How is the use of digital dental radiology in a developing country? An overview of Brazil / ¿Cómo es el uso de la radiología dental digital en un país en vías de desarrollo? Una visión general de Brasil

Abstract The aim of this study was to assess the use of digital dental radiology in Brazil, by focusing on the use of image receptors, imaging exams and digital image enhancement tools, also assessing the methods of professional image transfer. Questionnaires were distributed in person on dental meetings and digitally via messaging (WhatsApp®) and mailings list. The sample of this cross-sectional study consisted of 478 questionnaires. Most participants were woman (n=315, 65.9%), with average age of 33.8±9.2 years. Descriptive and frequency analysis was performed. Chi-square and Fisher's exact tests were used (α=0.05). Most dentists worked at shared dental clinics (34.7%) and use digital image receptors (51.1%), but a representative percentage (48.9%) still exclusively use radiographic films. Photostimulable phosphor plate is the most used digital image receptor. Among extraoral exams, panoramic radiography (PAN) is the most used. Regarding dental specialties, oral radiologists and oral and maxillofacial surgeons mostly use cone-beam computed tomography (p<0.001). Most dentists who use digital systems make use of digital image enhancement tools (87.8%), mainly contrast, zoom, brightness and measurements. The most common method of professional image transfer (professional-professional and professional-patiens) is by email, with few dentists using online app and social media (26%). Therefore, while most Brazilian dentists use digital imaging systems, a significant percentage still exclusively use radiographic films. The most extraoral imaging exams used is PAN. Regarding image enhancement tools, brightness and contrast adjustments, zoom and measurements are the most applied. Finally, dentists generally use email for professional image transfer.

Resumen El objetivo de este estudio fue evaluar uso de la radiología dental digital en Brasil, centrándose en uso de receptores de imagen, exámenes de imágenes y herramientas de mejora de imagen digital, evaluando también los métodos de transferencia de imagen profesional. Cuestionarios se distribuyeron de forma presencial en reuniones odontológicas y de forma digital a través de mensajería (WhatsApp®) y lista de correo. Muestra de este estudio transversal estuvo compuesta por 478 cuestionarios. Mayoría de los participantes eran mujeres (n=315, 65,9%), con edad promedio de 33,8±9,2 años. Se realizó un análisis descriptivo y de frecuencias. Se utilizaron las pruebas Chi-cuadrado y exacta de Fisher (α=0,05). La mayoría de los odontólogos trabajaban en clínicas dentales compartidas (34,7%) y utilizan receptores de imágenes digitales (51,1%), pero un porcentaje representativo (48,9%) todavía utiliza exclusivamente películas radiográficas. Placa de fósforo fotoestimulable es el receptor de imagen digital más utilizado. Entre los exámenes extraorales, la radiografía panorámica (PAN) es la más utilizada. En cuanto a las especialidades odontológicas, los radiólogos orales y los cirujanos orales y maxilofaciales utilizan mayoritariamente la tomografía computarizada de haz cónico (p<0,001). Mayoría de los odontólogos que utilizan sistemas digitales utilizan herramientas de mejora de imagen digital (87,8%), principalmente contraste, zoom, brillo y medidas. Método más común de transferencia de imágenes profesionales (profesional-profesional y profesional-pacientes) es por correo electrónico, con pocos dentistas que utilizan aplicaciones en línea y redes sociales (26%). Por lo tanto, mientras que la mayoría de dentistas brasileños utilizan sistemas de imágenes digitales, un porcentaje significativo aún utiliza exclusivamente películas radiográficas. Examen de imagen extraoral más utilizado es el PAN. En cuanto a las herramientas de mejora de imagen, los ajustes de brillo y contraste, el zoom y las medidas son las más aplicadas. Finalmente, los dentistas generalmente usan el correo electrónico para la transferencia de imágenes profesionales.

Atitudes dos cirurgiões-dentistas em relação à proteção radiológica, de acordo com a lei brasileira / Attitudes of dentists in relation to radiological protection, according to brazilian law

Objetivo: Realizar uma pesquisa em consultórios odontológicos na cidade de São José do Rio Preto - SP sobre conhecimento e atitudes dos profissionais sobre proteção radiológica e comparar os dados com as recomendações da Portaria 453 do Ministério da Saúde. Material e Método: Cento e cinqüenta consultórios odontológicos foram visitados e foi aplicado um questionário. Resultados: Observou-se que 26% dos entrevistados não conheciam a lei, 23% não avaliavam radiografias existentes do paciente, 21% não usavam vestimenta plumbífera nos pacientes, 49% não usavam posicionadores de filmes, 58% ainda utilizavam processamento visual; 93% utilizavam filme E ou F, entretanto a média de tempo de exposição foi 0.5 segundo, 14% dos equipamentos possuíam cone localizador e 83% seletor de tempo manual, 17% dos dentistas não se protegiam durante a exposição do paciente e 64% ainda utilizavam disparador com retardo. Conclusão: Há falta de conhecimento sobre proteção radiológica; um programa educacional em Radiologia pode produzir mudanças nas atitudes dos profissionais em relação ao uso da radiação ionizante.

Objective: To perform a research in dental offices in the city of São José do Rio Preto-SP about the practitioners' knowledge and attitudes related to radiological protection and compare the data with the recommendations of Ordinance 453 of the Health Ministry. Material and Methods: One hundred and fifty dental offices were visited and a questionnaire was applied. Results: Was observed that 26% of the interviewed did not know the law, 23% did not evaluate the patient's existing radiographs, 21% did not wear lead clothing in patients, 49% did not use film positioners, 58% still used visual processing, 93% used film E or F, however the average exposure time was 0.5 second, 14% of the equipment had locator cone and 83% had manual time selector, 17% of dentists do not protect themselves during the patient's exposure and 64% still used delayed trigger. Conclusion: There Atitudes dos Cirurgiões-Dentistas em Relação à Proteção Radiológica, de Acordo com a Lei Brasileira Pesquisa Rev Odontol Bras Central 2010;19(51) 305 is a lack of knowledge about radiological protection. An educational program in Radiology can produce changes in attitudes of professionals regarding the use of ionizing radiation.