Diagnostic value of clinical examination for the identification of children in need of orthodontic treatment compared with clinical examination and screening pantomography.
Ninety children in the 5th school grade (means age = 11.9 years) participated in this investigation. As part of the orthodontic screening examination, pantomograms of all children had been performed as a routine procedure. Prior to assessment of the pantomograms each child was assigned to one of the following treatment categories based on clinical examination: -T (no indication for orthodontic treatment), O (observation of dentition development) and +T (indication for orthodontic treatment). Children, in whom clinical symptoms gave rise to a radiographic examination, were selected and their pantomograms assessed. Finally, the pantomograms of all children were interpreted, and the clinically established treatment categories re-evaluated on basis of the findings on the pantomograms. Fifteen children were selected for pantomography, but only one changed treatment category (from O to +T) due to observation of developmentally missing premolars. Three of the children not selected for pantomography changed categories from -T; two to O and one to +T. Clinical examination with selective pantomography was thus able to correctly identify 97 per cent of children in need of immediate orthodontic treatment, while it was able to correctly exclude 94 per cent of the healthy children. On the basis of these results, routine screening pantomography may be omitted.
Hintze
H
H
Department of Radiology, Royal Dental College, Aarhus, Denmark.
Wenzel
A
A
Williams
S
S
D000848:Anodontia / Q000175:diagnosis / Q000000981:diagnostic imaging; D002648:Child; D003718:Denmark; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000145:classification / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D009971:Orthodontics, Corrective; D011862:Radiography, Panoramic; D012680:Sensitivity and Specificity; D014097:Tooth, Unerupted / Q000175:diagnosis / Q000000981:diagnostic imaging