title: Diagnostic accuracy and observer performance in the diagnosis of abnormalities in the anterior maxilla: a comparison of panoramic with intraoral radiography.
abstract: An investigation was undertaken to assess the reliability of radiographic diagnosis of abnormalities of orthodontic significance in the anterior region of the maxilla from intraoral and dental panoramic tomograph (DPT) views. DPT films of 200 patients were scrutinised by two observers on two separate occasions, who also examined intraoral radiographs of the same patients. Sixty-three of these patients were selected because they had previously been diagnosed as presenting with a defined abnormality of orthodontic relevance, such as supernumerary teeth, absent incisors, etc. The remaining cases had been assessed as depicting normal radiographic appearances. Each radiograph was allocated a unique, randomly selected code number as the only means of identification. It was not possible for the observers to match the DPT to the corresponding intraoral films, and this information was only available to the principal investigator (JWF). Both observers were asked to record the presence or otherwise of any abnormalities at each observation of each radiograph, and to record their findings. The overall level of diagnostic accuracy and reproducibility was fairly high, and in general terms the DPT views were as reliable as the intraoral films with regard to the detection of abnormalities; however, there were significant differences between the observers. It was concluded that in many instances supplementary intraoral films would not contribute any additional information compared to the DPT and that selection criteria should be defined for the former.
authors.affiliation: Selly Oak Hospital, Birmingham.
authors.forename: J W
authors.initials: JW
authors.lastname: Ferguson
authors.forename: R I
authors.initials: RI
authors.lastname: Evans
authors.forename: L H
authors.initials: LH
authors.lastname: Cheng
mesh_terms: D016009:Chi-Square Distribution; D003951:Diagnostic Errors; D005188:False Negative Reactions; D005189:False Positive Reactions; D006801:Humans; D007180:Incisor / Q000002:abnormalities; D016014:Linear Models; D008437:Maxilla / Q000000981:diagnostic imaging*; D015588:Observer Variation; D011861:Radiography, Dental / Q000145:classification / Q000379:methods*; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D012391:Root Resorption / Q000000981:diagnostic imaging; D014071:Tooth Abnormalities / Q000000981:diagnostic imaging*; D014096:Tooth, Supernumerary / Q000000981:diagnostic imaging; D014097:Tooth, Unerupted / Q000000981:diagnostic imaging