title: Diagnostic value of panoramic radiography in predicting inferior alveolar nerve injury after mandibular third molar extraction: a meta-analysis.
abstract: BACKGROUND
  The aim of this study was to evaluate the predictive value of panoramic radiography on inferior alveolar nerve (IAN) injury after extraction of the mandibular third molar.
  
  
  METHODS
  Relevant studies up to 1 June 2014 that discussed the association of panoramic radiography signs and post-mandibular third molar extraction IAN injury were systematically retrieved from the databases of PubMed, Embase, Springerlink, Web of Science and Cochrane library. The effect size of pooled sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR) and diagnostic odds ratio (DOR) with their 95% confidence intervals (CI) were statistically analysed with Meta-disc 1.4 software.
  
  
  RESULTS
  Nine articles were included in this meta-analysis. The pooled estimates of sensitivity and specificity were 0.56 (95% CI: 0.50-0.61) and 0.86 (95% CI: 0.84-0.87), respectively. The overall PLR was 3.46 (95% CI: 2.02-5.92) and overall NLR was 0.58 (95% CI: 0.45-0.73). The pooled estimate of DOR was 6.49 (95% CI: 2.92-14.44). The area under the summary receiver operating characteristic curve was 0.7143 ± 0.0604.
  
  
  CONCLUSIONS
  The meta-analysis indicated that interpretation of panoramic radiography based on darkening of the root had a high specificity in predicting IAN injury after mandibular third molar extraction. However, the ability of this panoramic radiography marker to detect true positive IAN injury was not satisfactory.
authors.affiliation: Department of Stomatology of Shanghai Xuhui Central Hospital, Shanghai, China.
authors.forename: W
authors.initials: W
authors.lastname: Liu
authors.affiliation: Department of Prosthodontics of Yangpu Dental Clinic, Shanghai, China.
authors.forename: W
authors.initials: W
authors.lastname: Yin
authors.affiliation: Department of Stomatology of the Fifth People's Hospital, Shanghai, China.
authors.forename: R
authors.initials: R
authors.lastname: Zhang
authors.affiliation: Department of Stomatology of Shanghai Huadong Hospital affiliated to Fudan University, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Li
authors.affiliation: Department of Stomatology, Special Consultation Clinic, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Zheng
mesh_terms: D006801:Humans; D008340:Mandibular Nerve; D008964:Molar, Third; D016017:Odds Ratio; D011862:Radiography, Panoramic; D012680:Sensitivity and Specificity; D014081:Tooth Extraction / Q000009:adverse effects*; D061221:Trigeminal Nerve Injuries / Q000000981:diagnostic imaging* / Q000209:etiology
keywords: Inferior alveolar nerve injury; mandibular third molar extraction; meta-analysis; panoramic radiography; post-mandibular