Implementación del Nuevo Estándar de Garantía de Calidad de la Asociación Dental Americana (ADA) para los Sistemas Radiográficos Intraorales Digitales Indirectos
Aspectos Legales, Técnicos y Procedimentales Vigentes en la República Argentina
DOI:
https://doi.org/10.62172/revfouba.n95.a255Palabras clave:
estándares odontológicos, rayos X, sistemas radiográficos digitales, protección radiológicaResumen
El presente artículo tiene como objetivo describir los métodos desarrollados para garantizar una adecuada calidad en el uso de los sistemas de radiografía intraoral digital indirecta de acuerdo con el protocolo emitido desde la Asociación Dental Americana (ADA) y el Instituto Nacional de Normas Americanas (ANSI). Se analiza la secuencia procedimental inherente a la digitalización radiográfica con el propósito de exponer las exigencias que deben respetarse para implementar con éxito una norma de calidad integral en la obtención de radiografías durante el ejercicio profesional odontológico. Asimismo, se discuten aspectos legales y técnicos vigentes en la República Argentina, enfatizando respecto al interés y necesidad de validar criterios internacionales que contribuyan a optimizar la seguridad radiológica para profesionales y pacientes, cumpliendo con los criterios estipulados por el principio ALARA, es decir, garantizar el uso de dosis ionizantes tan bajas como sea razonablemente posible.
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ADA. (2012). Dental radiographic examinations: recommendations for patient selection and limiting radiation exposure. En American Dental Association, X-Rays/Radiographs (pp. 1–29). https://www.ada.org/resources/ada-library/oral-health-topics/x-rays-radiographs
ADA. (2017). Quality assurance for digital intra-oral radiographic systems (Technical Report No. 1094). American Dental Association.
Aldrich, J. E., y Rutledge, J. D. (2005). Assessment of PACS display systems. Journal of Digital Imaging, 18(4), 287–295. https://doi.org/10.1007/s10278-005-6974-7
American Association of Physicists in Medicine (AAPM). (2016). Acceptance testing and quality control of dental imaging equipment. AAPM Report No. 175 [en línea]. https://www.aapm.org/pubs/reports/rpt_175.pdf
ANSI/ADA (2020). Quality assurance for digital intraoral radiographic systems. (Standard No.1094). American National Standard Institute/American Dental Association. https://engage.ada.org/p/eg/ada-standard-no-1094-quality-assurance-for-digital-intra-oral-radiographic-e-book-1235
Briem Stamm, A. D., La Pasta, A. A., Müller, A. S., Rolón Lara, M. C., Pujol, M. H., y Vázquez, D. J. (2021). Aplicación forense de tecnología radiográfica dental portátil en Argentina: estado actual y perspectivas futuras. Revista de la Facultad de Odontología. Universidad de Buenos Aires, 36(82), 49–55. https://revista.odontologia.uba.ar/index.php/rfouba/article/view/78
Buchanan, A., Morales, C., Looney, S., y Kalathingal, S. (2017). Fish scale artefact on an intraoral imaging receptor. Dentomaxillofacial Radiology, 46(8), 20170224. https://doi.org/10.1259/dmfr.20170224
Buchanan, A., Orta, A., y Kalathingal, S. (2019). Postprocessing of all-zirconia restorations in digital dental radiographs: a quality assurance predicament. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 127(4), 330–338. https://doi.org/10.1016/j.oooo.2018.12.013
Buchanan, A., Hancock, R., & Kalathingal, S. (2020). The role of software in quality assurance for indirect digital intraoral imaging. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 130(3), 313–321. https://doi.org/10.1016/j.oooo.2020.03.043
California Dental Association. (2014). Radiation safety in dental practice — a study guide [en línea]. https://www.aapd.org/globalassets/media/safety-toolkit/radiation-safety-in-dental-practice-cda.pdf
Centers for Desease Control and Prevention. (2024). ALARA: As Low As Reasonably Achievable. https://www.cdc.gov/radiation-health/safety/alara.html
Decreto 6320. (1968). Normas para la instalación y utilización de equipos de rayos X. Reglamentación de la ley 17557. Poder Ejecutivo Nacional, Argentina. Publicado en el Boletín Oficial Nacional, 30 de octubre de 1968. https://www.argentina.gob.ar/normativa/nacional/decreto-6320-1968-195056
Flynn M. (2020). Clinical Physics in Informatics Display, Chapter 26. Clinical Imaging Physics, 1. https://doi.org/10.1002/9781118753798.ch23
Gray J. E. (1992). Use of the SMPTE test pattern in picture archiving and communication systems. Journal of Digital Imaging, 5(1), 54–58. https://doi.org/10.1007/BF03167824
Greenall, C., Drage, N., y Ager, M. (2014). Quality assurance tests for digital radiography in general dental practice. Dental Update, 41(2), 126–134. https://doi.org/10.12968/denu.2014.41.2.126
Haak, R., Wicht, M. J., Hellmich, M., Nowak, G., y Noack, M. J. (2002). Influence of room lighting on grey-scale perception with a CRT-and a TFT monitor display. Dentomaxillofacial Radiology, 31(3), 193–197. https://doi.org/10.1038/sj/dmfr/4600668
Hellén-Halme, K., y Lith, A. (2012). Effect of ambient light level at the monitor surface on digital radiographic evaluation of approximal carious lesions: an in vitro study. Dentomaxillofacial Radiology, 41(3), 192–196. https://doi.org/10.1259/dmfr/15422221
Hellén-Halme, K., Johansson, C., y Nilsson, M. (2016). Comparison of the performance of intraoral X-ray sensors using objective image quality assessment. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 121(5), e129–e137. https://doi.org/10.1016/j.oooo.2016.01.016
Hellén-Halme, K., Nilsson, M., y Petersson, A. (2009). Effect of monitors on approximal caries detection in digital radiographs--standard versus precalibrated DICOM part 14 displays: an in vitro study. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 107(5), 716–720. https://doi.org/10.1016/j.tripleo.2008.12.011
Hirschorn, D. S., Krupinski, E. A., y Flynn, M. J. (2014). PACS displays: how to select the right display technology. Journal of the American College of Radiology, 11(12 Pt B), 1270–1276. https://doi.org/10.1016/j.jacr.2014.09.016
International Commission on Radiological Protection. (2007). The 2007 recommendations of the International Commission on Radiological Protection. ICRP publication 103. Ann ICRP, 37(2-4). https://www.icrp.org/publication.asp?id=ICRP%20Publication%20103
Kirchhoff, S., Fischer, F., Lindemaier, G., Herzog, P., Kirchhoff, C., Becker, C., Bark, J., Reiser, M. F., y Eisenmenger, W. (2008). Is post-mortem CT of the dentition adequate for correct forensic identification?: comparison of dental computed tomograpy and visual dental record. International Journal of Legal Medicine, 122(6), 471–479. https://doi.org/10.1007/s00414-008-0274-y
Kutcher, M. J., Kalathingal, S., Ludlow, J. B., Abreu, M., Jr, y Platin, E. (2006). The effect of lighting conditions on caries interpretation with a laptop computer in a clinical setting. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 102(4), 537–543. https://doi.org/10.1016/j.tripleo.2005.11.004
Lima, C. A. S., Freitas, D. Q., Ambrosano, G. M. B., Haiter-Neto, F., y Oliveira, M. L. (2019). Influence of interpretation conditions on the subjective differentiation of radiographic contrast of images obtained with a digital intraoral system. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 127(5), 444–450. https://doi.org/10.1016/j.oooo.2019.01.003
Mah, P., Buchanan, A., y Reeves, T. E. (2023). The importance of the ANSI ADA Standard for digital intraoral radiographic systems-a pragmatic approach to quality assurance. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 135(1), 117–128. https://doi.org/10.1016/j.oooo.2022.07.011
Mah, P., McDavid, W. D., y Dove, S. B. (2011). Quality assurance phantom for digital dental imaging. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 112(5), 632–639. https://doi.org/10.1016/j.tripleo.2011.05.015
Minnesota Department of Health. (2015). X-ray regulatory guide dental X-ray facilities. https://www.web.health.state.mn.us/communities/environment/radiation/docs/xray/guidance/dentregguide.pdf
Mol, A., y Yoon, D. C. (2015). Guide to digital radiographic imaging. Journal of the California Dental Association, 43(9), 503–511. https://doi.org/10.1080/19424396.2015.12222890
National Council on Radiation Protection and Measurements. (2003). Radiation protection in dentistry. NCRP Report 145. NCRP. https://ncrponline.org/publications/reports/ncrp-reports-145/
National Council on Radiation Protection and Measurements. (2012). Reference levels and achievable doses in medical and dental imaging: recommendations for the United States, NCRP Report No. 172. NCRP. https://ncrponline.org/publications/reports/ncrp-report-172/
National Council on Radiation Protection and Measurements. (2019). Radiation protection in dentistry and oral and maxillofacial imaging. Report No 177. NRCP. https://ncrponline.org/shop/reports/report-no-177/
North Carolina Division of Health Service Regulation Radiation Protection Section a. (2015a). Digital imaging tips for lower radiation doses and better image quality in dentistry. Radiology Compliance Branch. https://radiation.ncdhhs.gov/
North Carolina Division of Health Service Regulation Radiation Protection Section b. (2015b). Entrance skin exposure (ESE) facts — dental. Radiology Compliance Branch. https://www.ncvmb.org/content/professional/documents/RadiationProtection_Memo.pdf
Olsson, L., Nilsson, M., Svenson, B., y Hellén-Halme, K. (2016). The effect of anatomical noise on perception of low contrast in intra-oral radiographs: an in vitro study. Dentomaxillofacial Radiology, 45(4), 20150402. https://doi.org/10.1259/dmfr.20150402
Organismo Internacional de Energía Atómica. (2013). Programa Nacional de Protección Radiológica en las Exposiciones Médicas. OIEA. https://Www-Pub.Iaea.Org/MTCD/Publications/PDF/TE-1710_Web.Pdf
Reeves, T. E., Lien, W., y Mah, P. (2020). Quality assurance: acceptance testing for digital dental intraoral sensors. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 129(4), 388–400. https://doi.org/10.1016/j.oooo.2019.11.005
Resolución 3590. (2021). Resolución N° 3590/2021. Estándares de Calidad en Diagnóstico y Tratamiento por Imágenes. Publicada en el Boletín Oficial, Ciudad de Buenos Aires, 09 de diciembre de 2021. Ministerio de Salud de la Nación. https://www.argentina.gob.ar/normativa/nacional/resoluci%C3%B3n-3590-2021-357945/texto
Resolución 900. (2017). Resolución N° 900-E/2017. Publicada en el Boletín Oficial, Ciudad de Buenos Aires, 17 de julio de 2017. Ministerio de Salud de la Nación. http://servicios.infoleg.gob.ar/infolegInternet/anexos/275000-279999/277042/norma.htm
Shahin, K. A., Chatra, L. y Shenai, P. (2013). Dental and craniofacial imaging in forensics. Journal of Forensic Radiology and Imaging, 1(2), 56–62. https://doi.org/10.1016/j.jofri.2012.12.001
Superintendencia de Riesgos de Trabajo. (2018). Manual de buenas prácticas. Tecnologías Radiológicas / Radiodiagnóstico. Ministerio de Trabajo, Empleo y Seguridad Social, Argentina. https://www.srt.gob.ar/wp-content/uploads/2018/06/MBP_Radiodiagnostico_2018.pdf
Texas Department of State Health Services. (2019). Radiation Control Regulations for Dental Radiation Machines. En Texas Administrative Code. Laws and Rules Texas Laws - Health and Safety Code (cap. 289.232). https://www.dshs.texas.gov/radiation/laws-rules.aspx
Udupa, H., Mah, P., Dove, S. B., y McDavid, W. D. (2013). Evaluation of image quality parameters of representative intraoral digital radiographic systems. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 116(6), 774–783. https://doi.org/10.1016/j.oooo.2013.08.019
Wade, C., y Brennan, P. C. (2004). Assessment of monitor conditions for the display of radiological diagnostic images and ambient lighting. The British Journal of Radiology, 77(918), 465–471. https://doi.org/10.1259/bjr/18928981
Walker, T. F., Mah, P., Dove, S. B., y McDavid, W. D. (2014). Digital intraoral radiographic quality assurance and control in private practice. General Dentistry, 62(5), 22–29. http://www.dentalimagingconsultants.com/uploads/5/2/5/2/52527701/digital_intraoral_radiographic_quality_assurance.pdf
Wood, R. E., y Kogon, S. L. (2010). Dental radiology considerations in DVI incidents: A review. Forensic Science International, 201(1-3), 27–32. https://doi.org/10.1016/j.forsciint.2010.04.018
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