Evaluation of the maxillary sinus in panoramic radiography-a comparative study

Area of Science:

• Dentistry
• Radiology
• Oral and Maxillofacial Surgery

Background:

• Panoramic radiography is a common imaging technique for the maxillary sinus.
• Cone beam computed tomography (CBCT) provides detailed 3D imaging of the maxillary sinus.
• Assessing the diagnostic accuracy of panoramic radiography compared to CBCT is crucial.

Purpose of the Study:

• To evaluate the validity of panoramic radiography for diagnosing maxillary sinus variations and pathologies.
• To assess the inter- and intra-examiner reliability of panoramic radiography findings.
• To compare panoramic radiography findings with prediagnosed CBCT findings.

Main Methods:

• CBCT and panoramic radiographs of patients were analyzed.
• Two consultants prediagnosed 54 maxillary sinus conditions on CBCT images.
• Consultants later evaluated panoramic radiographs using the same criteria, assessing inter-imaging and inter-/intra-observer reliability.

Main Results:

• Panoramic radiography carries a moderate risk of false diagnoses for maxillary sinus conditions.
• Maxillary bone cysts penetrating the sinus were frequently detected differently between 2D panoramic and 3D CBCT.
• Inter-observer agreement was low for basal septa, and intra-observer reliability was poor for detecting bone cysts on panoramic radiographs.

Conclusions:

• Panoramic radiography can be adequate but has examiner-dependent limitations for specific maxillary sinus findings.
• CBCT provides superior information for precise preoperative evaluation, particularly for surgical procedures.
• The decision to use CBCT should consider its higher radiation dose and cost versus diagnostic necessity.