Efficacy of panoramic radiography in dental diagnosis and treatment planning

We compared treatment decisions based on a clinical examination alone with decisions based on an examination plus a panoramic radiograph to determine whether the panoramic radiograph increased the diagnostic yield and consequently affected treatment. Provisional treatment plans, based on a screening clinical examination alone (n = 33), or on a screening clinical examination plus panoramic radiograph (n = 43), were compared with final treatment plans based on a complete diagnostic assessment (including all necessary radiographs). For this analysis, the final treatment plan was considered correct and used as the gold standard. The two groups used in the comparison were equivalent in age, gender, and final treatment plan needs. The availability of a panoramic radiograph did not improve the accuracy with which provisional treatment plans predicted the number of teeth requiring composites, amalgams, crowns, or extraction, nor did it improve the accuracy of the assessment of the periodontal status (Wilcoxon rank sum, alpha = 0.05). The proportion of patients who had an intra-oral full-mouth series as part of the complete diagnostic work-up was essentially the same for both groups (58% and 60%, respectively); the availability of the panoramic film did not reduce the need for full-mouth series radiographs for the development of the final treatment plans.