Turkiye Klinikleri Journal of Dental Sciences

.: ORIGINAL RESEARCH
Efficacy of Panoramic Radiography in Determining Bony Changes in Temporomandibular Joint
Panoramik Radyografinin Temporomandibular Eklem Kemik Değişikliklerini Belirlemedeki Etkinliğinin Değerlendirilmesi
Melike BAŞARANa, Sinem Sırlı YILMAZTÜRKb, Esin BOZDEMİRb
aDepartment of Oral and Maxillofacial Radiology, Kütahya Health Sciences University Faculty of Dentistry, Kütahya, TURKEY
bDepartment of Oral and Maxillofacial Radiology, Süleyman Demirel University Faculty of Dentistry, Isparta, TURKEY
Turkiye Klinikleri J Dental Sci. 2021;27(1):6-14
doi: 10.5336/dentalsci.2019-72888
Article Language: EN
Full Text
ABSTRACT
 Objective: To investigate the utility of panoramic radiography in determining bony changes in temporomandibular joint (TMJ) based on cone-beam computed tomography (CBCT) images. Material and Methods: Two hundred eight TMJs on panoramic radiography and CBCT images of 104 (55 male, 49 female) patients were examined. Erosion, flattening, subcortical sclerosis or cyst, osteophyte, loose joint bodies, generalized sclerosis and deviation in form on the mandibular condyle, flattening, subcortical sclerosis and erosion of the articular eminence and articular fossa were evaluated both on CBCT and panoramic images. Data were scored as follows: false positive, false negative, true positive and true negative, and statistically analyzed with SPSS software using chi-square test (p<0.05), Cohen's kappa, receiving operating characteristic curve analysis. Results: Flattening (51.4% on CBCT, 24% on panoramic) and erosion (50% on CBCT, 15.9% on panoramic) was most commonly detected on the condylar head (p˂0.05). In the articular eminence, flattening in 2.4% and erosion in 12.5% and the articular fossa flattening in 1% and erosion in 20.2% were detected on CBCT. Flattening and erosion of the articular eminence and articular fossa could not be determined by panoramic radiography. Bony change that the most (38.5%) scored as the false negative was erosion. Accuracy values of panoramic radiography for the detection of any osseous change was poor compared with CBCT images (≤50%). Conclusion: Panoramic radiography was inadequate for detecting bony changes in TMJ especially in articular eminence and articular fossa. Therefore, radiological examination should be supported with more reliable imaging modalities like CBCT to examine hard tissues of TMJ.

Keywords: Cone-beam computed tomography; osteoarthritis; radiography; panoramic; temporomandibular joint disorders
ÖZET
 Amaç: Bu çalışmanın amacı, konik ışınlı bilgisayarlı tomografi (KIBT) görüntüleri baz alınarak, panoramik radyografinin temporomandibular eklemde (TME) görülen kemik değişikliklerini saptamadaki etkinliğinin değerlendirilmesidir. Gereç ve Yöntemler: Panoramik radyografi ve KIBT görüntüleri üzerinde 104 hastaya (55 erkek, 49 kadın) ait 208 TME incelendi. Mandibular kondilde erozyon, düzleşme, subkortikal skleroz veya kist, osteofit, serbest cisimler (loose bodies), generalize skleroz ve kondil başında deviasyon ile artiküler eminens ve artiküler fossada düzleşme, subkortikal skleroz ve erozyon varlığı değerlendirildi. Veriler yanlış pozitif, yanlış negatif, doğru pozitif ve doğru negatif olarak skorlandı ve ki-kare testi (p<0,05), Cohen kappa ve alıcı işlem karakteristik analizi kullanılarak SPSS yazılımı ile istatistiksel olarak analiz edildi. Bulgular: Mandibular kondilde en sık düzleşme (KIBT'de %51,4; panoramikte %24) ve erozyon (KIBT'de %50; panoramikte %15,9) saptandı (p˂0,05). KIBT görüntülerinde artiküler eminenste %2,4 oranında düzleşme ve %12,5 oranında erozyon, artiküler fossada %1 oranında düzleşme ve %20,2 oranında erozyon tespit edildi. Panoramik radyografi görüntülerinde artiküler eminenste ve artiküler fossada düzleşme ve erozyon saptanmadı. Tüm parametreler için doğru negatif skorlama oranı en yüksekti. En çok (%38,5) yanlış negatif olarak skorlanan kemik değişikliği erozyondu. Kemik değişikliklerinin saptanmasında panoramik radyografinin doğruluk değeri, KIBT'ye oranla daha azdı (≤%50). Sonuç: Panoramik radyografinin, TME'de özellikle artiküler eminens ve fossada görülen kemik değişikliklerini saptamada yetersiz olduğu saptandı. Bu nedenle radyolojik inceleme, TME'nin sert dokularını incelemek için KIBT gibi daha güvenilir görüntüleme yöntemleriyle desteklenmelidir.

Anahtar Kelimeler: Konik ışınlı bilgisayarlı tomografi; osteoartrit; radyografi; panoramik; temporomandibular eklem bozuklukları
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www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

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