Is ULD (ultra low dose) the new PA?
While 3D dentistry as a concept is nothing new, the rapid increase in the application of various types of 3D reconstructions in dentistry is both remarkable and for some, even overwhelming.
New advances such as Ultra Low Dose CBCT (ULD-3D) cause positive disruption in our thinking around how to properly apply these tools in the clinical setting. Ultra-low dose (ULD) technology is Planmeca’s proprietary protocol for minimizing the radiation exposure delivered by a CBCT scan. And while the reduced exposure is always a plus, what is the effect on the diagnostic quality of the scans?
Glad you asked because independent researchers from the UNC School of Dentistry and the University of Helsinki Department of Physics teamed up to find out. After meticulous, comprehensive testing and sophisticated quantitative analysis of a broad range of factors, the researchers concluded: “An average reduction in dose of 77% was achieved using ULD protocols when compared with standard protocols. While this dose reduction was significant, no statistical reduction in image quality between ULD and standard protocols was seen.”
Drs. Jaju and Jaju pointed out in their recent report, “Cone-beam computed tomography: Time to move from ALARA to ALADA” that: “If "pretty pictures" are being obtained when only a diagnostic image is needed, we are doing the patient a disservice. We, as imaging specialists, should educate our colleagues about the difference in risk between "diagnostically acceptable" and "beautiful" images.”
I agree with this concept. In my view, it is prudent that no x-rays should be made prior to reviewing dental, medical and radiology histories and a clinical examination is performed. When available, we should utilize CBCT at the appropriate FOV and dose settings in instances where this type of imaging study offers a potential for improved diagnosis. Ultra low dose 3D allows us to elect to opt for 3D studies that support the principle of ALADA while significantly improving our diagnostic precision.
While the published study* included an acknowledgment that further study was indicated, these evidence-based results are indeed impressive.
From this author’s perspective based on many clinical diagnostic journeys similar to the one described above, ULD 3D is not only the “new PA”, it is not fair to compare the two as 3D offers significantly more diagnostic potential versus 2D without compromising patient safety.
*According to “Dosimetry of Orthodontic Diagnostic FOVs Using Low Dose CBCT Protocol” by JB Ludlow and J Koivisto. For a copy of this study visit: planmecausa.com
Dr. Alex Touchstone is a Key Opinion Leader for Planmeca.
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