2012年4月15日日曜日

Use of radiographs in children

何才になったらエックス線検査を行うべきか?
どの程度の間隔で再検査するべきか?
この2つは、臨床で重要な事です。これについては、

EAPD guidelines for use of radiographs in children を参照して臨床で活用することができます。

http://www.eapd.gr/12A5AECC.en.aspx

ガイドラインのabstractから


Guidelines in dental radiology are designed to avoid unnecessary exposure to X-radiation and to identify individuals who may benefit from a radiographic examination. Every prescription of radiographs should be based on an evaluation of the individual patient benefit. 
Due to the relatively high frequency of caries among 5 year old children it is recommended to consider dental radiography for each child even without any visible caries or restorations. Furthermore, radiography should be considered at 8-9 years of age and then at 12-14, that is 1-2 years after eruption of premolars and second molars. Additional bitewing controls should be based on an overall assessment of the caries activity/risk. The high-risk patient should be examined radiographically annually, while a 2-3 years interval should be considered when caries activity/risk is low. 
Routine survey by radiographs, except for caries, has not been shown to provide sufficient information to be justified considering the balance between cost (radiation and resources) and benefit.
EAPD guidelines for use of radiographs in children Table 3より
I. ESPELID, I. MEJヒRE, K. WEERHEIJM


初回のバイトウイング撮影については、
・地域のう蝕有病者率などのデータ
・患者のう蝕経験
・口腔衛生の状態
・フッ化物の利用状況
・社会的生活背景
などを考慮して決定する、とあります。