title: Are panoramic images reliable in planning sinus augmentation procedures?
abstract: OBJECTIVE
  The inherent deformation and two-dimensional nature of panoramic radiographs jeopardise their interpretation and quantitative measurements. This study aims to estimate the degree of underestimation of available mesio-distal bone in the premolar area (comparing panoramic radiographs with multi-slice/cone-beam computer tomography [CT]) to determine the prevalence, width, length and position of the bony canal [artery] in the lateral sinus wall and to explore the prevalence, width and length of another (newly detected) bony canal at the palatal aspect of the upper canine.
  
  
  METHODS
  The distance between the distal side of the canine/first premolar and the mesial side of the first molar or the anterior wall of the maxillary sinus was measured on panoramic radiographs and corresponding multi-slice/cone-beam CT images (65 patients). Measurements were made at apical, mid-radicular and crestal regions, parallel to the occlusal plane. The presence and dimensions of the two above-mentioned intra-osseous canals were verified on multi-slice CT scans (144 patients) using reformatted cross-sectional images and/or axial slices.
  
  
  RESULTS
  For all 65 patients, panoramic radiographs underscored the mesio-distal distance of available bone in the upper premolar region (mean 2.9 mm, range 0.1-7.5 mm). An intra-osseous canal in the lateral maxillary sinus wall was clearly visible in 49.5% of the cases (mean diameter 1.4 mm). In the canine region, a bony canal was obvious in 32.9% of the cases, with a mean diameter of 1.23 mm. For both canals, there was no correlation between diameter and patient's age.
  
  
  CONCLUSIONS
  Based on the present data, cone-beam CT imaging can be recommended for visualising anatomical structures during planning of sinus augmentation procedures.
authors.affiliation: Department of Periodontology, School of Dentistry, Oral Pathology & Maxillo-Facial Surgery, Faculty of Medicine, Catholic University Leuven, Kapucijnenvoer 33, Leuven, Belgium. andy.temmerman@uz.kuleuven.ac.be
authors.forename: Andy
authors.initials: A
authors.lastname: Temmerman
authors.forename: Stijn
authors.initials: S
authors.lastname: Hertelé
authors.forename: Wim
authors.initials: W
authors.lastname: Teughels
authors.forename: Christel
authors.initials: C
authors.lastname: Dekeyser
authors.forename: Reinhilde
authors.initials: R
authors.lastname: Jacobs
authors.forename: Marc
authors.initials: M
authors.lastname: Quirynen
mesh_terms: D000328:Adult; D000368:Aged; D054893:Cone-Beam Computed Tomography; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging* / Q000601:surgery*; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000000981:diagnostic imaging* / Q000601:surgery*; D011862:Radiography, Panoramic; D018709:Statistics, Nonparametric