Comparison of panoramic and intraoral radiography for the diagnosis of caries and periapical pathology.

Abstract

Panoramic and intraoral radiographs from 400 consecutive patients were compared for their ability to demonstrate periapical pathology and caries. Two hundred panoramic radiographs were exposed with the rotational technique and 200 with the intraoral X-ray tube technique. Periapical osteolytic and sclerotic lesions as well as approximal caries were recorded independently by two observes. Agreement with intraoral radiographs for periapical osteolytic lesions was, on average, 63% for the rotational and 55% for the intraoral X-ray tube technique and for sclerotic lesions 40% and 36%, respectively. The agreement varied with tooth type and lesion size. When teeth without periapical lesions were also included in the comparisons, the values for agreement were over 96%. Interobserver agreement for periapical osteolytic lesions was 61% for the rotational and 56% for the intraoral X-ray tube technique. The corresponding values for sclerotic lesions were 29% and 23%. Intraobserver agreement for periapical osteolytic lesions was 71% for the rotational and 67% for the intraoral X-ray tube technique. The corresponding values for sclerotic lesions were 46% and 56%. Agreement with intraoral radiographs for enamel caries was, on average, 21% for the rotational and 27% for the intraoral X-ray tube technique and for dentinal lesions 44% and 53%, respectively. When caries-free approximal surfaces were also included in the comparisons, the values for agreement were over 95%. It is concluded that panoramic and intraoral radiography perform equally well as diagnostic tools for the detection of periapical lesions, although the results are not identical.(ABSTRACT TRUNCATED AT 250 WORDS)

A study to determine the added value of 740 screening panoramic radiographs compared to intraoral radiography in the management of adult (>18 years) dentate patients in a primary care setting

“…Air shadows in particular have been highlighted in causing problems with regard to diagnosis of apical pathology. 11 The researchers recorded 186 retained roots compared to the 133 recorded by the dentists which was significant at the p = 0.001 level. …”

“…11,[28][29][30] Many of the problems highlighted relate to the lack of orthogonality of the beam to the dental arch leading to horizontal overlap of the approximal regions of the teeth whilst incorrect patient positioning in the focal trough can exacerbate this problem. The conclusions drawn from these studies submit that bitewing radiography has a greater diagnostic accuracy in detecting caries lesions than panoramic radiography which supports the advice promoted by the national guidelines.…”

Sequential Test Selection by Quantifying of the Reduction in Diagnostic Uncertainty for the Diagnosis of Proximal Caries

“…If necessary, periapical radiographs are preferred for these regions. A number of investigations have compared conventional intraoral radiography with PAN radiography for the diagnosis of caries (15)(16)(17)(18)(19)(20). However, in this study, the ability of radiographic techniques to reveal both the presence and absence of caries was measured.…”

An analysis of oral radiographic findings and their interpretations in women with eating disorders

“…Furthermore, some authors reported underestimation 36,37 of the periapical pathologies on panoramic radiography compared to periapical films, whereas others found no difference between the two imaging modalities. 38 According to our approach, the level of agreement between inter-and intra-observer scores was rated good to excellent when evaluating the two imaging modalities separately to describe the teeth status and the condition of periapical tissues. Therefore, from a clinical point of view, we suggest that radiologic details of ED patients can be interpreted with similar efficacy by dental professionals with different backgrounds.…”