Pediatric Phantom Dosimetry Evaluation of the Extraoral Bitewing

This study's purpose was to evaluate the effective dose (E) and equivalent dose (H_T) of exposing a pediatric phantom to the extraoral bitewing programs of the Planmeca ProMax 2D S3 (ProMax) and Instrumentarium Orthopantomograph OP30 (OP30) and compare these results with dosimetry associated with the intraoral bitewing and panoramic radiograph. Dosimetry was acquired by placing 24 dosimeters in tissues of interest in a 10-year-old phantom. Manufacturer child settings were used for all scans. Repeat exposures of 20 scans were utilized. The average values of E and H_T were calculated. The E for the ProMax and OP30 units, respectively, were 16.84 μSv and 5.82 μSv. The highest E for both units was delivered to the thyroid, remainder tissues, and salivary glands. The highest HT for both units was delivered to the oral mucosa, salivary glands, extrathoracic airway, and thyroid. The mean differences between units were statistically significant (P<0.05). The average effective dose of the ProMax was higher than for the OP30. The effective dose of the pediatric extraoral bitewing is three to 11 times higher than that of the intraoral bitewing and comparable to the traditional panoramic radiograph of a pediatric phantom. Pediatric extraoral bitewing radiation protection guidelines are recommended.