title: A study to determine the added value of 740 screening panoramic radiographs compared to intraoral radiography in the management of adult (>18 years) dentate patients in a primary care setting.
abstract: OBJECTIVE
  To measure the added value of panoramic radiography in new dentate patients attending for routine treatment.
  
  
  METHODS
  Thirty-seven general dental practitioners using panoramic radiographs routinely were recruited. Twenty dentate patients were identified prospectively by each participating dentist if they were new to the practice, attending for an examination and requesting any treatment deemed necessary. A panoramic radiograph was taken with appropriate intraoral radiographs in line with national guidelines. Each dentist completed a radiological report for the panoramic radiograph only and these 20 reports were forwarded to the researchers along with the 20 panoramic radiographs, their accompanying bitewing and periapical radiographs and twenty completed clinical assessment sheets.
  
  
  RESULTS
  740 panoramic, 1418 bitewing and 325 periapical radiographs were assessed by the researchers. Only 32 panoramic films provided any additional diagnostic value when compared to intraoral films when guidelines had been observed resulting from the poor technical and processing quality of the accompanying intraoral films. Assessment of the number of caries and periapical lesions and the degree of periodontal bone loss from the intraoral films provided a greater diagnostic yield at the p<0.001 level of significance. The research found that dentists underestimated the number of caries lesions present and level of periodontal bone loss when compared to the researchers but overestimated the presence of periapical pathology, at the level of significance at p<0.001.
  
  
  CONCLUSIONS
  The study found that there was no support for the use of panoramic radiographs in routine screening as there was no net diagnostic benefit to the patient.
authors.affiliation: Little Budworth, Cheshire, United Kingdom.
authors.forename: Michael N
authors.initials: MN
authors.lastname: Rushton
authors.forename: Vivian E
authors.initials: VE
authors.lastname: Rushton
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016301:Alveolar Bone Loss / Q000000981:diagnostic imaging; D003729:Dental Care; D003731:Dental Caries / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000706:statistics & numerical data; D008443:Maxillary Sinus / Q000000981:diagnostic imaging; D008875:Middle Aged; D009078:Mucocele / Q000000981:diagnostic imaging; D015588:Observer Variation; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging; D010483:Periapical Diseases / Q000000981:diagnostic imaging; D011320:Primary Health Care; D011446:Prospective Studies; D016300:Radiography, Bitewing / Q000706:statistics & numerical data*; D011862:Radiography, Panoramic / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D014092:Tooth Root / Q000000981:diagnostic imaging; D014097:Tooth, Unerupted / Q000000981:diagnostic imaging; D055815:Young Adult