Imaging of Mandibular Trauma: ROC Analysis

Abstract

Abstract. Objectives:To compare the diagnostic efficacies of panoramic radiographs, mandibular trauma series, and digitized radiographs for detection of fractures of the mandible. Methods: Fractures were induced using blunt trauma in 25 cadaver mandibles. Panoramic radiographs, digitized radiographs, and mandibular series comprising an anteroposterior view, two lateral oblique, and a reverse Towne's were used. Six observers recorded their diagnoses using a five-point confidence rating scale. The data were analyzed using receiver operating characteristic (ROC) curve analysis. Results: Significant differences based on imaging modalities were found (p < 0.0015) in the area under the curves (A z ): panoramic radiograph, 0.8762; mandibular series, 0.7521; panoramic plus anteroposterior radiographs combination, 0.8886; and digitized mandibular series, 0.7723. No observerbased differences were noted. Condylar and coronoid fractures were difficult to detect than those in other areas of the mandible (p < 0.033). Intra-and interobserver agreements were high ( w = 0.81 and 0.76, respectively). Conclusions: Panoramic radiographs are adequate for detection of mandibular fractures. Addition of an anteroposterior view augments diagnostic accuracy.

Guidelines for dental radiography immediately after a dento‐alveolar trauma, a systematic literature review

“…Panoramic radiography can provide useful diagnostic information in cases of mandibular including condylar fractures (16, 34, 49). But panoramic radiographs have shortcomings in detecting the most common fracture of the mandible in the condyle area (49).…”

Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

“…Panoramic radiography is superior to other conventional radiography and it is adequate in evaluating mandibular fractures 8,9,16. With the growing use of the panoramic radiography, the occasions for general dentists to diagnose mandibular fractures have been increasing.…”

“…It means that they had a considerable knowledge on the fracture interpretation. The mandibular condyle is considered as one of the most difficult regions to detect fractures,5,9,17,18 and this is especially true for the sagittal splitting fracture of the condylar head. This study showed that the sensitivity of the condylar fractures was different according to the location of the fractures.…”

Oral health: Concrete example of altruism

“…1 These plain radiographs are technique sensitive, time consuming, difficult to interpret and expose patients to high levels of radiation. 2 In comparison to the MS, OPG radiographs are superior in identifying mandibular fractures. 2,3 The MS offers one advantage over the OPG: they are more suitable for uncooperative patients and patients who unable to stand upright and motionless for short periods.…”

“…Healing follows spontaneous exfoliation of the fragment or surgical removal. 2 I would like to share this reference with your readers as I hope they will find it interesting; in five years of dental school this condition was never mentioned. …”