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Best clinical practice guidance for prescribing dental radiographs in children and adolescents: an EAPD policy document

European Archives of Paediatric Dentistry volume 21, pages 375–386 (2020)Cite this article

Abstract

Background

The European Academy of Paediatric Dentistry (EAPD) proposes this best clinical practice guidance to help practitioners decide when and how to prescribe dental radiographs in children and adolescents.

Methods

Four expert working groups conducted each a systematic review of the literature. The main subjects were radiation protection, intraoral dental radiography (bitewing and periapical radiographs), panoramic radiography (PR) and cone-beam computed tomography (CBCT). In addition, three workshops were held during the corresponding EAPD Interim Seminar in Chania (Crete, Greece) in 2019. On the basis of the identified evidence, all invited experts presented their findings and during the workshops aspects of clinical relevance were discussed.

Results

Several clinical-based recommendations and statements were agreed upon.

Conclusion

There is no or low-grade evidence about the efficacy of dental radiographic examinations in young populations. The given recommendations and rationales should be understood as best clinical practice guidance. It is essential to respect the radiological principles of an individualized and patient-specific justification. When a dental radiograph is required, its application needs to be optimized, aiming at limiting the patient’s exposure to ionising radiation according to the ALADAIP principle (As Low As Diagnostically Achievable being Indication-oriented and Patient-specific).

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Acknowledgements

The European Academy of Paediatric Dentistry wants to thank the Hellenic Society of Paediatric Dentistry for organizing the 11th EAPD Interim Seminar and Workshop in Chania, Greece May 3rd─4th, 2019 on “Conventional and modern imaging tools in Paediatric Dentistry: from intraoral radiographs to 3D technologies”. Special thanks to the chair of the local organizing committee, Dr. Nick Lygidakis and the president of the Hellenic Society of Paediatric Dentistry, Dr. Sofia Gkeki, as well as all involved in arrangements, for organizing a successful and memorable seminar. Furthermore, the EAPD wants to express gratitude to all participants of the workshops from the member countries for their valuable contributions.

Workshop I “Intraoral radiography” A. De Grauwe (Belgium), N. Kokkinos (Cyprus), C. Onisiforou (Cyprus), J. Vasakova (Czech Republic), P. Hess (Denmark), D. Emmanouil (Greece), D. Kavoura (Greece), A. Ní Chaollaí (Ireland), M. Ashkenazi (Israel), C. Silvia (Italy), A. Jacobsen (Norway), M. Tanase (Romania), T. Tomaževič (Slovenia), M. Ivanovic (Serbia), N. Sabel (Sweden), S. Selvi Kuvvetli (Turkey), T. Kandiah (UK), O. Hrynyshyn (Ukraine), U. Schiffer (Germany), L.Z. Lim (Singapore, expert), J. Tong (Singapore, expert), J. Aps (Australia, expert), M. Sobczak (Poland, moderator), S. Rajasekharan (Belgium, moderator).

Workshop 2 “Panoramic radiography” R. Billen (Belgium), H. Juric (Croatia), P. Kokkinos (Cyprus), V. Merglova (Czech Republic), E. Esclasson (France), K. Arapostathis (Greece), Z. Yfanti (Greece), A. Shmueli (Israel), A. Majorana (Italy), I.J. Brusevold (Norway), C. Bica (Romania), T. Leban (Slovenia), Z. Mandinic (Serbia), E. Esclasson (Sweden), L. Vasquez (Switzerland), D. Özge Yilmaz (Turkey), P. Ashley (United Kingdom), T. Lysak (Ukraine), K. Tsiklakis (Greece, expert), J. Kühnisch (Germany, moderator, chair of CAC), V. Anttonen (Finland, moderator).

Workshop 3 “Cone-beam CT” S. Theys (Belgium), J. Kaiferova (Czech Republic), M.-C. Maniére (France), K. Bücher (Germany), A. Mitsea (Greece), D. Finucane (Ireland), E. Davidovich (Israel), S. Friedlander-Barenboim (Israel), G. Fabrizio Ferrazzano (Italy), K. van Nes (Netherlands), A. J. Schmalfuss (Norway), C. Antohi (Romania), L. Hočevar (Slovenia), B. Wondimu (Sweden), D. Dagassan (Switzerland), D. Tabakcilar (Turkey), J. Monteiro (United Kingdom), M. Dolhova (Ukraine), K. Horner (United Kingdom, expert), M. Duggal (Singapore, moderator), E. Stratigaki (Switzerland, moderator).

Author information

Author notes

  1. J. W. G. Van Acker, J. K. M. Aps, K. Horner and K. Tsiklakis are shared senior authorship.

Authors and Affiliations

  1. Department of Conservative Dentistry and Periodontology, University Hospital, Ludwig-Maximilians-Universität München, Goethestraße 70, 80336, München, Germany

    J. Kühnisch

  2. Department of Cariology, Endodontology and Paediatric Dentistry, Research Unit of Oral Health Sciences, University of Oulu, Oulu, Finland

    V. Anttonen

  3. Medical Research Center, Oulu University Hospital and University of Oulu, Oulu, Finland

    V. Anttonen

  4. Faculty of Dentistry, National University of Singapore, Singapore, Singapore

    M. S. Duggal

  5. Specialist Private Practice, Paediatric Dentistry, Nicosia, Cyprus

    M. Loizides Spyridonos

  6. Department of Paediatric Dentistry, PaeCoMeDiS Research Cluster, Ghent University, Ghent, Belgium

    S. Rajasekharan & J. W. G. Van Acker

  7. Specialized Dental Practice, Warsaw, Poland

    M. Sobczak

  8. Department of Orthodontics and Paediatric Dentistry, University of Basel, Basel, Switzerland

    E. Stratigaki

  9. Division of Oral Diagnostic and Surgical Sciences, University of Western Australia, Perth, Australia

    J. K. M. Aps

  10. Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, Manchester, UK

    K. Horner

  11. Department of Oral Diagnosis and Radiology National and Kapodistrian, University of Athens, Athens, Greece

    K. Tsiklakis

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  1. J. Kühnisch
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  8. J. W. G. Van Acker
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  9. J. K. M. Aps
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Correspondence to J. Kühnisch.

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Kühnisch, J., Anttonen, V., Duggal, M.S. et al. Best clinical practice guidance for prescribing dental radiographs in children and adolescents: an EAPD policy document. Eur Arch Paediatr Dent 21, 375–386 (2020). https://doi.org/10.1007/s40368-019-00493-x

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