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KMID : 0361920100400060364
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Korean Journal of Orthodontics
2010 Volume.40 No. 6 p.364 ~ p.372
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Comparison of bony changes between panoramic radiograph and cone beam computed tomographic images in patients with temporomandibular joint disorders
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Lee Dong-Yul
Kim Yun-Jung
Song Yun-Heon
Lee Nam-Ho
Lim Yong-Kyu
Kang Sung-Taek
Ahn Sug-Joon
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Abstract
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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).
Conslusions: 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.
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KEYWORD
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Temporomandibular joint, Bony change, CBCT, Panoramic radiograph
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