1.Opportunistic investigation of vascular calcification using 3-dimensional dental imaging
Masoud MIRIMOGHADDAM ; Hollis LAI ; Camila PACHECO-PEREIRA
Imaging Science in Dentistry 2024;54(3):283-288
Purpose:
Given the growing use of cone-beam computed tomography (CBCT) scans, this study assessed radiation exposure from these scans in the context of national guidelines and recommended dose limits.
Materials and Methods:
The current literature was reviewed to quantify the benefit of opportunistic diagnosis of carotid artery calcification relative to the potential risk of radiation-induced cancer.
Results:
The average radiation from CBCT at its largest field of view and highest resolution possible amounts to a reasonable but still low ionizing radiation exposure. This exposure is comparable to 22 days of background radiation and is notably lower than the radiation exposure from medical CT scans. According to the risk assessment analysis, the risk of stroke events involving internal and external carotid artery calcification (CAC) was 202 and 67 per 100,000 individuals, respectively. In contrast, the estimated risk of radiation-induced cancer associated with CBCT was notably lower, at 0.6 per 100,000.
Conclusion
The present study advocates for a comprehensive assessment of CBCT scans encompassing the areas of the internal and external carotid arteries by a knowledgeable professional, given the potential advantages of early detection of vascular abnormalities. Dental professionals who take scans involving these areas need to be mindfulof reporting these findings and refer patients to their primary care physician for further investigation.
2.Opportunistic investigation of vascular calcification using 3-dimensional dental imaging
Masoud MIRIMOGHADDAM ; Hollis LAI ; Camila PACHECO-PEREIRA
Imaging Science in Dentistry 2024;54(3):283-288
Purpose:
Given the growing use of cone-beam computed tomography (CBCT) scans, this study assessed radiation exposure from these scans in the context of national guidelines and recommended dose limits.
Materials and Methods:
The current literature was reviewed to quantify the benefit of opportunistic diagnosis of carotid artery calcification relative to the potential risk of radiation-induced cancer.
Results:
The average radiation from CBCT at its largest field of view and highest resolution possible amounts to a reasonable but still low ionizing radiation exposure. This exposure is comparable to 22 days of background radiation and is notably lower than the radiation exposure from medical CT scans. According to the risk assessment analysis, the risk of stroke events involving internal and external carotid artery calcification (CAC) was 202 and 67 per 100,000 individuals, respectively. In contrast, the estimated risk of radiation-induced cancer associated with CBCT was notably lower, at 0.6 per 100,000.
Conclusion
The present study advocates for a comprehensive assessment of CBCT scans encompassing the areas of the internal and external carotid arteries by a knowledgeable professional, given the potential advantages of early detection of vascular abnormalities. Dental professionals who take scans involving these areas need to be mindfulof reporting these findings and refer patients to their primary care physician for further investigation.
3.Opportunistic investigation of vascular calcification using 3-dimensional dental imaging
Masoud MIRIMOGHADDAM ; Hollis LAI ; Camila PACHECO-PEREIRA
Imaging Science in Dentistry 2024;54(3):283-288
Purpose:
Given the growing use of cone-beam computed tomography (CBCT) scans, this study assessed radiation exposure from these scans in the context of national guidelines and recommended dose limits.
Materials and Methods:
The current literature was reviewed to quantify the benefit of opportunistic diagnosis of carotid artery calcification relative to the potential risk of radiation-induced cancer.
Results:
The average radiation from CBCT at its largest field of view and highest resolution possible amounts to a reasonable but still low ionizing radiation exposure. This exposure is comparable to 22 days of background radiation and is notably lower than the radiation exposure from medical CT scans. According to the risk assessment analysis, the risk of stroke events involving internal and external carotid artery calcification (CAC) was 202 and 67 per 100,000 individuals, respectively. In contrast, the estimated risk of radiation-induced cancer associated with CBCT was notably lower, at 0.6 per 100,000.
Conclusion
The present study advocates for a comprehensive assessment of CBCT scans encompassing the areas of the internal and external carotid arteries by a knowledgeable professional, given the potential advantages of early detection of vascular abnormalities. Dental professionals who take scans involving these areas need to be mindfulof reporting these findings and refer patients to their primary care physician for further investigation.
4.Opportunistic investigation of vascular calcification using 3-dimensional dental imaging
Masoud MIRIMOGHADDAM ; Hollis LAI ; Camila PACHECO-PEREIRA
Imaging Science in Dentistry 2024;54(3):283-288
Purpose:
Given the growing use of cone-beam computed tomography (CBCT) scans, this study assessed radiation exposure from these scans in the context of national guidelines and recommended dose limits.
Materials and Methods:
The current literature was reviewed to quantify the benefit of opportunistic diagnosis of carotid artery calcification relative to the potential risk of radiation-induced cancer.
Results:
The average radiation from CBCT at its largest field of view and highest resolution possible amounts to a reasonable but still low ionizing radiation exposure. This exposure is comparable to 22 days of background radiation and is notably lower than the radiation exposure from medical CT scans. According to the risk assessment analysis, the risk of stroke events involving internal and external carotid artery calcification (CAC) was 202 and 67 per 100,000 individuals, respectively. In contrast, the estimated risk of radiation-induced cancer associated with CBCT was notably lower, at 0.6 per 100,000.
Conclusion
The present study advocates for a comprehensive assessment of CBCT scans encompassing the areas of the internal and external carotid arteries by a knowledgeable professional, given the potential advantages of early detection of vascular abnormalities. Dental professionals who take scans involving these areas need to be mindfulof reporting these findings and refer patients to their primary care physician for further investigation.
5.Safety and efficacy of target controlled infusion administration of propofol and remifentanil for moderate sedation in non-hospital dental practice
Douglas LOBB ; Masoud MIRIMOGHADDAM ; Don MACALISTER ; David CHRISP ; Graham SHAW ; Hollis LAI
Journal of Dental Anesthesia and Pain Medicine 2023;23(1):19-28
Background:
Fearful and anxious patients who find dental treatment intolerable without sedative and analgesic support may benefit from moderate sedation. Target controlled infusion (TCI) pumps are superior to bolus injection in maintaining low plasma and effect-site concentration variability, resulting in stable, steady-state drug concentrations. We evaluated the safety and efficacy of moderate sedation with remifentanil and propofol using TCI pumps in non-hospital dental settings.
Methods:
A prospective chart review was conducted on 101 patients sedated with propofol and remifentanil using TCI pumps. The charts were completed at two oral surgeons and one general dentist's office over 6 months. Hypoxia, hypotension, bradycardia, and over-sedation were considered adverse events and were collected using Tracking and Reporting Outcomes of Procedural Sedation (TROOPS). Furthermore, patient recovery time, sedation length, drug dose, and patient satisfaction questionnaires were used to measure sedation effectiveness.
Results:
Of the 101 reviewed sedation charts, 54 were of men, and 47 were of women. The mean age of the patients was 40.5 ±18.7 years, and their mean BMI was 25.6 ± 4.4. The patients did not experience hypoxia, bradycardia, and hypotension during the 4694 min of sedation. The average minimum Mean Arterial Pressure (MAP) and heartbeats were 75.1 mmHg and 60.4 bpm, respectively. 98% of patients agreed that the sedation technique met their needs in reducing their anxiety, and 99% agreed that they were satisfied with the sedation 24 hours later. The average sedation time was 46.9 ± 55.6 min, and the average recovery time was 12.4 ± 4.4 min. Remifentanil and propofol had mean initial effect-site concentration doses of 0.96 µ/.ml and 1.0 ng/ml respectively. The overall total amount of drug administered was significantly higher in longer sedation procedures compared to shorter ones, while the infusion rate decreased as the procedural stimulus decreased.
Conclusion
According to the results of this study, no patients experienced adverse events during sedation, and all patients were kept at a moderate sedation level for a wide range of sedation times and differing procedures. The results showed that TCI pumps are safe and effective for administering propofol and remifentanil for moderate sedation in dentistry.