Selective periapical radiology compared to panoramic screening.
OBJECTIVE
To assess whether selected periapical radiographs, taken according to High Yield Criteria, can reveal as much intra-osseous pathology as universal panoramic screening.


METHODS
The records of 1101 RAF recruits enlisted in 1988-89, average age 19 years (range 16-26).


METHODS
The clinical records and bitewing radiographs of the recruits were examined and the requirement for periapical radiographs determined according to high yield criteria. A template, cut out to simulate the area covered by a periapical bitewing radiograph, was placed over the suspect region on the panoramic film and any findings found within the template recorded. The entire dental panoramic tomograph was then examined on a masked screen under 2X magnification and any further findings recorded.


RESULTS
There was a considerable number of findings reported, including three large isolated radiolucent areas, 75 periradicular radiolucent areas, four probable cysts and 1187 unerupted mandibular third molars. However, when the clinical significance of these 'lesions' was assessed only those related to dental causes appeared to have significant clinical implications and the results indicated that these could have been detected by selective radiology.


CONCLUSIONS
This study showed that the only pathology which occurs frequently enough to justify radiographic screening of the jaws in young adults is related to teeth. It seems probable that this type of pathology can be at least as well detected by selective periapical screening, using high yield criteria, as is possible by universal panoramic screening.
Richardson
P S
PS
Defence Dental Agency, RAF Halton, Aylesbury, Buckinghamshire.
D000293:Adolescent; D000328:Adult; D001845:Bone Cysts / Q000000981:diagnostic imaging; D005069:Evaluation Studies as Topic; D006801:Humans; D008889:Military Personnel; D016300:Radiography, Bitewing / Q000379:methods* / Q000706:statistics & numerical data; D011862:Radiography, Panoramic / Q000379:methods* / Q000706:statistics & numerical data; D019227:Tooth Apex / Q000000981:diagnostic imaging*; D006113:United Kingdom