A re-audit of the quality of digital lateral cephalometric radiographs

From Volume 8, Issue 1, January 2015 | Pages 24-27

Authors

John Perry

BDS, MJDF, PgDipClinEd

StR in Orthodontics, Cardiff Dental Hospital, Cardiff, CF14 4XY

Articles by John Perry

Anchal Puri

BDS, MJDF, MClinDent

StR in Orthodontics

Articles by Anchal Puri

John Ho-A-Yun

BDS, MSc

Specialty Dentist in Orthodontics, Victoria Hospital, Kirkcaldy, Fife, KY2 5AH, UK

Articles by John Ho-A-Yun

Abstract

An audit was conducted within a district general hospital's orthodontic department to improve the quality of digital lateral cephalometric radiographs. The results of the audit show improvements in the quality of lateral cephalometric radiographs, following the introduction of a new picture archiving and communications system and charged coupling device cephalometric machine.

Clinical Relevance: A Quality Assurance programme is one of the essential legal requirements of the Ionizing Radiations Regulations 1999 (IRR99). This article demonstrates a simple method to monitor the quality of lateral cephalometric radiographs, based on the Health Protection Agency ratings of radiographic quality.

Article

Lateral cephalometric radiography is a practical, quantitative method providing information on the morphology and relationship of skeletal, dental and soft tissues. Exposures for lateral cephalometric radiographs result in lower effective doses when compared to three-dimensional imaging.1 Antero-posterior relationships remain some of the most challenging aspects of orthodontic treatment. As such, the cephalogram still represents a dose-efficient diagnostic tool.

Cephalometric analyses vary in measurements, but a common set of anatomical landmarks is generally utilized.2 As well as an aid to diagnosis, cephalograms also form a pre-treatment record, monitor the progress of treatment and monitor growth. All cephalograms produced should be of acceptable diagnostic quality and should be clinically justified prior to exposure. Good quality radiographs are essential for efficient and safe healthcare delivery.

A Quality Assurance programme is one of the essential legal requirements of the Ionizing Radiations Regulations 1999 (IRR99). Clinical audit ensures that quality assurance mechanisms are satisfactory and lead to relevant change and improvement.1 The Health Protection Agency (HPA) has developed subjective ratings of radiographic quality to be used for audit purposes. They class Grade 1 as excellent, Grade 2 as diagnostically acceptable and Grade 3 as unacceptable. The HPA minimum standards for radiological image quality are:

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