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

  • Rosado, Lucas de Paula Lopes (Division of Oral Radiology, Department of Oral Diagnosis, Piracicaba Dental School, State University of Campinas) ;
  • Barbosa, Izabele Sales (Department of Dentistry, Federal University of Juiz de Fora Governador Valadares Campus) ;
  • de Aquino, Sibele Nascimento (Division of Oral Diagnosis, Department of Dentistry, Federal University of Juiz de Fora Governador Valadares Campus) ;
  • Junqueira, Rafael Binato (Division of Endodontics, Department of Dentistry, Federal University of Juiz de Fora Governador Valadares Advanced Campus) ;
  • Verner, Francielle Silvestre (Division of Oral Diagnosis, Department of Dentistry, Federal University of Juiz de Fora Governador Valadares Campus)
  • Received : 2019.05.03
  • Accepted : 2019.07.17
  • Published : 2019.09.30

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.

Keywords

References

  1. Maillet M, Bowles WR, McClanahan SL, John MT, Ahmad M. Cone-beam computed tomography evaluation of maxillary sinusitis. J Endod 2011; 37: 753-7. https://doi.org/10.1016/j.joen.2011.02.032
  2. Maestre-Ferrin L, Galan-Gil S, Carrillo-Garcia C, Penarrocha-Diago M. Radiographic findings in the maxillary sinus: comparison of panoramic radiography with computed tomography. Int J Oral Maxillofac Implants 2011; 26: 341-6.
  3. Nunes CA, Guedes OA, Alencar AH, Peters OA, Estrela CR, Estrela C. Evaluation of periapical lesions and their association with maxillary sinus abnormalities on cone-beam computed tomographic images. J Endod 2016; 42: 42-6. https://doi.org/10.1016/j.joen.2015.09.014
  4. Rege IC, Sousa TO, Leles CR, Mendonca EF. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health 2012; 12: 30. https://doi.org/10.1186/1472-6831-12-30
  5. Tadinada A, Fung K, Thacker S, Mahdian M, Jadhav A, Schincaglia GP. Radiographic evaluation of the maxillary sinus prior to dental implant therapy: a comparison between two-dimensional and three-dimensional radiographic imaging. Imaging Sci Dent 2015; 45: 169-74. https://doi.org/10.5624/isd.2015.45.3.169
  6. Malina-Altzinger J, Damerau G, Gratz KW, Stadlinger PD. Evaluation of the maxillary sinus in panoramic radiography - a comparative study. Int J Implant Dent 2015; 1: 17. https://doi.org/10.1186/s40729-015-0015-1
  7. Jaju PP, Jaju SP. Cone-beam computed tomography: time to move from ALARA to ALADA. Imaging Sci Dent 2015; 45: 263-5. https://doi.org/10.5624/isd.2015.45.4.263
  8. Dau M, Marciak P, Al-Nawas B, Staedt H, Alshiri A, Frerich B, et al. Evaluation of symptomatic maxillary sinus pathologies using panoramic radiography and cone beam computed tomography - influence of professional training. Int J Implant Dent 2017; 3: 13. https://doi.org/10.1186/s40729-017-0075-5
  9. Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics 1977; 33: 159-74. https://doi.org/10.2307/2529310
  10. Jaju PP, Jaju SP. Clinical utility of dental cone-beam computed tomography: current perspectives. Clin Cosmet Investig Dent 2014; 6: 29-43. https://doi.org/10.2147/CCIDE.S41621
  11. Baciut M, Hedesiu M, Bran S, Jacobs R, Nackaerts O, Baciut G. Pre- and postoperative assessment of sinus grafting procedures using cone-beam computed tomography compared with panoramic radiographs. Clin Oral Implants Res 2013; 24: 512-6. https://doi.org/10.1111/j.1600-0501.2011.02408.x
  12. Shahbazian M, Jacobs R. Diagnostic value of 2D and 3D imaging in odontogenic maxillary sinusitis: a review of literature. J Oral Rehabil 2012; 39: 294-300. https://doi.org/10.1111/j.1365-2842.2011.02262.x
  13. Simuntis R, Kubilius R, Padervinskis E, Ryskiene S, Tusas P, Vaitkus S. Clinical efficacy of main radiological diagnostic methods for odontogenic maxillary sinusitis. Eur Arch Otorhinolaryngol 2017; 274: 3651-8. https://doi.org/10.1007/s00405-017-4678-5
  14. Shahbazian M, Vandewoude C, Wyatt J, Jacobs R. Comparative assessment of panoramic radiography and CBCT imaging for radiodiagnostics in the posterior maxilla. Clin Oral Investig 2014; 18: 293-300. https://doi.org/10.1007/s00784-013-0963-x
  15. Phothikhun S, Suphanantachat S, Chuenchompoonut V, Nisapakultorn K. Cone-beam computed tomographic evidence of the association between periodontal bone loss and mucosal thickening of the maxillary sinus. J Periodontol 2012; 83: 557-64. https://doi.org/10.1902/jop.2011.110376
  16. Venskutonis T, Plotino G, Tocci L, Gambarini G, Maminskas J, Juodzbalys G. Periapical and endodontic status scale based on periapical bone lesions and endodontic treatment quality evaluation using cone-beam computed tomography. J Endod 2015; 41: 190-6. https://doi.org/10.1016/j.joen.2014.10.017
  17. Nascimento EH, Pontual ML, Pontual AA, Freitas DQ, Perez DE, Ramos-Perez FM. Association between odontogenic conditions and maxillary sinus disease: a study using cone-beam computed tomography. J Endod 2016; 42: 1509-15. https://doi.org/10.1016/j.joen.2016.07.003
  18. Gang TI, Huh KH, Yi WJ, Lee SS, Heo MS, Choi SC. The effect of radiographic imaging modalities and the observer's experience on postoperative maxillary cyst assessment. Imaging Sci Dent 2014; 44: 301-5. https://doi.org/10.5624/isd.2014.44.4.301
  19. Cho BH. Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images. Imaging Sci Dent 2011; 41: 53-7. https://doi.org/10.5624/isd.2011.41.2.53
  20. Shintaku WH, Enciso R, Covington JS, Migliorati CA. Can dental students be taught to use dental radiographs for osteoporosis screening? J Dent Educ 2013; 77: 598-603. https://doi.org/10.1002/j.0022-0337.2013.77.5.tb05508.x
  21. Kratz RJ, Nguyen CT, Walton JN, MacDonald D. Dental students' interpretations of digital panoramic radiographs on completely edentate patients. J Dent Educ 2018; 82: 313-21. https://doi.org/10.21815/JDE.018.033
  22. Baghdady MT, Carnahan H, Lam EW, Woods NN. Integration of basic sciences and clinical sciences in oral radiology education for dental students. J Dent Educ 2013; 77: 757-63. https://doi.org/10.1002/j.0022-0337.2013.77.6.tb05527.x
  23. Baghdady MT, Carnahan H, Lam EW, Woods NN. Dental and dental hygiene students' diagnostic accuracy in oral radiology: effect of diagnostic strategy and instructional method. J Dent Educ 2014; 78: 1279-85. https://doi.org/10.1002/j.0022-0337.2014.78.9.tb05799.x
  24. Turgeon DP, Lam EW. Influence of experience and training on dental students' examination performance regarding panoramic images. J Dent Educ 2016; 80: 156-64. https://doi.org/10.1002/j.0022-0337.2016.80.2.tb06071.x

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