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The Use of Extra-oral Bitewing Radiographs for Treatment Planning in Paediatric Patients Bethan Jones Eleanor O'Grady Nicholas Drage Mechelle Collard Dental Update 2024 50:9, 707-709.
Authors
BethanJones
BDS, MFDS (RCSEng)
Dental Core Trainee in Paediatric Dentistry, University Dental Hospital, Cardiff and Vale University Health Board
The extra-oral bitewing is becoming increasingly popular among clinicians to help overcome some of the challenges posed when taking intra-oral radiographs for paediatric patients. When combined with clinical examination, this radiographic view provides important diagnostic information in the management of caries in the posterior dentition. In this article, the use of extra-oral bitewings will be explored. The introduction of a decision tree provides the dental practitioner working in either a primary or secondary care setting, a pathway to assist with deciding the optimal radiographic prescription.
CPD/Clinical Relevance: Extra-oral bitewings can be a useful radiographic tool for dental caries diagnosis in the mixed dentition.
Article
Although there is an inherent contradiction in calling an extra-oral approach a ‘bitewing’, this term best describes the panoramic alternative. The terms ProxiPan and Proxi-optimised radiograph have been suggested; however, the term extra-oral bitewing (EBW) is more widely used, and is the term used in this article.
The European Academy of Paediatric Dentistry (EAPD) advise that any radiographs should be optimised in terms of dose, following the ‘as low as diagnostically achievable being indication-oriented and patient-specific’ principle.2 Indications for radiographs in children include suspected and active caries, dental and facial trauma, pathology of teeth and bone, including infections and abscesses, suspected loss of vitality and developmental abnormalities.3,4 EAPD guidance recommends that an EBW may be considered when a child is unable to tolerate a conventional intra-oral bitewing, whether through disability or sensory discomfort.1,2
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