title: Effective dose of dental CBCT-a meta analysis of published data and additional data for nine CBCT units.
abstract: OBJECTIVE
  This article analyses dose measurement and effective dose estimation of dental CBCT examinations. Challenges to accurate calculation of dose are discussed and the use of dose-height product (DHP) as an alternative to dose-area product (DAP) is explored.
  
  
  METHODS
  The English literature on effective dose was reviewed. Data from these studies together with additional data for nine CBCT units were analysed. Descriptive statistics, ANOVA and paired analysis are used to characterize the data.
  
  
  RESULTS
  PubMed and EMBASE searches yielded 519 and 743 publications, respectively, which were reduced to 20 following review. Reported adult effective doses for any protocol ranged from 46 to 1073 µSv for large fields of view (FOVs), 9-560 µSv for medium FOVs and 5-652 µSv for small FOVs. Child effective doses from any protocol ranged from 13 to 769 µSv for large or medium FOVs and 7-521 µSv for small FOVs. Effective doses from standard or default exposure protocols were available for 167 adult and 52 child exposures. Mean adult effective doses grouped by FOV size were 212 µSv (large), 177 µSv (medium) and 84 µSv (small). Mean child doses were 175 µSv (combined large and medium) and 103 µSv (small). Large differences were seen between different CBCT units. Additional low-dose and high-definition protocols available for many units extend the range of doses. DHP was found to reduce average absolute error for calculation of dose by 45% in comparison with DAP.
  
  
  CONCLUSIONS
  Large exposure ranges make CBCT doses difficult to generalize. Use of DHP as a metric for estimating effective dose warrants further investigation.
authors.affiliation: 1 North Carolina Oral Health Institute, Koury Oral Health Sciences, Chapel Hill, NC, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Ludlow
authors.forename: R
authors.initials: R
authors.lastname: Timothy
authors.forename: C
authors.initials: C
authors.lastname: Walker
authors.forename: R
authors.initials: R
authors.lastname: Hunter
authors.forename: E
authors.initials: E
authors.lastname: Benavides
authors.forename: D B
authors.initials: DB
authors.lastname: Samuelson
authors.forename: M J
authors.initials: MJ
authors.lastname: Scheske
mesh_terms: D000367:Age Factors; D054893:Cone-Beam Computed Tomography / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D011829:Radiation Dosage; D011861:Radiography, Dental / Q000379:methods*; D011874:Radiometry; D012062:Relative Biological Effectiveness; D018570:Risk Assessment
keywords: adult; child; cone beam computed tomography; humans; phantoms; radiation dosage