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Response from Planmeca Regarding “The Truth About CBCT Radiation”

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Dear Editor: We take strong exception to the article “The Truth About CBCT Radiation,” published in the September 2011 issue of Orthotown Magazine. Our complaints boil down to two main arguments:
    1. The chart on page 63 uses incorrect and inaccurate radiation exposure rates that the author later corrected. In 2010, Ludlow published (Oral Surgery, Oral Medicine, Oral Pathology and Endodontology, Vol. 110, No. 6, December 2010) a study that essentially corrected the information in the table Orthotown printed: “ProMax 3D can provide a wide range of radiation dose levels. Reduction in radiation dose can be achieved when using lower settings of exposure parameters.” He further states that: “Effective doses (ICRP 2007) for default patient sizes from small to large ranged from 102 to 298Sv.” Compare this with the rates used in the Orthotown article – 407uSv and 488uSv – respectively and you now have radiation exposure rates that are a quarter of those published in your magazine!

    2. The article and the chart do not take into consideration the fact that Planmeca went into the field in 2008 and upgraded each of our X-ray/imaging units sold to add a comb filter that reduced radiation. Had the authors reached out to the manufacturers of cone beam imaging units they might have learned this and factored it into their story. Planmeca has taken a number of steps through engineering, upgrades and education and outreach to adhere to the ALARA principles when dealing with radiation and we would have been happy to share this information with the writers to help create an accurate and timely article.

Earlier this year, Planmeca distributed an article in wake of The New York Times article about how the use of imaging procedures such as CT scans and CBCT imaging are putting those at risk for cancer. This week comes new research showing that Americans are exposed to six more times radiation than they were 10 years ago, mainly via the overuse of medical CT scans.
Radiation and medical and dental imaging are at a point where reasonable minds can come together and implement new guidelines and changes to protect patients and dental workers. Unfortunately, articles like the one published in your September issue create an alarming environment that is not conducive to working together to form guidelines to protect patients.

Bob Pienkowski
President, Planmeca USA



Response from Sean Carlson, DMD, MS, Co-author of “The Truth About CBCT Radiation,” to Planmeca’s Letter

Understandably, Planmeca has a valid point. I imagine many of the machines from the Ludlow studies reprinted in our article are outdated. Therefore, updating the dosimetry data for all machines in common use is a worthwhile research endeavor.

However, the authors did not intend for the paper to be a comparison between manufacturers, nor did we emphasize machine comparison. In fact, the intent of the article was purely to put CBCT X-ray exposure risk in perspective with other risks. Therefore, even with the outdated Planmeca exposure rates, the authors would argue that even those exposures are minimal.

We applaud Planmeca for working hard to decrease exposure rates and to increase education for the profession and the public about how to decrease patient risk. The intent of our article is in concert with those efforts, not opposed to them. We hope that by reading the article, our audience becomes more educated about dosimetry, and in turn becomes smarter consumers for all manufacturers, and also smarter clinicians.
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