Age-Specific Radiation Dose Distributions in Pediatric Intraoral Radiography: A Monte Carlo Analysis Across...

Purpose: This study quantified age-specific differences in organ and effective doses during intraoral radiography in pediatric patients, with emphasis on identifying developmental stages associated with increased radiation exposure to critical organs. Methods: Monte Carlo simulations were performed using PCXMC 2.0 software for 3 pediatric age groups (5, 10, and 15 years), representing key developmental stages. Simulated full-mouth intraoral radiographic series used 4 exposure combinations: 60 kilovolt peak (kVp)/3 milliampere (mA), 60 kVp/6 mA, 70 kVp/3 mA, and 70 kVp/6 mA. Organ dose distributions and total effective doses were calculated according to the 2007 recommendations of the International Commission on Radiological Protection. One-way analysis of variance with post hoc tests assessed differences between groups. Results: Clear age-dependent variations in organ and effective radiation doses were observed. The 5-year-old group showed the highest effective doses (62.4 to 129.6 microsieverts [μSv]), despite fewer exposures. The 10-year-olds had the lowest doses (37.2 to 76.8 μSv). Thyroid doses in 5-year-olds were 3.2 times higher than in older groups (P<0.001), due to anatomical proximity. Bone surface doses were similar in 5 and 15-year-olds but lower in 10-year-olds. These trends persisted across exposure combinations, though optimized settings (60 kVp/3 mA) reduced doses by over 50%. Conclusions: Age significantly influences radiation dose in pediatric dental imaging, with 5-year-olds receiving higher organ doses, especially to the thyroid. These findings stress the importance of age-specific protection strategies beyond adjusting exposure settings, emphasizing the developmental stage in radiation safety.