %nd be,%.se '%ny e0%'in%tions ,onsist o1 % series o1 r%di%tion e0pos.res /-i,- '%y involve overl%ppin& 1ields+ In %ddition2 '%ny o1 t-e p%tients involved %re ,-ildren %nd yo.n& %d.lts <2C=+ *-e r%di%tion e0pos.re o1 p%tients 1ro' dent%l pro,ed.res involves t-ree i'port%nt ,onsider%tions? "+ $ent%l @(r%y e0%'in%tions %l/%ys involve p%rti%l body e0pos.re2 sin,e t-e @(r%y be%' is li'ited to spe,i1i, %n%to'i,%l %re% o1 di%&nosti, ,on,ern+ 2+ *-e %&e %nd se0 distrib.tion o1 individ.%ls re,eivin& dent%l @(r%y e0%'in%tions di11ers si&ni1i,%ntly 1ro' t-%t o1 t-e &ener%l p.bli,+ 3+ *-e 1re5.en,y o1 @(r%y e0%'in%tions v%ries ,onsider%bly+ #o'e individ.%ls -%ve no @(r%y e0%'in%tions2 /-ile % 1e/ '%y -%ve %s '%ny %s "99 or 'ore e0%'in%tions+ #ever%l st.dies -%ve been ,%rried o.t to deter'ine %bsorbed doses in spe,i1i, or&%ns %nd tiss.es 1ro' di11erent dent%l r%dio&r%p-i, te,-ni5.es %nd e5.ip'ent+ Entr%n,e s.r1%,e doses %re s.''%ri3ed in U!#CEA: 2999 <*%bles 2"/22= *-e ter's Se0pos.reH %nd SdoseH %re /idely .sed b.t o1ten 'is.nderstood by dentists+ SE0pos.reH .s.%lly re1ers to e5.ip'ent ,ondition settin&s <ti'e2 'A2 4V=2 /-en dent%l oper%tor .s.%lly set only t-e ti'e in 1r%,tion o1 se,ond %nd been 'A %nd 4V 1i0ed+ S$osesH2 ener&y per .nit '%ss2 '%y be 'e%s.red 1or p%rti,.l%r tiss.es or or&%ns <e+&+ s4in2 eye2 bone '%rro/= or 1or t-e /-ole body+ A ,o''only .sed 'e%s.re o1 dose in s.rveys is Sentr%n,e doseH2 'e%s.red in 'illi&r%ys <'By=+ *-is -%s %n %dv%nt%&e o1 bein& very e%sily 'e%s.red by pl%,in& dosi'eters on t-e
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p%tientHs s4in+ $i%&nosti, re1eren,e levels <$:Ls=2 b%sed .pon entr%n,e dose s.rveys2 %nd '%y be set %s st%nd%rds %&%inst /-i,- @(r%y e5.ip'ent ,%n be %ssessed %s p%rt o1 A.%lity Ass.r%n,e+ In t-is ,-%pter2 -o/ever2 r%di%tion dose is e0pressed %s effecti&e d se <re1er to Bloss%ry 1or de1inition=2 'e%s.red in .nits o1 ener&y %bsorption per .nit '%ss <Jo.les / 4&= ,%lled t-e #ievert <#v=2 .sed 'ore .s.%lly t-e 1r%,tion o1 it %s 'i,ro#ievert <V#v=2 representin& one 'illiont- o1 % #ievert+ In pr%,ti,e2 e11e,tive dose is ,%l,.l%ted '%&nit.de 1or %ny @(r%y te,-ni5.e by 'e%s.rin& t-e ener&y %bsorption in % n.'ber o1 S4eyH or&%ns in t-e body2 so t-%t t-e 1in%l 1i&.re is % represent%tion o1 S/-ole bodyH detri'ent+ W-ile e11e,tive dose is %n i'possible 5.%ntity to 'e%s.re in &i& 2 it is possible to deter'ine it 1ro' l%bor%tory st.dies or ,o'p.ter 'odelin&+ *-is ,%n t-en be .sed to esti'%te r%di%tion ris4+ A'on& t-e '%ny ris4s to /-i,- /e %re prone2 /e %re %ll ,onst%ntly e0posed to nor'%l b%,4&ro.nd r%di%tion2 /-i,- %ver%&es %bo.t 2499 V#v e%,- ye%r <3CE d%ys=+ )edi,%l e0pos.res <in,l.din& dent%l= %dd s.bst%nti%lly to t-is 1i&.re2 /it- /ide v%ri%tion 1ro' ,o.ntry to ,o.ntry+ Co'p%red to t-ese v%l.es2 % p%nor%'i, r%dio&r%p- '%y be %sso,i%ted /it- %n e11e,tive dose t-e s%'e %s "(E d%ysH %ddition%l b%,4&ro.nd r%di%tion2 /-ile t/o bite/in& r%dio&r%p-s /o.ld be e5.iv%lent to %bo.t one d%y+ or ,o'p%r%tive p.rposes2 % ,-est @(r%y <29 V#v= /o.ld be e5.iv%lent to %ro.nd t-ree d%ys o1 %ddition%l b%,4&ro.nd r%di%tion+ $ent%l r%dio&r%p-y doses %nd ris4s %re 'ini'%l2 ,o'p%r%ble in 'ost ,%ses </it- t-e e0,eption o1 C* %nd '.ltiple ,ross(se,tion%l to'o&r%p-y= /it- e0pos.re to % 1e/ d%ys o1 n%t.r%l b%,4&ro.nd r%di%tion+ E11e,tive doses %nd ris4 1ro' di11erent dent%l @(r%y te,-ni5.es %re s-o/n in *%ble <000= <EC"3C= *%ble 4+@@ E11e,tive doses %nd ris4 1ro' di11erent dent%l @(r%y te,-ni5.es

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E5.ip'ent %nd %,,essories rel%ted re5.ire'ents %re o1 spe,i%l i'port%n,e in dose red.,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,es2 '%ny o1 /-i,- %re ,o''er,i%lly %v%il%ble2 1or -oldin& 1il's %re s-o/n 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, vie/s %re s-o/n 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, vie/s+

Figure *.2 Schematic diagrams f intra ra" radi graphic &ie2s. *%bles <AC+"2 AC+22 AC+32 AC+42 %nd AC+E= /-i,- s.''%ri3e te,-ni5.e 1%,tors %nd r%di%tion doses 1or intr%or%l bite/in& r%dio&r%p-y p.blis-ed by Velders <28= %re s-o/n in Anne0 C+ Also s-o/n in Anne0 C %re dose 'e%s.re'ents per1or'ed on e5.ip'ent oper%tin& %t 89 4V /it- % 29 ,' 1o,.s s4in dist%n,e <*%bles AC+C2 AC+82 AC+D %nd AC+7= p.blis-ed by Le,o'ber %nd %.l4ner <2D= /-i,- s.''%ri3e typi,%l e0pos.re ti'es2 or&%n %bsorbed doses %nd e11e,tive dose 1or bot- t-e bise,tin& %n&le %nd p%r%llelin& te,-ni5.es+ Addition%l d%t%2 %s s-o/n in C-%pter I ,%n be 1o.nd in t-e 2999 U!#CEA: report <2= <see Anne0 "+"= %nd in t-e !E@* <!%tion%l Ev%l.%tion o1 @(r%y *rends= st.dies in t-e United #t%tes o1 A'eri,% <27=+
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$osi'etry te,-ni5.es .sin& t-er'ol.'ines,ent dosi'eters in post%l p%,4s <see C-%pter 3= 1or p%tient prote,tion %nd 5.%lity %ss.r%n,e st.dies %re /idespre%d+ or e0%'ple t-e Instit.te 1or :%di%tion Prote,tion %nd $osi'etry in :io de J%neiro2 -%s -%d %n %,tive pro&r%''e involvin& sever%l t-o.s%nd dent%l .nits t-ro.&-o.t ;r%3il+ In 1%,t 'ost o1 t-e d%t% in t-e "773 U!#CEA: report 1or ,o.ntries in t-e -e%lt- ,%re level II /ere obt%ined 1ro' t-ese s.rveys <2=+ *-e !E@* <000= pro&r%''e -%s per1or'ed % trends %n%lysis 1or di%&nosti, @(r%y e0%'in%tions on %n on&oin& b%sis+ E%,- ye%r % s.rvey is '%de to deter'ine t-e r%di%tion %ir( 4er'% 1or % spe,i1i, di%&nosti, @(r%y e+&+ dent%l r%dio&r%p-y /-i,- in,l.ded i'%&e 5.%lity+ <*%ble 4+00= $ent%l Intr%or%l E0%'s !E@* report Entr%n,e Air Fer'% <'By= Clini,%l 4V Per,ent )%n.%l il' Pro,essin& P-%nto' il' Opti,%l $ensity Per,ent .sin& $(speed il' "773 "+7 82+9 27+9 "+4D 79 "774 "+C 8"+9 "9+9 "+47 DE

*e,-ni5.es e'ployed in dent%l r%dio&r%p-y s-o.ld be t-ose /-i,- %,-ieve t-e desired di%&nosti, ob>e,tives /it-o.t .nne,ess%ry dose to t-e p%tient+ *-e .se o1 -i&-er @(r%y t.be volt%&es %nd &re%ter t-i,4nesses o1 %dded 1iltr%tion in dent%l r%dio&r%p-y &ener%lly res.lts in s'%ller doses to t-e p%tient 1or % &iven opti,%l density o1 t-e @(r%y 1il'+ Under t-ese ,onditions2 -o/ever2 t-e ,ontr%st o1 t-e r%dio&r%p-i, i'%&e is red.,ed2 res.ltin& in % possible loss o1 in1or'%tion /-i,- '%y be ,riti,%l in ,ert%in types o1 e0%'in%tions+ A red.,tion o1 entr%n,e s4in e0pos.re <s.r1%,e %ir 4er'%= 1or intr%or%l 1il's '%y res.lt in in,re%ses in t-e t-yroid dose %nd t-e orbit%l dose+ In %ddition2 t-is dose red.,tion '%y res.lt in % de&r%d%tion o1 i'%&e 5.%lity <22 282 2D=+ 4!2! Ra%io&ra'(ic selection 9re$erral: criteria 4.2. . 5election criteria :%dio&r%p-i, :e1err%l Criteri% -%ve been de1ined %s? Wdescripti ns f c"inica" c nditi ns deri&ed fr m patient signs- s!mpt ms and hist r! that identif! patients 2h are "i5e"! t %enefit fr m a particu"ar radi graphic technique:. As /it- %ny &.ideline2 t-ese %re not intended to be ri&id ,onstr%ints on ,lini,%l pr%,ti,e2 b.t % ,on,ept o1 &ood pr%,ti,e %&%inst /-i,- t-e needs o1 t-e individ.%l p%tient ,%n be ,onsidered+ #o'e dentists '%y re1er p%tients 1or r%dio&r%p-y to -ospit%ls or dent%l ,olle%&.es /-ere t-ey do not -%ve t-e ne,ess%ry e5.ip'ent in t-eir o/n pr%,ti,es+ All dent%l @(r%ys %re potenti%lly -%r'1.l to t-e p%tient bein& e0%'ined2 b.t t-e in1or'%tion &%ined 1ro' t-e i'%&e prod.,ed .s.%lly is bene1i,i%l to t-e p%tient+ *-e bene1it s-o.ld o.t/ei&- t-e ris4+ In ,%ses /-ere % lesion is s.spe,ted on &ood ,lini,%l &ro.nds2 t-en .sin& @(r%y e0%'in%tion to %id in t-e di%&nosis is >.sti1ied <E=+

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Ho/ever2 t-e n.'ber o1 vie/s 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 vie/s t%4en2 did not ,ontrib.te to t-e di%&nosis2 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 vie/s2 % syste' o1 Wsele,tion ,riteri%X ,%n be est%blis-ed+ #ele,tion ,riteri% 1or ,%ries s,reenin& %re e0tre'ely i'port%nt2 sin,e t-e peri%pi,%l %nd bite/in& 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 ris4 '.st be %ssessed 1or %ll ne/ p%tients %nd t-en s.bse5.ently %t re,%ll %ppoint'ent %s ris4 1%,tors '%y ,-%n&e in t-e intervenin& period+ ;y identi1yin& p%tients /-o %re %t t-e &re%test ris4 o1 dent%l de,%y2 ,lini,i%ns ,%n i'ple'ent prevention te,-ni5.es to '%int%in lo/ ,%ries ris4 st%t.s+ *-e in1or'%tion needed to est%blis- s.,- sele,tion ,riteri% is?
( ( (

t-e p%tientHs ,%ries -istory6 t-e r%te o1 pro&ression o1 ,%ries in en%'el %nd dentine6 t-e presen,e2 or %bsen,e2 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'ents2 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'ent2 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%4en 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-Y6 Vie/s 1or i'p%,ted /isdo' teet-6 Vie/s 1or .ner.pted '%0ill%ry ,%nines6 Is t-ere %ny bene1it in t-e verte0 o,,l.s%l vie/ o1 t-e '%0ill%Y6 ollo/(.p o1 -e%lin& ,rypt ,%vities+ Ho/ o1ten to r%dio&r%p-Y6 re5.en,y o1 r%dio&r%p-i, e0%'in%tion 1or lesions t-%t tend to re,.r2 e+&+ 4er%to,yst2 every si0 'ont-s or %nn.%llyY %,i%l In>.ries ( e0%'in%tion in e'er&en,ies .ll 1%,i%l %nd s4.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%tientY *e'poro()%ndib.l%r Joints <*)J= vie/s Is t-ere %ny bene1it in t-e tr%ns,r%ni%l obli5.e vie/ 1or deter'inin& t-e /idt- o1 t-e >oint sp%,eY Endodonti,s :%te o1 -e%lin& o1 %pi,%l lesions+ At /-%t st%&e %1ter endodonti, tre%t'ent ,%n t-e -e%lin& o1 %n %pi,%l %re% be ,on1idently deter'ined r%dio&r%p-i,%llyY Periodontolo&y
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Ho/ o1ten do yo. t%4e r%dio&r%p-i, vie/s to deter'ine pro&ress o1 periodont%l tre%t'entY Ort-odonti,s At /-%t %&e do yo. t%4e r%dio&r%p-s to deter'ine need 1or ort-odonti,sY $o yo. %l/%ys need % r%dio&r%p- to deter'ine t-e need 1or ort-odonti, tre%t'entY Are ,ep-%lost%t vie/s %l/%ys neededY Are ,ep-%lost%t vie/s needed %t t-e end o1 tre%t'entY $o yo. need to see t-e /-ole s4.ll on % ,ep-%lo&r%'Y 4!3! ?usti$ication an% o'timi0ation o$ 'rotection

a+ 6usti3ication o3 a dental practice


A,,ordin& to t-e ;%si, #%1ety #t%nd%rds <C= dent%l e0pos.res s-o.ld be >.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 ,%.se2 t%4in& into %,,o.nt t-e bene1its %nd ris4s 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.t/ei&- t-e potenti%l detri'ent+ Any @(r%y e0pos.re ent%ils % ris4 to t-e p%tient+ Under nor'%l ,ir,.'st%n,es t-e ris4 1ro' dent%l r%dio&r%p-y is very lo/+ !onet-eless2 it is essenti%l t-%t %ny @(r%y e0%'in%tion s-o.ld s-o/ % net bene1it to t-e p%tient2 /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,%,y2 bene1its %nd ris4 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%4en into %,,o.nt+ In order t-%t t-e >.sti1i,%tion pro,ess ,%n be ,%rried o.t2 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%tientHs -istory %nd % ,lini,%l e0%'in%tion+ *-e Sro.tineH .se o1 r%dio&r%p-y on p%tients b%sed on % &ener%li3ed %ppro%,r%t-er t-%n individ.%l pres,ription is .n%,,ept%ble+ A Sro.tineH or Ss,reenin&H e0%'in%tion is de1ined %s one in /-i,- % r%dio&r%p- is t%4en re&%rdless o1 t-e presen,e or %bsen,e o1 ,lini,%l si&ns %nd sy'pto's+ *-e dentist s-o.ld?
( (

A.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 ioni3in& r%di%tion++

#o'e %ltern%tive 'et-ods to ioni3in& r%di%tion /it- /-i,- to di%&nose ,%ries -%ve %lso been developed+ *-ese in,l.de est%blis-ed te,-ni5.es s.,- %s 1ibreopti, tr%nsill.'in%tion < O*I= %nd ele,tri,%l ,ond.,t%n,e 'e%s.re'ents <EC)=+ Ot-er ne/er e'er&in& te,-nolo&ies in,l.de A.%ntit%tive Li&-t(ind.,ed l.ores,en,e <AL =2 In1r%red L%ser l.ores,en,e <$IAB!Odent= %nd $i&it%l I'%&in& iber Opti, *r%nsill.'in%tion <$I O*I=+ #o'e o1 t-ese te,-ni5.es -%ve li'it%tions t-%t %11e,t t-eir di%&nosti, or ,o''er,i%l %v%il%bility %nd in so'e ,%ses2 t-eir pr%,ti,%lity /it-in t-e dent%l s.r&ery+ Ot-ers re5.ire 1.rt-er rese%r,- %nd v%lid%tion b.t '%y be,o'e /ell %,,epted di%&nosti, tool in t-e 1.t.re+
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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 ris4s 1ro' @(r%y e0pos.re t-%n %re %d.lts+ )%ny ,-ildren see4 ort-odonti, tre%t'ent+ W-en s.,- tre%t'ent is ,lini,%lly re5.ired2 '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%lly2 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 o3 patient protection in dental !"ray e-posures


Opti'i3%tion '%y be s.b(divided into t/o '%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'i3%tion o1 t-e e0%'in%tion itsel1+ *-ere %re % n.'ber o1 /%ys to opti'i3e e5.ip'ent %nd pro,ed.re <39=+ C-%n&in& 1ro' old lo/ t.be potenti%l2 intr%or%l dent%l .nits to 'odern -i&- t.be potenti%l2 -i&- o.tp.t2 'edi.' 1re5.en,y @(r%y .nits /it- 2+E '' tot%l %l.'ini.' 1iltr%tion /ill ,ontrib.te si&ni1i,%ntly to t-e opti'i3%tion o1 intr%or%l dent%l r%diolo&y2 %s /ill t-e %doption o1 better ,olli'%tion te,-ni5.es involvin& t-e .se o1 lon&er 1o,.s s4in dist%n,es+ C-%n&in& to E speed 1il'2 to&et-er /it- ens.rin& t-%t t-e e0posed 1il's %re ,orre,tly pro,essed in %,,ord%n,e /itt-e '%n.1%,t.rers re,o''end%tions2 /ill %lso ,ontrib.te to t-e opti'i3%tion pro,ess in intr%or%l dent%l r%dio&r%p-y+ *-e .se o1 E(speed 1il's red.,es t-e %ver%&e %bsorbed dose %ppro0i'%tely by % 1%,tor o1 2 %nd re,t%n&.l%r ,olli'%tion by % 1%,tor o1 2+D+ In p%nor%l r%dio&r%p-y2 .se o1 r%re(e%rt- 1il' s,reen ,%ssettes is i'port%nt2 to&et-er /it- t-e .se o1 opti'%l 1il' pro,essin&+ *-e ,-oi,e o1 p%nor%l r%dio&r%p-y e0%'in%tion te,-ni5.es ,%n si&ni1i,%ntly e11e,t p%tient e0pos.res+ or inst%n,e2 on re,ently introd.,ed e5.ip'ent it is possible to sele,t /-i,- %re%s o1 %n%to'y %re to be i'%&ed d.rin& p%nto'o&r%p-y+ Avoidin& t-e e0pos.re o1 t-e te'poro('%ndib.l%r >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- /ill2 t-ere1ore opti'i3e t-is e0%'in%tion+ *-e pro&r%'s %nd e0pos.re p%r%'eters 1or t/o typi,%l p%nor%l dent%l @(r%y .nits %re s-o/n in *%ble 4+"+ *-e res.ltin& or&%n doses %re s-o/n in *%ble 4+2 %nd t-e e11e,tive doses %re s-o/n in *%ble 4+3 <3"=+ *%ble 4+" E0pos.re p%r%'eters 1or p%nor%l dent%l @(r%y e5.ip'ent+

Ta%"e *.1 E+p sure parameters f r pan ra" denta" #$ra! equipment.

*%ble 4+2 Or&%n doses 1ro' p%nor%'i, r%dio&r%p-y <3"=+

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Ta%"e *.2 Organ d ses fr m pan ramic radi graph! ('1).

*%ble 4+3 C%l,.l%ted e11e,tive doses 1ro' p%nor%'i, r%dio&r%p-y <3"=+

Ta%"e *.' 3a"cu"ated effecti&e d ses fr m pan ramic radi graph! ('1).

4!4! )ssessment an% met(o%s o$ re%ucin& 'atient %ose 4.4. . Procedures 3or minimi8ing dose to patients *-e l%r&est sin&le ,ontrib.tor o1 '%n('%de <%rti1i,i%l= r%di%tion e0pos.re to t-e pop.l%tion is 'edi,%l in,l.din& dent%l di%&nosti, r%diolo&y+ $ent%l r%dio&r%p-y is one o1 t-e 'ost 1re5.ent types o1 r%diolo&i,%l pro,ed.re2 %lt-o.&- t-e e0pos.res to individ.%l p%tients %re lo/+ In developed ,o.ntries dent%l r%diolo&y '%y %,,o.nt 1or 2EK o1 %ll @(r%y e0%'in%tions2 b.t only "K o1 t-e ,olle,tive e11e,tive dose+ Ho/ever2 it is &ener%lly %&reed by e0perts t-%t dent%l @(r%y e0pos.res ,%n be red.,ed s.bst%nti%lly /it- no de,re%se in t-e v%l.e o1 di%&nosti, in1or'%tion derived+ *-e ris4 to t-e individ.%l p%tient 1ro' % sin&le dent%l @(r%y e0pos.re is very lo/+ $%t% on 1re5.en,ies %nd e11e,tive doses in dent%l r%diolo&y reported 1or v%rio.s ,o.ntries %re presented in U!#CEA: 2999 :eport <*%ble 00=+ Ho/ever2 t-e ris4 to % pop.l%tion is in,re%sed by in,re%sin& t-e 1re5.en,y o1 dent%l @( r%y e0%'in%tions %nd by in,re%sin& t-e n.'ber o1 persons e0posed to @(r%ys+ or t-is re%son2 every e11ort s-o.ld be '%de to li'it t-e n.'ber o1 r%dio&r%p-s %nd t-e n.'ber o1 persons e0posed2 %s /ell %s to li'it t-e dose involved in % p%rti,.l%r e0%'in%tion+ *o %,,o'plis- t-is li'it%tion2 it is i'port%nt t-%t p%tients not be s.b>e,ted to .nne,ess%ry r%diolo&i,%l e0%'in%tions %nd2 /-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%tions2 it is i'port%nt t-%t % ne,ess%ry e0%'in%tion be per1or'ed /it- &ood te,-ni5.e+ It is possible2 1or e0%'ple2 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-is2 %nd to 4no/ -o/ to ,%rry o.t % pres,ribed e0%'in%tion /it- t-e lo/est possible e0pos.re to t-e p%tient+ P%rti,.l%r ,%re s-o.ld be t%4en d.rin& e0%'in%tions o1 ,-ildren /-o %re ,onsidered to be 'ore %t ris42 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 o3 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 </-en t-e i'%&e re,eptor is pl%,ed inside t-e 'o.t- s.,- %s bite/in& %nd peri%pi,%l e0%'in%tions= or e0tr%or%l </-en t-e i'%&e re,eptor is lo,%ted o.tside o1 t-e 'o.t-2 li4e p%nor%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 s4.ll(vie/ r%dio&r%p-y %nd spe,i%l p.rpose to'o&r%p-i, r%dio&r%p-y2 %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 positioned intr%or%lly 1or % st%tion%ry pro>e,tion+ *-is type o1 e5.ip'ent is .sed 1or peri%pi,%l2 bite/in& %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 lo/est 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%s4s+ #o'e %dv%nt%&es %re?
( ( ( ( ( ( (

'ore %,,.r%te reprod.,tion o1 t-e '%r&in%l bone level2 'ore %,,.r%te ,%ries di%&nosis2 p%rti,.l%rly re,.rrent ,%ries2 less distortion o1 t-e i'%&e2 less &eo'etri, .ns-%rpness2 1%,ilit%tes periodi, identi,%l e0pos.res2 -e%d post.re irrelev%nt2 no 1in&er dose /-en 1il'(-olders .sed2 less s4in 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%tientHs -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 >%/s2 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,4ness 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 s4.ll or '%y only i'%&e % li'ited re&ion o1 interest+ *-e need 1or spe,i%l e0%'in%tions li4e ,ep-%lo'etri, r%dio&r%p-s2 spe,i1i, te'poro('%ndib.l%r >%/s <*)J= r%dio&r%'s or to'o&r%'s is 5.ite li'ited+ As sever%l ,onditions -%ve to be 1.l1illed to prod.,e i'%&es o1 -i&- 5.%lity2 it is re,o''ended in &ener%l t-%t p%tients be re1erred to spe,i%li3ed ,lini, or -ospit%l 1or t-ese e0%'in%tions+ In p%rti,.l%r2 /-en s.,,essive tre%t'ent is ,%rried o.t by % spe,i%list2 t-is pro,ed.re s-o.ld be 1ollo/ed+
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4.4.3. ,quipment and accessories technical parameters in patient dose reduction *.*.'.1. #$ra! generati n and set parameters (5;- mA- time)

*-e t.be potenti%l <4ilovolt%&e(4V= o1 %n @(r%y '%,-ine is t-e potenti%l di11eren,e t-%t e0ists %,ross t-e @(r%y t.be d.rin& .se+ It ,ontrols t-e 'e%n %nd pe%4 @(r%y ener&ies in t-e @( r%y be%'+ Lo/ potenti%ls2 &ivin& lo/er ener&y @(r%ys2 le%ds to -i&-er s4in doses 1or p%tients+ *-ey %lso ne,essit%te lon&er e0pos.re ti'es t-%n /o.ld be needed 1or % -i&-er potenti%l @( r%y set <'illi%'per%&e %ss.'ed to be e5.%l=+ Hi&-er t.be potenti%ls red.,e s4in dose2 b.t le%d to -i&-er Sdept-H dose %nd 'ore s,%tter o1 @(r%ys+ In t-e ,%se o1 dent%l intr%or%l @(r%y sets2 4V is .s.%lly eit-er 1i0ed or 'ini'%lly v%ri%ble+ An i'port%nt ,onsider%tion /it- intr%or%l r%dio&r%p-y is t-e @(r%y spe,tr%l sensitivity o1 dent%l @(r%y 1il' %nd t-e i'%&e 5.%lity %t di11erent 4V+ In,re%sin& t-e 4V '.,- beyond 89 4V /o.ld res.lt in % spe,tr.' ill('%t,-ed to t-e opti'%l sensitivity o1 dent%l 1il'+ SLo/H 4V prod.,es i'%&es o1 -i&-er ,ontr%st t-%n do -i&-er 4V+ *-is re1le,ts t-e di11erent types o1 %tten.%tion o1 lo/ %nd -i&- ener&y r%di%tion+ *-ere is deb%te %bo.t t-e opti'%l 4V 1or dentistry+ A 4V o1 %ro.nd C9(89 4V 1or intr%or%l r%dio&r%p-y is ,onsidered to be % re%son%ble ,o'pro'ise ,-oi,e in ter's o1 li'itin& dose %nd di%&nosti, e11i,%,y+ or intr%or%l @(r%y sets2 .sin& ,onvention%l AC e5.ip'ent2 CE to 89 4V is re,o''ended %nd 1or ) &ener%tors <,onst%nt potenti%l=2 C9 4V is pre1er%ble+ *-e @(r%y t.be potenti%l s-o.ld not be lo/er t-%n E94V+ As I t /%s 'entioned be1ore2 t-e ,-oi,e o1 potenti%l /ill %lso %11e,t t-e r%di%tion re,eived by t-e p%tient+ *-e -i&-er t-e potenti%l2 t-e lo/er t-e r%di%tion dose %nd s-orter t-e e0pos.re ti'e2 /it- ,onse5.ent 'ini'i3%tion o1 'otion .ns-%rpness+ Ho/ever2 t-e ,ontr%st de,re%ses %t -i&-er potenti%l2 %nd % ,o'pro'ise '.st be re%,-ed on t-e opti'%l v%l.e to be .sed+ Const%nt potenti%l e5.ip'ent provides 'ore predi,t%ble %nd %,,.r%te @(r%y o.tp.t %nd is t-ere1ore % better ,-oi,e 1or .se espe,i%lly /it- di&it%l re,eptor syste's+ Const%nt potenti%l <Sdire,t ,.rrentH= @(r%y &ener%tion is % 'odern %ltern%tive to tr%dition%l p.ls%tin& 4ilovolt%&e 1or bot-2 dent%l intr%or%l %s /ell %s p%nor%'i,/,ep-%lo'etri, e5.ip'ent+ #.,- % 'et-od o1 @( r%y &ener%tion prod.,es proportion%tely 1e/er lo/ ener&y @(r%ys %nd -en,e &ives red.,tions in s4in dose 1or p%tients+ *-e 'e%n @(r%y ener&y 1ro' % ,onst%nt potenti%l <$C= @(r%y set is -i&-er t-%n t-%t 1ro' %n %ltern%tin& potenti%l <AC= @(r%y set %t t-e s%'e oper%tin& 4ilovolt%&e+ It -%s been de'onstr%ted t-%t 1or % ,onst%nt potenti%l set % 4ilovolt%&e settin& o1 E(D 4V lo/er is needed to '%int%in r%dio&r%p-i, ,ontr%st+ *-.s C9 4V is re,o''ended %s t-e opti'%l oper%tin& potenti%l 1or intr%or%l e0%'s+ Unli4e intr%or%l r%dio&r%p-y2 4V is .sed %s t-e prin,iple 'e%ns o1 e0pos.re ,ontrol 1or p%nor%'i, r%dio&r%p-y+ *-.s 'ost p%nor%'i, @(r%y .nits o11er % /ide r%n&e o1 4V to t-e oper%tor+ #ele,tion o1 4V is prin,ip%lly &overned by t-e need to ,ontrol @(r%y intensity %nd by t-e ener&y sensitivity o1 t-e 1il'/s,reen ,o'bin%tion+

,-posure control (#imer+


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*-e e0pos.re s-o.ld be ter'in%ted %.to'%ti,%lly /-en % predeter'ined ,ondition2 s.,%s % pre(set ti'e2 -%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 s/it,- 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 '%4e repe%t e0pos.res /it-o.t rele%se o1 t-e e0pos.re s/it,- <2"2 2C=+ *.*.'.2. .sefu" %eam fi"trati n

iltr%tion is intended to pre1erenti%lly %bsorb t-e lo/er ener&y p%rt o1 t-e spe,tr.' o1 t-e pri'%ry @(r%y be%'+ *-e lo/er ener&y r%di%tion is not .se1.l 1or di%&nosti, p.rposes b.t it is %bsorbed by t-e tiss.es+ *-.s it is inv%l.%ble %s % 'e%ns o1 red.,in& s4in doses to p%tients+ Al.'ini.' -%s been t-e tr%dition%l '%teri%l .sed 1or be%' 1iltr%tion in di%&nosti, r%diolo&y+ #.,- 1iltr%tion is 1itted %t '%n.1%,t.re %nd is t-ere1ore % 1%,tor t-%t is not re%dily .nder t-e ,ontrol o1 t-e dentist+ *-e tot%l 1iltr%tion o1 t-e be%' <'%de .p o1 t-e in-erent 1iltr%tion %nd %ny %dded 1iltr%tion= s-o.ld be e5.iv%lent to not less t-%n t-e 1ollo/in&?
( (

"+E'' %l.'ini.' 1or @(r%y t.be volt%&es .p to %nd in,l.din& 894V6 2+E'' %l.'ini.'2 o1 /-i,- "+E'' s-o.ld be per'%nent2 1or @(r%y t.be volt%&es %bove 894V+

*-e 1iltr%tion o1 t-e pri'%ry be%' '%y be in1erred 1ro' % -%l1 v%l.e l%yer 'e%s.re'ent in %l.'ini.' <2"=+ Addition%l 1iltr%tion .sin& spe,i%l '%teri%ls <F(ed&e 1ilters= ot-er t-%n %l.'ini.'2 s.,%s r%re(e%rt- '%teri%ls2 -%ve been investi&%ted %s 'e%ns o1 dose red.,tion in intr%or%l dent%l r%dio&r%p-y by % n.'ber o1 rese%r,-ers <EC "3C=+ *-e .nderlyin& re%son 1or t-eir .se is t-%t t-ey Ss-%peH t-e @(r%y spe,tr.' %nd 'ore ,losely '%t,- t-e spe,tr%l sensitivity o1 dent%l 1il'+ *-e eviden,e %ppe%rs to be t-%t %ll o11er red.,tions in dose2 b.t t-%t t-is '.st be b%l%n,ed %&%inst ,ost2 e11e,ts on i'%&e 5.%lity %nd t-e li4ely in,re%se in e0pos.re ti'es %sso,i%ted /it- t-eir .se+ <EC "3C= :%re(e%rt- 1iltr%tion o11ers so'e dose red.,tion in intr%or%l r%dio&r%p-y2 b.t it s-o.ld only be %dopted %1ter %dvi,e 1ro' % 5.%li1ied e0pert on settin& ne/ e0pos.re 1%,tors+ $ose red.,tion -%s %lso been de'onstr%ted 1or p%nor%'i, r%dio&r%p-y+ <EC "3C= *.*.'.'. 3 ""imati n- fie"d si<e and p siti ning (intra ra" and e+tra ra")

In intr%or%l r%dio&r%p-y t-e be%' li'itin& devi,e2 so'eti'es ,%lled t-e ,olli'%tor2 di%p-r%&'2 1ield(de1inin& sp%,er ,one or Sposition indi,%tin& devi,eH <PI$=2 serves %s % &.ide 1or est%blis-in& t-e so.r,e(s.b>e,t dist%n,e %nd %lso %s % &.ide 1or t-e %li&n'ent o1 t-e @(r%y be%'2 %s /ell %s be%' %re% restri,tion+ :ed.,in& t-e si3e o1 t-e @(r%y be%' to t-e 'ini'.' si3e needed to i'%&e t-e ob>e,t o1 interest is %n obvio.s 'e%ns o1 li'itin& dose to p%tients+ Li'itin& be%' %re% on t-e s4in
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s.r1%,e %lso li'its t-e vol.'e o1 t-e p%tient t-%t is irr%di%ted+ As /ell %s S1ield si3eH on t-e p%tientHs s4in bein& i'port%nt2 t-e @(r%y so.r,e to s4in dist%n,e pl%ys % role in li'itin& doses+ ;e,%.se o1 t-e diver&en,e o1 t-e @(r%y be%'2 in,re%sin& t-is dist%n,e red.,es t-e diver&en,e /it-in t-e p%tient %nd t-ere1ore red.,es t-e vol.'e irr%di%ted+ *-e %li&n'ent is depend%nt .pon oper%tor s4ill+ or ,onvention%l dent%l r%dio&r%p-y % 1ield(de1inin& sp%,er ,one provides % 'ini'.' 1o,.s s4in dist%n,e o1 29,' 1or e5.ip'ent oper%tin& %bove C94V2 %nd "9,' 1or e5.ip'ent oper%tin& %t C94V or belo/+ Open(ended ,ylinders or diver&ent ,ones %nd re,t%n&.l%r ,ones %re pre1er%ble to pointed ,ones /-i,prod.,e s,%tter r%di%tion+ #-ort pointed sp%,er ,ones /ere on,e 1%vored be,%.se t-e ,oni,%l s-%pe %llo/ed % less obstr.,ted vie/ o1 1il'/teet- rel%tions-ip %nd provided % vis.%l indi,%tion o1 t-e ,entr%l r%y+ Ho/ever2 in t-e l%st 29 ye%rs 'ost dent%l intr%or%l sets -%ve been '%n.1%,t.red /it- %n open( ended PI$ o1 C9 '' di%'eter+ A ,ir,.l%r be%' o1 t-is si3e is "3EK l%r&er in %re% t-%n % ,onvention%l dent%l 1il' <39 0 49 ''=2 indi,%tin& %n obvio.s /%y o1 red.,in& p%tient dose+ :e,t%n&.l%r ,olli'%tors %re better t-%n ,ir,.l%r ones be,%.se t-ey red.,e t-e %re% e0posed+ V%rio.s investi&%tors -%ve esti'%ted t-%t re,t%n&.l%r ,olli'%tion ,%n %,-ieve dose red.,tions e0,eedin& C9K in dent%l r%dio&r%p-y <EC "3C=+ :eports 1ro' bot- lon& %nd s-ort re,t%n&.l%r ,olli'%tion res.lted in t-e lo/est e11e,tive doses2 /it- v%l.es 3+E to E ti'es less t-%n ro.nd ,olli'%tion+ *-e %doption o1 re,t%n&.l%r ,olli'%tion <39 0 49 '' be%'= -%s been re,o''ended in bot- UF %nd U#A+ Ho/ever2 it is i'port%nt to re'e'ber t-%t .se o1 re,t%n&.l%r ,olli'%tion re5.ires t-e .se o1 1il' -oldin& devi,es /it- % be%' %li&n'ent &.ide to prevent ,one ,.ts+ :e,t%n&.l%r ,olli'%tion ,%n be %,-ieved by repl%,in& t-e ro.nd PI$ /it- % re,t%n&.l%r one2 %tt%,-in& % spe,i%l re,t%n&.l%r ,olli'%tin& pl%te to t-e end o1 t-e ro.nd PI$ or .sin& % 1il' -older t-%t in,orpor%tes % 'et%l s-ield to blo,4 r%di%tion beyond t-e ed&es o1 t-e 1il'+ *-ese possibilities 'e%n t-%t e0istin& e5.ip'ent ,%n e%sily be %d%pted to %llo/ re,t%n&.l%r ,olli'%tion+ In t-ose ,%ses /-ere 1il' -olders %re not possible2 re,t%n&.l%r ,olli'%tion s-o.ld still be ,onsidered+ *-e 1ield di%'eter %t t-e ,olli'%tor end s-o.ld not e0,eed C ,' %nd s-%ll not e0,eed 8+E,'+ *o ,o'ply /it- t-is 1ield(si3e restri,tion2 ,olli'%tors s-o.ld be 1itted /it- % s.it%ble le%d %nn.l.s in t-e b%se <2"=+ W-enever possible t-e dent%l 1il' s-o.ld be 1i0ed in position /it- 'e,-%ni,%l s.pports to t-e @(r%y t.be -o.sin& %sse'bly to %ss.re st%bility d.rin& %n e0pos.re %1ter positionin&+ W-en properly .sed t-ese %.0ili%ry devi,es s-o.ld red.,e ret%4es %nd .ns-%rpness /it- % ,onse5.ent lo/er dose to t-e p%tient+ *-e inverse s5.%re l%/ st%tes t-%t2 1ro' % point so.r,e in % non(%bsorbin& 'edi.'2 t-e r%di%tion intensity v%ries inversely %s t-e s5.%re o1 t-e dist%n,e 1ro' t-e so.r,e+ In r%dio&r%p-y2 /-en t-e 1o,.s(to(ob>e,t dist%n,e is de,re%sed2 /-ile t-e 1ield si3e %nd in,ident dose %t t-e pl%ne o1 t-e i'%&e re,eptor %re 4ept ,onst%nt2 t-e dose %t t-e in,ident s.r1%,e rises s-%rply2 b.t t-e tot%l ener&y %bsorbed is %11e,ted only to % s'%ll e0tent+ In,re%sin& t-e 1o,.s( to(ob>e,t dist%n,e beyond one 'etre /ill res.lt in only 'inor red.,tion in dose+ <#ee i&.re 4+3=
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i&.re 4+3 E11e,t on s4in e0pos.re o1 %lterin& t-e 1o,.s(1il' dist%n,e <2C=+

Figure *.' Effect n s5in e+p sure f a"tering the f cus$fi"m distance (2=).

Diaphragm in e-tra"oral (panoramic9cephalometric+ radiography


P%nor%'i, r%dio&r%p-y /%s desi&ned ori&in%lly %s % 'e%ns o1 e0%'inin& t-e >%/s %nd t-e teet-+ Ho/ever2 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+ Ho/ever2 sever%l .nits no/ o11er pro&r%''ed 1ield(si3e 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%tion2 %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' <s-o.ld nor'%lly be "29 or "E9 ''=+ #o'e ne/ p%nor%'i, '%,-ines -%ve % S,-ild(i'%&in& 'odeH2 /-i,- red.,es t-e e0posed %re% by 28 to 4EK <EC "3C=+ #o'e %lso o11er 'ore sop-isti,%ted pro&r%''es to per'it i'%&in& o1 individ.%l >%/ se&'ents %nd te'poro'%ndib.l%r >oints+ In % st.dy2 Le,o'ber %nd %.l4ner <@@= reported t-%t by .sin& % 1ield si3e pro&r%''e on t-e Ort-op-os @(r%y .nit li'ited to t-e toot- be%rin& re&ions o1 t-e >%/s2 e11e,tive dose ,o.ld be red.,ed by 'ore t-%n E9K+ #.,1%,ilities o11er % si'ple /%y o1 red.,in& dose %nd t-e p.r,-%se o1 '%,-ines /it- t-ese 1%,ilities s-o.ld be en,o.r%&ed+ *-e pri'%ry ,on,ern is t-%t t-e ne,ess%ry in1or'%tion be obt%ined /it- t-e 'ini'.' %'o.nt o1 %bsorbed dose %nd t-ere1ore t-e le%st ris4 to t-e p%tient+ or p%nor%'i, to'o&r%p-y t-e be%' si3e %t t-e ,%ssette -older s-o.ld not e0,eed "9'' 0 "E9''+ *-e tot%l be%' %re% s-o.ld not e0,eed t-e %re% o1 t-e re,eivin& slit o1 t-e ,%ssette -older by 'ore t-%n 29K+ *-e p%nor%'i, e0%'in%tion &ives less tot%l %bsorbed dose2 &ener%lly %bo.t "/C2 to t-e s.b>e,t %s % tot%l intr%or%l e0%'in%tion <33=+ *-is di11eren,e is '%inly be,%.se o1 t-e s.bst%nti%l overl%p in r%di%tion 1ields re5.ired 1or t-e seri%l e0pos.res o1 % ,o'plete intr%or%l e0%'in%tion+ It is i'port%nt to note t-%t t-e resol.tion o1 p%nor%'i, e0%'in%tions is not %de5.%te to dete,t or ,-%r%,teri3e s'%ll or e%rly ,%rio.s lesions nor is it %de5.%te 1or t-e dete,tion %nd ,-%r%,teri3%tion o1 periodont%l dise%se be1ore t-ere -%s been '%ssive destr.,tion o1 bone+ or t-e ot-er -%nd2 intr%or%l e0%'in%tions yield '.,'ore %,,.r%te represent%tions needed 1or pre,ise di%&nosti, in1or'%tion %nd/or oper%tive 'e%s.re'ents t-%n p%nor%'i, e0%'in%tions+ Only dent%l pro1ession%ls ,o'petent in dent%l r%dio&r%p-y %re 5.%li1ied to '%4e % >.d&'ent %s to t-e 4ind %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+ Ho/ever2 t-e %re% o1 interest to ort-odontists .s.%lly stops %t t-e level o1 t-e b%se o1 t-e s4.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+
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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 /or4in& 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 s4.ll 1ro' di%&nosti, %re% <EC "3C=+ Alt-o.&- s.,- ,olli'%tion s-o.ld si&ni1i,%nt red.,e p%tient dose2 '%n.1%,t.res o1 ,ep-%lo'etri, e5.ip'ent -%ve not yet in,l.ded t-is 1or' o1 ,olli'%tion %s st%nd%rd+ .rt-er ,olli'%tion o1 t-e l%ter%l ,ep-%lo&r%' to s-o/ t-e '%0ill% %nd '%ndible only is % vi%ble %ltern%tive 1or 'e%s.rin& ,ep-%lo'etri, v%l.es d.rin& tre%t'ent <EC "3C=+ *.*.'.*. Fi"m pr cessing and digita" imaging in patient d se reducti n.

Opti'%l pro,essin& is essenti%l 1or proper dent%l r%dio&r%p-y2 sin,e t-e n.'ber o1 r%dio&r%p-s t%4en per d%y is .s.%lly not l%r&e in % dent%l priv%te ,lini, %nd pro,essin& is .s.%lly '%n.%l+ Attention s-o.ld be dr%/n to pro,essin& te,-ni5.es %nd ret%4es %nd espe,i%lly to t-e .ndesir%ble pr%,ti,e o1 overe0pos.re %nd .nderdevelop'ent+ *-e 1%stest %v%il%ble 1il's ,onsistent /it- s%tis1%,tory di%&nosti, res.lts s-o.ld be .sed+ Intr%or%l 1il's s-o.ld be o1 I#O speed E or 1%ster+ Until "7D92 t-e 1%stest intr%or%l 1il' ,o''er,i%lly %v%il%ble /%s 1il' o1 &ro.p $+ In "7D"2 E(speed 1il's be,%'e %v%il%ble2 ,%p%ble o1 red.,in& t-e %'o.nt o1 r%di%tion by %ppro0i'%tely E9K+ Ho/ever2 t-is 1%st 1il' -%d % lo/er in-erent ,ontr%st2 /%s very sensitive to %&ed %nd depleted sol.tions %nd lost its -i&- speed %t -i&-er densities+ *-is /%s prob%bly t-e '%in re%son t-%t only % 1e/ dentists %dopted t-is type o1 1il'+ #.bse5.ent develop'ents in 1il' te,-nolo&y by v%rio.s '%n.1%,t.rers -%ve delivered i'proved E(speed e'.lsions %nd 1il's t-%t 1%ll into t-e I#O speed &ro.p + One br%nd o1 (speed 1il' t-%t is /idely %v%il%ble -%s been s-o/n to o11er dose red.,tions o1 29(2EK ,o'p%red /it- t-e s%'e '%n.1%,t.rerHs E(speed 1il'+ In ,on,l.sion2 1or intr%or%l r%dio&r%p-y t-e 1%stest %v%il%ble 1il's ,onsistent /its%tis1%,tory di%&nosti, res.lts s-o.ld be .sed+ Intr%or%l 1il's o1 I#O speed &ro.ps E or %re re,o''ended be,%.se t-ey red.,e t-e r%di%tion dose 'ore t-%n E9K ,o'p%red /it- &ro.p $( speed 1il's+ *-e .se o1 inst%nt pro,ess 1il'2 /-i,- -%s slo/er speeds %nd li'it%tions in i'%&e 5.%lity s-o.ld be li'ited to spe,i1i, essenti%l sit.%tions2 %s in endodonti,s or pree0tr%,tion ,%ses d.rin& o.t(o1(-o.rs ,%re+ or p%nor%'i,2 ,ep-%lo'etri, %nd ot-er e0tr%or%l r%dio&r%p-s2 t-e 1%stest %v%il%ble 1il'(intensi1yin& s,reen ,o'bin%tion ,onsistent /it- s%tis1%,tory di%&nosti, res.lts s-o.ld be .sed+ *-e 1il' s,reen ,o'bin%tion s-o.ld be %t le%st 499 %nd t-e li&-t sensitivity o1 t-e 1il' s-o.ld be ,orre,tly '%t,-ed /it- t-e intensi1yin& s,reens+ *-e introd.,tion o1 r%re(e%rtintensi1yin& s,reen/1il' ,o'bin%tion -%s been s-o/n to &ive dose red.,tion o1 %ro.nd E9K 1or p%nor%'i, %nd ,ep-%lo'etri, r%dio&r%p-y+ )%n.1%,t.rers &ener%lly e'p-%si3e t-e .se o1 '%t,-ed ,o'bin%tions o1 ort-o,-ro'%ti, 1il' %nd r%re(e%rt- s,reens be,%.se s.,- ,o'bin%tions 'ore e11i,iently ,onvert r%di%tion ener&y to li&-t in ,o'p%rison /it- ort-o,-ro'%ti, 1il' ,o'bined /it- ,%l,i.' t.n&st%te s,reens <EC "3C=+ #in,e r%re(e%rt- p-osp-or s,reens /ere introd.,ed in "7822 '%n.1%,t.rers -%ve tried to develop s.,- ,o'bin%tions in order to i'prove speed %nd to in,re%se s-%rpness o1 t-e r%dio&r%p-i, i'%&es A n.'ber o1 st.dies -%ve been ,%rried o.t to ev%l.%te t-e sensito'etri, properties o1 t-ese 1il'(s,reen ,o'bin%tions <EC "3C=+ Wide l%tit.de 1il's per1or' better 1or p%nor%'i, r%dio&r%p-y t-%n -i&-er ,ontr%st 1il's+
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#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,4ed 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.rerHs instr.,tions+ *-e developer s-o.ld be ,-%n&ed %t le%st on,e per 'ont-+ A.%lity ,ontrol <AC= is re,o''ended %s % 'e%ns o1 ens.rin& opti'%l pro,essin& <see %lso C-%pter 2=+

Digital receptors in patient dose reduction.


:e,ently2 sever%l di&it%l i'%&in& syste's -%ve been introd.,ed %s %ltern%tives to ,onvention%l r%dio&r%p-i, te,-ni5.es+ *-e di&it%l i'%&es %re s.pposed to %,-ieve i'%&es o1 -i&- di%&nosti, 5.%lity2 %t le%st e5.%l to t-%t o1 ,onvention%l r%dio&r%p-i, 1il's+ !o pro,essin& ,-e'i,%ls %nd e5.ip'ent %re ne,ess%ry+ $et%iled te,-ni,%l in1or'%tion /%s dis,.ssed previo.sly in C-%pter 2+ or intr%or%l r%dio&r%p-y one st.dy de'onstr%ted t-%t t-e opti'%l e0pos.re ti'e 1or %ll syste's /%s %ppro0i'%tely -%l1 t-%t needed 1or ,onvention%l 1il' %nd t-%t di&it%l i'%&es -%d to be 'odi1ied by %d>.stin& t-e ,ontr%st %nd bri&-tness to opti'i3e t-e visibility o1 t-e re&ion o1 interest <EC "3C=+ Anot-er st.dy reported t-%t % CC$ syste' provided red.,tion in %ver%&e s4in entr%n,e dose o1 3"(34K /-en ,o'p%red /it- E(speed 1il'6 /it- %dded niobi.' 1iltr%tion t-e red.,tion /%s 1o.nd to be E"(C9K+ P#P syste's -%ve /ide e0pos.re l%tit.de %nd ;or& %nd Brond%-l <00= 1o.nd t-%t reli%ble endodonti, 'e%s.re'ents ,o.ld be obt%ined even %t very lo/ e0pos.re settin&s+ Alt-o.&- di&it%l r%dio&r%p-y o11ers % si&ni1i,%nt dose red.,tion2 t-e n.'ber o1 ret%4es d.e to b%d positionin& o1 t-e b.l4y CC$ /it- itsH /ire2 it '%y res.lt in in,re%sed dose 1or t-e p%tient+ .rt-er'ore2 d.e to s'%ller sensor si3es2 'ore t-%n one e0pos.re '%y be re5.ired to ,over t-e %n%to'i,%l %re% i'%&ed .sin& % sin&le ,onvention%l 1il'+ Proble's /it- positionin& sensors -%ve been reported %s le%din& to -i&- re>e,t r%te <EC "3C=+ P%nor%'i, %nd ,ep-%lo'etri, di&it%l r%dio&r%p-y -%ve t-e s%'e t/o types o1 di&it%l syste's %nd t-e si'il%r ,lini,%l %dv%nt%&es %s intr%or%l di&it%l r%dio&r%p-y2 %lt-o.&- dose red.,tion is not e0pe,ted to be %s e11e,tive %s /it- intr%or%l syste's+ *-e e0pos.res %re %l'ost e5.%l to t-ose o1 '%,-ines .sin& 1il'/s,reen ,o'bin%tions+ *-ere /ill be no dose red.,tion+ #o'e p%pers -o/ever2 report t-%t2 dependin& on t-e di%&nosti, t%s42 % lo/er e0pos.re o1 t-e r%dio&r%p- ,o.ld be s.11i,ient /-en density %nd ,ontr%st ,%n be %d>.sted 1ro' t-e so1t/%re 1e%t.res <EC "3C=+ *-is is one o1 t-e bene1its o1 di&it%l r%dio&r%p-y /-ere t-e density %nd ,ontr%st o1 %n i'%&e ,%n be opti'i3ed %1ter t-e i'%&e -%s been t%4en+ *-is is di11erent to ,onvention%l r%dio&r%p-y2 /-ere t-e ,ontr%st %nd density ,%nnot be ,-%n&ed %1ter t-e i'%&e is t%4en+ Intr%or%l di&it%l r%dio&r%p-y o11ers % potenti%l dose red.,tion+ It is .nli4ely t-%t di&it%l p%nor%'i, %nd ,ep-%lo'etri, r%dio&r%p-y ,%n ro.tinely o11er dose red.,tion ,o'p%red /it,onvention%l s,reen/1il' ,o'bin%tions+ A 5.%li1ied e0pert s-o.ld be ,ons.lted to %,-ieve dose red.,tion opti'i3%tion+ *.*.'.6. Th!r id and g nad e+p sures.

#hyroid
In dent%l r%dio&r%p-y2 one o1 t-e &re%test ,on,erns in r%di%tion prote,tion is t-e r%di%tion to t-e t-yroid+ *-e t-yroid &l%nd is one o1 t-e 'ore r%diosensitive or&%ns in t-e -e%d %nd ne,4 re&ion+ It is 1re5.ently e0posed to s,%ttered r%di%tion %nd o,,%sion%lly to pri'%ry
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be%' d.rin& dent%l r%dio&r%p-y+ ;e,%.se people .nder %&e 39 %re %t &re%ter ris4 o1 r%di%tion ind.,ed t-yroid ,%n,er t-%n older individ.%ls2 so'e -%ve %r&.ed t-%t t-yroid s-ieldin& <,oll%r= s-o.ld be .sed /-en intr%or%l r%dio&r%p-i, e0%'in%tions %re '%de on t-is pop.l%tion <EC "3C=+ W-en .sin& properly ,olli'%ted dent%l r%dio&r%p-i, e5.ip'ent2 t-ere is rel%tively little ris4 to ot-er tiss.es+ It is prob%ble t-%t re,t%n&.l%r ,olli'%tion 1or intr%or%l r%dio&r%p-y o11ers si'il%r level o1 t-yroid prote,tion to le%d ,oll%r2 in %ddition to its ot-er dose red.,in& e11e,ts+ *-yroid ,oll%r is in%ppropri%te 1or p%nor%'i, r%dio&r%p-y %s it '%y inter1ere /it- t-e pri'%ry be%'+ In ,ep-%lo'etri, r%dio&r%p-y le%d t-yroid prote,tion is ne,ess%ry i1 t-e be%' ,olli'%tion does not e0,l.de t-e t-yroid &l%nd+ *-yroid s-ieldin& /%s 1o.nd to red.,e r%di%tion doses o1 4EK d.rin& C* o1 t-e -e%d %nd is stron&ly re,o''ended2 espe,i%lly in yo.n&er %&e &ro.p+ *-e red.,tion is &re%ter in ,ep-%lo'etri, r%dio&r%p-y2 /-ere it ,%n res.lt in dose bet/een E9K %nd DEK lo/er+ *-ere %re so'e proble's in s-ieldin& t-e t-yroid o1 s'%ll ,-ildren2 be,%.se t-e st%nd%rd t-yroid s-ields %re too l%r&e 1or t-e'+ or e0%'ple2 % t-yroid s-ield so'eti'es '%y inter1ere /it- t-e vis.%li3%tion o1 t-e lo/er border o1 t-e '%ndible+ *-e s-ields ,%n2 -o/ever2 be ,.t do/n to %ppropri%te si3e 1or t-e s'%ller p%tients2 so t-%t t-ey do not obstr.,t t-e vie/ o1 i'port%nt str.,t.res <2C=+ *-e -ei&-t o1 t-e slit in p%nto'o&r%p-s s-o.ld be 4ept to % 'ini'.' so %s to irr%di%te only t-e %re% in 5.estion2 %nd t-.s to red.,e t-e dose to t-e t-yroid %nd ot-er or&%ns+

Gonad
$.rin& dent%l r%dio&r%p-y .sin& proper te,-ni5.es2 t-e e0pos.re o1 t-e &on%ds by t-e pri'%ry be%' s-o.ld not o,,.r+ Ho/ever2 it is %dvis%ble to .se %ddition%l s-ieldin& s.,- %s % le%d r.bber %pron to prote,t t-e %bdo'en <%nd 1oet.s i1 present= 1ro' str%y r%di%tion+ In pres,ribin& @(r%y e0%'in%tions o1 pre&n%nt or possibly pre&n%nt /o'en2 ,%re1.l ,onsider%tion s-o.ld be t%4en to %void 1oet%l e0pos.re+ It is &ener%lly %,,epted t-%t @(r%y e0%'in%tions &ivin& % si&ni1i,%nt 1oet%l e0pos.re s-o.ld be %voided in pre&n%n,y /-en possible+ ort.n%tely2 in dent%l r%diolo&y2 &ood r%diolo&i,%l prote,tion pr%,ti,e red.,es t-e 1et%l dose to %n %,,ept%ble 'ini'.' %nd does not ,onstit.te % si&ni1i,%nt -%3%rd+ Hi&-(speed s,reens ,%n be .sed in p%nor%'i, r%dio&r%p-y %nd ,ep-%lo'etry2 /it,onse5.ent de,re%se in dose+ *-ere is so'e loss o1 i'%&e 5.%lity /-en '.,- 1%ster 1il'( s,reen ,o'bin%tions %re .sed2 %nd % tr%de(o11 -%s to be '%de bet/een t-e dose %nd t-e in1or'%tion %v%il%ble on t-e 1il'+ *.*.'.=. Radi graph! in imp"ant " g!

$et%iled i'%&in& is essenti%l in i'pl%ntolo&y+ In tre%t'ent pl%nnin&2 r%dio&r%p-s provide in1or'%tion on t-e 5.%ntity %nd 5.%lity o1 bone in t-e proposed site o1 i'pl%nt pl%,e'ent+ ollo/in& tre%t'ent2 i'%&in& is .sed to %ssess i'pl%nt osteointe&r%tion2 bone -e%lin& %nd to periodi,%lly revie/ t-e 1i0t.re+ *-e revie/ o1 t-e liter%t.re displ%ys % p%.,ity o1 eviden,e(b%sed &.idelines on r%dio&r%p-y 1or i'pl%ntolo&y+ Eviden,e -%s2 in t-e '%in2 been derived 1ro' e0pert opinion %nd revie/ p%pers <EC "3C=+ An %ssess'ent o1 t-ese p%pers reve%led in,onsisten,ies %nd little reli%ble in1or'%tion on t-e 1re5.en,y o1 1ollo/(.p r%dio&r%p-y+ *-e n.'ber o1 i'pl%nts %nd t-eir proposed position in t-e or%l ,%vity %re o1ten t-e '%in 1%,tors di,t%tin& t-e ,-oi,e o1 i'%&in& te,-ni5.e+ A proportion o1 p%tients need %dv%n,ed
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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 <C*=2 %ll r%dio&r%p-i, pro>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%4en 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'%&es2 proposed i'pl%nts sites %nd/or to'o&r%p-i, l%nd'%r4s s-o.ld be identi1ied .sin& s.r&i,%l stents ,onsistin& o1 'et%l rods2 b%lls or r%diop%5.e '%r4ers+ 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-y2 t-e %bsorbed doses to r%diosensitive or&%ns %re belo/ 9+2 'By+ $oses 1ro' C* ,%n be ,onsider%bly -i&-er2 /it-2 1or e0%'ple2 '%0i'.' doses o1 3D 'By %nd 3"'By bein& 'e%s.red %t t-e s4in s.r1%,e %nd t-e p%rotid &l%nd2 respe,tively2 %lt-o.&- 'et-ods 1or red.,ed doses 1ro' -eli,%l C* -%ve %lso been de'onstr%ted <U!#CEA: 2999=+ *-e dose 1ro' % ne/ vol.'etri, C* s,%nner2 developed spe,i1i,%lly 1or dent%l i'%&in&2 /%s reported to be %ppro0i'%tely one si0t- o1 t-%t 1ro' tr%dition%l spir%l C*+ *-e .se o1 % dedi,%ted '.lti'od%l dent%l i'%&in& syste' -%s %lso been s-o/n to involve lo/er doses t-%n %ltern%tive C* te,-ni5.es+ On t-e b%sis o1 'e%s.re'ents in % -.'%n p-%nto'2 esti'%tes o1 e11e,tive dose 1or s.,- ,o'ple0 1il' to'o&r%p-y r%n&e 1ro' Z" V#v to 39 V#v2 dependin& on t-e %n%to'i,%l lo,%tion o1 t-e i'%&in& pl%ne %nd t-e ,olli'%tion option .sed6 si'il%r 'e%s.re'ents 1or p%nor%'i, r%dio&r%p-y &%ve %n e11e,tive dose o1 2C V#v+ <U!#CEA: 2999=+ In t-e p%st C* s,%nnin& -%s been restri,ted to &ener%l -ospit%l 1%,ilities2 -o/ever s'%ller dedi,%ted -e%d %nd ne,4 C* i'%&in& e5.ip'ent is be,o'in& 'ore ,o''onpl%,e+ #pir%l C* te,-ni5.es bene1it 1ro' s-orter s,%nnin& ti'es %nd i'proved %,,.r%,y+ *.*.'.>. Inf rmati n and c nsent f r patients.

An e0pl%n%tion o1 t-e ris4s o1 dent%l r%dio&r%p-y s-o.ld e'p-%si3e t-e potenti%l bene1it to t-e p%tientHs '%n%&e'ent %nd pro&nosis %&%inst very lo/ ris4 o1 %dverse ,onse5.en,es+ */o points s-o.ld be .nderlined?
( (

$ent%l r%dio&r%p-y is % very lo/ ris4 pro,ed.re %nd Wit-o.t t-e r%dio&r%p-<s=2 t-e p%tientHs tre%t'ent /ill be ,o'pro'ised+

.rt-er'ore2 %ss.'in& %d-eren,e to re,o''end%tions2 t-e dentists ,%n in1or' p%tients t-%t t-ey e'ploy st%te o1 t-e %rt te,-ni5.es to 'ini'i3e t-e ris4 %nd -%s % 5.%lity %ss.r%n,e pro&r%''e in pl%,e to opti'i3e i'%&e 5.%lity+ Wit- re&%rd to t-e r%dio&r%p-y o1 p%tients /-o %re2 or '%ybe2 pre&n%nt2 t-e s%'e points ,%n be e'p-%si3ed2 e0pl%inin& t-%t t-e ris4s 1ro' dent%l r%dio&r%p-y %re no di11erent /-et-er t-e p%tient is or is not pre&n%nt <EC "3C=+
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*-e dentist .s.%lly see4s 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%,tory2 %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 <i1 % r%dio&r%p- -%s re,ently been t%4en=+ *-ere is %n in,re%sin& e'p-%sis on t-e need to obt%in in1or'ed ,onsent 1or %ll %spe,ts o1 'edi,%l %nd dent%l pr%,ti,e %nd not 'erely 1or -i&-(ris4 pro,ed.res s.,- %s intervention%l r%diolo&y or irreversible tre%t'ents s.,- %s toot- e0tr%,tion+ In1or'ed ,onsent is '%nd%tory in so'e ,o.ntries+ Written ,onsent is no 'ore t-%n %n indi,%tion t-%t t-e pro,ess o1 in1or'ed ,onsent -%s been s%tis1%,torily ,o'pleted+ *-ere %re t/o sit.%tions in dent%l r%dio&r%p-y /-en /ritten ,onsent is spe,i1i,%lly re5.ired? 1irst2 1or p%tients re,r.ited to rese%r,- pro>e,ts /-i,- '.st -%ve re,eived %pprov%l by %n Et-i,s Co''ittee 1irst %nd se,ond2 1or p%tients .nder&oin& % 'edi,o(le&%l e0pos.re /-i,- -%s no dire,t -e%lt- bene1it+ 4!5! Ne+ ima&in& mo%alities 4... . General &spects ).,- e11ort is spent in di%&nosti, r%diolo&y to red.,e t-e r%di%tion dose %nd si'.lt%neo.sly to i'prove t-e in1or'%tion obt%ined /it- dent%l r%dio&r%p-s+ Co'p.ter te,-nolo&y -%s si&ni1i,%nt i'p%,t on r%dio&r%p-y in 'edi,ine %nd so in dentistry to %,-ieve t-is &o%l+ Adv%n,ed di&it%l i'%&in& te,-ni5.es /ill be %v%il%ble 1or t-e &ener%l pr%,titioner /it-in t-e ne0t de,%de+ #tor%&e %nd retriev%l o1 i'%&es2 ,ontr%st en-%n,e'ent %nd noise red.,tion %re so'e e0%'ples o1 % 'odern i'%&e '%nip.l%tion tools+ #.btr%,tion r%dio&r%p-y %nd i'%&e re,onstr.,tion %s /ell %s ,o'p.ted to'o&r%p-y <C*=2 /ill i'prove di%&nosis %nd tre%t'ent pl%nnin&+ Clini,%l 4no/led&e o1 dentists %nd r%diolo&ist /ill be in,l.ded in ,o'p.ter pro&r%'s to per1or' 'ore sop-isti,%ted t%s4s %s %.to'%ted i'%&e %n%lysis %nd ,o'p.ter %ided i'%&e interpret%tion+ 4...2. Distance to the occupied area *-e dist%n,e <d= 1ro' t-e so.r,e to t-e o,,.pied %re% o1 interest sh u"d be t%4en to t-e ne%rest li4ely %ppro%,- o1 t-e sensitive or&%ns o1 % person to t-e b%rrier+ or % /%ll t-is '%y be %ss.'ed to be not less t-%n 9+3 '+ or % so.r,e lo,%ted %bove <.pper roo'= potenti%lly o,,.pied sp%,es2 t-e sensitive or&%ns o1 t-e person in roo' belo/ ,%n be %ss.'ed to be not 'ore t-%n "+8 ' %bove t-e lo/er 1loor2 /-ile 1or ,eilin& tr%ns'ission t-e dist%n,e o1 %t le%st 9+E ' %bove t-e 1loor o1 t-e roo' %bove <.pper roo'= is &ener%lly re%son%ble+ 4...3. 7ccupancy 3actors *-e o,,.p%n,y 1%,tor <T= 1or %n %re% is de1ined %s t-e 1r%,tion o1 t-e /or4in& -o.rs in t-e /ee4 t-%t % &iven person /o.ld o,,.py t-e %re%2 %ver%&ed over t-e period o1 ti'e2 .s.%lly t-e ye%r+ It is not t-e 1r%,tion o1 t-e ti'e t-%t it is o,,.pied by %ny persons2 b.t r%t-er is t-e 1r%,tion o1 t-e ti'e it is o,,.pied by t-e sing"e person /-o spends t-e 'ost ti'e t-ere+ *-.s2 %n .n%ttended /%itin& roo' 'i&-t be o,,.pied %t %ll ti'es d.rin& t-e d%y2 b.t -%ve % very lo/ o,,.p%n,y 1%,tor sin,e no sin&le person is li4ely to spend UE9 - per ye%r in % &iven /%itin& roo'+ O,,.p%n,y 1%,tors in .n,ontrolled %re%s /ill r%rely be deter'ined by visitors to t-e 1%,ility or its environs /-o 'i&-t be t-ere only 1or % s'%ll 1r%,tion o1 % ye%r+ *-e
VOL 3 JULY 24 vers I!AL A" #ECO!$ Co'pressed()*(IAEA(*e'pl%te+do,

P%&e CD

'%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 /or4 period in ,ontrolled or s.pervised %re%s+ *-ere1ore2 %re%s s.,- %s 0(r%y roo's %nd ,ontrol boot-s sh u"d be 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 sh u"d nor'%lly be ,onsidered %s 1.lly o,,.pied <T L "=2 re&%rdless o1 t-e n%t.re o1 t-e %d>%,ent interior %re%2 sin,e t-ese %re%s %re s.b>e,t to ,-%n&e in 1.n,tion /it-o.t t-e 4no/led&e or ,ontrol o1 t-e 0( r%y 1%,ility+ *-is is %lso %ppli,%ble to %d>%,ent sp%,e 1or /-i,- 1.t.re o,,.p%n,y is %nti,ip%ted+ *-is does not %pply to t-e &ro.nds o1 %n %d>%,ent b.ildin& /-ere 1r%,tion%l o,,.p%n,y 1%,tors '%y be .tili3ed+ *%ble +" 1ro' !C:P "4E s-o/s s.&&ested o,,.p%n,y 1%,tors i1 'ore det%iled in1or'%tion on o,,.p%n,y is not %v%il%ble+ *A;LE +" J #.&&ested o,,.p%n,y 1%,tors <1or .se %s % &.ide in pl%nnin& s-ieldin& /-ere ot-er o,,.p%n,y d%t% %re not %v%il%ble= 7ocation Ad'inistr%tive or ,leri,%l o11i,es? l%bor%tories2 P-%r'%,ies %nd ot-er /or4 %re%s 1.lly o,,.pied by %n individ.%l6 re,eptionist %re%s2 %ttended /%itin& roo's2 ,-ildrenHs indoor pl%y %re%s2 %d>%,ent 0(r%y roo's2 1il' re%din& %re%s2 n.rseHs st%tions2 0(r%y ,ontrol roo's :oo's .sed 1or p%tient e0%'in%tions %nd tre%t'ents Corridors2 p%tient roo's2 e'ployee lo.n&es2 st%11 toilets P.bli, toilets2 .n%ttended vendin& %re%s2 stor%&e roo's2 o.tdoor %re%s /it- se%tin&2 .n%ttended /%itin& roo's2 p%tient -oldin& %re%s+ O.tdoor %re%s /it- only tr%nsient pedestri%n or ve-i,.l%r tr%11i,2 .n%ttended p%r4in& lots2 ve-i,.l%r drop o11 %re%s <.n%ttended2 %tti,s2 st%ir/%ys2 .n%ttended elev%tors2 >%nitorHs ,losets+
%

Occu'ancy Factor 9T: "

"/2 "/E "/29 "/49

W-en .sin& % lo/ o,,.p%n,y 1%,tor 1or % roo' i''edi%tely %d>%,ent to %n 0(r%y roo'2 ,%re 2 u"d e t%4e to 2h ,onsider t-e %re%s 1.rt-er re'oved 1ro' t-e 0(r%y roo'+ *-ere %re% '%y -%re si&ni1i,%ntly -i&-er o,,.p%n,y 1%,tors t-%n t-e %d>%,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 3actors *-e .se 1%,tor <.= is t-e 1r%,tion o1 t-e pri'%ry be%' /or4lo%d t-%t is dire,ted to/%rd % &iven pri'%ry b%rrier+ *-e v%l.e o1 . /ill depend on t-e type o1 r%di%tion inst%ll%tion %nd t-e b%rrier o1 ,on,ern+ In dent%l r%dio&r%p-i, roo's2 t-e t.be is %rr%n&ed to %llo/ '%ny di11erent be%' orient%tions2 so t-%t di11erent b%rriers '%y -%ve di11erent .se 1%,tors+ or e0%'ple in % dedi,%ted ,ep-%lo'etry roo'2 . L " 1or t-e %re% o1 t-e /%ll be-ind t-e i'%&e re,eptor2 %nd . L 9 1or %ll ot-er roo's /-ere only se,ond%ry r%di%tion need be ,onsidered+ *%ble +2 1ro' !C:P "4E s-o/s s.&&ested .se 1%,tors 1or intr%or%l r%dio&r%p-y .nits <),$on%ld et %l+2 "7D3=
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P%&e C7

*%ble +2 ;%rrier #ide /%lls ;%,4 /%ll </%ll %t p%tientHs b%,4= ront /%ll </%ll %t p%tientHs 1ront= Ceilin& loor Use %,tor <U= 9+4 9+2 929 929 929

4..... ;or0load *-e /or4lo%d <?= o1 % dent%l i'%&in& 0(r%y t.be is t-e ti'e inte&r%l o1 t-e 0(r%y t.be ,.rrent over % spe,i1ied period %nd is ,onvention%lly &iven in .nits o1 'illi%'pere(se,onds <'As= or 'illi%'pere('in.te <'A 'in=+ *-e 'ost ,o''on period o1 ti'e in /-i,- t-e /or4lo%d is spe,i1ied is one /ee4+ At % &iven 0(r%y t.be oper%tin& potenti%l %nd % &iven dist%n,e2 t-e %ir 4er'% %t % &iven re1eren,e point 1ro' t-e pri'%ry be%' is dire,tly proportion%l to t-e /or4lo%d+ *-e tr%ns'ission is t-e 1r%,tion by /-i,- t-e %ir 4er'% is de,re%sed d.e to t-e presen,e o1 t-e s-ieldin& b%rrier+ *-e /or4lo%d %nd t-e tr%ns'ission %re typi,%lly stron& 1.n,tions o1 t-e t.be oper%tin& potenti%l+ or dent%l r%dio&r%p-y2 p%rti,.l%rly 1or intr%or%l it is %ss.'ed t-%t t-e @(r%y t.be only oper%tes %t % sin&le potenti%l bet/een E9 to 89 4V+ I1 t-is r%n&e o1 oper%tin& potenti%l is .sed t-e &ood ,onserv%tive %ss.'ption /ill be .sin& t-e -i&-est one+ Wor4lo%d '%y be ,onverted to %ir 4er'% in .nits o1 'illi&r%y per /ee42 by '.ltiplyin& by t-e %ir 4er'% per .nit /or4lo%d %t " '2 in .nits o1 'By 'A(" 'in("+ Air 4er'% per .nit /or4lo%d is dependent on 4V2 in,re%sin& %ppro0i'%tely %s t-e s5.%re o1 t-e 4V %nd is %lso depend%nt o1 type o1 t-e /%ve1or'+ ;%rrier tr%ns'ission %nd -e%d le%4%&e %re stron&ly dependent on 4V+ W%ve1or' is t-e te'por%l v%ri%tion o1 t-e oper%tin& potenti%l %pplied to t-e @(r%y t.be d.rin& t-e e0pos.re+ )ost o1 t-e dent%l @(r%y .nits %re sin&le(p-%se2 -%l1(/%ve re,ti1ied+ #o d.rin& t-e 1irst -%l1(,y,le2 t-e potenti%l &oes 1ro' 3ero to its '%0i'.' %nd t-%n b%,4 to 3ero in -e'i(sin.soid%l /%ve6 it re'%ins %t 3ero d.rin& t-e se,ond -%l1J,y,le /-en t-e line volt%&e reverses+ In t-ese .nits t-e %ver%&e p-oton ener&y is &ener%lly less t-%n -%l1 o1 its '%0i'.' v%l.e+ As it /%s 'entioned in previo.s ,-%pter in -i&- 1re5.en,y <H = &ener%tors .sed in ne/er '%,-ines t-e %ver%&e p-oton ener&y is '.,- &re%ter 1r%,tion o1 its pe%4 4V+ Wor4lo%d %lso depends o1 t-e len&t- o1 t-e sp%,er ,one+ L%r&er t-e ,one &re%ter t-e /or4lo%d+ Wor4lo%d ,%n be deter'ined by ,o.ntin& t-e n.'ber o1 e0posed 1il's over sever%l /ee4s %nd t-%n %ver%&in& t-e n.'ber 1or one /ee4+ *-is %ver%&e n.'ber o1 1il's per /ee4
VOL 3 JULY 24 vers I!AL A" #ECO!$ Co'pressed()*(IAEA(*e'pl%te+do,

P%&e 89

'.ltiplied by %ver%&ed 'illi%'pere(se,onds per 1il' %nd t-%n divided by C9 /ill yield t-e /or4lo%d in 'illi%'pere('in.tes per /ee4+ In p%nor%'i, r%dio&r%p-y % n%rro/2 slit(li4e .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%rrier be-ind t-e i'%&e re,eptor+ *-e .se1.l be%' tresp%sses only t-e p%tient %re% to be e0%'ined %nd doesnHt stri4e ot-er ob>e,t2 t-%n only se,ond%ry b%rriers to be t%4in& into %,,o.nt+ #o'e %.t-ors <:eid %t %l+6 "773= 'e%s.red %ir(4er'% levels %ro.nd t-e p%nor%'i, .nit /-ose '%0i'.' te,-ni5.es /%s 79 4V %nd "2 'A2 b.t oper%ted %t 8E 4V %nd "9 'A %nd 1o.nd t-e %ver%&e %ir(4er'% o1 4+E 0 "9(E 'By per e0pos.re %nd ,on,l.ded t-%t no %ddition%l s-ieldin& /%s re5.ired+ It /%s d.e in p%rt t-e .nit bein& oper%ted /ell belo/ its '%0i'.' le%4%&e r%di%tion ,onditions+ #o'eti'es it is %lso .se1.l to de1ine t-e nor'%li3ed /or4lo%d < ?nor'= %s t-e %ver%&e /or4lo%d per p%tient+ !ote t-%t ?nor' '%y in,l.de '.ltiple e0pos.res dependin& on t-e type o1 r%dio&r%p-i, e0%'in%tion %nd ,lini,%l &o%l+ *-e prod.,t o1 ?nor' %nd t-e %ver%&e n.'ber o1 p%tients per /ee4 <N= is t-e tot%l /or4lo%d per /ee4 <?tot=? ;tot @ N.;norm! It is i'port%nt to distin&.is- bet/een t-e n.'ber o1 p%tients e0%'ined in % /ee4 < N= %s .sed in t-is )%n.%l Oon /-i,- is b%sed t-e %ver%&e /or4lo%d per p%tient < ?nor'= 1ro' t-e AAP) s.rvey <#i'p4in2 "77C%=P %nd t-e n.'ber o1 We0%'in%tionsX per1or'ed in % &iven 0( r%y roo'+ A sin&le p%tient '%y re,eive sever%l s.,- We0%'in%tionsX /-ile in t-e 0(r%y roo' %nd t-%t '%y even involve 'ore t-%n one i'%&e re,eptor < e.g+2 bot- t-e i'%&e re,eptor %sso,i%ted /it- t-e p%nor%'i, %nd t-e one %sso,i%ted /it- t-e ,ep-%lo'etri, e0pos.re=+ *-e esti'%ted /or4lo%d 1or intr%or%l %nd p%nor%'i, .nits is &iven in *%ble 3+ *-e %,t.%l /or4lo%d /ill %lso v%ry 1ro' 1%,ility to 1%,ility %nd even 1ro' /ee4 to /ee4 in t-e s%'e 1%,ility+

*%ble +3 <!C:P "4E= J Esti'%ted /or4lo%d 1or intr%or%l %nd p%nor%'i, .nits %(b
*ype o1 Units Lo/ Vol.'e Intr%or%l )edi.' 299 *ot%l il's or I'%&es Per /ee4 Per .nits "99 4V E9 89 79 E9 'As per 1il' or i'%&e D+E 4+E 2+E D+E E il' #peed or I'%&e :e,eptor speed E Wor4lo%d <'A 'in/Wee4= "4 8+E 4+2 2D

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

P%&e 8"

Vol.'e Intr%or%l Hi&Vol.'e Intr%or%l Lo/ Vol.'e p%nor%'i, )edi.' Vol.'e p%nor%'i, Hi&Vol.'e p%nor%'i,
%

89 79 399 E9 89 79 2E E9 89 79 E9 E9 89 79 8E E9 89 79

4+E 2+E D+E 4+E 2+E "D9 "99 C9 "D9 "99 C9 "D9 "99 C9 499 499 499 E

"E D+3 43 23 "3 8E 42 2E "E9 D3 E9 22E "2E 8E

*-e intr%or%l /or4lo%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 .sed2 t-e /or4lo%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,e2 /or4lo%d s-o.ld be do.bled 1or $(speed 1il'+ or % ,onst%nt(potenti%l /%ve1or'2 t-e te,-ni5.e 1%,tor <'illi%'pere(se,onds= %nd /or4lo%d s-o.ld be red.,e by %bo.t one(t-ird+ b In t-e %bsen,e o1 ot-er spe,i1i, lo,%l d%t%2 t-e entries in t-is *%ble %re s.&&ested in t-is :eport+

4!;!

(iel%in& calculation met(o%s $or %ental 23ray room

4.<. . Barrier #hic0ness )alculations *-e ob>e,tive o1 % s-ieldin& ,%l,.l%tion is to deter'ine t-e t-i,4ness o1 t-e b%rrier t-%t is s.11i,ient to red.,e t-e %ir 4er'% in %n o,,.pied %re% to % v%l.e 1 = P9#2 t-e /ee4ly s-ieldin& desi&n &o%l 'odi1ied by t-e o,,.p%n,y 1%,tor 1or t-e %re% to be s-ielded+ *-e tot%l %ir 4er'% tr%ns'itted to %n o,,.pied %re% OF tot<02'=P d.e to r%di%tion 1ro' %n 0(r%y t.be in % dent%l r%diolo&i,%l roo'2 s-ieldin& by % b%rrier o1 t-i,4ness 1 o1 '%teri%l m2 is t-e s.' o1 t-e pri'%ry <p=2 s,%ttered <s= %nd le%4%&e <L= %ir(4er'% ,ontrib.tions 1ro' t-e t.be+ *-.s i1 Fp<02'=2 Fs<02'= %nd FL <02'= %re t-e %ir(4er'% tr%ns'itted to t-e o,,.pied %re% 1ro' pri'%ry2 s,%ttered %nd le%4%&e r%di%tion respe,tively2 t-en? Atot91,m: @ A'91,m: B As91,m: B A791,m:! 911: I1 % roo' ,ont%ins 'ore t-%n one 0(r%y t.be2 t-e ,ontrib.tions 1ro' e%,- t.be need to be s.''ed+
VOL 3 JULY 24 vers I!AL A" #ECO!$ Co'pressed()*(IAEA(*e'pl%te+do,

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A r%di%tion b%rrier o1 t-i,4ness 1 acc o1 '%teri%l m is %,,ept%ble /-en t-e tot%l %ir 4er'% %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 <i+e+2 9+" 'By /ee4(" 1or ,ontrolled %re%s %nd 9+92 'By /ee4(" 1or s.pervised %re%s=+ As it /%s 'entioned e%rlier in t-is C-%pter2 t-ese /ee4ly s-ieldin& desi&n &o%ls ,orrespond to %nn.%l %ir(4er'% v%l.es o1 E 'By <,ontrolled %re%s= %nd " 'By <s.pervised %re%s= Controlled %re%s %re t-ose /-ere e'ployees -%ve si&ni1i,%nt potenti%l 1or e0pos.re to r%di%tion in t-e ,o.rse o1 t-eir %ssi&n'ents2 or /-ere t-e e'ployees %re dire,tly responsible 1or involved /it- t-e .se %nd ,ontrol o1 r%di%tion+ *-ese individ.%l &ener%lly -%ve tr%inin& in r%di%tion '%n%&e'ent %nd %re s.b>e,t to ro.tine person%l 'onitorin&+ Un,ontrolled %re%s %re t-ose o,,.pied by individ.%ls s.,- %s p%tients2 visitors to t-e 1%,ility2 %nd e'ployees /-o do not /or4 ro.tinely /it- or %ro.nd r%di%tion so.r,es+ Are%s %d>%,ent to b.t not p%rt o1 t-e 0( r%y 1%,ility %re %lso s.pervised %re%s+ In ,%se /-ere %n individ.%l only o,,.pies t-e s-ielded %re% 1r%,tion * o1 t-e ti'e2 t-e s-ieldin& desi&n &o%l P is %d>.sted by t-e 1%,tor "/*+ *-ere1ore2 %n %,,ept%ble r%di%tion( s-ieldin& b%rrier is de1ined by? Atot91 acc, m: @ . = T 9111: In &ener%l2 t-e %,,ept%ble b%rrier t-i,4ness 1 acc ,%n be deter'ined 1ro' E5.%tion <000= only by .sin& n.'eri,%l or &r%p-i,%l 'et-ods+ *-%t is2 t-e tot%l %ir 4er'% t-ro.&- % b%rrier o1 t-i,4ness 0 is ,%l,.l%ted 1ro' E5.%tion <00= .tili3in& t-e 'odels 1or t-e pri'%ry2 s,%ttered2 %nd le%4%&e %ir 4er'% <!C:P Appendi0 +3=+ *-e bro%d(be%' tr%ns'ission 1.n,tion O1<+=P is de1ined %s t-e r%tio o1 t-e %ir 4er'% be-ind % b%rrier o1 t-i,4ness + to t-e %ir 4er'% %t t-e s%'e lo,%tion /it- no intervenin& r%di%tion b%rrier+ An %,,ept%ble b%rrier t-i,4ness <+b%rrier= is one in /-i,- t-e v%l.e o1 t-e bro%d(be%' tr%ns'ission 1.n,tion is? ; <+b%rrier= L <P/*= <dp 2 / F" U != /-ere dp is t-e dist%n,e bet/een t-e r%di%tion so.r,e %nd t-e individ.%l beyond t-e b%rrier2 F" is t-e %ver%&e .ns-ielded %ir 4er'% per p%tient %t " ' 1ro' t-e so.r,e2 U is t-e .se 1%,tor %nd N is t-e e0pe,ted n.'ber o1 p%tients e0%'ined in t-e roo' per /ee4+

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Figure *. ++. ,rimar! and sec ndar! %arriers pr tecting a pers n at , (,) fr m direct and scattered radiati n fr m patien *r%ns'ission ; <+b%rrier= depends on t-e type o1 r%di%tion deliverin& t-e %ir 4er'%2 t-e ener&y o1 t-e r%di%tion2 %nd t-e t-i,4ness %nd '%teri%l ,onstit.tin& t-e b%rrier+ *-e s,%tter tr%ns'ission is %ss.'ed to be e5.%l to t-%t o1 t-e pri'%ry be%'2 sin,e to 1irst %ppro0i'%tion t-e ener&y spe,tr.' o1 s,%ttered p-otons is t-e s%'e %s t-%t 1or pri'%ry p-otons &ener%ted %t less t-%n "E9 4V+ *-e tr%ns'ission o1 le%4%&e r%di%tion is %ss.'ed e0ponenti%l2 sin,e penetr%tion t-ro.&- t-e t.be -o.sin& /ill -%ve re'oved %ll b.t t-e -i&-est ener&y 0 r%ys &ener%ted in t-e t.be+ or t.be oper%tion %t % &iven potenti%l2 t-e le%4%&e r%di%tion tr%ns'ission /ill e0,eed t-e pri'%ry %nd s,%ttered r%di%tion tr%ns'ission+ *-e -%l1(v%l.e l%yer o1 t-e le%4%&e r%di%tion is obt%ined 1ro' t-e pri'%ry be%' tr%ns'ission %t -i&%tten.%tion+ Usin& t-e /or4lo%d distrib.tions2 t-e .ns-ielded pri'%ry or se,ond%ry %ir 4er'% per p%tient <or tot%l /or4lo%d per p%tient= %t " ' '%y be ,%l,.l%ted+ #,%lin& t-ese by t-e /ee4ly n.'ber o1 p%tients i'%&ed in t-e 0(r%y roo' %nd ,orre,tin& by t-e inverse s5.%re o1 t-e dist%n,e yields t-e .ns-ielded %ir 4er'% in t-e o,,.pied %re%+ ;y deter'inin& t-e r%di%tion tr%ns'ission t-ro.&- % &iven b%rrier '%teri%l 1or t-is spe,i1i, /or4lo%d distrib.tion2 t-e t-i,4ness o1 t-e b%rrier t-%t red.,es t-e .ns-ielded %ir 4er'% to t-e desired v%l.e o1 ,/T ,%n be deter'ined+ APPE!$I@ 3 !C:P "4E ,ont%ins t-e &r%p-s %nd det%iled 1or'.l%e 1or pri'%ry %nd se,ond%ry r%di%tion ,%l,.l%tion %nd on -o/ to %pply t-ese ,on,epts+ 4.<.2. &ppro-imate shielding calculations. #o'eti'es %,,.r%te s-ieldin& ,%l,.l%tions '%y not be possible d.e to .n%v%il%bility o1 %ll ne,ess%ry d%t% or ,onserv%tively s%1er b%rrier ,ondition '%y be desired+ In t-ese ,%ses si'pli1ied %nd e%siest 'et-ods '%y be .sed+

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*%bles 3+E+2+" to 3+E+2+4 1ro' !C:P "4E 1or sin&le(p-%se %nd ,onst%nt potenti%l .nits %re t-e res.lts o1 t-ese ,%l,.l%tions2 b%sed on ,onserv%tive %ss.'ptions+ or le%4%&e r%di%tion t-e t.be ,.rrent is %ss.'ed to be "9 'A2 re&%rdless o1 4V2 res.ltin& o1 %n e11e,tive le%4%&e ,.rrent o1 9+E 'A+ Ho.sin& le%4%&e is %ss.'ed to 'eet t-e st%nd%rd %t t-e -i&-est 4V+ *-e s,%ttered r%di%tion %re% is %ss.'ed to be 4C ,'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,4ness re5.ired 1or pri'%ry %nd se,ond%ry <le%4%&e %nd s,%ttered= r%di%tion prote,tive b%rriers 1or le%d2 &yps.'2 /%llbo%rd %nd solid ,on,rete+ #-ieldin& re5.ire'ents o1 % dent%l @(r%y roo' .sin& t-ese t%bles ,%n be obt%ined 1ro' % deter'in%tion o1 t-e 1ollo/in& p%r%'eters?
( ( ( ( (

'%0i'.' -V t-e .nit is oper%tin& t-e dist%n,e %' 1ro' t-e @(r%y t.be <so.r,e= t-e /ee4ly /or4lo%d <m)! min = +ee-= t-e o,,.p%n,y 1%,tor T t-e lea-a&e ,-%r%,teristi,s o1 t-e .nit

#o'e e0%'ples in t-e Appendi0 @@@ /ill ill.str%te t-e .se o1 t-ese b%rrier t-i,4ness t%bles+

*%ble 3+E+2+E %lso des,ribes t-e properties o1 ,o''on b.ildin& '%teri%ls+ *%bles 3+E+2+" to 3+E+2+4 1ro' !C:P "4E <E0,el *%bles Appro0i'%te #-ieldin& C%l,.l%tions=

4!C! "m'lementation o$ sa$ety measures *-e i'ple'ent%tion o1 s%1ety 'e%s.res 'e%ns ev%l.%tions per1or'ed by % 5.%li1ied e0pert o1 potenti%l r%di%tion e0pos.re 1ro' t-e .se o1 dent%l @(r%y e5.ip'ent .nder t-e spe,i1i, ,onditions o1 % p%rti,.l%r inst%ll%tion+ *-e e0pos.re o1 individ.%ls 1ro' % poorly desi&ned %nd ,onstr.,ted @(r%y 1%,ility ,%n be l%r&e6 t-ere1ore it is i'port%nt t-%t t-e r%di%tion prote,tion 1e%t.res o1 %n @(r%y 1%,ility be inspe,ted+ :%di%tion prote,tion s.rveys s-o.ld be per1or'ed %t v%rio.s st%&es d.rin& t-e ,onstr.,tion %nd ,o''issionin& o1 % ne/ @(r%y 1%,ility+ .rt-er s.rveys s-o.ld be per1or'ed d.rin& its .se %nd /-enever t-e 1%,ility is 'odi1ied+ *-e pri'%ry ob>e,tive o1 t-e r%di%tion prote,tion s.rvey is to ,-e,4 t-%t t-e inst%ll%tion 'eets t-e desi&n spe,i1i,%tions %nd 'ini'.' s%1ety st%nd%rds %nd t-%t it ,o'plies /it- %ll relev%nt re&.l%tory re5.ire'ents+ *-is /ill in,l.de % vis.%l ,-e,4 o1 /%rnin& si&ns2 /%rnin& li&-ts %nd e5.ip'ent l%belin&2 %s /ell %s % series o1 'e%s.re'ents to %ssess t-e r%di%tion e0pos.re levels to st%11 %nd to t-e &ener%l p.bli, t-ereby ens.rin& t-%t no one is li4ely to
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re,eive % r%di%tion e0pos.re in e0,ess o1 % relev%nt dose ,onstr%int+ In %ddition2 '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,tion2 /-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%te2 ,%libr%ted r%di%tion 'e%s.rin& e5.ip'ent2 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%ry2 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,4ness 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%,ility2 to&et-er /it- %n indi,%tion o1 t-e /or4lo%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 /or4+ or e0%'ple2 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 bet/een le%d s-eets %nd ot-er ,onstr.,tion '%teri%ls2 t-e prote,tion provided %t re,esses in s-ieldin&2 %nd ot-er ,onstr.,tion det%ils ,%n be inspe,ted+ I1 %ny r%di%tion prote,tion proble's %re dis,overed2 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,4 p-ysi,%lly t-e le%d e5.iv%len,e o1 prote,tive b%rriers2 %s b.ildin& pl%ns <espe,i%lly older ones= '%y be%r no rel%tion to /-%t %,t.%lly e0ists+ W-ile not re5.ired i1 t-e s-ieldin& '%teri%l is re%dily visible2 it '%y be ne,ess%ry to 'e%s.re t-e le%d e5.iv%len,e o1 /%lls t-%t %re to be .sed %s prote,tive b%rriers :%di%tion prote,tion s.rvey %t inst%ll%tion < %,ility %nd E5.ip'ent= A r%di%tion prote,tion s.rvey s-o.ld be per1or'ed %1ter inst%ll%tion o1 t-e e5.ip'ent b.t prior to ,lini,%l .se+ *-e press.re to %llo/ ,lini,%l pro,ed.res to be per1or'ed prior to t-e ,o'pletion o1 % r%di%tion prote,tion s.rvey %nd ,orre,tion o1 %ny proble's '.st be resisted2 %s de1e,ts ,o.ld le%d to .nne,ess%ry r%di%tion e0pos.res o1 individ.%ls %nd possible liti&%tion+ Prior to t-e end o1 t-e '%n.1%,t.rerQs /%rr%nty2 %not-er 1ollo/(.p r%di%tion prote,tion s.rvey s-o.ld be '%de+ Ho/ever2 it is not ne,ess%ry to repe%t ite's2 /-i,- %re not li4ely to -%ve ,-%n&ed+ *-is 1ollo/(.p visit %lso provides %n opport.nity 1or t-e 5.%li1ied e0pert to dis,.ss %ny proble's /it- t-e st%11+ Personnel 'onitorin& res.lts %nd relev%nt lo&boo4s '%y be inspe,ted %nd dis,.ssed %t t-e s%'e ti'e+ Environ'ent%l s.rvey
P%&e 8C

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*-e r%di%tion prote,tion s.rvey s-o.ld reve%l %ny potenti%l proble's+ Ho/ever2 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%4e %n environ'ent%l </or4pl%,e= s.rvey+ Environ'ent%l </or4pl%,e= 'onitorin& s-o.ld be per1or'ed .sin& s.it%ble dete,tors <e+&+ 1il' b%d&e 'onitors or t-er'ol.'ines,ent dosi'eters= pl%,ed %t v%rio.s positions %ro.nd t-e @(r%y 1%,ility+ Environ'ent%l 'onitorin& s-o.ld be .ndert%4en 1or % period o1 %t le%st one 'ont- %nd pre1er%bly t-ree 'ont-s2 so t-%t % re%listi, i'pression o1 environ'ent%l doses '%y be obt%ined+ *-e s.rvey s-o.ld en%ble t-e 5.%li1ied e0pert to %ssess t-e r%di%tion e0pos.re levels o.tside t-e roo' %nd to ,on1ir' t-%t t-e dose ,onstr%int .sed in t-e roo' desi&n /ill be 'et+ Periodi, s.rveys It '%y be ne,ess%ry to repe%t so'e or %ll o1 t-e r%di%tion s.rveys listed %bove .nder ,ert%in ,ir,.'st%n,es+ I1 t-e @(r%y e5.ip'ent is to be 'odi1ied or ne/ e5.ip'ent is to be inst%lled2 it is i'port%nt to re%ssess t-e r%di%tion prote,tion re5.ire'ents2 deter'ine t-e ,-%n&e o1 /or4lo%d %nd %1ter/%rds to per1or' % repe%t s.rvey+ #'%ll ,-%n&es in e5.ip'ent desi&n '%y not re5.ire %ny %lter%tions in t-e 'e%s.res 1or r%di%tion prote,tion2 /-ere%s '%>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,4ed on %n %nn.%l b%sis2 %s t-e e5.ip'ent '%y develop de1e,ts+ Ite's s.,- %s interlo,4s 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 /or4lo%d+

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5! .ROTECT"ON OF T)FF )ND /ENER)7 .#67"C 5!1! /eneral consi%erations *-e ;%si, #%1ety #t%nd%rds <C= st%te t-%t o,,.p%tion%l e0pos.re is t-%t re,eived by individ.%ls in t-e ,o.rse o1 t-eir /or4+ E0pos.res '%y be ,l%ssi1ied %s nor'%l or potenti%l+ A,,ordin& to t-e #t%nd%rds n rma" e+p sure is %n e0pos.re /-i,- is e0pe,ted to be re,eived .nder nor'%l oper%tin& ,onditions o1 % so.r,e2 in,l.din& possible 'inor 'is-%ps t-%t ,%n be 4ept .nder ,ontrol+ A potenti%l e0pos.re is %n e0pos.re t-%t is not e0pe,ted to be delivered /it- ,ert%inty b.t t-%t '%y res.lt 1ro' %n %,,ident %t % so.r,e or o/in& to %n event or se5.en,e o1 events o1 % prob%bilisti, n%t.re2 in,l.din& e5.ip'ent 1%il.res %nd oper%tin& errors+ *-is ,-%pter de%ls /it- nor'%l e0pos.res+ Potenti%l e0pos.res %re ,onsidered in vol.'e "+ *-e esti'%tion o1 o,,.p%tion%l e0pos.re 1ro' dent%l r%diolo&y is ,o'pli,%ted by t-e 1%,t t-%t t-e r%di%tion ,o'es l%r&ely 1ro' point so.r,es 1%irly ,lose to t-e /or4ers %nd is in &ener%l o1 very lo/ ener&y+ E0pos.re is very non(.ni1or' be,%.se o1 t-e inverse s5.%re l%/ %nd %tten.%tion in t-e body+ E11e,tive dose is di11i,.lt to %ssess be,%.se dosi'eters %re not %l/%ys /orn %t t-e s%'e lo,%tion+ #o'eti'es t-ey %re pl%,ed %bove t-e prote,tive ,lot-in& <le%d %pron=2 so'eti'es belo/+ It /%s >.d&ed in t-e U!#CEA: "7DD report <34= t-%t 1or r%di%tion 5.%lities .sed in di%&nosti, @(r%y pro,ed.res2 i1 t-e e0pos.re is rel%tively .ni1or'6 t-e dosi'eter .s.%lly &ives % re%din& t-%t is t/o to 1o.r ti'es -i&-er t-%n t-e e11e,tive dose i1 no prote,tive %pron is /orn+ I1 % prote,tive %pron is /orn2 %nd t-e person%l dosi'eter is pl%,ed on t-e o.tside2 t-en t-e dosi'eter re%din& ,o.ld be %s '.,- %s "9(29 ti'es -i&-er t-%n t-e e11e,tive dose+ )et-ods 1or %ssess'ent o1 o,,.p%tion%l e0pos.re %re dis,.ssed in det%il in vol.'e "2 %nd t/o re,ently p.blis-ed IAEA #%1ety B.ides <3E2 3C=+ Aver%&e Ann.%l E11e,tive $ose levels to 'onitored st%11 /or4in& /it- dent%l r%diolo&y e5.ip'ent %re very lo/ <9+9"( 9+39 '#v/ye%r2 /it- % 'e%n %nn.%l v%l.e o1 9+9C '#v+ <U!#CEA: 2999=+

Fig. 6.1 A&erage Annua" Effecti&e D se t @ nit red ? r5ers

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*-e !C:P 1ro' U#A %lso reports t-%t t-e 'e%n dose re,eived by dent%l /or4ers is 9+2 '#v/ye%r <!C:P :eport "98=+ *-ese v%l.es %re b%sed on e0tern%l dosi'eter re%din&s %nd t-e %,t.%l e11e,tive dose '.st be lo/er+ O1 %ll st%11 /or4in& /it- ioni3in& r%di%tions in 'edi,ine2 t-ose /-o %re involved /it- dent%l r%diolo&y %re %s % &ro.p per-%ps t-e one /-i,- re,eives t-e lo/est dose+ Lo/ r%di%tion doses %re % res.lt o1 t-e lo/ /or4 lo%ds %nd lo/ levels o1 le%4%&e %nd s,%ttered r%di%tion 1ro' dent%l @(r%y e5.ip'ent %nd t-e %ppli,%tion o1 so.nd oper%tion%l pro,ed.res+ E5.ip'ent %nd pro,ed.re t-%t red.,e p%tient e0pos.re /ill %lso red.,e e0pos.res to st%11 %nd &ener%l p.bli,+ Ho/ever %ddition%l 'e%s.res /ill 1.rt-er red.,e o,,.p%tion%l %nd p.bli, e0pos.res2 /it-o.t %11e,tin& p%tient dose or i'%&e 5.%lity+ 5!2! Dose limits #t%11 *-e ;%si, #%1ety #t%nd%rds <4= in,l.de % set o1 individ.%l dose li'its 1or persons /-o %re o,,.p%tion%lly e0posed to ioni3in& r%di%tion %nd 1or t-e p.bli, <see C-%pter C 1or dose li'its 1or t-e P.bli,=+ A,,ordin& to t-e #t%nd%rds? AThe ccupati na" e+p sure f an! 2 r5er sha"" %e s c ntr ""ed that the f "" 2ing "imits %e n t e+ceededB (a) (%) (c) an effecti&e d se f 2C mS& per !ear a&eraged &er fi&e c nsecuti&e !earsD an effecti&e d se f 6C mS& in an! sing"e !earD an equi&a"ent d se t the "ens f the e!e f 16C mS& in a !earD and

(d) an equi&a"ent d se t the e+tremities (hands and feet) r the s5in1 f 6CC mS& in a !ear.E Pre&n%nt /or4ers In dent%l r%diolo&y2 it is li4ely t-%t t-e '%>ority o1 dent%l %ssist%nts /ill be 1e'%le2 % si&ni1i,%nt proportion o1 /-o' /ill be o1 ,-ildbe%rin& %&e+ Conse5.ently2 t-e e0pos.re o1 pre&n%nt /or4ers '.st be &iven spe,i%l ,onsider%tion+ A,,ordin& to t-e ;%si, #%1ety #t%nd%rds <C=2 % 1e'%le /or4er s-o.ld2 on be,o'in& %/%re t-%t s-e is pre&n%nt2 noti1y t-e e'ployer in order t-%t -er /or4in& ,onditions '%y be 'odi1ied i1 ne,ess%ry+ *-e noti1i,%tion o1 pre&n%n,y s-%ll not be ,onsidered % re%son to e0,l.de % 1e'%le /or4er 1ro' /or46 -o/ever2 t-e e'ployer o1 % 1e'%le /or4er /-o -%s noti1ied pre&n%n,y s-%ll %d%pt t-e /or4in& ,onditions in respe,t o1 o,,.p%tion%l e0pos.re so %s to ens.re t-%t t-e e'bryo or 1oet.s is %11orded t-e s%'e bro%d level o1 prote,tion %s re5.ired 1or 'e'bers o1 t-e p.bli,+ *-is 'e%ns t-%t t-e dose to t-e e'bryo or 1oet.s s-o.ld not nor'%lly e0,eed "'#v+ Ho/ever t-e li'it %ppli,%ble to pre&n%nt /or4ers o1 9+E '#v e5.iv%lent dose to t-e 1oet.s per 'ont-2 on,e pre&n%n,y is noti1ied2 s.&&est t-%t person%l dosi'etry '%y be % pr.dent 'onitorin& pr%,ti,e 1or t-ose /or4ers+

"*-e e5.iv%lent dose li'its 1or t-e s4in %pply to t-e %ver%&e dose over ",' 2 o1 t-e 'ost -i&-ly irr%di%ted %re% o1 t-e s4in+
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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 /or4in& 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 <bot- in -ospit%ls %nd &ener%l pr%,ti,e= re,eives lo/ doses+ Us.%lly t-ere is no re5.ire'ent 1or % pre&n%nt 'e'ber o1 t-e st%11 to ,-%n&e -er d.ties b%sed on t-e e0pe,ted dose to t-e e'bryo or 1oet.s+ Ho/ever2 %ll doses s-o.ld be red.,ed /-enever possible+ As r%di%tion dose levels to st%11 %re lo/2 it is not .s.%lly ne,ess%ry to iss.e pre&n%nt st%11 %n %ddition%l dosi'eter or to %pply e0tr% prote,tive 'e%s.res <t-o.&- t-e l%tter '%y be desir%ble 1or v%rio.s psy,-olo&i,%l re%sons=+ !evert-eless '%ny s.pervisors /o.ld %,,ept re5.ests 1ro' /o'en to be re%ssi&ned to ot-er d.ties 1or 'edi,o(le&%l re%sons+ Conditions 1or yo.n& persons A,,ordin& to t-e ;%si, #%1ety #t%nd%rds2 no person .nder t-e %&e o1 "C ye%rs s-%ll be s.b>e,ted to o,,.p%tion%l e0pos.re2 %nd no person .nder t-e %&e o1 "D ye%rs s-%ll be %llo/ed to /or4 in % ,ontrolled %re% .nless s.pervised %nd t-en only 1or t-e p.rposes o1 tr%inin& <C=+ .rt-er'ore %,,ordin& to t-e #t%nd%rds? AF r apprentices f 1= t 1F !ears f age 2h are training f r emp" !ment in& "&ing e+p sure t radiati n and f r students f age 1= t 1F 2h are required t use s urces in the c urse f their studies- the ccupati na" e+p sure sha"" %e s c ntr ""ed that the f "" 2ing "imits %e n t e+ceededB (a) an effecti&e d se f = mS& in a !earD (%) an equi&a"ent d se t the "ens f the e!e f 6C mS& in a !earD and (c) an equi&a"ent d se t the e+tremities r the s5in f 16C mS& in a !ear.E W-en /or4in& in %n @(r%y dep%rt'ent st.dents %nd tr%inees s-o.ld %l/%ys be %,,o'p%nied by %n %.t-ori3ed te%,-er+ 5!3! .rotecti*e measures *-e r%di%tion e0pos.re o1 individ.%ls '%y be li'ited by t-e %ppli,%tion o1 one2 or 'ore2 o1 t-e b%si, pr%,ti,%l 'e%ns o1 r%di%tion prote,tion+ As 'entioned in C-%pter 32 t-ese pr%,ti,%l 'et-ods %re 4no/n %s s-ieldin&2 dist%n,e %nd ti'e+ A 4no/led&e o12 %nd t-e s.bse5.ent %ppli,%tion o12 t-ese t-ree pr%,ti,%l 'et-ods o1 red.,in& e0pos.res %re essenti%l to t-e 'ini'i3%tion o1 individ.%l doses+ *-ese pr%,ti,%l 'et-ods o1 r%di%tion prote,tion %re des,ribed in t-e ,onte0t o1 dent%l r%diolo&y in t-e ne0t t-ree se,tions+ IC:P in its P.bli,%tion E82 Radi " gica" ,r tecti n f the ? r5er in @edicine and Dentistr! %lso provides pr%,ti,%l %dvi,e 1or prote,tion o1 t-e st%11 in dent%l r%dio&r%p-y <38=+ It is % 1.nd%'ent%l prin,iple o1 r%di%tion prote,tion t-%t no one2 ot-er t-%n t-e p%tient .nder&oin& t-e pro,ed.re is %llo/ed in t-e roo' d.rin& t-e r%di%tion e0pos.re+ #-ieldin& #-ieldin& is % p%rti,.l%rly .se1.l 'e%ns o1 r%di%tion prote,tion %s it provides %n intrinsi,%lly s%1e environ'ent+ *-e prin,iple o1 s-ieldin& is b%sed on t-e pre'ise o1 pl%,in& % b%rrier /-i,- %tten.%tes r%di%tion bet/een t-e individ.%l %nd t-e so.r,e o1 t-e r%di%tion+ #-ieldin& doesnHt ne,ess%rily 'e%n le%d(lined 0(r%y roo's+ !or'%l b.ildin& '%teri%ls '%y be s.11i,ient in 'ost ,%ses+ W-en % ,onvention%l b.ildin& str.,t.re does not provide %de5.%te s-ieldin&2 it s-%ll be in,re%sed by &r%ter t-i,4ness o1 b.ildin& '%teri%ls or by %ddin& le%d
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s-eets2 &yps.' /%llbo%rd2 ,on,rete2 steel or ot-er s.it%ble '%teri%l+ As it /%s 'entioned be1ore2 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%tients2 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 <b%rrier= in t-e roo'6 ot-er/ise t-e prin,iple o1 dist%n,e is .sed+ A le%d %pron /ill red.,e st%11 doses 1ro' %n %lre%dy lo/ level to % '.,- s'%ller level+ Prote,tive %pron e5.iv%lent to 9+"9 to 9+2E '' le%d /ill %11ord s.bst%nti%l prote,tion to t-e /e%rer %t t-e @(r%y ener&ies typi,%lly .sed in dent%l r%diolo&y+ ).,- 'ore i'port%nt t-%n t-e t-i,4ness o1 t-e prote,tive %pron is its s-%pe %nd desi&n+ W-ile le%d %prons '%y be 5.ite -e%vy2 t-ey need to be /orn only d.rin& t-e ti'e /-en @(r%ys %re &ener%ted+ or t-e re'%inder o1 t-e dent%l pro,ed.re2 t-e le%d r.bber prote,tive %pron '%y be re'oved %nd it s-o.ld be -.n& .p on % s.it%ble -%n&er to prevent ,re%sin& or 1oldin& o1 t-e '%teri%l le%din& to pre'%t.re deterior%tion in its prote,tive e11e,t+ $ist%n,e %nd positionin& In dent%l r%diolo&y2 provided t-e r%di%tion prote,tion oper%tion%l pro,ed.res -%ve been 1ollo/ed %nd t-e e5.ip'ent -%s been %de5.%tely desi&ned2 t-e st%11 /ill '%inly be e0posed to s,%ttered r%di%tion+ #,%ttered r%di%tion dose(r%tes de,re%se /it- dist%n,e %/%y 1ro' t-e p%tient+ #t%ndin& eno.&- 1%r /%y 1ro' t-e p%tient d.rin& dent%l r%diolo&y pro,ed.re is % si'ple 'et-od o1 red.,in& st%11 doses+ #i'il%rly2 t-e r%di%tion intensity in t-e .n%tten.%ted pri'%ry be%' de,re%ses /itdist%n,e 1ro' t-e @(r%y t.be2 %,,ordin& to t-e inverse s5.%re l%/+ *-.s2 dist%n,e /ill %lso red.,e e0pos.res 1ro' t-is so.r,e in % dr%'%ti, 1%s-ion+ Ho/ever2 it '.st be stressed t-%t t-e intensity o1 t-e .n%tten.%ted pri'%ry be%' '%y be over "999 ti'es &re%ter t-%n t-%t o1 t-e s,%ttered r%di%tion %nd it is t-ere1ore vit%l to re'%in o.tside t-e .n%tten.%ted pri'%ry be%'+ Ho/ever it /%s 'entioned be1ore2 % s-ielded lo,%tion %llo/in& ,ontin.o.s vis.%l observ%tion o1 t-e p%tient is re5.ired 1or dent%l 0(r%y e5.ip'ent+ In t-e %bsen,e o1 % b%rrier in dent%l 1%,ility 1or &ener%l pr%,ti,e %nd lo/ /or4lo%d2 t-e oper%tor s-%ll re'%in %t le%st 2 ' 1ro' t-e t.be -e%d d.rin& t-e e0pos.re+ #o t-e 0(r%y .nit needs to be provided /it- %n e0pos.re b.tton on % lon& ,%ble /-i,- s-o.ld be %t le%st 2 ' lon&+ *-is is to en%ble t-e person initi%tin& t-e e0pos.re to st%nd %s 1%r %/%y 1ro' t-e p%tient %s possible2 t-ereby .sin& dist%n,e to red.,e -is/-er e0pos.re+ *-e re,o''ended positionin& 1or 'ini'.' e0pos.res is lo,%ted %t 4E de&rees 1ro' t-e e0it be%'+ *-e 'ost s,%ttered r%di%tion is b%,4/%rd+

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(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'i3e t-e ti'e to /-i,- t-ey %re e0posed to r%di%tion+ Bood /or4in& pr%,ti,e ens.res t-%t bot- t-e n.'ber o1 persons e0posed to r%di%tion2 %nd t-e ti'e o1 t-eir e0pos.re is 4ept to % 'ini'.'+ *-e %void%n,e o1 repe%t r%dio&r%p-s /ill %lso 'ini'i3e e0pos.re+ 5!4! Ra%iation 'rotection sur*ey *-is is %n ev%l.%tion2 done by 5.%li1ied e0pert2 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'ent2 p-ysi,%l s%1e&.%rds s.,- %s ,ontrol boot-s2 'ov%ble s-ields2 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 ioni3%tion s.rvey 'eters <,-%'bers=+ C%re s-o.ld be t%4en to ens.re t-%t t-e instr.'ent %,,.r%tely dete,t r%di%tion levels2 p%rti,.l%rly /-en %ssessin& b%rrier e11e,tiveness+ Are% 'onitorin& is %n essenti%l re5.isite to do,.'ent t-e s%1ety o1 t-e inst%ll%tion2 p%rti,.l%rly in s.pervised %re%s /-ere person%l dosi'eters %re .s.%lly not /orn+ Periodi, r%di%tion s%1ety s.rveys s-o.ld be per1or'ed by pl%,in& dent%l p-%nto's2 si'.l%tin& t-e positions o1 p%tients .nder&oin& di%&nosti, r%diolo&y st.dies+ *-e r%di%tion levels in e%,roo' in,l.din& bot- t-e le%4%&e r%di%tion o1 t-e 0(r%y .nits %nd t-e s,%ttered r%di%tion 1ro'
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t-e p%tients <p-%nto's= 1or di11erent oper%tin& te,-ni5.es s-o.ld be 'e%s.red %nd do,.'ented+ #.,- s.rveys s-o.ld be dis,.ssed /it- t-e st%112 '%inly 1or tr%inin& p.rposes+ #.rveys s-o.ld be ,%rried o.t /-en % ne/ 0(r%y syste' is inst%lled %nd periodi,%lly %1ter/%rds2 espe,i%lly /-en t-e 0(r%y t.be is repl%,ed+ ro' t-e %ir 4er'% 'e%s.re'ents 1or % p%rti,.l%r dent%l 0(r%y te,-ni5.e2 %nd .sin& %,t.%l /or4lo%d v%l.es2 t-e doses t-e st%11 '%y re,eive2 ,%n t-%n be ,%l,.l%ted %nd ,o'p%red /it- %,t.%l person%l dosi'eter re,ords+ L%r&e dis,rep%n,ies s-o.ld be dis,.ssed+ :e,ords o1 t-e r%di%tion s%1ety s.rveys s-o.ld be 4ept %v%il%ble 1or ,ons.lt%tion by t-e st%11+ All s.rvey 'eters .sed 1or /or4pl%,e 'onitorin& s-o.ld be ,%libr%ted %nd t-is ,%libr%tion s-o.ld be tr%,e%ble to % st%nd%rds dosi'etry l%bor%tory+ :%di%tion /%rnin& devi,es %nd instr.'ent oper%bility s-o.ld be ,-e,4ed prior to e%,- d%y o1 .se+ 5!5! 'ecial 'ro,lems

Intr%or%l r%dio&r%p-y :%di%tion doses to st%11 t-%t per1or' intr%or%l dent%l r%dio&r%p-y in % dedi,%ted roo' s-o.ld be very lo/+ #t%11 s-o.ld be %ble to st%nd be-ind % prote,tive b%rrier <1i0ed ,ontrol boot- or 'obile s-ield= %t t-e ,ontrol ,onsole+ *-e prote,tion %11orded by % dedi,%ted prote,tive b%rrier <typi,%lly 9+E to "+9 '' le%d e5.iv%lent= is '.,- &re%ter t-%n o1 t-%t %11orded by % le%d %pron2 t-o.&- it is still i'port%nt to %void dire,tin& t-e pri'%ry be%' %t t-e ,ontrol ,onsole+ *-e prote,tive b%rrier s-o.ld per'it t-e oper%tor st%ndin& %t t-e ,ontrol ,onsole to -%ve %n .nrestri,ted vie/ o1 t-e p%tient+ In so'e ,%ses /%ll 'o.nted 'irror %llo/ t-e oper%tor 1ro' o.tside position o1 t-e 0(r%y roo'2 vis.%l ,ont%,t to t-e p%tient+ $ist%n,e ,%n %lso be .sed %s % 'e%ns o1 red.,in& individ.%l e0pos.res+ *-e dent%l @( r%y .nit '%y be pl%,ed in % ,orner o1 t-e roo' to en%ble t-e oper%tor to st%nd b%,4 %s 1%r %s possible /it- t-e %id o1 t-e lon& e0pos.re ,%ble+ $.rin& %n e0pos.re it is pre1er%ble 1or t-e oper%tor to st%nd in % perpendi,.l%r dire,tion <or %t % l%r&er %n&le= to t-e dire,tion o1 t-e pri'%ry be%'2 %t t-e re%r o1 t-e p%tient+ *-e s,%ttered r%di%tion distrib.tion <#ee i&+ 00= in t-is &ener%l dire,tion is .s.%lly t-e lo/est+ I1 % p%tient needs to be s.pported d.rin& % r%dio&r%p-i, e0pos.re2 it s-o.ld be done by so'eone /-o is not o,,.p%tion%lly e0posed+ #pe,i%l r.les %pply to t-is sit.%tion+<see 000=+ P%nor%'i, %nd Cep-%lo'etri, r%dio&r%p-y #i'il%r &ener%l re,o''end%tion %s 1or intr%or%l r%dio&r%p-y '%y %pply to P%nor%'i, %nd Cep-%lo'etri, r%dio&r%p-y+ P%nor%'i, i'%&es provided ,.rve(pl%ne to'o&r%'s o1 t-e teet- %nd >%/s+ or lo/ /ee4ly /or4lo%ds <less t-%n E9 1il's per /ee4= i1 no b%rrier is provided 1or s,%ttered r%di%tion %t le%st t-e dist%n,e o1 3 'eters 1ro' t-e p%tient is re,o''ended+ P%nor%'i, 0(r%y be%'2 no l%r&er t-%n t-e %re% <slit in t-e i'%&e(re,eptor ,%rrier= o1 re,eptor -older e0posed to t-e str%i&-t be%' %t %ny ti'e %nd point2 irr%di%ted rel%tively s'%ll portion o1 t-e -e%d+ *-e %'o.nt o1 s,%ttered r%di%tion 1ro' t-e p%tients -e%d is rel%tively less t-%n % '.ltiple peri%pi,%l <1.ll 'o.t-= e0%'in%tions+ *-e pri'%ry be%' is stopped by t-e e5.ip'ent b%rrier2 b.ilt %t t-e b%,4 o1 t-e i'%&e re,eptor+ In t-is ,%se only se,ond%ry b%rrier s-ieldin& is re5.ired+ Aro.nd t-e p%nor%'i, .nit %n %ver%&e 4er'% o1 9+94E VBy per e0pos.re /%s 'e%s.red2 so 1or s'%ll /or4lo%ds2 no %ddition%l s-ieldin& is re5.ired+
VOL 3 JULY 24 vers I!AL A" #ECO!$ Co'pressed()*(IAEA(*e'pl%te+do,

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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 s4.ll2 %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-ip2 typi,%lly %t t-e dist%n,e o1 "+E9 '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'i3ed by t-e %ppli,%tion o1 t-e pro,ess o1 ,onstr%ined opti'i3%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'ed2 e5.ip'ent2 prote,tive devi,es %v%il%ble %nd t-e /or4lo%d+ In &ener%l2 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 /or4in& pr%,ti,es2 s.,- %s t-ose des,ribed in t-e &.id%n,e 1or &ood pr%,ti,e %nd lo,%l r.les <see Anne0 2=2 '%n%&e'ent %nd roo' desi&n %ll si&ni1i,%ntly ,ontrib.te to % red.,tion in st%11 doses+ Properly desi&ned dent%l r%diolo&y e5.ip'ent %nd roo's /ill s-ield st%112 p%tients %nd t-e &ener%l p.bli, 1ro' r%di%tion+ Even i1 it is not possible to -%ve % spe,i%lly desi&ned roo' 1or dent%l r%diolo&y in % &ener%l pr%,ti,e2 ,onsider%tion o1 t-e t-ree b%si, 'e%s.res 1or red.,in& e0pos.res ,%n red.,e r%di%tion doses to lo/ levels+ Opti'i3%tion o1 st%11 doses is t-.s %,-ieved by t-ree 'et-ods+ *-ese %re &ood /or4in& pr%,ti,es2 red.,in& p%tient doses %nd t-e %doption o1 t-e prote,tive 'e%s.res des,ribed in #e,tion E+3+ *-e introd.,tion o1 % ,o'bin%tion o1 t-ese t-ree 'et-ods s-o.ld res.lt in st%11 doses bein& 4ept to % 'ini'.'+ )ost o1 t-e 'et-ods o1 'ini'i3in& p%tient doses2 des,ribed in C-%pter 42 /-i,- oper%te by red.,in& t-e tot%l r%di%tion e0pos.re2 /ill %lso red.,e st%11 doses+ or inst%n,e2 t-e introd.,tion o1 % 1%st intr%or%l dent%l 1il' or % r%re(e%rt- 1il' s,reen ,o'bin%tion /ill red.,e p%tient doses by red.,in& t-e n.'ber o1 @(r%y p-otons re5.ired to 1or' %n i'%&e+ !ot only -%s t-e n.'ber o1 pri'%ry p-otons been red.,ed2 b.t so -%s t-e intensity o1 t-e s,%ttered r%di%tion+ As % si'ple r.le o1 t-.'b2 t-e %ir 4er'% 1ro' s,%ttered r%di%tion %t " ' 1ro' % p%tient /ill be "/"999 <one t-o.s%ndt-= o1 t-e %ir 4er'% stri4in& on t-e p%tient+ 5!C! "n%i*i%ual 9'ersonal: monitorin& *-e '%in ob>e,tive o1 individ.%l <person%l= %nd %re% 'onitorin& /it-in %nd %ro.nd dent%l @(r%y %s des,ribed in Vol.'e " is to ev%l.%te t-e r%di%tion s%1ety o1 t-e p%tients2 t-e st%11 %nd p.bli, <e+&+ o,,.p%nts o1 nei&-borin& roo's= %nd to ens.re t-%t t-e doses re,eived %re belo/ %ny dose ,onstr%ints or li'its+ As des,ribed in vol.'e " <see C-%pter D= /it- re1eren,e to t-e ;%si, #%1ety #t%nd%rds %n o,,.p%tion%lly e0posed individ.%l /-o &ener%lly /or4s in % ,ontrolled %re% %nd /-o '%y re,eive % si&ni1i,%nt e0pos.re s-o.ld be in,l.ded in %n individ.%l 'onitorin& pro&r%''e+ I1 individ.%l 'onitorin& is not %ppropri%te2 o,,.p%tion%l e0pos.re '%y be %ssessed 1ro' t-e res.lts o1 /or4pl%,e 'onitorin&+ In dent%l r%dio&r%p-y2 individ.%l 'onitorin& is per1or'ed to 'e%s.re t-e r%di%tion dose to %n individ.%l 1ro' e0tern%l so.r,es o1 r%di%tion over % &iven 'onitorin& period+ *-e individ.%l /ill be provided /it- % r%di%tion dosi'eter <e+&+ % 1il' or *L$ b%d&e= to /e%r %t % spe,i1ied position <.s.%lly on t-e tr.n4= to esti'%te t-e dose to t-e /-ole body+ In ,ert%in ,ir,.'st%n,es2 not t-e ,%se in dentistry2 e0tr% dosi'eters /ill be iss.ed
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to be /orn %t t-e -e%d or on t-e -%nds2 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 <*L$= 3= Ele,troni, dosi'eters 4= Po,4et ioni3%tion ,-%'bers+ or 'ore det%iled des,ription o1 'onitorin& devi,es %nd dosi'etri, te,-ni5.es2 see vol.'e "2 C-%pter D+ *-e esti'%tion o1 o,,.p%tion%l e0pos.re 1ro' di%&nosti, r%diolo&y is ,o'pli,%ted %s t-e so.r,e o1 r%di%tion is ,lose to t-e /or4ers %nd is in &ener%l o1 very lo/ ener&y+ *-e IC:U -%s p.blis-ed ,onversion ,oe11i,ients 1or .se in r%diolo&i,%l prote,tion %&%inst e0tern%l r%di%tion <IC:U E82 "77D= t-%t %llo/s t-e ,%l,.l%tion o1 e11e,tive dose 1ro' oper%tion%l 5.%ntities s.,- %s t-e person%l dose e5.iv%lent <H=2 t-e p%r%'eter t-%t person%l dosi'eters 'e%s.re+ In di%&nosti, r%diolo&y2 e0pos.re is very non(.ni1or' be,%.se o1 t-e inverse s5.%re l%/ %nd %tten.%tion in t-e body+ *o ill.str%te t-is point2 i&.re @@ <IC:U E82 "77D= s-o/s t-e ,onversion ,oe11i,ients 1or t-e oper%tion%l 5.%ntities2 person%l dose e5.iv%lent O<H p<"9=P2 %'bient dose e5.iv%lentOH[<"9=P %nd dire,tion%l dose e5.iv%lent HH<"92 \= vs p-oton ener&y 1or % posterior/%nterior <PA= &eo'etry <\ L "D99= J t-e <"9= indi,%tes t-%t t-e dose e5.iv%lent is 'e%s.red %t % dept- o1 "9 ''+

Ta%"e 6.+++ (TITLEGGGG) .rt-er'ore2 t-e e11e,tive dose is di11i,.lt to %ssess be,%.se dosi'eters %re not %l/%ys /orn %t t-e s%'e lo,%tion+ #o'eti'es t-ey %re pl%,ed %bove t-e prote,tive ,lot-in& <le%d %pron=2 so'eti'es belo/+ I1 % prote,tive %pron is /orn2 %nd t-e person%l dosi'eter is pl%,ed on t-e o.tside2 t-en t-e dosi'eter re%din& ,o.ld be %s '.,- %s "9(29 ti'es -i&-er t-%n t-e e11e,tive dose+ W-ere%s /e%rin& % dosi'eter .nder t-e le%d %pron '%y .nderesti'%te t-e
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e11e,tive dose+ )et-ods 1or %ssess'ent o1 e11e,tive dose %re dis,.ssed in det%il in <IC:U E82 "77D=+ )oreover2 doses re,eived by individ.%ls in dent%l r%dio&r%p-y %re &ener%lly only % s'%ll 1r%,tion <,o'p%r%ble to n%t.r%l b%,4&ro.nd= o1 t-e relev%nt o,,.p%tion%l dose li'it+ Individ.%l 'onitorin& %lso provides % .se1.l ,-e,4 on t-e %de5.%,y o1 r%di%tion prote,tion pro,ed.res in % dep%rt'ent+ *-e i'p%,t o1 ne/ inst%ll%tions %nd e0%'in%tion te,-ni5.es on st%11 doses ,%n %lso be %ssessed+ Individ.%l 'onitorin& is %lso .se1.l 1or t-e %ssess'ent o1 environ'ent%l e0pos.re %nd its in1l.en,e on o,,.p%tion%l e0pos.res+ 5!D! 'ecial Com'ensatory arran&ements

A,,ordin& to t-e ;## <T+=2 Athe c nditi ns f ser&ice f 2 r5ers sha"" %e independent f the e+istence r the p ssi%i"it! f ccupati na" e+p sure. Specia" c mpensat r! arrangements r preferentia" treatment 2ith respect t sa"ar! r specia" insurance c &erage- 2 r5ing h urs- "ength f &acati n- additi na" h "ida!s r retirement %enefits sha"" neither %e granted n r %e used as su%stitutes f r the pr &isi n f pr per pr tecti n and safet! measures t ensure c mp"iance 2ith the requirements f the Standards.E 5!E! .rotection o$ t(e &eneral 'u,lic P.bli, A,,ordin& to t-e ;%si, #%1ety #t%nd%rds <C=2 1or r%di%tion prote,tion p.rposes2 % 'e'ber o1 t-e &ener%l p.bli, is ,onsidered to be %nyone /-o is not o,,.p%tion%lly e0posed nor % p%tient .nder&oin& % dent%l r%dio&r%p-i, e0%'in%tion nor so'eone 4no/in&ly %nd vol.nt%rily -elpin& <ot-er t-%n in t-eir e'ploy'ent= in t-e ,%re2 s.pport or ,o'1ort o1 t-e p%tient+ *-e e0pos.re o1 t-e &ener%l p.bli, is restri,ted by t-e %ppli,%tion o1 dose li'its %nd t-e opti'i3%tion o1 r%di%tion prote,tion+ *-ese dose li'its do not %pply to %ny r%di%tion e0pos.res /-ose '%&nit.de or li4eli-ood is .n%'en%ble to ,ontrol F(49 in t-e body %nd ,os'i, r%di%tion+ *-e #t%nd%rds st%te t-%t t-e dose to 'e'bers o1 t-e p.bli, s-%ll not e0,eed t-e 1ollo/in& li'its? <%= %n e11e,tive dose o1 " '#v in % ye%r6 <b= in spe,i%l ,ir,.'st%n,es2 %n e11e,tive dose o1 .p to E '#v in % sin&le ye%r2 provided t-%t t-e %ver%&e dose over 1ive ,onse,.tive ye%rs does not e0,eed " '#v per ye%r+ *-e dent%l s.r&ery or dent%l @(r%y roo' s-o.ld %lso be desi&ned so t-%t t-e r%di%tion e0pos.re o1 t-e &ener%l p.bli, o.tside t-e roo' is belo/ t-e dose(li'it+ *-is '%y be %,-ieved by prote,tive b%rriers2 dist%n,e or % ,o'bin%tion o1 t-e t/o+ W-en desi&nin& % ne/ dent%l s.r&ery s.ite2 t-e prote,tion s-o.ld be s.11i,ient so t-%t t-e e11e,tive dose to t-e &ener%l p.bli, is so'e/-%t less t-%n " '#v per ye%r 1ro' %ll pr%,ti,es+ *-is desi&n v%l.e o1 less t-%n " '#v per ye%r serves %s % ,onstr%int on p.bli, e0pos.res 1ro' 'ore t-%n one so.r,e+ *-e .se o1 dose ,onstr%ints ,o'bined /it- t-e ALA:A prin,iple <%s lo/ %s re%son%bly %,-iev%ble= provides 1or ,onstr%ined opti'i3%tion o1 r%di%tion prote,tion+ In &ener%l dent%l pr%,ti,e it is .nli4ely t-%t t-e roo' -%s been spe,i1i,%lly desi&ned 1or per1or'in& dent%l r%diolo&y+ It is 'ore li4ely t-%t %n e0istin& roo' -%s been %d%pted 1or .se
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%s % dent%l s.r&ery+ In t-e l%tter inst%n,e2 t-e /%lls /ill not -%ve been desi&ned 1or .se %s r%di%tion b%rriers+ I1 it is possible2 t-e pri'%ry be%' s-o.ld be dire,ted %t e0istin& s.bst%nti%l /%lls <e+&+? one l%yer t-i,4 o1 bri,4 or its e5.iv%lent=+ *-e pri'%ry be%' s-o.ld not be pointed %t t-in p%rtitionin& /%lls or /indo/s i1 t-ere is %n o,,.pied %re% <e+&+? o11i,e or p%tient /%itin& roo'= on t-e ot-er side+ A sep%r%te roo' 1or dent%l r%diolo&y2 %/%y 1ro' o,,.pied %re%s is desir%ble+ An i'port%nt 'et-od o1 'ini'i3in& t-e r%di%tion e0pos.re o1 t-e &ener%l p.bli, 1ro' dent%l r%diolo&y is by t-e %ppli,%tion o1 en&ineerin& ,ontrols <s.,- %re proper t.be s-ieldin& %nd ,olli'%tion= %t t-e so.r,e o1 @(r%ys <i+e? t-e @(r%y t.be=+ Prote,tion 'e%s.res %re in,orpor%ted in t-e desi&n o1 t-e @(r%y t.be -o.sin&+ Pl%,in& s-ieldin& %ro.nd t-e @(r%y so.r,e is %n e11i,ient 'e%ns o1 'ini'i3in& p.bli, e0pos.res+ It is %l/%ys i'port%nt to ,onsider t-e r%di%tion e0pos.re o1 ,riti,%l &ro.ps /-en %ssessin& t-e prote,tion o1 t-e &ener%l p.bli,+ I1 % dent%l s.ite is in %n %p%rt'ent b.ildin&2 t-e ,riti,%l &ro.p '%y ,onsist o1 t-ose people livin& ne0t door+ In s.,- ,ir,.'st%n,es % re%listi, %ssess'ent o1 t-eir possible e0pos.re s-o.ld be '%de+ P.bli, e0pos.res '%y %rise 1ro' t-e .se o1 dent%l r%diolo&y2 eit-er in % dent%l s.ite or 1ro' % dent%l @(r%y roo' in % -ospit%l+ In % dent%l s.ite2 t-e e0pos.re to t-e p.bli, ,%n be 'ini'i3ed by t-e %ppli,%tion o1 r%di%tion prote,tion oper%tion%l pro,ed.res or lo,%l r.les+ )e'bers o1 t-e p.bli, s-o.ld be e0,l.ded 1ro' t-e dent%l s.ite .nless t-ey %re % p%tient .nder&oin& % dent%l r%diolo&y pro,ed.re or %re 4no/in&ly %nd vol.nt%rily -elpin& in t-e ,%re o1 % p%tient+ Bood dent%l s.ite desi&n ,%n si&ni1i,%ntly red.,e t-e e0pos.re o1 t-e &ener%l p.bli,+ Ide%lly2 t-ere s-o.ld be so'e s-ieldin& in,orpor%ted or in-erent in t-e dent%l 0(r%y /%lls+ Ho/ever2 i1 it is not possible to -%ve s.bst%nti%l roo' /%lls2 t-en t-e dent%l @(r%y .nit s-o.ld be sit.%ted %s 1%r %/%y %s possible 1ro' %re%s /-ere t-e &ener%l p.bli, '%y be sit.%ted <e+&+ t-e /%itin& roo'=+ $ire,tin& t-e @(r%y t.be %t % t-in p%rtition /%ll sep%r%tin& t-e dent%l roo' 1ro' t-e /%itin& roo' or %t % /indo/ or roo' door s-o.ld be %voided+ *-ere is % spe,i%l sit.%tion 1or p.bli, e0pos.re in so ,%lled open(%re% desi&ns2 '%inly in -ospit%ls or dent%l ,lini,s2 /-ere sever%l oper%tory %re%s %re sep%r%ted by 'od.l%r ,%binets or t-in 'obile p%rtitions+ *-is desi&n presents r%di%tion prote,tion proble's+ or t-is re%son it is not %dvised2 b.t i1 it e0ist2 ,%re1.l %ttention to s-ieldin& providin& is re5.ired+ Even in t-e %bsen,e o1 open sp%,e desi&n2 oper%tory s.ites '%y -%ve door(lees entries %nd /indo/s on e0terior /%lls+ or t-ese sit.%tions2 spe,i%l ,onsider%tions s-o.ld be &iven to individ.%ls o,,.pyin& %d>%,ent oper%tory roo' %nd/or p%ssin& by .ns-ielded openin&s+ or inst%n,e p%tients <p.bli, in t-is ,%se= in open sp%,e oper%tories s-o.ld be lo,%ted s.,- t-%t t-ey %re not e0posed by t-e pri'%ry be%' 1ro' %n %d>%,ent p%tient .nder&oin& 0(r%y e0pos.re+ *-e %ppli,%tion o1 r%di%tion prote,tion oper%tion%l pro,ed.res %lso serves to 'ini'i3e p.bli, e0pos.res 1ro' dent%l r%diolo&y per1or'ed in % -ospit%l+ *-e need 1or in,orpor%tion o1 %de5.%te s-ieldin& in t-e desi&n o1 t-e @(r%y t.be -o.sin& %nd roo' %lso %pplies+ Ho/ever2 t-e /%lls o1 % dent%l @(r%y roo' in % -ospit%l tend to be 'ore s.bst%nti%l %nd %re .s.%lly s.11i,ient to red.,e p.bli, e0pos.res 1ro' dent%l r%diolo&y+ I1 %n @(r%y roo' in % -ospit%l is .sed 1or &ener%l r%diolo&y %s /ell %s dent%l r%diolo&y2 t-en p%tient ,-%n&in& ,.bi,les '%y be present %nd t-e prote,tion o1 persons o,,.pyin& t-ese ,-%n&in& ,.bi,les '.st be ,onsidered+ #.11i,ient prote,tion s-o.ld be provided to li'it t-e e0pos.re o1 'e'bers o1 t-e p.bli, o,,.pyin& t-ese ,.bi,les to % level /-i,- is % 1r%,tion o1
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t-e %nn.%l p.bli, dose li'it2 1or e0%'ple by %pplyin& % dose ,onstr%int /-i,- is belo/ t-e dose li'it <0=+ 5!1>! <el'in& in t(e care, su''ort or com$ort o$ 'atients 9111: Cert%in p%tients2 s.,- %s ,-ildren2 t-e elderly or t-e in1ir' '%y -%ve di11i,.lty in re'%inin& 'otionless d.rin& % dent%l @(r%y e0pos.re+ In t-ese ,ir,.'st%n,es it is desir%ble 1ro' t-e r%di%tion prote,tion point o1 vie/ to .se 'e,-%ni,%l 'e%ns o1 s.pport or p-ysi,%l ,onstr%int+ Ho/ever2 t-is is not %l/%ys pr%,ti,%ble %nd o,,%sion%lly people 4no/in&ly %nd vol.nt%rily <ot-er t-%n in t-eir e'ploy'ent or o,,.p%tion= '%y vol.nteer to -elp in t-e ,%re2 s.pport or ,o'1ort o1 p%tients+ In s.,- ,ir,.'st%n,es %,,ordin& to t-e ;%si, #%1ety #t%nd%rds <C=2 t-e dose to t-ese 'e'bers o1 t-e p.bli, s-%ll be ,onstr%ined so t-%t it is not li4ely to e0,eed E '#v d.rin& t-e period o1 t-e p%tientHs di%&nosti, e0%'in%tion or tre%t'ent+ In % -ospit%l o,,%sion%lly % n.rse es,ortin& % p%tient to t-e dent%l r%diolo&y dep%rt'ent is %s4ed to provide %ssist%n,e d.rin& % r%diolo&i,%l e0%'in%tion+ Any res.lt%nt e0pos.re s-o.ld be re&%rded %s o,,.p%tion%l+ #t%11 o1 % dent%l r%diolo&y dep%rt'ent s-o.ld not be %s4ed to -old % p%tient+ In eit-er o1 t-e %bove ,ir,.'st%n,es2 t-e person ,on,erned s-o.ld /e%r %ppropri%te prote,tive ,lot-in& <i+e+ % le%d %pron2 %nd &loves i1 ne,ess%ry= %nd s-o.ld be instr.,ted /-ere to st%nd2 so %s not to inter1ere /it- t-e r%diolo&i,%l e0%'in%tion %nd to 'ini'i3e t-eir o/n r%di%tion dose+ In %ddition t-ey s-o.ld be instr.,ted to 4eep t-eir -%nds %nd body o.tside t-e .n%tten.%ted @(r%y be%'+ I1 t-e p%tient is very ill %nd re5.ires % series o1 r%diolo&i,%l e0%'in%tions2 it is &ood r%di%tion prote,tion pr%,ti,e to %void -%vin& t-e s%'e individ.%l -oldin& t-e p%tient repe%tedly+ in%lly2 it is i'port%nt t-%t p%tients s-o.ld not be -eld by so'eone /-o is2 or '%y be pre&n%nt+ *-is is p%rti,.l%rly relev%nt 1or yo.n& ,-ildren2 /-o '%y be %,,o'p%nied by t-eir 'ot-er+ It is s.&&ested t-%t % noteboo4 be .sed to re,ord det%ils o1 t-e o,,%sions /-en p%tients need to be %ssisted+ *-is provides % &ood /%y o1 %ssessin& r%di%tion prote,tion oper%tion%l pro,ed.res %nd it -elps to %void t-e s%'e individ.%l repe%tedly bein& %s4ed to -old % p%tient+

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;! 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,es2 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 <@= provision '.st be '%de to ens.re t-%t? Aa"" pers nne" n 2h m pr tecti n and safet! depend %e appr priate"! trained and qua"ified s that the! understand their resp nsi%i"ities and perf rm their duties 2ith appr priate Hudgment and acc rding t defined pr ceduresE. )ost dentists %re &ener%l pr%,titioners /-o provide '%ny types o1 dent%l ,%re6 %nd less t-%n "9 per,ent o1 t-e' %re spe,i%lists+ *-e l%r&est spe,i%lty &ro.ps %re t-e ort-odontists %nd endodonti,s2 /-o ,orre,t dent%l '%lo,,l.sions+ *-e ne0t l%r&est &ro.ps2 or%l s.r&eons2 oper%te on t-e 'o.t- %nd >%/s+ *-e re'%inin& spe,i%lties %re pedodonti,s <dentistry 1or ,-ildren=6 periodonti,s <tre%t'ent o1 dise%ses o1 t-e &.'s=6 prost-odonti,s <t-e '%4in& o1 dent.res=6 endodonti,s <root ,%n%l t-er%py=6 %nd dent%l r%diolo&ists+ Even b%si, dent%l servi,es /ill -%ve %,,ess to one o1 t-e %bove spe,i%lties+ *-e %.0ili%ry personnel involved in r%diolo&i,%l pro,ed.res %re dent%l -y&ienists %nd dent%l %ssist%nts2 /-o '%y or not '%y be ,erti1ied+ It is essenti%l t-%t dentist %s /ell %s %.0ili%ry personnel in &ener%l <not only t-e e5.ip'ent oper%tors= %,5.ire t-e b%si, 4no/led&e on o1 r%di%tion on livin& or&%nis's2 p%rti,.l%rly on -.'%ns %nd t-e ris4 %sso,i%ted to t-e .se o1 0( r%y e5.ip'ent %nd t-e pre,%.tions re5.ired2 not only to 4eep t-eir dose %s lo/ %s re%son%bly %,-iev%ble <ALA:A=2 b.t %lso p%tient >.sti1i,%tion ,riteri%2 opti'i3%tion on prote,tion %nd 'et-ods on red.,in& p%tient dose+ All st%11 personnel '.st -%ve % b%si, ,o.rse in r%di%tion p-ysi,s %nd r%di%tion prote,tion2 to&et-er /it- % 'ore det%iled 4no/led&e %ppropri%te to t-eir o/n pro1ession%l sp-ere+ In %ll ,%ses t-eoreti,%l ed.,%tion '.st %lso be s.pple'ented /it- pr%,ti,%l tr%inin&+ All dent%l s,-ools s-o.ld provide % ,o.rse spe,i1i,%lly desi&ned to te%,- t-e t-eoreti,%l2 te,-ni,%l2 %nd interpret%tive %spe,ts o1 di%&nosti, dent%l r%diolo&y+ Also o1 p%rti,.l%r i'port%n,e %re se'in%rs %nd .pd%te ,o.rses providin& &ro.p instr.,tion in t-e bro%d 1ield o1 r%diolo&i,%l interpret%tion+ or t-ose personnel /-o pro1ession%lly %nd re&.l%rly .se ioni3in& r%di%tion2 %s 1or e0%'ple in $ent%l :%diolo&y Instit.tes2 t-e b%si, ed.,%tion o1 r%di%tion prote,tion s-o.ld be %n inte&r%ted p%rt o1 t-eir &ener%l ed.,%tion in t-e pro1ession+ *o provide %n %de5.%te 1lo/ o1 /or4 %nd s.pervision2 t-e pr%,ti,%l %spe,ts o1 tr%inin& %re best ,%rried o.t %t % ,entr%l2 %nd b.sy2 dent%l @(r%y dep%rt'ent+ Ho/ever2 it is i'port%nt t-%t tr%inin& be ,%rried o.t /it- e5.ip'ent t-%t is identi,%l or %t l%st si'il%r to t-%t /-i,- /ill be inst%lled in t-e r%diolo&i,%l 1%,ility+ E'p-%sis s-o.ld be pl%,ed on le%rnin& e%,- pro,ed.re step by step2 %nd it is i'port%nt t-%t .ni1or' pro,ed.res be est%blis-ed /it- pre(ordered positionin& %nd te,-ni5.es+ As % &.ide t-ere '.st %l/%ys be % .ser '%n.%l %v%il%ble %nd t-is s-o.ld %lso in,l.de relev%nt in1or'%tion on r%di%tion prote,tion+
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*-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%inees2 t-eir level o1 4no/led&e2 %nd t-e 1.t.re d.ties+ A b%si, tr%inin& pro&r%''e is des,ribed in Anne0 8 <00=+ #pe,i%l tr%inin& ,o.rses '%y -%ve to be or&%ni3ed 1or individ.%ls /-o %re %lre%dy pro1ession%lly 5.%li1ied b.t not espe,i%lly tr%ined in r%di%tion prote,tion+ Certi1i,%tes o1 %ttend%n,e '%y need to be iss.ed to de'onstr%te %de5.%te tr%inin&+ *-ere is so'eti'es %lso % &re%t ,on1.sion %'on& %n,ill%ry -ospit%l st%11 re&%rdin& ele,tro'%&neti, n%t.re o1 r%di%tion2 ,ont%'in%tion vs irr%di%tion+ A very b%si, tr%inin& ,o.rse in r%di%tion s%1ety <type %nd n%t.re o1 so.r,es2 pri'%ry vs s,%ttered r%di%tion2 b%si, r%di%tion s%1ety prin,iples2 s-ieldin&2 dist%n,e %nd ti'e= '%y -elp t-e' very /ell+ In ,%se o1 % per,eived proble'2 t-e %n,ill%ry st%11 s-o.ld 4no/ /-o' to ,ont%,t+ ;!2! Continuin& learnin& 'ro&rammes $or 'ro$essionals *-e te,-nolo&y o1 dent%l r%diolo&y is ,-%n&in& r%pidly+ Contin.in& ed.,%tion reso.r,es %re &ener%lly %v%il%ble to 4eep t-e dentists %nd %ssist%nts %pprised o1 ne/ develop'ents+ In so'e ,o.ntries2 r%di%tion prote,tion le&isl%tion re5.ires ,ontin.in& ed.,%tion %1ter t-e s.,,ess1.l ,o'pletion o1 %n initi%l tr%inin& pro&r%''e2 t-e intention bein& to ens.re t-%t %ll individ.%ls ,on,erned /it- ioni3in& r%di%tion -%ve .p(to(d%te 4no/led&e+ In so'e pl%,es spe,i%l tr%inin& ,o.rses '%y -%ve to be or&%ni3ed 1or individ.%ls /-o %re %lre%dy pro1ession%lly 5.%li1ied b.t not tr%ined in r%di%tion prote,tion+ Certi1i,%tes o1 %ttend%n,e '%y need to be iss.ed to de'onstr%te %de5.%te tr%inin&+ C.rri,.l% %re o1ten est%blis-ed in ,onne,tion /it- le&%l re&.l%tions+ In so'e ,o.ntries2 r%di%tion prote,tion le&isl%tion re5.ires ,ontin.in& ed.,%tion %1ter t-e s.,,ess1.l ,o'pletion o1 %n initi%l tr%inin& pro&r%''e2 t-e intention bein& to ens.re t-%t %ll individ.%ls ,on,erned /it- ioni3in& r%di%tion -%ve .p(to(d%te 4no/led&e+ *-e !C:P re,ently prod.,ed sever%l .se1.l p.bli,%tions 1or r%di%tion ed.,%tion %nd tr%inin& in t-e .se o1 0(r%ys in dent%l pr%,ti,es+ !C:P "28 <"77D=2 !C:P "34 <2999= p.bli,%tions re,o''ended t-%t %ll dent%l person%l be %ppropi%rly tr%ined in r%di%tion prote,tion+ <00=+ *-e IC:P -%s prep%red % do,.'ent? #.pportin& B.id%n,e 2? :%di%tion %nd Yo.r P%tient? A &.ide 1or )edi,%l Pr%,titioners <re1 00=2 /-i,- '%y be very .se1.l to non(r%diolo&ists2 %nd -%s '%de %v%il%ble t-ro.&- its /eb site slide present%tions on t-eir re,ent reports on p%tient %nd st%11 s%1ety <IC:P D42 DE2 %nd 73= ;!3! )ccre%itation an% certi$ication *r%inin& pro&r%''es in r%di%tion prote,tion 1or pro1ession%l &ro.ps s-o.ld be %,,redited+ *-.s % pr%,ti,in& dentist s-o.ld -%ve .nder&one %n %,,redited tr%inin& pro&r%''e+ *-is in t.rn i'plies t-%t e%,- pro1ession%l &ro.p re5.ires %n %,,reditin& body o1 e0perts in t-%t 1ield to %ssess tr%inin& ,o.rses in r%di%tion prote,tion %nd ,.rri,.l%+ *-e ,erti1i,%tion %nd re&istr%tion o1 pro1ession%ls is desir%ble+ Fno/led&e o1 t-e r%di%tion prote,tion re5.ire'ents in t-e re&.l%tions s-o.ld %lso be in,l.ded in t-e ,.rri,.l%+

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;!4! .ost&ra%uate trainin& an% researc( #t.dents o1 dentistry %s /ell %s pr%,ti,in& dentists s-o.ld be &ener%lly 4no/led&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+ ;otte,-ni,%l %nd interpret%tive s4ills '%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%li3e 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&y2 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%lly2 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%ted2 %t le%st to % li'ited de&ree2 in rese%r,- %,tivity+ A b%si, r%di%tion s%1ety ,o.rse 1or st%11 /o.ld in,l.de t-e 1ollo/in& topi,s? "+ Introd.,tion ( *-e n%t.re o1 r%di%tion2 !%t.r%l %nd )%n('%de so.r,es o1 ioni3in& r%di%tion 2+ :%di%tion .nd%'ent%ls ( C-%r%,teristi,s o1 ioni3in& r%di%tion2 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 E+ ;iolo&i,%l e11e,ts o1 ioni3in& r%di%tion ( #to,-%sti, %nd $eter'inisti, E11e,ts2 :is4 rel%ted to e0pos.re in t-e /or4pl%,e C+ O,,.p%tion%l %nd P.bli, E0pos.re $ose Li'its ( O,,.p%tion%l r%di%tion e0pos.re %nd ris4+ e00pos.re o1 /o'en o1 reprod.,tive ,%p%,ity2 t-e ALA:A Prin,iple 8+ :%di%tion Prote,tion ( ;%si, prin,iples o1 r%di%tion prote,tion? ti'e2 dist%n,e2 %nd s-ieldin&2 :esponsibilities o1 e'ployees %nd o1 t-e instit.tion2 W%rnin& si&ns %nd l%bellin&2 :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 /or4ers+

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P%&e 7"

)NNE2 "! )VER)/E )NN#)7 N#56ER OF DENT)7 23R)4 E2)5"N)T"ON )ND T4."C)7 DO E 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 <2= is s-o/n in *%bles A"+"2 A"+22 %nd A"+3+ *-ere -%s been no s,ienti1i, eviden,e /-i,- -%s .ne5.ivo,%lly de'onstr%ted t-e -%r'1.l e11e,ts o1 e0pos.re to s'%ll doses o1 r%di%tion+ Ho/ever2 it is %ss.'ed t-%t t-e ris4 o1 r%di%tion ind.,ed e11e,ts line%rly in,re%ses /it- r%di%tion dose+ *-.s %ny e0pos.re to r%di%tion2 -o/ever s'%ll2 is ,onsidered potenti%lly -%r'1.l+ *-is is % ,%.tio.s %ss.'ption+ #.b(let-%l rep%ir o1 r%di%tion d%'%&ed ,ells -%s been /ell est%blis-ed s,ienti1i,%lly+ *%ble A"+" Aver%&e %nn.%l n.'ber o1 dent%l @(r%y e0%'in%tions Per "999 pop.l%tion <2=+

*%ble A"+" Aver%&e %nn.%l n.'ber o1 dent%l @(r%y e0%'in%tions per "999 pop.l%tion <2=+

*%ble A"+2 Esti'%tes o1 e11e,tive dose e5.iv%lent 1ro' dent%l @(r%y e0%'in%tions <2=+

*%ble A"+2 Esti'%tes o1 e11e,tive dose e5.iv%lent 1ro' dent%l @(r%y e0%'in%tions <2=+

*%ble A"+3 )e%n %bsorbed doses 1ro' @(r%y e0%'in%tions in r%n,e <2=+

*%ble A"+3 )e%n %bsorbed doses 1ro' @(r%y e0%'in%tions in r%n,e <2=+

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P%&e 72

)NNE2 ""! #ee EC A!!E@ 2

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

*-e 1ollo/in& 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 <"= %re desi&ned to pro'ote dent%l r%diolo&i,%l s%1ety+ *-ey %re to be re&%rded %s b%si, r.les2 to /-i,- ot-ers 'i&-t be %dded %,,ordin& to t-e p%rti,.l%r ,ir,.'st%n,es+ *-e lo,%l r.les s-o.ld be /ritten in t-e l%n&.%&e o1 t-e oper%tor+ Every individ.%l /or4in& in dent%l r%diolo&y -%s % d.ty to prote,t t-e'selves %nd ot-ers %&%inst @( r%y e0pos.re+ *-e '%in ob>e,tive o1 % set o1 lo,%l r.les is to pro'ote &ood oper%tion%l pr%,ti,es %nd r%di%tion s%1ety+ *-e lo,%l r.les %re to be re&%rded %s % b%si, set o1 r.les2 to /-i,- ot-ers 'i&-t be %dded %,,ordin& to t-e p%rti,.l%r ,ir,.'st%n,es+ *-ey s-o.ld be displ%yed pro'inently 1or t-e &.id%n,e o1 %ll st%11 'e'bers /-o s-o.ld be 1%'ili%r /it- t-e'+ In ,o''on /it- %ll e0pos.res2 t-e r%di%tion doses re,eived by t-e p%tient '.st be no &re%ter t-%n ne,ess%ry to %,-ieve t-e desired ,lini,%l res.lts+ ""!1! /ui%ance $or Dental Ra%iolo&y in /eneral .ractice "= :%diolo&i,%l e0%'in%tions s-o.ld not be '%de in t-e %bsen,e o1 ,le%r(,.t ,lini,%l indi,%tions+ E0tensive or repe%ted @(r%y e0%'in%tions o1 ,-ildren or pre&n%nt /o'en s-o.ld not be .ndert%4en /it-o.t ,onsider%ble >.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-er/ise 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.be2 b= A re,ord s-o.ld be '%de in t-e noteboo4 provided2 o1 t-e individ.%lHs n%'e2 t-e d%te2 t-e n.'ber o1 e0pos.res %nd t-e r%dio&r%p-i, te,-ni5.e .sed+ 4= W-en '%4in& %n e0pos.re2 t-e st%11 s-o.ld st%nd %s 1%r %/%y 1ro' t-e p%tient %s possible2 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 'etre2 % prote,tive %pron s-o.ld be /orn+ E= *-e p%tient s-o.ld be prote,ted by % prote,tive %pron <9+"9(9+2E'' le%d e5.iv%lent= l%r&e eno.&- to ,over t-e /-ole tr.n4 %nd t-e ne,4 <t-yroid=+ C= *-e @(r%y be%' si3e s-o.ld be restri,ted by s.it%ble ,olli'%tors to t-e 'ini'.' %pert.re %ppropri%te to t-e p%rti,.l%r e0%'in%tion+ 8= *-e @(r%y e5.ip'ent s-o.ld be re&.l%rly '%int%ined+ Periodi, ,-e,4s o1 r%di%tion s%1ety 1e%t.res s-o.ld be per1or'ed+ D= Only s.it%bly 5.%li1ied st%11 s-o.ld oper%te t-e @(r%y e5.ip'ent+ 7= I1 %n overe0pos.re o1 %ny individ.%l is s.spe,ted t-en t-e %ppropri%te %.t-orities '.st be in1or'ed+ ""!2! Contin&ency .lanF /eneral .ractice I1 %n @(r%y &ener%tor %ppe%rs to deliver %n e0pos.re &re%ter t-%n t-%t sele,ted t-en it '.st be i''edi%tely isol%ted 1ro' t-e ele,tri,%l s.pply+ A noti,e '.st be %tt%,-ed to t-e &ener%tor indi,%tin& t-%t it '.st not be .sed+ *-e %ppropri%te %.t-orities s-o.ld be noti1ied+
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*-e oper%tor is %dvised to est%blis- t-e lo,%tion o1 t-e ele,tri,%l po/er s/it,- be1ore .sin& % &ener%tor+

""!3! /ui%ance $or a Dental 23ray Room in a <os'ital "= :%diolo&i,%l e0%'in%tions s-o.ld not be '%de in t-e %bsen,e o1 ,le%r(,.t ,lini,%l indi,%tions+ E0tensive or repe%ted @(r%y e0%'in%tions o1 ,-ildren or pre&n%nt /o'en s-o.ld not be .ndert%4en /it-o.t ,onsider%ble >.sti1i,%tion+ 2= ;e1ore '%4in& %n e0pos.re ,lose t-e doors o1 t-e @(r%y roo'+ 3= $o not dire,t t-e @(r%y be%' %t t-e /indo/s o1 t-e roo' or to/%rds t-e ,ontrol p%nel or d%r4roo' /%ll+ 4= *-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+ E= $.rin& r%dio&r%p-y %ll st%11 '.st st%nd be-ind t-e prote,ted ,ontrol p%nel %nd '%y observe t-e p%tient t-ro.&- t-e le%d &l%ss /indo/+ C= W-enever possible t-e dent%l 1il' s-o.ld be 'e,-%ni,%lly 1i0ed in position ot-er/ise it s-o.ld be -eld by t-e p%tient+ It s-o.ld never be -eld by t-e 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.be2 b= A re,ord s-o.ld be '%de in t-e noteboo4 provided2 o1 t-e individ.%lHs n%'e2 t-e d%te2 t-e n.'ber o1 e0pos.res %nd t-e r%dio&r%p-i, te,-ni5.e .sed+ 8= *-e p%tient s-o.ld be prote,ted by % prote,tive %pron <9+"9(9+2E'' le%d e5.iv%lent= l%r&e eno.&- to ,over t-e /-ole tr.n4 %nd t-e ne,4 <t-yroid=+ D= *-e @(r%y be%' si3e s-o.ld be restri,ted by s.it%ble ,olli'%tors to t-e 'ini'.' %pert.re %ppropri%te to t-e p%rti,.l%r e0%'in%tion+ 7= *-e @(r%y e5.ip'ent s-o.ld be re&.l%rly '%int%ined+ Periodi, ,-e,4s o1 r%di%tion s%1ety 1e%t.res s-o.ld be per1or'ed+ "9= Only s.it%bly 5.%li1ied st%11 s-o.ld oper%te t-e @(r%y e5.ip'ent+ ""= I1 %n overe0pos.re o1 %ny individ.%l is s.spe,ted t-en t-e %ppropri%te %.t-orities '.st be in1or'ed+ ""!4! Contin&ency .lanF <os'ital I1 %n @(r%y &ener%tor %ppe%rs to deliver %n e0pos.re &re%ter t-%n t-%t sele,ted t-en it '.st be i''edi%tely isol%ted 1ro' t-e ele,tri,%l s.pply+ A noti,e '.st be %tt%,-ed to t-e &ener%tor indi,%tin& t-%t it '.st not be .sed+ *-e %ppropri%te %.t-orities s-o.ld be noti1ied+ *-e oper%tor is %dvised to est%blis- t-e lo,%tion o1 t-e ele,tri,%l po/er s/it,- be1ore .sin& % &ener%tor+

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)NNE2 """! 7" T OF .)R)5ETER , .ROCED#RE )ND E8#".5ENT RE8#"RED FOR )CCE.T)NCE TE T"N/ OF DENT)7 23R)4 E8#".5ENT )ND F)C"7"T"E """!1! "ntraoral %ental unit .arameters "+ 2+ 3+ 4+ E+ C+ 8+ D+ 7+ *.be potenti%l ,%libr%tion *.be o.tp.t %nd ,onsisten,y E0pos.re or te,-ni5.e sele,tor ti'er %,,.r%,y H%l1 v%l.e l%yer ;e%' si3e %nd %li&n'ent o,.s s4in dist%n,e Le%4%&e r%di%tion Pro,essin& o,%l spot si3e Frequency A/3A/! A/3A/! A/3A/! ! A/3A/! A/3A/! A/3A/! $/A/! ! A/3A/!

"9+ I'%&e 5.%lity E5.ip'ent? $ent%l post p%,4 ( !on(inv%sive t.be potenti%l divider %nd os,illos,ope+ ( Penetr%'eter+ ( Ele,tro'eter %nd ioni3%tion ,-%'ber+ ( Ali&n'ent/1o,.s s4in dist%n,e >i&+ ( E0pos.re ti'er <spinnin& top or solid st%te devi,e=+ ( $ent%l 1il' <pre(e0posed=+ ( Pin -ole+ ( o,%l spot slit ,%'er%+ ( Al.'ini.' 1ilters+ ( I'%&e 5.%lity p-%nto's+ """!2! .anoral ra%io&ra'(y unit .arameters "+ 2+ 3+ 4+ E+ C+ 8+ D+ 7+ *.be potenti%l ,%libr%tion *.be o.tp.t %nd ,onsisten,y E0pos.re ti'er %,,.r%,y Colli'%tor slit si3e %nd %li&n'ent Le%4%&e r%di%tion iltr%tion %nd -%l1 v%l.e l%yer Pro,essin& )ove'ent .ni1or'ity %nd sy''etry o,%l spot si3e

Frequency A/! A/! A/! A/! A/! ! $/A/! A/! !


P%&e 7E

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

E5.ip'ent? Penetr%'eter+ ( !oninv%sive t.be potenti%l divider %nd os,illos,ope+ ( Ele,tro'eter %nd ioni3%tion ,-%'ber+ ( E0pos.re ti'er <spinnin& top or solid st%te devi,e=+ ( #ensito'eter %nd densito'eter+ ( Pin -ole+ ( o,%l spot slit ,%'er%+ ( Al.'ini.' 1ilters+ """!3! Ce'(alostat .arameters "+ 2+ 3+ 4+ E+ C+ 8+ D+ *.be potenti%l ,%libr%tion *.be o.tp.t %nd ,onsisten,y E0pos.re ti'er %,,.r%,y A.to'%ti, e0pos.re ,ontrol syste' Li&-t be%' di%p-r%&' %nd @(r%y be%' %li&n'ent o,%l spot si3e Le%4%&e r%di%tion iltr%tion %nd -%l1 v%l.e l%yer Frequency A/! )/! )/! )/! )/! ! A/! ! $/A/!

7+ Pro,essin& E5.ip'ent? Penetr%'eter+ ( !on(inv%sive t.be potenti%l divider %nd os,illos,ope+ ( Ele,tro'eter %nd ioni3%tion ,-%'ber+ ( E0pos.re ti'er <spinnin& top or solid st%te devi,e=+ ( #ensito'eter %nd densito'eter+ ( Pin -ole+ ( o,%l spot slit ,%'er%+ ( Al.'ini.' 1ilters+ FEY? $ L d%ily ) L 'ont-ly A L %nn.%l 3A L trienni%l ! L %s o1ten %s ne,ess%ry

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P%&e 7C

)NNE2 "V! <"E7D"N/ C)7C#7)T"ON , TR)N 5" "ON D)T) )ND 7E)D E8#"V)7ENCE OF .ROTECT"VE 6)RR"ER "V!1! (iel%in& Calculation E1am'le Let .s %ss.'e t-%t on %ver%&e 89 1il's %re t%4en every d%y in t-e dent%l @(r%y roo' s-o/n in i&.re A4+" /-ere % ,onst%nt potenti%l intr%or%l dent%l @(r%y .nit oper%tin& %t 8E 4V is inst%lled+

i&.re A4+" E0%'ple o1 % dent%l @(r%y roo'+

Figure A*.1

E+amp"e f a denta" #$ra! r m.

Ass.'in& t-%t e%,- 1il' re5.ires %n e0pos.re o1 %bo.t E 'As2 t-e /or4lo%d is 89 1il's/d%y 0 E d%ys/ /ee4 0 E 'As/1il' L "8E9 'As//ee4+ *-is is e5.iv%lent to % /or4lo%d o1 %ppro0i'%tely 39 'A 'in.tes per /ee4+ In ,%l,.l%tin& t-e prote,tion re5.ire'ents o1 t-e /%lls % .se 1%,tor o1 9+2E '%y be %ss.'ed i1 'ore spe,i1i, in1or'%tion is not %v%il%ble+ It /ill %lso be %ss.'ed t-%t % ,orridor2 " 'eter 1ro' t-e @(r%y so.r,e %nd not .nder ,ontrol o1 t-e $ent%l #ervi,e2 is /-ere t-e persons to be prote,ted /-o %re 'e'bers o1 t-e p.bli, %re lo,%ted %nd t-e o,,.p%n,y 1%,tor is 9+2E+ It is possible to ,%l,.l%te pri'%ry %nd se,ond%ry prote,tive b%rriers .sin& t-e 1or'.l%e &iven by IC:P <2"=+ *-e tr%ns'ission ; re5.ired 1or % 'rimary b%rrier is &iven by? ;L P d2

WU* W-ere d is t-e dist%n,e 1ro' t-e so.r,e to t-e b%rrier %nd P is t-e %bsorbed dose <'By= per /ee4 %t t-e point 1or /-i,- t-e s-ieldin& is bein& ,%l,.l%ted+ or t-e type %nd ener&y o1 r%di%tion involved in dent%l r%diolo&y %nd t-e e0pos.re ,onditions 1or b%rrier /%lls2 t-e 'By %nd '#v %re essenti%lly e5.iv%lent+ *-.s P '%y be ,onsidered to be t-e dose ,onstr%int on t-e e0pos.re o1 t-e persons to be prote,ted <,riti,%l &ro.p o1 t-e p.bli, in t-is e0%'ple=+ W is t-e /ee4ly /or4lo%d <'A 'in=2 U is t-e .se 1%,tor2 %nd * is t-e o,,.p%n,y 1%,tor+ *-e b%rrier re5.ire'ents /ill be ,%l,.l%ted .sin& % desi&n dose ,onstr%int o1 9+E'#v per ye%r /-i,- /o.ld %ppro0i'%tely e5.%l 9+9" '#v/ /ee42 %lt-o.&- %not-er v%l.e o1 dose ,onstr%int ,o.ld -%ve been ,-osen %s /ell+ Usin& t-e v%l.es &iven %bove in t-e 1or'.l% s.&&ested by IC:P yields % v%l.e 1or ; o1 E+3 "9(3 'By/'A 'in+ <9+9"= <"2= L E+3 "9(3

39 <9+2E= <9+2E=
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P%&e 78

W-en t-is v%l.e is .sed %s t-e ordin%te in i&.re A4+2 <2"= %nd pro>e,ted -ori3ont%lly to its interse,tion /it- t-e ,.rve 1or 8E 4V %nd t-en verti,%lly do/n/%rd to t-e %bs,iss%2 % re5.ired b%rrier t-i,4ness o1 9+D '' o1 le%d is obt%ined+ Alt-o.&- t-e v%l.es s-o/n in i&.re A4+2 %re &iven in ,' t-ey /ill be ,onverted %nd re,orded %s '' /-i,- is t-e .nit nor'%lly %sso,i%ted /it- t-i,4ness o1 le%d+

i&.re A4+2

;ro%d be%' tr%ns'ission o1 @( r%ys t-ro.&- le%d2 density ""3E9 4& ' (3+ Const%nt potenti%l &ener%tor2 t.n&sten re1le,tion t%r&et2 2 '' %l.'ini.' tot%l be%' 1iltr%tion <2"=+

Figure A*.2 1r ad %eam transmissi n f #$ ra!s thr ugh "ead- densit! 11'6C 5g m$'. 3 nstant p tentia" generat r- tungsten ref"ecti n target- 2 mm a"uminium t ta" %eam fi"trati n (21). I1 t-e prote,tive b%rrier /ere desi&ned to li'it t-e e0pos.re o1 t-e relev%nt ,riti,%l &ro.p o1 t-e p.bli, to t-e 1.ll dose li'it est%blis-ed in t-e ;%si, #%1ety #t%nd%rds <C= /it- no ,onstr%int bein& i'posed <i+e+ " '#v per ye%r or +92 'By per /ee4 1or t-e s-ieldin& ,%l,.l%tion=2 t-en t-e v%l.e o1 ; /o.ld be "+" "9(2 'By/'A 'in+ A prote,tive b%rrier ,onstr.,ted 1ro' '%teri%ls e5.iv%lent to 9+8 '' o1 le%d /o.ld be re5.ired %,,ordin& to i&.re A4+2+ *-e v%l.e o1 t-e ; in t-e IC:P ,%l,.l%tion 'et-od is proportion%l to t-e dist%n,e 1ro' t-e so.r,e to t-e b%rrier s5.%red+ Conse5.ently2 one possibility o1 red.,in& t-e s-ieldin& re5.ire'ent 1or % &iven prote,tive b%rrier is to in,re%se t-e dist%n,e bet/een it %nd t-e so.r,e o1 r%di%tion+ L%r&e roo's /it- %'ple sp%,e %ro.nd t-e dent%l ,-%ir not only 1%,ilit%te t-e /or4 b.t %lso re5.ire less s-ieldin& in t-e /%lls to 'ini'i3e e0pos.res to t-e desi&n dose ,onstr%int+ Addition%l in1or'%tion ,on,ernin& %tten.%tion o1 @(r%y be%'s in ,on,rete2 'et-yl 'et-%,ryl%te <perspe0=2 %nd 'ild steel is &iven in %n IC:P report <2"=+ *-ere is only % '%r&in%l in,re%se in ,ost bet/een spe,i1yin& s-ieldin& to % dose ,onstr%int o1 9+E '#v r%t-er t-%n t-e 1.ll p.bli, dose li'it o1 " '#v+ *-is is %n e0%'ple o1 % ,ost e11e,tive 'et-od o1 dose red.,tion+ Also %s 'entioned le%d is ,o''er,i%lly %v%il%ble in ,ert%in si3es+ or e0%'ple in t-e United #t%tes ,o''er,i%lly rolled le%d is %v%il%ble in t-e si3es s-o/n in *%ble A4+" <29=+ *%ble A4+" Co''er,i%lly %v%il%ble si3es o1 le%d s-eets <29=+

*%ble A4+"

Co''er,i%lly %v%il%ble si3es o1 le%d s-eets <29=+

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P%&e 7D

*-.s in t-e e0%'ple sin,e t-e ne%rest si3e o1 ,o''er,i%lly %v%il%ble le%d is 9+87 '' <"/32 in,- or no'in%l 2 po.nd le%d=2 t-is /o.ld be .sed in eit-er ,%se+ In '%ny dent%l r%diolo&y sit.%tions /-en re%listi, %ss.'ptions %re '%de ,on,ernin& t-e b%rrier desi&n ,%l,.l%tions2 it /ill o,,.r t-%t ,o''on b.ildin& '%teri%ls provide s.11i,ient prote,tion+ *%bles A4+C %nd A4+8 in #e,tion C o1 t-is Anne0 provide in1or'%tion re&%rdin& t-e le%d e5.iv%len,e o1 ,o''on b.ildin& '%teri%ls+ or e0%'ple 1or t-e pri'%ry b%rrier ,%l,.l%tion %bove 1ro' *%ble A4+C it '%y be observed t-%t %t 8E 4V2 9+D '' o1 le%d is e5.iv%lent to "9 ,' o1 ,l%y bri,4+ Li4e/ise 1ro' *%ble A4+8 it '%y be ded.,ed t-%t %t 8E 4V2 9+D '' o1 le%d /o.ld be %ppro0i'%tely e5.iv%lent to "2+C ,' o1 bree3e blo,4+ *-e b%rrier re5.ire'ents 1or secon%ary b%rriers '%y %lso be ,%l,.l%ted+ #e,ond%ry b%rriers %re re5.ired 1or t-ose %re%s %t /-i,- t-e .se1.l <pri'%ry= @(r%y be%' ,%nnot be pointed+ It is only ne,ess%ry to prote,t t-ese %re%s %&%inst scatter r%di%tion 1ro' t-e p%tient or ot-er ob>e,ts %nd 1ro' lea-a&e r%di%tion t-ro.&- t-e prote,tive @(r%y t.be -o.sin&+ or t-e p.rpose o1 t-ese ,%l,.l%tions it /ill be %ss.'ed t-%t t-e te,-ni,%l 1%,tors %re t-e s%'e %s %bove %nd t-%t t-e dist%n,e to t-e persons to be prote,ted is " 'eter+ *-ese %re 'e'bers o1 t-e p.bli, %nd % dose ,onstr%int o1 9+" '#v per /ee4 /ill be .sed+ As be1ore2 t-e o,,.p%n,y 1%,tor is 9+2E+ ;e,%.se se,ond%ry r%di%tion is ,on,erned %nd %ll /%ll %re%s %re e0posed "99K o1 t-e ti'e2 t-e .se 1%,tor is "+ or prote,tion %&%inst scatter r%di%tion t-e re5.ired le%d e5.iv%len,e o1 t-e prote,tive b%rrier '%y be ,%l,.l%ted .sin& t-e 1ollo/in& e5.%tion <2"=+ ;s L "99 P ds] W*# W-ere P is t-e dose ,onstr%int2 ds is t-e dist%n,e in 'etres 1ro' t-e so.r,e o1 s,%tter to t-e lo,%tion o1 t-e persons to be prote,ted %nd # is t-e per,ent o1 t-e in,ident r%di%tion s,%ttered to % dist%n,e o1 " ' %s s-o/n in *%ble A4+2 <2"=+ *%ble A4+2 Per ,ent o1 %bsorbed dose <4er'%= r%te d.e to in,ident r%di%tion s,%ttered to "' by % tiss.e(li4e p-%nto' 1or 499 ,'2 irr%di%ted %re% <2"=+

*%ble A4+2

Per ,ent o1 %bsorbed dose <4er'%= r%te d.e to in,ident r%di%tion s,%ttered to " ' by % tiss.e(li4e p-%nto' 1or 499 ,'2 irr%di%ted %re% <2"=+

I1 t-e dist%n,e o1 t-e so.r,e to s,%tterer is not " ' t-en %n %llo/%n,e b%sed on t-e inverse s5.%re l%/ s-o.ld be %pplied+ #i'il%rly %n %llo/%n,e s-o.ld be '%de 1or %ny di11eren,es in s,%tterin& %re%+ or t-is e0%'ple it is %ss.'ed t-%t t-e dist%n,e 1ro' t-e so.r,e o1 @(r%ys <t.be 1o,.s= to t-e s,%tterin& ob>e,t <p%tient= is 9+29' %nd t-e 1ield di%'eter is 8+E ,' <%re% L44 ,'2=+
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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+C "9(2 'By/'A 'in+ "99 <9+9"= <9+292= <"2= 39 <9+2E= <9+9E= 499 L7+8 "9(" 44

W-en t-is v%l.e is .sed %s t-e ordin%te in i&.re A4+2 %nd pro>e,ted -ori3ont%lly to its interse,tion /it- t-e ,.rve 1or 8E 4V %nd t-en verti,%lly do/n/%rd to t-e %bs,iss%2 % re5.ired b%rrier t-i,4ness o1 9+2 '' o1 le%d is obt%ined 1or prote,tion %&%inst s,%tter r%di%tion+ C%l,.l%tin& prote,tive b%rrier re5.ire'ents .sin& t-e 1.ll p.bli, dose li'it <9+92 '#v//ee4= %s t-e desi&n ,riteri% /o.ld yield %ppro0i'%tely t-e s%'e v%l.e o1 le%d e5.iv%lent %s bein& needed to provide %de5.%te s-ieldin& 1ro' s,%ttered r%di%tion+ or lea-a&e r%di%tion t-e b%rrier re5.ire'ent '%y be ,%l,.l%ted dire,tly 1ollo/in& t-e IC:P 'et-od+ *-e n.'ber o1 tent-(v%l.e t-i,4nesses <!T;T= ,orrespondin& to t-e tr%ns'ission o1 % b%rrier is &iven by? !T;T L lo&"9 WL * d2 P * 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%4%&e <t-e @(r%y t.be -o.sin&= to t-e persons to be prote,ted+ *-e .se 1%,tor U is %l/%ys " 1or le%4%&e r%di%tion+ WL is t-e /ee4ly le%4%&e r%te in %ir <4er'%= %t " 'etre 1ro' t-e so.r,e+ or prote,tive b%rrier ,%l,.l%tions2 i1 t-e %,t.%l le%4%&e is not 4no/n it '%y be %ss.'ed t-%t it does not e0,eed intern%tion%l re,o''end%tions or n%tion%l re&.l%tory re5.ire'ents+ A,,ordin& to IC:P re,o''end%tions WEvery @(r%y t.be .sed 1or di%&nosti, p.rposes s-%ll be en,losed in % -o.sin& s.,- t-%t t-e 4er'% in %ir 1ro' le%4%&e r%di%tion 'e%s.red %t % dist%n,e o1 " ' 1ro' t-e 1o,.s does not e0,eed " 'By in " - %t every r%tin& spe,i1ied by t-e '%n.1%,t.rer 1or t-%t t.be in t-%t -o.sin&X <2"=+ WL '%y be ,onsidered %s t-e e11e,tive oper%tin& ti'e o1 t-e t.be '.ltiplied by t-e '%0i'.' %llo/%ble le%4%&e r%te <i+e+ " 'By in " -o.r=+ or ,%l,.l%tin& le%4%&e r%di%tion t-e e11e,tive oper%tin& ti'e '%y be obt%ined by dividin& t-e /or4lo%d W <'A 'in per /ee4= by t-e '%0i'.' 'A 1or ,ontin.o.s oper%tion+ *-e '%0i'.' 'A '%y be obt%ined 1ro' t-e @( r%y t.be %node t-er'%l ,-%r%,teristi,s d%t% %nd 1or 'ost di%&nosti, r%dio&r%p-i, or 1l.oros,opi, t.bes is in t-e r%n&e o1 3 'A to E 'A+ *%ble A4+3 /-i,- s-o/s v%rio.s %ss.'ptions .sed by !C:P in ,%l,.l%tin& se,ond%ry b%rrier re5.ire'ents in,l.des v%l.es 1or t-e '%0i'.' di%&nosti, r%dio&r%p-i, %nd 1l.oros,opi, t.bes <29=+ *%ble A4+3 <29=+ Ass.'ptions .sed by !C:P in ,%l,.l%tin& se,ond%ry b%rrier re5.ire'ents

*%ble A4+3

Ass.'ptions .sed by !C:P in ,%l,.l%tin& se,ond%ry b%rrier re5.ire'ents <29=+

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P%&e "99

Usin& % v%l.e o1 E 'A 1or t-e '%0i'.' r%ted ,ontin.o.s t.be ,.rrent %s s-o/n in *%ble A4+3 <1or "99 4V=2 WL '%y be ,%l,.l%ted+ WL L 39 'A 'in //ee4 <"/ C9 'in -("= <" 'By -= L 9+" 'By//ee4 E 'A Usin& t-e IC:P 1or'.l% 1or t-e re5.ired n.'ber o1 tent-(v%l.e t-i,4nesses? !T;T L lo&"9 WL * d2 P #.bstit.tin& in t-e 1or'.l%? !T;T L lo&"9 <9+"= <9+2E= <"=2 <9+9"= V%l.es o1 -%l1(v%l.e t-i,4ness %nd tent- (v%l.e t-i,4ness 1or -e%vily %tten.%ted bro%d be%' @( r%ys in le%d %nd ,on,rete %re s-o/n in *%ble A4+4 <2"=+ *%ble A4+4 Appro0i'%te -%l1(v%l.e t-i,4nesses %nd tent-(v%l.e t-i,4nesses 1or -e%vily %tten.%ted bro%d be%'s o1 @(r%ys <2"=+ L lo&"9 2+E L9+4

*%ble A4+4

Appro0i'%te -%l1(v%l.e t-i,4nesses %nd tent-(v%l.e t-i,4nesses 1or -e%vily %tten.%ted bro%d be%'s o1 @(r%ys <2"=+

One tent-(v%l.e t-i,4ness 1or 8E 4V %,,ordin& to *%ble A4+4 is 9+9E9 ,' or 9+E9 '' o1 le%d or %ppro0i'%tely 4 ,' o1 ,on,rete+ *-.s t-e re5.ired b%rrier t-i,4ness is <9+4= <9+E9 ''= L 9+2 '' o1 le%d2 or <9+4= <4 ,'= L "+C ,' o1 ,on,rete+ An %ltern%te 1or' o1 t-e IC:P 1or'.l% 1or le%4%&e r%di%tion '%y be /ritten by introd.,in& %n %tten.%tion 1%,tor ;+ *-.s? ; L P d2 I C9 2 %nd s.bstit.tin& in t-e 1or'.l%2 ; L <+9"= <"= 2 <E= <C9= L4 "9 (" W* <39= <9+2E=

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P%&e "9"

#in,e t-e le%4%&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,4ness /-i,- in t-is ,%se is 9+2 '' o1 le%d+ W-en s-ieldin& 1or s,%tter %nd le%4%&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,4nesses 1or s,%tter %nd le%4%&e di11er by t-ree tent-( v%l.e t-i,4nesses or 'ore2 only t-e t-i,4er b%rrier v%l.e s-o.ld be .sed6 i1 -o/ever t-ey di11er by less t-%n one tent-(v%l.e t-i,4ness2 t-e t-i,4er b%rrier v%l.e s-o.ld be .sed %nd one -%l1(v%l.e t-i,4ness 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%4%&e+ *-ese di11er by less t-%n one tent-(v%l.e t-i,4ness %nd t-.s %,,ordin& to t-e IC:P re,o''end%tion one -%l1( v%l.e t-i,4ness <9+"E ''= s-o.ld be %dded to t-e t-i,4er &ivin& % tot%l o1 9+3E '' o1 le%d 1or prote,tion %&%inst bot- s,%tter %nd le%4%&e r%di%tion+ I1 ,on,rete is ,onsidered %s % s-ieldin& '%teri%l t-e re5.ired v%l.es /o.ld be " ,' 1or prote,tion %&%inst s,%tter %nd "+C ,' 1or prote,tion %&%inst le%4%&e+ *-.s %ddin& one -%l1( v%l.e l%yer <%bo.t "+4 ,'= to t-e l%r&er v%l.e /o.ld &ive % tot%l o1 3 ,' o1 ,on,rete %s t-e re5.ired b%rrier t-i,4ness+ "V!2! Transmission Data *-e t-i,4ness o1 prote,tive s-ieldin& ne,ess%ry to red.,e t-e e0pos.re r%te 1ro' %ny @( r%y '%,-ine to %ny dose level depends on t-e t.be potenti%l2 t-e e0tent to /-i,- t-e '%,-ine is .sed </or4lo%d i+e+ 'A 'in//ee4=2 t-e dist%n,e 1ro' t-e t.be to t-e o,,.pied %re%2 t-e de&ree %nd n%t.re o1 t-e o,,.p%n,y2 t-e type o1 %re%2 %nd t-e '%teri%l o1 /-i,- t-e b%rrier is ,onstr.,ted+ ;ro%d be%' tr%ns'ission d%t% o1 di%&nosti, @(r%y t-ro.&- ,on,rete2 perspe0 %nd 'ild steel /ere p.blis-ed in t-e IC:P report 33 <2"=+

i&.re A4+3 ;ro%d be%' tr%ns'ission d%t% 1or di%&nosti, @(r%ys in ,on,rete <2"=

Figure A*.'

1r ad %eam transmissi n f r diagn stic #$ra!s in c ncrete (21).

"V!3! 7ea% Equi*alence o$ Common 6uil%in& 5aterials As 'entioned in #e,tion "2 /-en re%listi, %ss.'ptions %re '%de ,on,ernin& t-e desi&n ,riteri% it o1ten o,,.rs t-%t ,o''on b.ildin& '%teri%ls in s.11i,ient t-i,4ness /ill provide %de5.%te prote,tive b%rriers+

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P%&e "92

*%ble A4+E t%4en 1ro' IC:P <2"= %nd *%ble A4+C /-i,- -%s been %d%pted 1ro' % report by t-e Hospit%l P-ysi,istsH Asso,i%tion <37= provide in1or'%tion ,on,ernin& t-e le%d e5.iv%len,e o1 ,o''on b.ildin& '%teri%ls+ *%ble A4+E Le%d e5.iv%len,e o1 ,o''on b.ildin& '%teri%ls 1ro' IC:P <2"=+

*%ble A4+E Le%d e5.iv%len,e o1 ,o''on b.ildin& '%teri%ls 1ro' IC:P <2"=+

*%ble A4+C Le%d e5.iv%len,e o1 ,o''on b.ildin& '%teri%ls 1ro' t-e HPA <37=

*%ble A4+C

Le%d e5.iv%len,e o1 ,o''on b.ildin& '%teri%ls 1ro' t-e HPA <37=

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P%&e "93

)NNE2 V!

R)D")T"ON .ROTECT"ON E8#".5ENT

Person%l Prote,tion Le%d r.bber prote,tive %prons+ Le%d r.bber &loves+ W-ole body dosi'eters <e+&+? 1il' b%d&es or *L$ b%d&es=+ E0tre'ity 'onitors <e+&+? *L$ 1in&er s%,-ets=+ P%tient restr%inin& devi,es+ Port%ble le%d s,reens+ P%tient Prote,tion Le%d r.bber %pron+ Le%d r.bber s-eets+ Le%d r.bber t-yroid s-ields+ Environ'ent%l </or4pl%,e= Prote,tion $ose(r%te s.rvey 'eter+ P%tient e5.iv%lent p-%nto'+ Prote,tion level ioni3%tion ,-%'ber %nd ele,tro'eter+ il'/*L$ b%d&es+ :.ler+ Port%ble prote,tive s,reens+ NOTEB "= Le%d e5.iv%len,e re5.ired 1or prote,tive devi,es /ill depend on p%tient /or4lo%d %nd lo,%l pr%,ti,e2 e+&+ 9+"(9+E ''+ 2= All instr.'ents /ill re5.ire ,%libr%tion %t r%di%tion ener&ies %nd dose(r%tes en,o.ntered in r%di%tion prote,tion s.rveys+

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P%&e "94

)NNE2 V"!

TEC<N"8#E F)CTOR )ND R)D")T"ON DO E FOR "NTR)OR)7 R)D"O/R).<4

*e,-ni5.e 1%,tors 1or intr%or%l <bite/in&= r%dio&r%p-y p.blis-ed by Velders <28= %nd by Le,o'ber %nd %.l4ner <2D= %re presented belo/+ *%ble AC+" *ypi,%l @(r%y '%,-ines %nd e0pos.re ,onditions <28=+

*%ble AC+" *ypi,%l @(r%y '%,-ines %nd e0pos.re ,onditions <28=+

*%ble AC+2 Absorbed dose <'By= in t-e t-yroid &l%nd d.e to bite/in& r%dio&r%p-y <28=+

*%ble AC+2 Absorbed dose <'By= in t-e t-yroid &l%nd d.e to bite/in& r%dio&r%p-y <28=+

*%ble AC+3 Absorbed dose <'By= to t-e p%rotid &l%nd d.e to bite/in& r%dio&r%p-y <28=+

*%ble AC+3 Absorbed dose <'By= to t-e p%rotid &l%nd d.e to bite/in& r%dio&r%p-y <28=

*%ble AC+4 Absorbed dose <'By= to t-e s.blin&.%l &l%nd d.e to bite/in& r%dio&r%p-y <28=+

*%ble AC+4 Absorbed dose <'By= to t-e s.blin&.%l &l%nd d.e to bite/in& r%dio&r%p-y <28=+

*%ble AC+E Absorbed <'By= to br%in2 -ypop-ysis2 %nd eyes d.e to bite/in& r%dio&r%p-y <28=+

*%ble AC+E Absorbed dose <'By= to t-e br%in2 t-e -ypop-ysis %nd t-e eyes d.e to bite/in& r%dio&r%p-y <28=+

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*%ble AC+C *ypi,%l e0pos.re ti'es <se,onds= 1or intr%or%l r%dio&r%p-i, vie/s <2D=+

*%ble AC+C *ypi,%l e0pos.re ti'es <se,onds= 1or intr%or%l r%dio&r%p-i, vie/s <2D=+

*%ble AC+8 Or&%n %bsorbed dose <VBy= in tiss.e per 1il' 1or intr%or%l vie/s bise,tin& %n&le te,-ni5.e <2D=+

*%ble AC+8 Or&%n %bsorbed dose <VBy= in tiss.e per 1il' 1or intr%or%l vie/s .sin& t-e bise,tin& %n&le te,-ni5.e <2D=+

*%ble AC+D Or&%n %bsorbed dose <VBy= in tiss.e per 1il' 1or intr%or%l vie/s .sin& t-e p%r%llelin& te,-ni5.e <2D=+

*%ble AC+D Or&%n %bsorbed dose <VBy= in tiss.e per 1il' 1or intr%or%l vie/s .sin& t-e p%r%llelin& te,-ni5.e <2D=+

*%ble AC+7 E11e,tive dose <V#v= per 1il' ,%l,.l%ted 1or v%rio.s r%dio&r%p-i, vie/s .sin& bott-e bise,tin& %n&le te,-ni5.e %nd t-e p%r%llelin& te,-ni5.e+ <2D=+

*%ble AC+7 E11e,tive dose <V#v= per 1il' ,%l,.l%ted 1or v%rio.s r%dio&r%p-i, vie/s .sin& bott-e bise,tin& %n&le te,-ni5.e %nd t-e p%r%llelin& te,-ni5.e+ <2D=+

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P%&e "9C

)NNE2 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%inee2 t-eir level %nd re5.ired %ppli,%tion o1 4no/led&e2 %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 %= b= ,= d= e= 1= &= -= i= >= 4= V""!2! %= b= ,= d= e= 1= &= -= i= >= 4= l= '= :%diolo&i,%l p-ysi,s :%di%tion dete,tors :%di%tion dose %nd dosi'etry :%di%tion biolo&y :%di%tion p%t-olo&y In,idents <A,,idents= %nd e'er&en,y pro,ed.res !%t.r%l %nd '%n('%de r%di%tion e0pos.re @(r%y inst%ll%tions Prin,iples o1 r%di%tion prote,tion #pe,i%l proble's o1 r%di%tion prote,tion </or4ers2 p%tients2 &ener%l p.bli,= :e&.l%tory r%'e/or4 'ecial trainin& requirements in %ental ra%iolo&y @(r%y e5.ip'ent in dent%l r%diolo&y #pe,i%l proble's o1 dosi'etry in di%&nosti, r%diolo&y :%dio&r%p-i, %nd 1l.oros,opi, syste's Prin,iples o1 r%dio&r%p-i, e0pos.re *-e @(r%y 1il' %nd its ,-%r%,teristi,s :%di%tion prote,tion o1 /or4ers :%di%tion prote,tion o1 t-e p%tient Control %nd re,ordin& o1 r%di%tion e0pos.re Esti'%tes o1 ris4s A.%lity %ss.r%n,e %nd 5.%lity ,ontrol A.%lity ,riteri% 1or t-e r%dio&r%p-i, i'%&e In,idents %nd %,,idents #pe,i%l le&%l %nd re&.l%tory %spe,ts

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5TGs noteF T<E TE2T END <ERE! T<E FO77OW"N/ .)/E CONT)"N T<O E T)67E W<"C< )RE NOT <OWN "N T<E TE2T! " W"77 6#"7D T<E5 "NTO T<E TE2T ) 7"TT7E 7)TER, )T )N )..RO.R")TE T"5E TO 6E )/REED W"T< .EDRO!

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*%ble 3+" Occupancy factors for exposed persona (20) < or .se %s % &.ide in pl%nnin& s-ieldin& /-ere ot-er o,,.p%n,y d%t% %re not %v%il%ble=

Full Occupancy (T=1) Wor4 %re%s s.,- %s o11i,es2 l%bor%tories2 s-ops2 /%rds2 n.rsesH st%tions2 livin& 5.%rters2 ,-ildrenHs pl%y %re%s2 %nd o,,.pied sp%,e in ne%rby b.ildin&s+ Partial Occupancy (T=1/4) Corridors2 rest roo's2 elev%tors .sin& oper%tors2 .n%ttended p%r4in& lots+ Partial Occupancy (T=1/10) W%itin& roo's2 toilets2 st%ir/%ys2 .n%ttended elev%tors2 >%nitorsH ,losets2 o.tside %re%s .sed 1or pedestri%ns or ve-i,.l%r tr%11i,+

It is %dv%nt%&eo.s in s-ieldin& desi&n to t%4e into %,,o.nt t-%t t-e o,,.p%n,y 1%,tor in %re%s %d>%,ent to t-e r%di%tion roo' .s.%lly is 3ero 1or %ny sp%,e 'ore t-%n 2+" ' <8 1eet= %bove t-e 1loor %s t-e -ei&-t o1 'ost individ.%ls is less+ It is possible2 t-ere1ore2 to red.,e t-e t-i,4ness o1 t-e /%ll s-ieldin& %bove t-is -ei&-t provided t-e r%di%tion so.r,e is belo/ 2+" ' <8 1eet=+ In deter'inin& t-e s-ieldin& re5.ire'ents 1or /%ll %re%s %bove 2+" ' <8 1eet=2 ,onsider%tion '.st be &iven to t-e prote,tion o1 %ny persons o,,.pyin& t-e 1loor %bove t-e %re%s %d>%,ent to t-e r%di%tion roo'+ *-e /%ll %re%s over 2+" ' <8 1eet= 1ro' t-e 1loor o1 t-e r%di%tion roo' '.st %lso -%ve s.11i,ient s-ieldin& to %de5.%tely red.,e t-e s,%tterin& 1ro' t-e ,eilin& o1 %d>%,ent roo's to/%rd o,,.p%nts+

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*%ble 3+2 Use factors for pri ary protecti!e "arriersa (20) #adio$rap%ic installations
loor

"

W%lls

Ceilin&

*-e .se 1%,tor 1or se,ond%ry prote,tive b%rriers is .s.%lly "+

*-e s-ieldin& re5.ire'ents 1or t-e ,eilin& o1 % r%dio&r%p-i, inst%ll%tion %re deter'ined by t-e se,ond%ry b%rrier re5.ire'ents r%t-er t-%n by t-e .se 1%,tor 1or pri'%ry b%rriers /-i,- is &ener%lly e0tre'ely lo/+

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*%ble 4+" &xposure para eters for panoral dental '(ray e)uip ent (*ie ens) Ort%opanto o$rap% (OP+&), one sin$le o!e ent Ort(o'(os, 12 selecte% 'ro&rams 931:

#nit

-V

m)

9s:

Ort-op-os .nit Pro&r%' " Pro&r%' 2 Pro&r%' C Pro&r%' "9 Pro&r%' "" OP3E .nit C9 C9 8" CC CC CE "2 "9 "E "C "C "E "4+2 ""+D 7+7 ""+D "4+4 "3+9

Pro&r%' "? Pro&r%' 2? Pro&r%' C? Pro&r%' "9? Pro&r%' ""?

#t%nd%rd e0pos.re i'%&in& .pper %nd lo/er teet-2 entire '%ndible %nd le1t %nd ri&-t te'poro'%ndib.l%r >oints <*)Js= As pro&r%' "2 b.t li'ited in s,ope to teet- only2 e0,l.din& %s,endin& r%'i %nd *)Js+ $o.ble e0pos.re te,-ni5.e2 i'%&in& le1t %nd ri&-t *)Js /it- open %nd ,losed 'o.t<1o.r i'%&es re,orded on one 1il'=+ As pro&r%' "2 b.t /it- 1%,tors %d>.sted 1or pedi%tri, i'%&in&+ As pro&r%' "2 b.t /it- ,onst%nts '%&ni1i,%tion o1 "+2E0+

All t-e %bove pro&r%'s .se % 43 '' 0 "+E '' pri'%ry ,olli'%tor2 e0,ept 1or pro&r%' "92 /-ere it is 22 '' 0 "+E ''+ *-e .nit -%s % 1o,.s(,olli'%tor dist%n,e < C$= o1 "E9 ''+

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*%ble 4+2 Or$an a"sor"ed doses fro panora ic radio$rap%y (+1)


Ort(o'(os unit 9'ro&ram num,er: O.3E unit

1>

11

Bon%ds :ed bone '%rro/ Colon L.n& #to'%,;l%dder ;re%st Liver Oesop-%&.s *-yroid #4in ;one s.r1%,e :e'%inder ;r%in tiss.e

4+C 48 3+3 C+2 4+" "+8 4+3 4+3 7D 82 "E 2"4 "D

ZE+2 D+7 ZE+2 "+" ZE+2 ZE+2 ZE+2 ZE+2 4" 3D 2+3 4" "C

"+" 4+C "+7 E+D 3+8 "+3 E+E 4+3 C3 E2 3+9 2" 4C

ZC+2 "3 ZC+2 2+7 ZC+2 ZC+2 ZC+2 ZC+2 E4 43 8+4 ED ""

"+E 27 ZE+E 4+D 2+C ZE+E "+C ZE+E DD C3 8+D "3" 27

9+4 3E Z3+8 2+C Z3+8 Z3+8 "+2 Z3+8 89 EC "E "C4 78

All or&%n doses in VBy per e0pos.re+ A 1%,tor o1 9+" -%s been .sed in t-e ,%l,.l%tion o1 t-e s4in %bsorbed dose to indi,%te t-e %ppro0i'%te 1r%,tion o1 tot%l s4in s.r1%,e %re% represented by t-e -e%d %nd ne,4 re&ion+

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*%ble 4+3 -alculated effecti!e doses fro panora ic radio$rap%y (+1)


Ort(o'(os unit 9'ro&ram num,er: O.3E unit

1>

11

E11e,tive dose% )%0i'.' )ini'.' 29+4 7+3 C+4 ""+9 ""+C 8+7 "C+3 "E+" "D+7 "8+C

All e11e,tive doses in V#v+ e0pos.re("+

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*%ble A"+" C-%n&e U!#CEA: 2999 .!era$e annual nu "er of dental x(ray exa inations per 1000 population (2)
Country=year 1EC>31ECE 1ED>31ED4 1ED531EE>

<ealt( care le*el " A.str%li% ;el&i.' C.b% C3e,-oslov%4i% $en'%r4 inl%nd r%n,e Ber'%ny2 ed+ :ep+ O1 It%ly J%p%n F./%it L.0e'bo.r& )%lt% !et-erl%nds !e/ Ge%l%nd !or/%y Pol%nd Port.&%l :o'%ni% #p%in #/eden #/it3erl%nd U##:2 :# #: United Fin&do'
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D9 2DD

82

DC

DE 48" 223

E49 2C4 ""7 D3" D34 8D3 2"7 "DC 3 "E9 32" C4" D9E C+2 377 D+2 4"" 28E D33 C" DC 29 32 42 232 443 27C E9 ""2 D4" 32E 84 "CE P%&e ""4 D9 D32

United #t%tes Aver%&e

3E9 329

4EC 379

492 3E9

<ealt(3care le*el "" ;r%3il C-ile C-in% E,.%dor *.nisi% Aver%&e 9+D "+E 3+7 9+D 4+4 2+" C+2 "+3 2+E 4+8

<ealt(3care le*el """ E&ypt )y%n'%r #ri L%n4% *-%il%nd Aver%&e T(e entries in t(is Ta,le are quali$ie% as $ollo+sF r%n,e? V%l.e represents n.'ber o1 1il's Ber'%ny2 ed+ :ep+ o1? It%ly? P%nto'o&r%'s not in,l.ded+ V%l.e is 1or nort-(e%st o1 It%ly+ 9+D "+4 2+3 9+D 2+" "+8 9+8 "+C

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*%ble A"+2 C-%n&e U#CEA: 2999 &sti ates of effecti!e dose e)ui!alent fro
4ear

dental x(ray exa inations (2)


Entrance %ose 9m *: sur$ace E$$ecti*e %ose equi*alent 9m *:

Country

<ealt(3care le*el " Ar&entin% A.str%li% C3e,-oslov%4i% "7DE("7D7 "789("784 "789("787 "7DC("779 r%n,e J%p%n "7D4 "789("784 "7D9("7D4 F./%it !et-erl%nds !e/ Ge%l%nd "7DE("7D7 "784("7DE "78E("787 "7DE("7D7 Pol%nd :o'%ni% "7DE("7D7 "7D9("7D4 "7DE("779 #p%in #/eden U##:2 :# #: United Fin&do' "7DC("779 "7D9("7D4 "7DE("779 "7D"("7DE 4<"+E(49= 8+4 2E<9+"(39= "D<9+"(2E= <3+7("3+E= E+D<3+E(D+8= 3+" 3+2<9+8C(7+8= <9+7(3"= E+2<"+2("+7= 4+7<"+2(22= 3 "9+8 2D<3+3(4C= C+9<9+7("2= E 9+93 9+92 9+922 9+93 9+994 9+9" 9+"" 9+92(9+2D 9+932 9+94 9+"E 9+"E 9+98

<ealt(3care le*el "" ;r%3il E,.%dor "7D8 "7DE("7D7 "+7 <"+3(2+8= 9+2

<ealt(3care le*el """

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)y%n'%r

"7DE("779

C+4

9+32

*-e entries in t-is *%ble %re 5.%li1ied %s 1ollo/s?


A.str%li%? r%n,e? J%p%n? E#$ &iven is per 1il' *-e r%n&e o1 t-e E#$ is t-e %ver%&e 1or di11erent pro>e,tions+ *-e v%l.e &iven 1or t-e e11e,tive dose e5.iv%lent is per 1il'2 t-e e11e,tive dose e5.iv%lent per ,%p.t is 9+938 '#v+ *-e E#$ -%s been esti'%ted 1ro' e0pos.re <':= '.ltiplied by 9+99D8/9+8E+ *-e 1irst v%l.e 1or e11e,tive dose e5.iv%lent 1or "7DE("7D7 is 1or intr%or%l2 t-e se,ond v%l.e 1or e0tr%or%l e0%'in%tions+ *-e per ,%p.t e11e,tive dose e5.iv%lent 1or J%p%n is 9+928 '#v+ or "7D72 HE? 9+924 '#v2 E? 9+9E2 '#v+ E#$? on %ver%&e2 2+4 1il's %re .sed per e0%'in%tion+ E11e,tive dose e5.iv%lent is 1or ,o'plete 'o.t- s.rvey6 1or p%nto'o&r%' it is 9+"3 '#v+ *-e E#$ v%l.es %re per 1il'+ *-e E#$ v%l.e 1or t-e period "7DE("7D7 is 5.%li1ied by t-e 1%,t t-%t on %ver%&e "+C 1il's /ere .sed per e0%'in%tion+ E11e,tive dose e5.iv%lent is per ,%p.t+ *-e v%l.es 1or E#$ <%nd r%n&e= %re 1or intr%or%l e0%'in%tions+ On %ver%&e2 "+2E 1il's /ere .sed per e0%'in%tion6 "7DE("7D7? on %ver%&e2 2+4 1il's /ere .sed per e0%'in%tion+ *-e e11e,tive dose e5.iv%lent per ,%p.t is 9+9" '#v2 1or t-e ,o'plete 'o.t- s.rvey it is 9+"4(9+23 '#v+ *-e v%l.e 1or e11e,tive dose e5.iv%lent is &iven 1or intr%or%l e0%'in%tions+ *-e 1irst v%l.e o1 t-e e11e,tive dose e5.iv%lent is 1or intr%or%l2 t-e se,ond one 1or e0tr%or%l e0%'in%tions+ On %ver%&e 2+4 1il's /ere .sed per e0%'in%tion <"7D"("7DE=+

!et-erl%nds? !e/ Ge%l%nd? :o'%ni%? #p%in? #/eden?

U##:? United Fin&do'?

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*%ble A "+3 /ean a"sor"ed doses fro


Or&an

dental x(ray exa inations in France a (2)


5ean a,sor,e% %ose 9m/y:

.eria'ical incisor

.eria'ical molar

.anoramic 'roHections

#''er

7o+er

#''er

7o+er

5a1illary occlusal

Circular

Elli'tical

2 centers o$ rotation

3 centers o$ rotation

Lens *-yroid P%rotids *on&.e #.blin&.%ls P-%ryn0 #in.ses ;%,4 o1 ne,4 ;r%in ;one s.r1%,e

9+"9 9+"4 9+9" 9+"2 9+93 Z9+9" 9+9D 9+94 Z9+9" 9+98

9+98 9+9D 9+92 C.2> 9+93 9+9" 9+9C 9+92 Z9+9" 9+97

9+9E 9+94 C.*C 9+9E 9+"9 9+9C C.2F 9+94 9+9" C.=6

9+92 9+9D C.*1 9+9C 9+"3 9+94 9+94 9+93 Z9+9" C.>*

'.=C 9+98 9+94 9+"2 9+94 9+9" *.'6 9+94 9+9" 9+"9

9+93 9+9" C.IC C.*C +++ 9+"7 +++ +++ +++ 9+"9

9+93 9+9E 1.*C '.1C +++ C.FC +++ +++ +++ 9+"E

9+9D 9+9C 9+9D C.6I +++ C.*C +++ +++ +++ 9+"E

It%li, v%l.es %re doses U9+2 'By+

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*%ble A4+" -o ercially a!aila"le si0es of lead s%eets (20)

T(ic-ness

Wei&(t in .oun%s $or a 1 quare Foot ection 5illimeter equi*alent Nominal +ei&(t )ctual +ei&(t

"nc(es

"/C4 3/"2D "/32 E/"2D 3/C4 8/"2D ( "/"C E/C4 3/32 ( ( "/D E/32 3/"C 8/32 ^ "/3 2/E

9+49 9+C9 9+87 "+99 "+"7 "+37 "+E9 "+ED "+7D 2+3D 2+E 3+9 3+"8 3+78 4+8C E+EE C+3E D+48 "9+8C

" "_ 32 2_ 3 3_ ( 4 E C ( ( D "9 "2 "4 "C 29 24

9+72 "+3D "+DE 2+3" 2+8C 3+22 3+4D 3+C7 4+C9 E+E3 E+D9 C+7D 8+3D 7+22 ""+9C "2+7 "4+8E "7+CC 23+C9

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_ 2/3 " !otes? "+ 2+ 3+

"2+89 "C+73 2E+49

39 49 C9

27+E9 37+33 E7+99

*-e density o1 ,o''er,i%lly rolled le%d is ""+3C & ,' (3[ *-e ,o''er,i%l toler%n,es %re `9+99E in,-es 1or le%d .p to 8/"2D %nd `"/32 -e%vier s-eets+[ It s-o.ld be noted t-%t le%d s-eet less t-%n "/32 in,- t-i,4 is 1re5.ently 'ore e0pensive t-%n -e%vier s-eet in ,ost o1 '%teri%l %nd ,ost o1 inst%ll%tion+

Le%d Ind.stries Asso,i%tion2 In,+2 272 )%dison Aven.e2 !e/ Yor4 +

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*%ble A4+2 Per cent of a"sor"ed dose (1er a) rate due to incident radiation scattered to 1 m ,y a tissue3li-e '(antom $or 4>> cm2 irra%iate% areaa 921:

)n&le o$ scatter

1>> -V

2>> -V

3>> -V

;>

Co

; 5V

"E 39 4E C9

( 9+92 9+93 9+94

( 9+24 9+23 9+"7

( 9+34 9+2C 9+22

( (

<9+4D= <9+28=

9+CE <9+4D= 9+39 <9+24= 9+"4 <9+"2= 9+9D <9+98=

9+"D <9+"4= 9+"4 <9+9D=

79 "29 "3E "E9

9+9E 9+"2 9+"8 9+2"

9+"4 9+23 9+39 9+38

9+"7 9+2C 9+33 9+4D

9+98 <9+94= 9+9E <9+93= 9+94 <9+92= ( <9+92=

9+94 <9+93= 9+93 <9+92= 9+93 <9+92= ( <9+92=

% Per ,ent s,%ttered r%di%tion is rel%ted to pri'%ry be%' 'e%s.re'ents in %ir %t t-e point o1 re1eren,e2 t-%t is2 %t t-e s%'e position %s t-e p-%nto' s.r1%,e or p-%nto' ,entre+

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*%ble A4+3 .ssu ptions used "y 2-#P in calculatin$ secondary "arrier re)uire ents (20) "a a, %scac F%

"nstallations

"994Ve di%&nosti, 1l.oros,opi, di%&nosti, 1l.oros,opi, "2E4Ve di%&nosti, 1l.oros,opi, "E94Ve di%&nosti, r%dio&r%p-i, "994Ve di%&nosti, r%dio&r%p-i, "2E4Ve di%&nosti, r%dio&r%p-i, "E94Ve

E 4 3+3 E 4 3+3

9+99"3 9+99"E 9+99"C 9+99"3 9+99"E 9+99"C

9+4E 9+4E 9+4E 9+D 9+D 9+D

499 499 499 "9991 "9991 "9991

% b , d e 1

I is t-e '%0i'.' r%ted ,ontin.o.s t.be ,.rrent in 'illi%'peres %t t-e t.be potenti%l listed % is t-e r%tio o1 s,%ttered to in,ident e0pos.re %t " 'eter ds,% is t-e dist%n,e in 'eters 1ro' t-e r%di%tion so.r,e to t-e s,%tterer is t-e 1ield %re% %t t-e s,%tterer in ,'2 Pe%4 p.ls%tin& 0(r%y t.be potenti%l ;%sed on 3C 0 43 ,' <"4 0 "8 in,-= 1ield %t " 'eter

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

P%&e "22

*%ble A4+4 .pproxi ate %alf(!alue t%ic1nesses and tent% !alue t%ic1ness $or (ea*ily attenuate% ,roa% ,eams o$ 23 rays 921:

23ray source

<al$3*alue t(ic-nesses, cm 7ea% Concrete

Tent(3*alue t(ic-nesses, cm 7ea% Concrete

E9 4V 89 8E "99 "2E "E9

9+99E ( 9+9"E 9+92E ( 9+927

9+4 "+9 ( "+C "+7 2+2

9+9"D ( 9+9E9 9+9D4 ( 9+97C

"+3 3+C ( E+E C+4 8+9

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

P%&e "23

*%ble A4+E 3ead e)ui!alence of co on "uildin$ aterials fro 4-#P report (21)

5aterial

Density 9-& m33: 5> -V

T(ic-ness 9mm:

7ea% Equi*alence 9mm:

1>> -V 2""9 "2+8

125 -V 9+49 "+CE "+29

;%rytes pl%ster

;ree3e blo,4

"289

"2C

9+8

9+7

9+8E

;ri,4

"C99

""4

9+8

"+9

;ri,4

"DE9

"2D

9+7E

"+4

"+"E

Con,rete <blo,4=

"CC9

"22

9+72

"+28

"+9E

Con,rete <%er%ted= DE9

8E

9+"8

9+28

Bl%ss <pl%te=

24E9

9+9E

9+9E

9+94

Le%d(%,ryli,

"C99

"2

9+EE

9+C9

9+EE

#teel

8799

"+C

9+27

9+2D

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

P%&e "24

*%ble A4+C 3ead e)ui!alence of co on "uildin$


Density 9-& m33:

aterials fro
T(ic-ness 9mm:

5P. (+6)
7ea% Equi*alence 9mm:

5aterial

5> -V

1>> -V

125 -V

;%rytes Pl%ster ;ree3e ;lo,4 ;ri,4 ;ri,4 Con,rete <blo,4= Con,rete <%er%ted= Bl%ss <pl%te= Le%d A,ryli, #teel

2""9 "289 "C99 "DE9 "CC9 DE9 24E9 "C99 8799

"2+8 "2C ""4 "2D "22 8E C "2 "+C

9+49 9+8 9+8 9+7E 9+72 9+"8 9+9E 9+EE 9+27

"+CE 9+7 "+9 "+4 "+28 9+28 9+9E 9+C9 9+2D

"+29 9+8E +++ "+"E "+9E +++ 9+94 9+EE +++

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

P%&e "2E

*%ble AC+" Typical '(ray ac%ines and exposure conditions (27)


-V .ointe%= o'en3en%e% F Da cm ,eam

23ray mac(ine

Or%li0 E9 Or%li0 E9 Or%li0 CE Or%li0 CE Pr%,ti0 CE Pr%,ti0 CE Pr%,ti0 8E Pr%,ti0 8E Pr%,ti0 79 Pr%,ti0 79

E9 E9 CE CE CE CE 8E 8E 79 79

pointed open(ended open(ended open(ended open(ended open(ended open(ended open(ended open(ended open(ended

"9 29 29 29 23 23 23 23 23 23

ro.nd ro.nd ro.nd re,t%n&.l%r ro.nd re,t%n&.l%r ro.nd re,t%n&.l%r ro.nd re,t%n&.l%r

#$ L o,%l #.r1%,e $ist%n,e

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

P%&e "2C

*%ble AC+2 ."sor"ed dose ( 8y) in t%e t%yroid $land due to "ite9in$ radio$rap%y (27)
),sor,e% %ose in t(e t(yroi% &lan%

23ray mac(ine <eterolateral

<omolateral

5e%ian

5ean

Or%li0 E9 Or%li0 E9 Or%li0 CE Or%li0 CE Pr%,ti0 CE Pr%,ti0 CE Pr%,ti0 8E Pr%,ti0 8E Pr%,ti0 79 Pr%,ti0 79

9+92E 9+997 9+9"C 9+994 9+9"" 9+994 9+9"3 9+99E 9+9"4 9+998

9+949 9+9"3 9+923 9+99C 9+9"4 9+99E 9+9"E 9+998 9+9"C 9+99D

9+9"D 9+99C 9+9"9 9+993 9+99C 9+993 9+99D 9+994 9+997 9+99C

9+927 9+997 9+9"8 9+994 9+9"" 9+994 9+9"3 9+99C 9+9"4 9+998

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

P%&e "28

*%ble AC+3 ."sor"ed dose ( 8y) in t%e parotid $land due to "ite9in$ radio$rap%y (27)
),sor,e% %ose in t(e 'aroti% &lan%

23ray mac(ine

<eterolateral

<omolateral

5ean

9+929 9+928 9+92E 9+9"9 9+939 9+9"E 9+934 9+922 9+93E 9+923

9+37" 9+327 9+972 9+9EC 9+"22 9+9EE 9+978 9+942 9+9DE 9+93E

9+29E 9+"8D 9+9ED 9+933 9+98C 9+93E 9+9EE 9+932 9+9C9 9+932

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

P%&e "2D

*%ble AC+4 ."sor"ed dose ( 8y) in t%e su"lin$ual $land due to "ite9in$ radio$rap%y (27)
),sor,e% %ose in t(e su,lin&ual &lan%

23ray mac(ine <eterolateral

<omolateral

5e%ian

5ean

Or%li0 E9 Or%li0 E9 Or%li0 CE Or%li0 CE Pr%,ti0 CE Pr%,ti0 CE Pr%,ti0 8E Pr%,ti0 8E Pr%,ti0 79 Pr%,ti0 79

9+23C 9+947 9+239 9+9"8 9+9E9 9+922 9+9E" 9+92E 9+9E2 9+939

9+34E 9+98C 9+39" 9+937 9+9CD 9+92E 9+9CD 9+92D 9+9C7 9+93"

9+29D 9+9E9 9+22" 9+9"D 9+94C 9+9"C 9+9E" 9+92" 9+9E" 9+922

9+2C3 9+9E3 9+2E" 9+92E 9+9E4 9+92" 9+9E8 9+92E 9+9E8 9+92D

Ta"le .:.; ),sor,e% %ose 9m/y: to t(e ,rain, t(e (y'o'(ysis an% t(e eyes %ue to ,ite+in& ra%io&ra'(y 92C:

23ray mac(ine

6rain

<y'o'(ysis

Eyes

9+9"9 9+99D 9+99E 9+992


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

9+9"D 9+9"C 9+997 9+994 9+9"4 9+99C

9+92" 9+9"E 9+997 9+993 9+9"2 9+99E P%&e "27

9+99D 9+994

9+997 9+99E 9+9"9 9+99C

9+9"E 9+998 9+9"8 9+997

9+9"4 9+998 9+9"E 9+99D

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

P%&e "39

*%ble A C+C Typical exposure ti es (seconds) for intra(oral radio$rap%ic !ie9s (2<)
#''er ?a+

7o+er ?a+

6isectin& )n&le Tec(nique

)ol%rs Pre'ol%rs C%nines In,isors

9+"C 9+"2 9+"2 9+"9

9+29 9+"C 9+"C 9+"2

.arallelin& Tec(nique

)ol%rs In,isors

9+29 9+"2

9+2E 9+"C

*%ble AC+8 Or&%n %bsorbed dose <VBy= in tiss.e per 1il' 1or intr%(or%l vie/s <usin& t(e ,isectin& an&le tec(nique 92D:

Or&an or Tissue

),sor,e% Dose 'er Film 9I/y:

5olars

.remolars

Canines

"ncisors

7o+er

;one )%rro/ ;one #.r1%,e Bon%ds ;re%st L.n&s *-yroid Bl%nd ;r%in *iss.e

4+3 4+3 9+" "+" 9+D "3 4+E

"+7 "+7 Z9+C "+" 9+3 "" "+"

"+7 "+7 Z9+4 "+2 9+E C+E 3+3

2+C 2+C 9+2 "+8 9+7 3+3 E+2 P%&e "3"

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

Opti, Lens #%liv%ry *iss.e Cr%ni%l #in.ses L%ryn0 P-%ryn0 *on&.e #4in Oesop-%&.s Colon #to'%,;l%dder Liver

2+" E7 3C "9 "92 E9 "9 "8 9+2 Z9+8 Z9+8 9+3

"+D C8 "9 E+D E" 34 C+8 D+" Z9+C Z9+C Z9+C Z9+C

E+" 33 ED 3+D 49 3E 4+C E+9 Z9+4 Z9+4 Z9+4 9+2

"9 28 4C "+8 D+2 4" 8+3 2+2 9+3 Z9+E 9+3 9+2

#''er

;one )%rro/ ;one #.r1%,e Bon%ds ;re%st L.n&s *-yroid Bl%nd ;r%in *iss.e Opti, Lens #%liv%ry *iss.e Cr%ni%l #in.ses L%ryn0 P-%ryn0 *on&.e #4in Oesop-%&.s

8+C 8+C Z"+4 Z"+4 9+2 7+D 8+2 2" 73 "39 8+9 33 E" "4 "E

9+D 9+D Z"+D Z"+D Z"+D C+7 4+9 3C9 29 ""9 4+7 22 4D 3+7 ""

9+D 9+D Z9+8 9+D 9+4 "E "+E "89 24 83 C+4 "C 37 8+D E+7

9+4 9+4 9+2 9+D 9+3 7+4 "+4 2C "C ""9 C+3 29 44 2+C C+D

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

P%&e "32

Colon #to'%,;l%dder Liver

Z"+4 Z"+4 Z"+4 Z"+4

Z"+D Z"+D Z"+D Z"+D

Z9+8 Z9+8 Z9+8 Z9+8

Z9+C Z9+C Z9+C Z9+C

!ote? A 1%,tor o1 9+" -%s been .sed in t-e ,%l,.l%tion o1 t-e s4in %bsorbed dose to indi,%te t-e %ppro0i'%te 1r%,tion o1 tot%l s4in s.r1%,e %re% represented by t-e -e%d %nd ne,4 re&ions+

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

P%&e "33

*%ble AC+D Or$an a"sor"ed dose (=8y) in tissue per fil #sin& t(e 'arallelin& tec(nique 92D: for intra(oral !ie9s

Or&an or Tissue

),sor,e% Dose 'er Film 9I/y:

7o+er 5olars

7o+er "ncisors

#''er 5olars

#''er "ncisors

;one )%rro/ ;one #.r1%,e Bon%ds ;re%st L.n&s *-yroid Bl%nd ;r%in *iss.e Opti, Lens #%liv%ry *iss.e Cr%ni%l #in.ses L%ryn0 P-%ryn0 *on&.e #4in Oesop-%&.s Colon #to'%,;l%dder Liver

"+3 "+3 Z2+8 9+3 9+" 8+3 "+" "+D 27 4+2 4+4 44 2D 2+3 7+9 9+" Z2+8 Z2+8 9+3

9+3 9+3 Z"+C 9+3 Z"+C "+7 "+7 2+E E" 2D 9+C 4+7 2E "+E "+9 Z"+C Z"+C Z"+C Z"+C

9+D 9+D 9+3 Z9+D Z9+D 4+8 2+D 4+3 33 22 3+3 42 48 2+7 4+3 9+3 9+4 9+C Z9+D

9+2 9+2 9+C 9+2 Z9+C 2+E "+D E+E "7 3E "+7 22 43 "+" 2+E Z9+C Z9+C 9+4 Z9+C

!ote? A 1%,tor o1 9+" -%s been .sed in t-e ,%l,.l%tion o1 t-e s4in %bsorbed dose to indi,%te t-e %ppro0i'%te 1r%,tion o1 tot%l s4in s.r1%,e %re% represented by t-e -e%d %nd ne,4 re&ions+

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

P%&e "34

*%ble AC+7 E$$ecti*e %ose 9I *: 'er $ilm calculate% $or *arious ra%io&ra'(ic *ie+s usin& ,ot( t(e ,isectin& an&le tec(nique an% t(e 'arallelin& tec(nique 92D:

Ra%io&ra'(ic Vie+

5a1imum Valuea

5inimum Valuea

6isectin&3)n&le Tec(nique

Lo/er )ol%rs Lo/er Pre'ol%rs Lo/er C%nines Lo/er In,isors Upper )ol%rs Upper Pre'ol%rs Upper C%nines Upper In,isors

2+D "+8 "+3 "+3 3+E "+7 "+D "+3

2+C "+4 "+" "+2 2+8 "+3 "+4 "+"

.arallelin& Tec(nique

Lo/er )ol%r Lo/er In,isors Upper )ol%rs Upper In,isors

2+" "+4 9+7 9+D

"+" 9+3 "+" 9+E

% )%0i'.' %nd 'ini'.' v%l.es o1 e11e,tive dose %re &iven 1or ,ert%in vie/s2 in order to t%4e %,,o.nt o1 %ny inst%n,es in /-i,- %n or&%n dose /%s 1o.nd to be less t-%n t-e dose t-res-old+

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

P%&e "3E

REFERENCE FOR VO7#5E 3 "+ 2+ 3+ 4+ E+ C+ Foren F2 W.e-r'%nn AH+ )%n.%l on r%di%tion prote,tion in -ospit%ls %nd &ener%l pr%,ti,e Vol+ 4 :%di%tion Prote,tion in $entistry+ Benev%2 World He%lt- Or&%ni3%tion2 "788+ #o.r,es %nd e11e,ts o1 ioni3in& r%di%tion+ United !%tions #,ienti1i, Co''ittee on t-e E11e,ts o1 Ato'i, :%di%tion2 U!#CEA:2 "773 :eport to t-e Bener%l Asse'bly /itAnne0es+ !e/ Yor42 United !%tions2 "773+ Rec mmendati ns n Insurance 3 mpan! Requirements f r Denta" #$ra! E+aminati ns+ U+#+ eder%l :e&ister2 "8 J.ne "7D92 4E eder%l :e&ister 4978C2 Codi1ied in C : p%r%+ "99C9+ Administrati&e"! required denta" radi graphs+ ;.re%. o1 :%diolo&i,%l He%lt-2 ood %nd $r.& Ad'inistr%tion2 U+#+ $ep%rt'ent o1 He%lt- %nd H.'%n #ervi,es2 W%s-in&ton $+C+2 U+#+Bovern'ent Printin& O11i,e2 "7D"<HH# P.bli,%tion $A D"(D"8C=+ ;roo4s #L+ ;%si, 3 ncepts in the Se"ecti n f ,atients f r Denta" #$ra! E+aminati ns + Ann Arbor2 #,-ool2 o1 $entistry2 University o1 )i,-i&%n2 "7DE+ Intern%tion%l ;%si,#s%1ety #t%nd%rds 1or Prote,tion %&%inst Ioni3in& :%di%tion %nd 1or t-e #%1ety o1 :%di%tion #o.r,es+ Jointly sponsored by? AO2 IAEA2 ILO2 OEC$/!EA2 PAHO2 WHO+ Vienn%2 Intern%tion%l Ato'i, Ener&y A&en,y2 "77C <IAEA #%1ety #eries2 !o+ ""E=+ A.%lity %ss.r%n,e in di%&nosti, r%diolo&y+ Benev%2 World He%lt- Or&%ni3%tion2 "7D2+ C.rry *#2 $o/dey JE2 ).rr%y :C+ 3hristensenJs intr ducti n t the ph!sics f diagn stic radi " g!. )%lvern2Le% %nd ebi&er2 "779+ Hendee2W+:+2 :iteno.r2 E+:++ @edica" Imaging ,h!sics- 'rd Ed+ #t+ Lo.is2+ )osby Ye%r ;oo42 "772+ Horton P#2 #ippy H2 Fo-o.t J2 !elson J 2 Fien3le BC+ A ,lini,%l ,o'p%rison o1 speed &ro.p $ %nd E speed dent%l @(r%y 1il's+ Ora" Surger!2 "7D42 ED? "94("9D+ Instit.te o1 P-ysi,%l #,ien,es in )edi,ine+ )e%s.re'ent o1 t-e per1or'%n,e ,-%r%,teristi,s o1 di%&nosti, @(r%y syste's in 'edi,ine2 p%rts "2 42 "7D92 "7D4+ Yor42 IP#)+ Instit.te o1 P-ysi,%l #,ien,es in )edi,ine+ Kua"it! assurance in denta" radi " g!+ Yor42 IP#)2 "774 <IP#) :eport C8=+ ;ritis- Instit.te o1 :%diolo&y+ Assurance f qua"it! in the diagn stic #$ra! department + London2 ;I:2 "7D7+ Br%y JE2 Win4ler !*2 #te%rs J2 r%n4 EI+ Kua"it! c ntr " in diagn stic imaging+ ;%lti'ore2 University Press2 "7D3+ )oores ;)2 W%t4inson #A2 Hens-%/ E*2 Pe%r,y ;J+ A practica" guide t qua"it! assurance in medica" imaging. C-i,-ester2 J+Wiley2 "7D8+ He/itt J)+ *-e develop'ent %nd oper%tion o1 % 'et-od 1or t-e re'ote deter'in%tion o1 @(r%y be%' p%r%'eters .sed in dent%l r%dio&r%p-y+ London2 H)#O2 "7D4 <!%tion%l :%diolo&i,%l Prote,tion ;o%rd :eport !:P;(:"C=4+ He/itt J)2 #-.ttle/ort- PB2 !elt-orpe PA2 H.dson AP+ I'provin& r%di%tion prote,tion st%nd%rds in dent%l r%dio&r%p-y+ In? Radiati n ,r tecti n $ The r! and ,ractice. <Ed? EP Bold1in,-=+ ;ristol2 Instit.te o1 P-ysi,s2 "7D7? D"(D4+ H%v.4%inen :+ A.%lity ,ontrol o1 dent%l @(r%y .nits+ In? ;ritis- Instit.te o1 :%diolo&y :eport "D S*e,-ni,%l %nd P-ysi,%l P%r%'eters 1or A.%lity Ass.r%n,e in )edi,%l $i%&nosti, r%diolo&y+ London2 ;I:2 "7D7 ?87(D"+ Denta" #$ra! pr tecti n+ ;et-esd%2 !%tion%l Co.n,il on :%di%tion Prote,tion %nd )e%s.re'ents2 "789 < !C:P :eport !o+ 3E=+
P%&e "3C

8+ D+ 7+ "9+ ""+ "2+ "3+ "4+ "E+ "C+ "8+ "D+ "7+

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

29+ 2"+ 22+ 23+ 24+ 2E+ 2C+ 28+ 2D+ 27+ 39+ 3"+ 32+ 33+ 34+ 3E+ 3C+

38+ 3D+ 37+

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