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

Abstract

PurposeTo 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 MethodsThis 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.ResultsIntraobserver 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).ConclusionCBCT 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.

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“…The maxillary sinuses (MS) form a pair of bony chambers located in the maxillary bone that contain air inside [1,2]. Its proximity to important structures can lead to the development of sinus pathologies and inflammatory processes of odontogenic origin [3], requiring special attention in dental planning. These changes include thickening of the sinus mucosa, mucous retention phenomenon, polyps, antroliths, opacified images of the indefinite origin or related to the inflammatory reaction, and less commonly, the presence of periostitis related to osteolytic lesions [3,4].…”

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