Autonomia e competenza dell’odontoiatra in ambito radiologico: l’anello mancante

Abstract

OBJECTIVES First-and second-level radiology in dentistry is fundamental in clinical practice for diagnostic evaluation and planning of dental treatments. This article explores the distinct roles of radiologists and dentists in utilizing radiological techniques. Italian Law 409/1985, which delineated the competencies between medicine and dentistry, has proven to be critical due to its significant ethical and medico-legal implications for interpreting radiological images in the dental field. The aim of this paper is to analyze the use of radiodiagnostics in dentistry, identify and clarify the specific competencies of radiologists and dentists, and propose solutions to ensure the appropriate use of radiological images in the clinical dental context. MATERIALS AND METHODS This study was conducted through a qualitative analysis of the existing literature concerning the competencies of radiologists and dentists, current regulations, and ethical practices in the medical and dental fields, considering the new epistemological orientations in contemporary medicine. The implications of Italian Law 409/1985, which delineates the separation between medicine and dentistry, were examined, as well as the need for a validation system for radiological reports in dentistry that differs from the current one. DISCUSSION The distinction of competencies between radiologists and dentists is crucial for ensuring accurate diagnoses and appropriate treatments. Current radiodiagnostics, which play a pivotal role in modern practice, cannot fully utilize their potential to aid dentistry without the necessary clinical knowledge and semiotics. It is the contextual integration with the clinical examination itself that allows for a comprehensive diagnosis. Italian Law 409/1985 clarified the separation of medical and dental competencies, emphasizing the need to respect professional boundaries and expertise. However, it does not address the radiological issues within the dental profession, which have historically been managed by the medical field. This omission creates a regulatory gap that restricts the autonomy of dentists in the use and interpretation of radiological techniques, despite their specialization and expertise in this field. CONCLUSIONS The current separation of competencies between radiologists and dentists, as established by Italian Law 409/1985, limits the autonomy of dentists in radiological reporting despite their specialized training. A holistic and integrated approach that recognizes the specific competencies of each professional is essential for improving diagnostic accuracy and the effectiveness of dental treatments. A potential regulatory revision could enable dentists to independently manage radiological diagnoses, thereby optimizing care and adequately addressing the clinical needs of patients. CLINICAL SIGNIFICANCE The distinction of competencies and the integration of dental clinical knowledge are essential for improving diagnostic accuracy and the effectiveness of dental treatments.