|Year : 2018 | Volume
| Issue : 2 | Page : 110-115
Knowledge, awareness, and aptitude of general dentists toward dental radiology and CBCT: A questionnaire study
Shalu Rai, Deepankar Misra, Ayush Dhawan, Kuber Tyagi, Mukul Prabhat, Mansi Khatri
Department of Oral Medicine and Radiology, Institute of Dental Studies and Technologies, Kadrabad, Modinagar, Ghaziabad, Uttar Pradesh, India
|Date of Submission||08-Nov-2017|
|Date of Acceptance||05-May-2018|
|Date of Web Publication||16-Jul-2018|
Dr. Shalu Rai
C-1 Sector 23 Noida - 201 201, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
| Abstract|| |
Background: This questionnaire study aims to assess the precise knowledge of dental radiography along with cone beam computed tomography (CBCT) in dental fraternity. Materials and Methods: The data in questionnaire were completely filled by 500 participants including Master of Dental Surgery and Bachelor of Dental Surgery (BDS) working as faculty and/or general practitioners, interns, and postgraduates. It consisted of multiple choice questions on CBCT. Overall assessment of answers obtained for each part was analyzed category-wise, specialty-wise, and qualification-wise. Results: A definite gap in knowledge of CBCT applications exists between different categories of dental specialists. Dental students should be provided with appropriate CBCT education supported by practical experience and guidance of oral medicine and maxillofacial radiologists. It is also recommended that all the CBCT scans should be performed under the guidance of an oral radiologist and the interpretation of these scans should be done by a trained oral and maxillofacial radiologist only. Conclusion: From the study it is evident dental practices are positively affected by high-end quality practice. More efforts for spreading awareness about this imaging modality, through inclusion of CBCT in curriculum of BDS and through lectures/Continuing Dental Education CDEs, should be undertaken to ensure better knowledge among dentists.
Keywords: Cone beam computed tomography, oral radiology, questionnaire
|How to cite this article:|
Rai S, Misra D, Dhawan A, Tyagi K, Prabhat M, Khatri M. Knowledge, awareness, and aptitude of general dentists toward dental radiology and CBCT: A questionnaire study. J Indian Acad Oral Med Radiol 2018;30:110-5
|How to cite this URL:|
Rai S, Misra D, Dhawan A, Tyagi K, Prabhat M, Khatri M. Knowledge, awareness, and aptitude of general dentists toward dental radiology and CBCT: A questionnaire study. J Indian Acad Oral Med Radiol [serial online] 2018 [cited 2019 Jul 16];30:110-5. Available from: http://www.jiaomr.in/text.asp?2018/30/2/110/236720
| Introduction|| |
Selection of appropriate imaging or diagnostic technique is an important step in the treatment of diseases and protects the patient from harmful effects of ionizing radiations. Constant research is focused toward better image acquisition with emphasis over minimum harmful effects of radiation., Cone beam computed tomography (CBCT) in our country has gained popularity among dentists and is preferred imaging modality in recent times. However, lack of inclusion in the curriculum at both undergraduate and postgraduate (PG) levels in our system of dental education is a matter of concern.
This survey study aims to assess the precise knowledge CBCT in dental fraternity.
| Materials and Methods|| |
Data were obtained in the form of a structured, close-ended, validated, predesigned, self-administered questionnaire which was approved by the institutional ethical committee. The questionnaire was validated after results obtained from pilot study. The questionnaire was given to 600 participants including Master of Dental Surgery (MDS) from all specialties of dentistry and Bachelor of Dental Surgery (BDS) working as faculty and/or general practitioners (GPs), interns, and PGs from reputed dental colleges of Western Uttar Pradesh, India, and the study was carried out from April 2015 to March 2016. Out of 600 participants, 100 incomplete questionnaires were not included in study.
The questionnaire consisted of multiple choice questions on CBCT. The total number of questions in the questionnaire included 32 questions. Overall assessment of answers obtained for each part was analyzed category-wise into five categories that were PG students, interns, GP, GP as faculty (GPF), and faculty/researcher (FR); specialty-wise into nine specialties that were oral medicine and radiology (OMR), oral surgery (OS), pedodontics (Pedo), orthodontics (Orth), periodontics (Perio), conservative dentist (Cons), prosthodontist (Pro), public health dentistry (PHD), and oral pathology (OP); and qualification-wise divided as BDS or MDS.
Statistical analysis was done using SPSS software version 18.0 (IBM, USA). Data were arranged in frequencies (percentages) for all questions and mean percentage was calculated. Chi-square and t-test were applied to compare percentages in different variables. Post hoc Bonferroni test was applied.
| Results|| |
Of these 500 completed questionnaires by participants, 250 participants had BDS degree, 177 had MDS degree, and 73 were completing their internship.
A series of questionnaire related to awareness of CBCT was assessed qualification-wise, category-wise, and specialty-wise [Table 1] and [Table 2]
| Discussion|| |
Several radiographic imaging techniques are available for diagnosis and treatment planning of patients visiting dental office for various dental procedures.,,,,,
This study used a questionnaire to gauge the awareness about CBCT, among dentists. This study has sought to understand primarily how efficiently dentists follow principles and practices of traditional and modern oral radiology. It also assesses the knowledge of dentists about CBCT and their opinions on the implications of increased use of CBCT in their practices.
Analyzing the results, a total of 500 completely filled forms were included, out of which 323 were BDS, 177 were MDS, 73 were intern, 94 were PG students, 213 were GP, 76 were faculty or researcher, and 44 were GP and faculty. Out of total MDS, 21 oral medicine and radiologist, 26 oral surgeons, 27 pedodontist, 21 orthodontist, 22 periodontist, 19 endodontist, 18 prostodontist, 8 PHD, and 15 oral pathologists participated in the study.
CBCT has an important role in the diagnosis of oral and maxillofacial pathologies with reduction in radiation dose. Category-wise, it was found that maximum participants in group GP/faculty 100%, qualification-wise 96.6% MDS, and specialty-wise 100% oral medicine and radiologist, oral surgeon, and PHD had heard about CBCT. The findings were dissimilar to a study conducted by Aditya et al. who found in their study that CBCT was less widely used in clinical practice due to low awareness regarding applications of CBCT among practitioners.
Category-wise 84.2% faculty/researcher, qualification-wise 66.1% MDS, and specialty-wise 84.6% oral surgeon considered CBCT over CT for 3D imaging. Category-wise 93.2% faculty/GP, qualification-wise 89.7% MDS, and specialty-wise 100% orthodontist, endodontist, PHD, and OP agreed that CBCT has low radiation dose over CT. The findings were similar to a study conducted by Chau and Fung. They reported that CBCT delivers the lowest radiation dose to the organs, whereas spiral multislice CT delivers the highest dose.
On analyzing level of satisfaction among the study population, it was found category-wise (89.5%) faculty/researcher, qualification-wise (76.5%) BDS, and specialty-wise (85.7%) oral medicine and radiologist were satisfied with use of CBCT. Most of the dentists obtained knowledge about CBCT through lectures (72.2%) and were interns. Most faculty/researchers (59.2%) agreed that lectures on CBCT should be included in clinical session of BDS and maximum interns (84.9%) had obtained knowledge of CBCT from their faculty. The findings were similar to a study conducted by Reddy et al. Tofangchiha M et al. to assess knowledge and attitude of dental fraternity toward CBCT in South India.
Category-wise it was found that maximum faculty/researcher (94.7%), qualification-wise (84.7%) MDS, and specialty-wise (100%) PHD advised their patients for CBCT. Category-wise (100%) faculty and GPs, qualification-wise (93.2%) MDS, and specialty-wise (100%) oral medicine and radiologist, PHD, and OP said that guidelines should be formed for taking CBCT scan. GP/faculty referred patients for trauma (20.5%), (9.7%) students referred for cyst/tumor, (34%) GPs referred for implant, (22.7%) GPs and faculty referred for orthodontic treatment, (15.3%) GPs referred for endodontic treatment, and (59.2%) faculty/researchers referred for all the procedures. Qualification-wise maximum (38.4%) MDS and (32.7%) BDS referred patients for CBCT. Specialty-wise maximum (37.5%) PHD referred patients for trauma, (4.8%) oral medicine and radiologist referred for cyst/tumor, (54.5%) periodontist referred for implant, 57.5% orthodontist refereed for orthodontic treatment, and 13.3% OP referred for endodontic treatment. The findings were in accordance with Balabaskaran and Srinivasan  and Shetty et al. who conducted a study to evaluate attitude of dentist toward CBCT and found in their study that dental practitioners prescribe CBCT imaging only when they expect that diagnostic yield will benefit patient care, enhance patient safety, or improve clinical outcomes significantly.
The need for provision of CBCT setup at dental institute was found to be category-wise maximum by faculty/researcher (97.4%), qualification-wise (96.6%) MDS, and specialty-wise 100% OMR, oral surgeon, endodontist, and PHD were in favor of availability of CBCT at their institute. Category-wise (93.8%) GP, qualification-wise (91.3%) MDS, and specialty-wise (100%) Perio, Prostho, and PHD wanted to use CBCT as an imaging modality in their clinical practice. Category-wise (85.5%) researcher/faculty and qualification-wise 76.3% BDS wanted to use CBCT as future professional carrier. An evaluation in different groups for reasons not using CBCT in dental practice was made and the results revealed that category-wise (32.9%) interns do not use CBCT due to lack of awareness, (24.1%) students do not use CBCT due to lack of knowledge, (83.3%) faculty/researchers do not use CBCT due to lack of availability, (9.5%) GPs/faculty do not use CBCT as they find it tough to perform. Qualification Wise (28.6%) BDS do not use CBCT due to lack of awareness, (17.5%) BDS do not use CBCT due to lack of knowledge, (68.1%) MDS do not use CBCT due to lack of availability, and (4.2%) BDS do not use CBCT as they find it tough to perform. Specialty-wise maximum of (66.7%) endodontist do not CBCT due to lack of awareness, (33.3%) endodontist do not use CBCT due to lack of knowledge, (84.2%) periodontist do not use CBCT due to lack of availability, and (25%) PHD do not use CBCT as they find it tough to perform. The findings are in accordance with a study conducted by Reddy et al. in South India; however, Aditya et al. found in their study that CBCT is still not very frequently used by dental specialists due to less availability of the technique, high cost, or inability of case selection for CBCT imaging by the dentists.
Category-wise it was found a maximum of participants (97.4%) in researcher/faculty group student had minimum (87.2%) interest in updating their information regarding CBCT. Qualification-wise it was found that maximum of (90.9%) MDS and minimum (90.4%) BDS were interested in updating information about CBCT. Specialty-wise maximum (100%) periodontist and PHD and minimum (81%) OMR were interested in updating information about CBCT. Category-wise (72.7%) GP faculty, qualification-wise (64.4%) MDS, and specialty-wise (88.9%) Pro were aware of different size of FOV in CBCT. Category-wise (72.7%) GP/faculty, qualification-wise (64.4%) MDS, and specialty-wise (88.9%) Pro were aware that focused FOV or small FOV should be advised in CBCT for endodontic purpose. Category-wise it was found participants in group faculty/researchers (97.2%), qualification-wise (89%) MDS, and specialty-wise (100%) Periodontist and PHD wanted conduction of CDE/workshop for enhancement of their knowledge about CBCT. The results indicate low awareness about CBCT among dentists and need enhancement of knowledge toward this promising new technology. Similar findings were reported in another study done in Turkey by Kamburoglu et al.
Some other important results of the survey study included questions emphasizing on need of oral and maxillofacial radiologist for better clinical practice and management of patients. These included category-wise (78.9%) faculty/researcher, qualification-wise (67.2%) BDS, and specialty wise (87.5%) PHD agreed for requirement of guidance from radiologist for radiological facility design and protection. The importance of referring patient to an oral radiologist trained to handle or have enough experience in handling CBCT machine was agreed by (100%) faculty/researchers category-wise, qualification-wise (95.5%) MDS, and specialty-wise (100%) Perio, OP, and PHD. The requirement for oral radiologist to take a regular hands-on/workshop/training for evaluation of CBCT scan was approved by (95.5%) faculty/GP category-wise, qualification-wise (92.7%) MDS, and specialty-wise (100%) Perio and PHD. Category-wise PG student (76.6%), qualification-wise (73.1%) MDS, and specialty-wise (92.3%) OP think that CBCT is OMR domain and should be present in OMR department only and CBCT scans should be interpreted by oral radiologist and signed by oral and maxillofacial radiologist completely seconded by (93.6%) PG students category-wise, qualification-wise (89.2%) BDS, and specialty-wise (100%) OP.
| Conclusion|| |
Therefore, we conclude that precise knowledge of oral radiology along with CBCT in dental fraternity is important due to its wide applications and profound potential of CBCT in different specialties of dentistry. Dental imaging is an essential tool for diagnostic and therapeutic orientation in the oral and dental surgery field. At student level introduction of training in CBCT at undergraduate and PG level shall ensure that dental specialists use this technique in an efficient way. Awareness of CBCT in dental fraternity and necessity to include it in the curriculum is the need of the hour.
It is further recommended that OMR departments in different dental colleges should actively participate and organize special qualification programs for dentists to increase their awareness toward different imaging modalities. Dentists including specialists from other specialties must gain more knowledge about indications and contraindications of digital imaging and CBCT for accurate diagnosis and better management of patients.
[Additional file 1]
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Kamburoglu K, Kursun S, Akarsala ZZ. Dental students' knowledge and attitudes towards cone beam computed tomography in Turkey. Dentomaxillofac Radiol 2011;40:439-43.
Balabaskaran K, Srinivasan AL. Awareness and attitude among dental professional towards CBCT. IOSR J Dent Med Sci 2013;10:55-9.
Reddy RS, Kiran CS, Ramesh T, Kumar BN, Naik RM, Ramya K. Knowledge and attitude of dental fraternity towards cone beam computed tomography in south India – A questionnaire study. Indian J Dent 2013;4:88-94.
Sudhakar KM, Hemant RD, Kedar B, Amit T. Assessment of response of dental clinicians and patients towards different imaging modalities used in diagnostic evaluation of dental implant therapy. Indian J Basic Appl Med Res 2012;1:341-50.
Ramakrishnan P, Shaifi FM, Subash A, Kumara AEG, Chakkarayan J, Vengalath J. A survey on radiographic prescription practices in dental implant assessment among dentists in Kerala, India. OHDM 2014;13:826-30.
Shetty SR, Castelino RL, Babu SG, Prasanna, Laxmana AR, Roopassri K. Knowledge and attitude of dentists towards cone beam computed tomography in Mangalore – A questionnaire survey. Austin J Radiol 2015;2:1-5.
Mahdizadeh M, Fazaelipour M, Namdari A. Evaluation of dentists' awareness of how to prescribe correct radiographs in Isfahan in 2010-2011. J Isfahan Dent Sch 2012;7:637-42.
Ardakani FE, Sarayesh V. Knowledge of correct prescription of radiographs among dentists in Yazd, Iran. J Dent Res Dent Clin Dent Prospects 2008;2:95-8.
Mehdizadeh M, Booshehri SG, Kazemzadeh F, Soltsni P, Motamedi MRK. Level of knowledge of dental practitioners in Isfahan, Iran about cone-beam computed tomography and digital radiography. Imag Sci Dent 2015;45:133-5.
Aditya A, Lele S, Aditya P. Current status of knowledge, attitude, and perspective of dental practitioners toward cone beam computed tomography: A survey. J Oral Maxillofac Radiol 2015;13:54-7.
Chau ACM, Fung K. Comparison of radiation dose for implant imaging using conventional spiral tomography, computed tomography, and cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107:559e565.
Tofangchiha M, Arianfar F, Bakhshi M, Khorasani M. The assessment of dentists' knowledge regarding indications of cone beam computed tomography in Qazvin, Iran. Biotech Health Sci 2015;2:1-5.
[Table 1], [Table 2]