Ambient dose during intra-oral radiography with current techniques Part 2 Quantifying the remnant beam - An in vivo study

Objectives: (1) To find a safe reference transmission factor for the remnant beam to be used when assessing the remnant beam during intra-oral radiography. (2) To identify factors such as exposure type, side (left or right), gender and age that might significantly affect transmission.Methods: Measurements were performed in the remnant beam during 323 intra-oral exposures of 43 patients. The exposure parameters were 60 kV and 7 mA. These measurements were compared with values in the same setting, but without a patient present to arrive at a transmission value. Differences between types of exposure [bitewing (BW), incisor and canine (IC) periapical, premolar and molar (PM) periapical], exposure side (left or right), gender and age were statistically analysed. The reference value was based on the exposure yielding the highest transmission value, to which a safety margin of two standard deviations (SDs) was added, and then rounding up. Results: The respective mean transmission values (SD) for BW, IC and PM exposures were as follows: 1.78% (1.15%), 0.639% (0.63%) and 2.60% (0.98%). The differences between PM and IC and between BW and IC were significant (p > 0.01). The differences between exposure side, gender and age were not significant. The reference transmission value, which was calculated from the highest mean transmission percentage for PM (2.60%) plus twice the SD (0.98%) and rounding up, was 5%. Conclusions: A transmission factor of 5% could be used to assess the remnant beam during intra-oral radiography. Anterior exposures led to significantly lower transmission values than posterior exposures.