Korean J Orthod.  2010 Dec;40(6):364-372. 10.4041/kjod.2010.40.6.364.

Comparison of bony changes between panoramic radiograph and cone beam computed tomographic images in patients with temporomandibular joint disorders

Affiliations
  • 1Professor, Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Korea.
  • 2Private Practice.
  • 3Graduate Student, Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Korea.
  • 4Clinical Instructor, Department of Orthodontics, Graduate School of Clinical Dentistry, Korea University, Korea.
  • 5Associate Professor, Department of Orthodontics, School of Dentistry, Seoul National University, Korea. titoo@snu.ac.kr.

Abstract


OBJECTIVE
This study was designed to assess the diagnostic validity of digital panoramic radiographs compared to cone beam computed tomography (CBCT) in patients with temporomandibular joint disorders.
METHODS
Panoramic radiograph and CBCT were taken from a total of 212 joints from 106 subjects. The joints were examined by two dentists and divided into the following six groups: normal, flattening, osteophyte formation, erosion, sclerosis, and unclassified. The sensitivity and specificity of each observer and inter-observer reliability were statistically analyzed.
RESULTS
The results showed relatively high intra-observer reliability in the diagnosis of both panoramic and CBCT images and the weighted Kappa indices of panoramic and CBCT images were 0.714 and 0.727, respectively. The sensitivities of panoramic images of observer A and B to CBCT images was 82.35% and 84.30%, respectively, while the specificity of observer A and B was 58.06% and 61.54%, respectively. However, guided diagnosis from panoramic and CBCT images were statistically different (p < 0.05).
CONCLUSIONS
The present study suggests that the panoramic radiograph could be used as a primary diagnostic device to detect bony changes of temporomandibular joints in clinical orthodontics, because panoramic images showed relatively high sensitivity compared to CBCT images. However, CBCT images may be one of the best choices when a more accurate diagnosis is necessary.

Keyword

Temporomandibular joint; Bony change; CBCT; Panoramic radiograph
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