Assessment of the reliability and validity of panoramic imaging for assessment of mandibular condyle morphology using both MRI and clinical examination as the gold standard.
OBJECTIVE
The purpose of this study was to evaluate both reliability and validity of the assessment of the shape of the mandibular condyle in panoramic images of the TMJ.


METHODS
Forty subjects were included and were examined according to the Research Diagnostic Criteria for Temporomandibular Disorders. Panoramic radiographs (PRs) and magnetic resonance images (MRIs) were completed for all subjects. Both MRIs and PRs were rated by raters blinded to the clinical diagnosis. Kappa statistics were used to compare the results of the raters of the PRs. Additionally, the specificity and the sensitivity of the PRs were calculated for 2 scenarios: one with MRI and the other with clinical findings as the gold standard.


RESULTS
The sensitivity was 0.94 (specificity = 0.45) for the assumption that MRI is the gold standard and 0.86 (specificity = 0.49) for the assumption that the clinical examination is the gold standard. For reliability, the results for kappa ranged from 0.06 to 0.327.


CONCLUSIONS
It can be concluded that PRs are not a reliable method of accurately judging the shape of the mandibular condyle.
Schmitter
Marc
M
Department of Prosthodontics, University of Heidelberg, Heidelberg, Germany. Marc_Schmitter@med.uni-heidelberg.de
Gabbert
Olaf
O
Ohlmann
Brigitte
B
Hassel
Alexander
A
Wolff
Diana
D
Rammelsberg
Peter
P
Kress
Bodo
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008279:Magnetic Resonance Imaging; D008297:Male; D008335:Mandibular Condyle / Q000000981:diagnostic imaging* / Q000473:pathology*; D008875:Middle Aged; D015588:Observer Variation; D010808:Physical Examination; D011862:Radiography, Panoramic; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016037:Single-Blind Method; D013704:Temporomandibular Joint / Q000000981:diagnostic imaging* / Q000473:pathology; D013705:Temporomandibular Joint Disorders / Q000000981:diagnostic imaging*