title: Routine panoramic radiography of new adult patients in general dental practice: relevance of diagnostic yield to treatment and identification of radiographic selection criteria.
abstract: OBJECTIVE
  We sought to measure the diagnostic yield of relevance to treatment on routine panoramic radiographs taken of new adult (ie, 18 years and over) patients in general dental practice.
  
  
  METHODS
  Routine panoramic radiographs (n = 1817) obtained from general dental practice were assessed and radiologic yield recorded using consensus viewing by 2 dental radiologists. A modified diagnostic yield of relevance to treatment for each radiograph was calculated by omission of findings that would have been identified on bilateral posterior bitewing radiographs and of radiologic findings of no relevance to treatment. Stepwise logistic regression analysis was used in attempt to identify clinical indicators of a high diagnostic yield of relevance to treatment.
  
  
  RESULTS
  The diagnostic yield of relevance to treatment was zero for the majority (56%) of patients. This figure rose to 71% when the symptom-free patients were considered. Five clinical indicators for panoramic radiography were identified, as follows: clinical suspicion of teeth with periapical pathologic conditions, presence of partially erupted teeth, clinically evident caries lesions, swelling, and clinically suspected unerupted teeth.
  
  
  CONCLUSIONS
  Routine panoramic radiography of adult dental patients is not supported by the results of this study. The use of clinical indicators to select patients may help to improve diagnostic yield.
authors.affiliation: Radiology Department, University Dental Hospital of Manchester, United Kingdom. vivian.e.rushton@man.ac.uk
authors.forename: V E
authors.initials: VE
authors.lastname: Rushton
authors.forename: K
authors.initials: K
authors.lastname: Horner
authors.forename: H V
authors.initials: HV
authors.lastname: Worthington
mesh_terms: D000328:Adult; D016009:Chi-Square Distribution; D003731:Dental Caries / Q000175:diagnosis / Q000000981:diagnostic imaging; D004487:Edema / Q000175:diagnosis / Q000000981:diagnostic imaging; D005260:Female; D005792:General Practice, Dental; D006801:Humans; D007575:Jaw, Edentulous / Q000000981:diagnostic imaging; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging; D016015:Logistic Models; D008297:Male; D015588:Observer Variation; D010347:Patient Care Planning; D010483:Periapical Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging; D010510:Periodontal Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D016300:Radiography, Bitewing; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D013223:Statistics as Topic; D018709:Statistics, Nonparametric; D014076:Tooth Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging*; D014078:Tooth Eruption; D014097:Tooth, Unerupted / Q000175:diagnosis / Q000000981:diagnostic imaging