Imaging Sci Dent.  2019 Sep;49(3):191-199. 10.5624/isd.2019.49.3.191.

Dental students' ability to detect maxillary sinus abnormalities: A comparison between panoramic radiography and cone-beam computed tomography

• Rosado LD
• Barbosa IS
• Aquino SN
• Junqueira
• Verner FS

• KMID: 2458367
• DOI: http://doi.org/10.5624/isd.2019.49.3.191

Abstract

PURPOSE
To compare the diagnostic ability of undergraduate dental students to detect maxillary sinus abnormalities in panoramic radiographs (PR) and cone-beam computed tomography (CBCT).
MATERIALS AND METHODS
This was a retrospective study based on the evaluation of PR and CBCT images. A pilot study was conducted to determine the number of students eligible to participate in the study. The images were evaluated by 2 students, and 280 maxillary sinuses were assessed using the following categories: normal, mucosal thickening, sinus polyp, antral pseudocyst, nonspecific opacification, periostitis, antrolith, and antrolith associated with mucosal thickening. The reference standard was established by the consensus of 2 oral radiologists based on the CBCT images. The kappa test, receiver operating characteristic curves, and 1-way analysis of variance with the Tukey-Kramer post-hoc test were employed.
RESULTS
Intraobserver and interobserver reliability showed agreement ranging from substantial (0.809) to almost perfect (0.922). The agreement between the students' evaluations and the reference standard was reasonable (0.258) for PR and substantial (0.692) for CBCT. Comparisons of values of sensitivity, specificity, and accuracy showed that CBCT was significantly better (P<0.05).
CONCLUSION
CBCT was better than PR for the detection of maxillary sinus abnormalities by dental students. However, CBCT should only be requested after a careful analysis of PR by students and more experienced professionals.

Keyword

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

MeSH Terms

Cone-Beam Computed Tomography*
Consensus
Humans
Maxillary Sinus*
Periostitis
Pilot Projects
Polyps
Radiography, Panoramic*
Retrospective Studies
ROC Curve
Sensitivity and Specificity
Students, Dental

Figure

• 

  Fig. 1 Sagittal sections of cone-beam computed tomography show examples of maxillary sinus abnormalities. A. Normal. B. Mucosal thickening. C. Sinus polyp. D. Antral pseudocyst. E. Non-specific opacification. F. Periostitis. G. Antrolith. H. Antrolith associated with mucosal thickening. The arrows indicate an antrolith inside the maxillary sinus.

• 

  Fig. 2 Sections of cropped panoramic radiographs show examples of maxillary sinus abnormalities. A. Normal. B. Mucosal thickening. C. Sinus polyp. D. Antral pseudocyst. E. Non-specific opacification. F. Periostitis. G. Antrolith. H. Antrolith associated with mucosal thickening.

• 

  Fig. 3 Receiver operating characteristic curves. A. Panoramic radiographs. B. Cone-beam computed tomographic images.

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