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KJO Korean Journal of Orthodontics

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eISSN 2005-372X
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Korean J Orthod

Published online December 10, 2020

Copyright © The Korean Association of Orthodontists.

Projected lifetime cancer risk from cone-beam computed tomography for orthodontic treatment

aNayansi Jha, BDS, MSD, bgYoon-Ji Kim, DDS, PhD, cgYoungjun Lee, DDS, PhD, dgJu Young Lee, DDS, PhD, eWon Jin Lee, MD, PhD, fg Sang-Jin Sung, DDS, PhD

aResearcher, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Korea
bAssistant professor, Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Korea
cPrivate practice, Plus one Orthodontics, Suite 501, 259 Jungbu-daero, Suwon, Korea
dPrivate practice, Rothwill Jun Orthodontic clinic, 3F #301, 124 Olympic-ro Songpa-gu, Seoul, Korea
eProfessor, Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul
fProfessor, Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Korea
gKorean Society of Digital Orthodontists

Correspondence to:Yoon-Ji Kim
Assistant Professor
Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Korea 05505
E-mail: yn0331@gmail.com
Tel: +82-10-3446-0575, Fax: +82-2921-7348

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: To estimate the projected cancer risk attributable to diagnostic cone-beam computed tomography (CBCT) for orthodontic purposes in children and adults under different exposure scenarios.
Methods: We collected a list of CBCT machines and their specifications from 38 orthodontists. Organ doses were estimated using median and maximum exposure settings of 105 kVp/ 156.8 mAs and 130 kVp/200 mAs, respectively. Projected cancer risk from undergoing CBCTs, 1-3 times within 2 years, was calculated for children (aged 5 and 10 years) and adult (aged 20, 30, and 40 years) male and female patients.
Results: For maximum exposure settings, mean lifetime fractional ratio (LFR) was 14.28% for children and 0.91% for adults, indicating that children’s risk is 16 times higher than for adults. For median exposure settings, mean LFR was 5.25 % and 0.58% for children and adults, respectively. The risk of cancer decreased with increasing age. Women had a higher risk of cancer than men in all age groups for both median and maximum exposure settings. Cancer risk increased as the frequency of undergoing CBCT within a given period increased.
Conclusions: The projected dental CBCT-associated cancer risk has a wide range depending on machine parameters and image acquisition settings. Children and females are at a higher risk of developing cancer owing to diagnostic CBCT. Hence, the use of diagnostic CBCT should be justified, and protective measures should be taken to minimize the harmful biological effects of radiation.

Keywords: cancer risk, cone-beam computed tomography, ionizing radiation, lifetime fractional ratio

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Korean J Orthod

Published online December 10, 2020

Copyright © The Korean Association of Orthodontists.

Projected lifetime cancer risk from cone-beam computed tomography for orthodontic treatment

aNayansi Jha, BDS, MSD, bgYoon-Ji Kim, DDS, PhD, cgYoungjun Lee, DDS, PhD, dgJu Young Lee, DDS, PhD, eWon Jin Lee, MD, PhD, fg Sang-Jin Sung, DDS, PhD

aResearcher, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Korea
bAssistant professor, Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Korea
cPrivate practice, Plus one Orthodontics, Suite 501, 259 Jungbu-daero, Suwon, Korea
dPrivate practice, Rothwill Jun Orthodontic clinic, 3F #301, 124 Olympic-ro Songpa-gu, Seoul, Korea
eProfessor, Department of Preventive Medicine, Korea University College of Medicine, 73 Goryeodae-ro, Seongbuk-gu, Seoul
fProfessor, Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Korea
gKorean Society of Digital Orthodontists

Correspondence to:Yoon-Ji Kim
Assistant Professor
Department of Orthodontics, Asan Medical Center, University of Ulsan College of Medicine 88 Olympic-ro 43-gil, Songpa-gu, Seoul, Korea 05505
E-mail: yn0331@gmail.com
Tel: +82-10-3446-0575, Fax: +82-2921-7348

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective: To estimate the projected cancer risk attributable to diagnostic cone-beam computed tomography (CBCT) for orthodontic purposes in children and adults under different exposure scenarios.
Methods: We collected a list of CBCT machines and their specifications from 38 orthodontists. Organ doses were estimated using median and maximum exposure settings of 105 kVp/ 156.8 mAs and 130 kVp/200 mAs, respectively. Projected cancer risk from undergoing CBCTs, 1-3 times within 2 years, was calculated for children (aged 5 and 10 years) and adult (aged 20, 30, and 40 years) male and female patients.
Results: For maximum exposure settings, mean lifetime fractional ratio (LFR) was 14.28% for children and 0.91% for adults, indicating that children’s risk is 16 times higher than for adults. For median exposure settings, mean LFR was 5.25 % and 0.58% for children and adults, respectively. The risk of cancer decreased with increasing age. Women had a higher risk of cancer than men in all age groups for both median and maximum exposure settings. Cancer risk increased as the frequency of undergoing CBCT within a given period increased.
Conclusions: The projected dental CBCT-associated cancer risk has a wide range depending on machine parameters and image acquisition settings. Children and females are at a higher risk of developing cancer owing to diagnostic CBCT. Hence, the use of diagnostic CBCT should be justified, and protective measures should be taken to minimize the harmful biological effects of radiation.

Keywords: cancer risk, cone-beam computed tomography, ionizing radiation, lifetime fractional ratio