title: Comparison of the diagnostic performance of panoramic and occlusal radiographs in detecting submandibular sialoliths.
abstract: OBJECTIVE
  The aim of this study was to assess and compare the diagnostic performance of panoramic and occlusal radiographs in detecting submandibular sialoliths.
  
  
  METHODS
  A total of 40 patients (20 cases and 20 controls) were included in this retrospective study. Cases were defined as subjects with a submandibular sialolith confirmed by computed tomography (CT), whereas controls did not have any submandibular calcifications. Three observers with different expertise levels assessed panoramic and occlusal radiographs of all subjects for the presence of sialoliths. Intraobserver and interobserver agreement were assessed using the kappa test. Sensitivity, specificity, accuracy, positive and negative predictive values, and the diagnostic odds ratio of panoramic and occlusal radiographs in screening for submandibular sialoliths were calculated for each observer.
  
  
  RESULTS
  The sensitivity and specificity values for occlusal and panoramic radiographs all ranged from 80% to 100%. The lowest values of sensitivity and specificity observed among the observers were 82.6% and 80%, respectively (P=0.001). Intraobserver and interobserver agreement were higher for occlusal radiographs than for panoramic radiographs, although panoramic radiographs demonstrated a higher overall accuracy.
  
  
  CONCLUSIONS
  Both panoramic and occlusal radiographic techniques displayed satisfactory diagnostic performance and should be considered before using a CT scan to detect submandibular sialoliths.
authors.affiliation: Department of Oral Radiology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Jun Ho
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Oral Radiology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Eduardo Massaharu
authors.initials: EM
authors.lastname: Aoki
authors.affiliation: Department of Oral Radiology, School of Dentistry, University of São Paulo, São Paulo, Brazil.; Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Charlestown, MA, USA.; Department of Radiology, Harvard Medical School, Boston, MA, USA.
authors.forename: Arthur Rodriguez Gonzalez
authors.initials: AR
authors.lastname: Cortes
authors.affiliation: Department of Oral Radiology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Reinaldo
authors.initials: R
authors.lastname: Abdala-Júnior
authors.affiliation: Department of Oral Radiology, School of Dentistry, University of Okayama, Okayama, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Asaumi
authors.affiliation: Department of Oral Radiology, School of Dentistry, University of São Paulo, São Paulo, Brazil.
authors.forename: Emiko Saito
authors.initials: ES
authors.lastname: Arita
keywords: Multidetector Computed Tomography; Radiography, Dental; Radiography, Panoramic; Salivary Gland Calculi