title: Temporomandibular joint imaging: a comparative study of diagnostic accuracy for the detection of bone change with biplanar multidirectional tomography and panoramic images.
abstract: This in vitro investigation compares biplanar (sagittal and coronal) temporomandibular joint images produced by multidirectional tomographic and panoramic techniques for diagnostic accuracy in the detection of simulated degenerative lesions. A series of dentin chips placed at four locations on the head of a temporomandibular joint condyle in a dried human skull were imaged with tomographic and panoramic modalities. Equal numbers of images with and without chips were scored by four examiners with the use of confidence levels for presence or absence of the lesion. To assess intra-examiner reliability, each examiner viewed one of the modalities twice. Responses were assessed by generating receiver operating characteristic curves and analyzing the area (A(z)) under the curves with analysis of variation methods. Biplanar tomography provided significantly more accurate assessment of condylar lesions than biplanar panoramic images (p = 0.007). No statistical difference by location (p = 0.592) was found. The effects of observer and repeated observation were marginally significant at p = 0.046 and p = 0.030, respectively.
authors.affiliation: Department of Diagnostic Sciences, University of North Carolina School of Dentistry, Chapel Hill 27599-7454, USA.
authors.forename: J B
authors.initials: JB
authors.lastname: Ludlow
authors.forename: K L
authors.initials: KL
authors.lastname: Davies
authors.forename: D A
authors.initials: DA
authors.lastname: Tyndall
mesh_terms: D000704:Analysis of Variance; D001175:Arthrography / Q000379:methods* / Q000592:standards; D005189:False Positive Reactions; D006801:Humans; D008335:Mandibular Condyle / Q000000981:diagnostic imaging; D015588:Observer Variation; D010003:Osteoarthritis / Q000000981:diagnostic imaging; D019047:Phantoms, Imaging; D012372:ROC Curve; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging*; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods