Radiographic examination of patient's initial care in a Brazilian Dental School

INTRODUCTION: For X-rays offer more benefits than risks, they need to be performed or ordered according to each clinical situation.OBJECTIVE: To evaluate the radiographic exams requested in the initial care in a dental school, considering signs/symptoms and the reported reasons for seeking care.MATERIAL AND METHOD: We evaluated the medical records of 3100 adult patients treated over a period of three years, and eliminated those who had not performed radiographic examinations in the initial care. In a final sample of 1567 records, was collected: age and gender, reason for seeking care, presence of signs and/or symptoms, beyond technique and the number of radiographs requested. The dates were analysed by descriptive statistics.RESULT: 5034 radiographs were made, mean of 3.24 (±2.97) per patient. Among the techniques, the most widely used was the periapical, followed by panoramic. Tooth extraction and pain were the most prevalent reasons for seeking care, while pain, periodontal disease and the presence of soft tissue pathologies were the signs/symptoms more common. 35.41% of the sample had no signs or symptoms.CONCLUSION: There is a wide variation in the request of radiographs for initial care showing a lack of application of criteria in the selection diagnostic imaging, which can lead to unnecessary exposure to radiation X.

引言：鉴于X射线检查的获益大于风险，需结合每一例临床具体情况开展该项检查或开具检查申请。
目的：本研究旨在评估某牙科学院初诊患者所申请的放射检查情况，结合患者的体征/症状及就诊主诉原因进行分析。
材料与方法：本研究回顾了3年内收治的3100例成人患者的病历，排除初诊未接受放射检查的病例。最终纳入1567份病历作为研究样本，收集的信息包括：患者年龄、性别、就诊原因、体征和/或症状情况，以及放射检查技术类型与申请的检查数量。采用描述性统计学方法对数据进行分析。
结果：本研究共完成5034次放射检查，每位患者平均接受3.24±2.97次检查。在检查技术中，根尖片（periapical）应用最为广泛，其次为全景片（panoramic）。拔牙诉求与疼痛为最常见的就诊原因，而疼痛、牙周疾病及软组织病变则为最常见的体征与症状。35.41%的研究样本无明显体征或症状。
结论：初诊患者放射检查的申请存在较大差异，提示诊断影像学检查的选择环节缺乏统一标准的应用，这可能导致患者接受不必要的X射线辐射暴露。