Efficacy of FDA guidelines for prescribing radiographs to detect dental and intraosseous conditions.
OBJECTIVE
This study compared the FDA guidelines for ordering dental radiographs to a conventional full-mouth examination for the detection of intraosseous disease and conditions affecting teeth other than caries.


METHODS
We examined 490 patients and selected posterior bite-wing and periapical views as indicated by the patient's signs or symptoms. We compared the radiographic findings with the use of this selected set of radiographs to those from a full-mouth set of radiographs to determine the rates of missed disease when the FDA guidelines were used.


RESULTS
The most commonly missed intraosseous findings were osteosclerosis, unerupted teeth, periapical radiolucencies, and primary root tips. Periapical radiolucencies that were most probably periapical cemental dysplasia were missed in six patients. The most commonly missed dental findings were resorbed roots and pulp stones. Three instances of dens in dente were missed.


CONCLUSIONS
When we used the FDA guidelines, the number of missed intraosseous and dental conditions was small and most likely inconsequential given the range of variability in dental diagnosis and treatment.
White
S C
SC
UCLA Schools of Dentistry, Section of Oral Radiology, USA.
Atchison
K A
KA
Hewlett
E R
ER
Flack
V F
VF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005069:Evaluation Studies as Topic; D005188:False Negative Reactions; D005260:Female; D017408:Guidelines as Topic; D006801:Humans; D007571:Jaw Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D011861:Radiography, Dental / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D014076:Tooth Diseases / Q000000981:diagnostic imaging*; D014481:United States; D014486:United States Food and Drug Administration