At the ADI Congress this year in Manchester there was a great lecture by Andrew Dawood who is one of the Masters of CBCT in the UK.
He was talking about the use of reduced doses and resetting your machine depending on the image you are trying to achieve. I took this idea back to the practice and we talked about the prospect of reducing the dose for CBCT in patients who have repeat CBCTs. For example, after a sinus graft to check consolidation of healing. We carried out 1 or 2 of these and found that the quality of image we were getting on a 50% power reduction was still excellent and wholly diagnostically acceptable.
Really my thoughts now are "what should we be doing?" or " who can teach us some essence of dose reduction?"
I would be interested in attempting to reduce down the dosage depending on the image I am trying to achieve but nobody seems to be talking about this. It would be great to have a protocol in the practice for doses depending upon the CBCT and what we are actually trying to view but similarly, it might be good to have the same protocol for other radiographs in the practice.
All machines tend to work on a 'one size fits most' policy and really we have a responsibility to factor the dose for individual patients. The CBCT is a particularly good example. Recently, looking through the quality audit of our CBCTs at the practice, our quality 1 images are in the high 90% with repeat scans being less than 1%. This is much, much more accurate that periapicals in terms of achieving a good image so perhaps it's time to look at CBCT now and make them even better by reducing the dosage.
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