Panoramic radiographic screening: a risk-benefit analysis.
OBJECTIVE
To determine the amount of clinically relevant pathology found by panoramic radiographic screening in a young adult population and to assess whether such screening is justified.


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


METHODS
The routine dental panoramic tomograph screening films of the sample population were inspected by the author on a masked-out screen under 2X magnification. Where instances of dubious pathology were found these films were shown to a consultant oral surgeon for a second opinion. The literature on the risks associated with radiographic screening and the prevalence of intra-osseous pathology was reviewed.


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 literature indicated that these could have been detected by selective radiology.


CONCLUSIONS
The quantity of clinically relevant pathology did not justify routine panoramic radiographic screening in young adults.
Richardson
P S
PS
Defence Dental Agency, RAF Halton.
D000293:Adolescent; D000328:Adult; D006801:Humans; D008297:Male; D008889:Military Personnel; D011862:Radiography, Panoramic / Q000706:statistics & numerical data*; D018570:Risk Assessment; D014076:Tooth Diseases / Q000000981:diagnostic imaging