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研究生:呂孟親
研究生(外文):Lu, Meng-Chin
論文名稱:牙科全口牙放射攝影對頭頸部範圍之表面劑量測量與健康效應評估
論文名稱(外文):Health effect assessment of surface dose measured within head and neck for a dental panoramic radiography.
指導教授:林招膨林招膨引用關係
指導教授(外文):Lin, Jao-Perng
學位類別:碩士
校院名稱:元培科技大學
系所名稱:醫學影像暨放射技術研究所
學門:醫藥衛生學門
學類:醫學技術及檢驗學類
論文種類:學術論文
畢業學年度:102
語文別:中文
論文頁數:50
中文關鍵詞:全口牙放射攝影風險評估光激發光劑量計
外文關鍵詞:Panoramic RadiographRisk AssessmentOptically Stimulated Luminescent Dosimeter
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目前在台灣口腔衛生保健逐漸受到重視,蛀牙、牙周病、齒顎矯正、根管治療、假牙膺復,以及人工植牙手術等,需要X光檢查的機率也相對增加。全口牙放射攝影已成為牙科醫學普及之檢查,由於輻射劑量較低,個人防護行為易被忽略,且多數牙科型X光機操作人員欠缺輻射防護的概念,本研究目的在評估牙科全口牙放射攝影之頭頸部範圍表面劑量及其健康風險評估,提供牙科醫師施行全口牙放射攝影評估病患的輻射劑量評估的參考。利用光激發光劑量計(optically stimulated luminescent dosimeter, OSLD)測量頭型假體各器官相對位置之表面劑量,再依據國際放射防護委員會(International Commission on Radiological Protection, ICRP)60號與103號報告建議組織加權因數計算有效劑量,利用美國國家輻射防護暨度量委員會(National Council on Radiation Protection and Measurements, NCRP)所建議之風險係數,評估施行牙科全口牙放射攝影造成的癌症風險。
頭頸部範圍施行牙科全口牙放射攝影所獲得表面劑量之結果顯示,獲得最大等價劑量之器官為甲狀腺,其平均值為304.0±15.7 μSv,藉由ICRP-60號報告建議之組織加權因數,頭頸部範圍之有效劑量經計算為63.4 μSv。
NCRP所建議之風險係數為1.65×10-2 Sv-1,藉由此風險係數可評估出施行牙科全口牙放射攝影所造成的健康風險為1.0×10-6,即為百萬分之一。根據行政院原子能委員會-醫療游離輻射劑量比較圖中所示之胸部X光攝影為0.02 mSv。故施行牙科全口牙放射攝影獲得有效劑量為胸部X光攝影的3.2 倍。
Oral healthcare is drawing ever-increasing attention in Taiwan. The probability of requiring radiographic examinations,such as cavities, periodontal diseases, orthodontics, root canal treatments, prosthodontics, dental implant surgeries, has thus increased. Dental panoramic radiography has become a routine dental examination. However, personal protection is easily overlooked because of low radiation dose. Moreover, most dental X-ray machine operators lack the relevant information about radiation protection. The objective of this study was to assess the surface dose and its health risks to the neck and head regions from panoramic radiograph examinations, and to provide further considerations for dentists to assess the radiation dose for patients who undergo panoramic radiograph examinations. The risk of cancer induced by panoramic radiography was assessed according to the surface dose to the organs of a prosthesis measured by an optically stimulated luminescent dosimeter (OSLD), while the effective dose was calculated using weighted tissue factors recommended in report Nos. 60 and 103 from the International Commission on Radiological Protection (ICRP) and the risk coefficient recommended by the National Council on Radiation Protection and Measurements (NCRP), USA.
The results of surface dose measurements in the neck and head regions during a panoramic radiograph examination showed that the maximum equivalent dose appeared at the thyroid gland, with an average value of 304.0 ± 15.7 μSv. The effective dose was 63.4 μSv in the neck and head regions, and calculated using the weighted tissue factors recommended in the ICRP No. 60 report.
The risk factor recommended by the NCRP is 1.65 × 10-2 Sv-1; based on this factor, the health risk caused by a panoramic radiograph is calculated to be 1.0×10-6, or one in a million. According to a medical ionizing radiation dose comparison chart published by the Atomic Energy Council, the dose from a chest radiograph is 0.02 mSv. Thus, the effective dose of a panoramic radiograph is 3.2 times that of a chest radiograph.

中文摘要 I
Abstract II
致謝詞 IV
目錄 V
圖目錄 VII
表目錄 IX
第一章 序論 1
1.1 前言 1
1.2 文獻回顧 2
1.3 研究背景 3
1.4 研究目的 4
第二章 頭頸部範圍之危及組織或器官解剖 7
2.1 口腔構造 7
2.2 水晶體構造 8
2.3 甲狀腺構造 9
第三章 基礎原理 10
3.1 克馬(KERMA) 10
3.2 光子與物質作用 11
3.3 光激發光劑量計原理 11
3.4 輻射劑量 12
第四章 實驗材料與方法 16
4.1 建立假設 17
4.2 假體佈點 17
4.3 全口牙放射攝影 23
4.4 計讀 27
第五章 結果與討論 29
5.1 輻射劑量測量結果 29
5.2 輻射劑量健康效應評估 31
5.3 牙科診所輻射安全調查 38
第六章 結論 47
參考文獻 48
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