To measure the added value of panoramic radiography in new dentate patients attending for routine treatment.
general dental practitioners using panoramic radiographs routinely were
recruited. Twenty dentate patients were identified prospectively by
each participating dentist if they were new to the practice, attending
for an examination and requesting any treatment deemed necessary. A
panoramic radiograph was taken with appropriate intraoral radiographs in
line with national guidelines. Each dentist completed a radiological
report for the panoramic radiograph only and these 20 reports were
forwarded to the researchers along with the 20 panoramic radiographs,
their accompanying bitewing and periapical radiographs and twenty
completed clinical assessment sheets.
panoramic, 1418 bitewing and 325 periapical radiographs were assessed by
the researchers. Only 32 panoramic films provided any additional
diagnostic value when compared to intraoral films when guidelines had
been observed resulting from the poor technical and processing quality
of the accompanying intraoral films. Assessment of the number of caries
and periapical lesions and the degree of periodontal bone loss from the
intraoral films provided a greater diagnostic yield at the p<0.001
level of significance. The research found that dentists underestimated
the number of caries lesions present and level of periodontal bone loss
when compared to the researchers but overestimated the presence of
periapical pathology, at the level of significance at p<0.001.
study found that there was no support for the use of panoramic
radiographs in routine screening as there was no net diagnostic benefit
to the patient.