Imaging Sci Dent.  2015 Sep;45(3):169-174. 10.5624/isd.2015.45.3.169.

Radiographic evaluation of the maxillary sinus prior to dental implant therapy: A comparison between two-dimensional and three-dimensional radiographic imaging

• Tadinada A
• Fung K
• Thacker S
• Mahdian M
• Jadhav A
• Schincaglia GP

• KMID: 2045024
• DOI: http://doi.org/10.5624/isd.2015.45.3.169

Abstract

PURPOSE
This study was performed to evaluate the diagnostic efficacy of panoramic radiography and cone-beam computed tomography (CBCT) in detecting sinus pathology.
MATERIALS AND METHODS
This study was based on a retrospective evaluation of patients who had undergone both a panoramic radiograph and a CBCT exam. A total of 100 maxillary sinuses were evaluated. Four examiners with various levels of expertise evaluated the images using a five-point scoring system. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the diagnostic efficacy of the two modalities. The image analysis was repeated twice, with at least two weeks between the evaluation sessions. Interobserver reliability was assessed using Cronbach's alpha, and intraobserver reliability was assessed using Cohen's kappa.
RESULTS
Maxillary sinus pathology was detected in 72% of the patients. High interobserver and intraobserver reliability were observed for both imaging modalities and among the four examiners. Statistical analyses using ROC curves demonstrated that the CBCT images had a larger area under the curve (0.940) than the panoramic radiographs (0.579).
CONCLUSION
Three-dimensional evaluation of the sinus with CBCT was significantly more reliable in detecting pathology than panoramic imaging.

Keyword

Dental Implants; Maxillary Sinus; Cone-Beam Computed Tomography; Radiography, Panoramic

MeSH Terms

Cone-Beam Computed Tomography
Dental Implants*
Humans
Maxillary Sinus*
Pathology
Radiography, Panoramic
Retrospective Studies
ROC Curve
Dental Implants

Figure

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  Fig. 1 Receiver operating characteristic (ROC) curves for panoramic radiography and cone-beam computed tomography (CT).

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  Fig. 2 Radiographic and schematic views of the proposed classification of mucosal thickening in the maxillary sinus. 0-2 mm (A), 2-5 mm (B), 5-9 mm (C), 9 mm (D) to complete obliteration of the sinus. Mucosal thickening is marked by *.

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