title: Effect of dose reduction in digital dental panoramic radiography on image quality.
abstract: OBJECTIVE
  To investigate the effect of dose reduction in digital panoramic radiography on subjective image quality and diagnostic performance.
  
  
  METHODS
  Two digital panoramic radiographs were obtained with the Orthophos DS(Sirona, Bensheim, Germany) of patients (n=100) receiving dental care. The first image was taken at the standard exposure setting. For the second image the tube current was reduced by between 48 and 53%, 63 and 69%, 75 and 80% and 80 and 81% respectively. Ten observers rated both images for 21 specific anatomical details and 30 pathological findings.
  
  
  RESULTS
  All radiographs taken at reduced mA levels had a significantly inferior score (P<0.01) for anatomical details. There was no difference in the scores for pathological findings.
  
  
  CONCLUSIONS
  Radiographs obtained at reduced mA had inferior subjective image quality, but there was no difference in diagnostic performance. Thus, a reduction in tube current of approximately 50% is recommended. In certain circumstances such as follow-up radiographic examinations, a reduction of up to 65% should be considered.
authors.affiliation: Section of Peridontology, Department of Operative Dentistry and Periodontology, School of Dental Medicine, Ruprecht-Karls-University Heidelberg, 69120 Heidelberg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Dannewitz
authors.forename: Stefan
authors.initials: S
authors.lastname: Hassfeld
authors.forename: P
authors.initials: P
authors.lastname: Eickholz
authors.forename: J
authors.initials: J
authors.lastname: Mühling
mesh_terms: D000704:Analysis of Variance; D016001:Confidence Intervals; D003626:Data Display; D005260:Female; D006801:Humans; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging; D008437:Maxilla / Q000000981:diagnostic imaging; D015588:Observer Variation; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement; D019252:Radiography, Dental, Digital; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D018709:Statistics, Nonparametric; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging; D014070:Tooth / Q000000981:diagnostic imaging