ÇOCUK DİŞ HEKİMLİĞİNDE KULLANILAN FARKLI RADYOGRAFİ TEKNİKLERİNDE RADYASYON DOZUNU AZALTICI ÖNLEMLER

Çocuk diş hekimliğinde teşhis, tedavi ve takip amacıyla radyografik görüntüleme yöntemlerine başvurulmak- tadır. Radyografik yöntemlerin çalışma prensibi iyonize edici radyasyona dayanmaktadır. Kullanılan radyografik yöntemlerin ihmal edilebilir düzeyde hasta dozu oluşturduğu kabul edilse de günümüzde iyonize radyasyon maruziyetinin herhangi bir eşik doz olmaksızın kanser gelişim riskine neden olabileceği bilinmektedir. Çocuk hastalarda erişkinlere kıyasla daha yüksek mitotik aktivite gösteren, daha az gelişmiş ve daha az farklılaşmış hücrelerin varlığı bunun yanı sıra çocukların fiziksel olarak küçük olmaları sebebiyle direk veya saçılmış radyas- yona daha çok organ ve dokunun maruz kalması kanser gelişme riskini arttırmaktadır. Çocuklarda radyasyona en duyarlı olan doku ve organlar tiroid, meme, kemik iliği, beyin ve cilt olarak gösterilmiş olup, dental rad- yografik muayene sırasında birincil veya saçılan X ışınlarından en çok etkilenen alanlardır. Bu nedenle, gerekli olduğu durumlarda radyografik muayeneye başvurulmalı ve radyasyon dozunu azaltan önlemler alınmalıdır. Bu derlemedeki amacımız; radyasyona daha duyarlı olan çocuk hastalarda, hangi durumlarda radyografik yöntem- lerin kullanılması gerektiğini, X ışını cihazlarındaki bazı modifikasyonlar ile çocuk hastalarda radyasyon dozunu azaltabilecek uygulamaları ve kullanılabilecek koruyucu ekipmanları yapılan pek çok çalışma yardımıyla ortaya koymaktır. Anahtar kelimeler: Deterministik etki, efektif doz, eşdeğer doz, ekstraoral radyografi, intraoral radyografi, iyo- nize radyasyon, sitokastik etki ABSTRACT Radiographic imaging methods are used in pediatric dentistry for diagnosis, treatment, and follow-up. The operation principle of radiographic methods is based on ionizing radiation. Even though the patient dose of the radiographic methods used is accepted to be at a negligible level, it is now known that ionizing radiation exposure can cause cancer without a threshold dose. The presence of less developed and less differentiated cells showing higher mitotic activity in pediatric patients compared to adults, as well as the exposure of more organs and tissues to direct or scatter radiation because children are physically small increases the risk of can- cer development. It has been shown that the thyroid, breast, bone marrow, brain, and skin are the tissues and organs most sensitive to radiation in children, and they are the areas most affected by primary or scattered X-rays during dental radiographic examination. Therefore, radiographic examinations should be performed only when necessary, and steps should be taken to reduce radiation exposure. With the help of numerous studies, our aim in this study is to present in which situation the radiographic methods should be used in pediatric patients who are more sensitive to radiation, some modifications in X-ray devices, applications that can reduce the radiation dose in pediatric patients, and protective equipment that can be used on pediatric patients. Keywords: Deterministic effect, effective dose, equivalent dose, extraoral radiography, intraoral radiography, ionizing radiation, stochastic effect

Keywords:

Deterministik etki, efektif doz, eşdeğer doz, ekstraoral radyografi, intraoral radyografi iyo- nize radyasyon, sitokastik etki,

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