Comparative Dosimetry of Handheld Versus Wall-Mounted Intraoral X-ray Systems: A Phantom-Based Study

Area of Science:

• Radiological Sciences
• Dental Imaging Technology
• Radiation Safety

Background:

• Handheld dental X-ray units offer imaging advantages for mobility-restricted patients.
• Concerns exist regarding the radiation safety of handheld units compared to traditional wall-mounted systems.

Purpose of the Study:

• To quantitatively compare operator and patient-equivalent radiation doses, ambient scatter, and diagnostic image quality.
• To evaluate a handheld (MaxRay Cocoon) versus a wall-mounted (Optima DC) intraoral X-ray unit.

Main Methods:

• A human cadaver mandible phantom was used for standardized radiography.
• Operator doses measured with electronic personal dosimeters and TLDs; patient-equivalent dose from dose-area product (DAP).
• Image quality assessed via SNR, CNR, and subjective radiologist evaluation.

Main Results:

• Handheld units yielded significantly higher operator finger (0.45 vs. 0.08 µSv), chest (0.18 vs. 0.05 µSv), and thyroid (0.11 vs. 0.04 µSv) doses.
• Patient-equivalent effective dose was higher for handheld (2.65 vs. 1.82 µSv).
• Ambient scatter was threefold higher with the handheld unit; no significant difference in image quality metrics.

Conclusions:

• Handheld dental X-ray units result in substantially higher radiation doses to operators and patients.
• Wall-mounted units should be the standard when feasible; handheld units reserved for specific clinical needs.
• Comparable diagnostic image quality does not outweigh increased radiation exposure from handheld devices.