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Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

  • Cho, Bong-Hae (Department of Oral and Maxillofacial Radiology, School of Dentistry, Pusan National University)
  • 투고 : 2010.12.09
  • 심사 : 2011.05.06
  • 발행 : 2011.06.30

초록

Purpose : The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images. Materials and Methods : Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student�fs t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics. Results : Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation. Conclusion : Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

키워드

참고문헌

  1. Buchbinder D. Treatment of fractures of the edentulous mandible, 1943 to 1993: a review of the literature. J Oral Maxillofac Surg 1993; 51 : 1174-80. https://doi.org/10.1016/S0278-2391(10)80285-X
  2. MacLennan WD. Fractures of the mandibular condylar process. Br J Oral Surg 1969; 7 : 31-9. https://doi.org/10.1016/S0007-117X(69)80058-2
  3. Thai KN, Hummel RP 3rd, Kitzmiller WJ, Luchette FA. The role of computed tomographic scanning in the management of facial trauma. J Trauma 1997; 43 : 214-8. https://doi.org/10.1097/00005373-199708000-00002
  4. Roth FS, Kokoska MS, Awwad EE, Martin DS, Olson GT, Hollier LH, et al. The identification of mandible fractures by helical computed tomography and panorex tomography. J Craniofac Surg 2005; 16 : 394-9. https://doi.org/10.1097/01.scs.0000171964.01616.a8
  5. Chacon GE, Dawson KH, Myall RW, Beirne OR. A comparative study of 2 imaging techniques for the diagnosis of condylar fractures in children. J Oral Maxillofac Surg 2003; 61 : 668-73. https://doi.org/10.1053/joms.2003.50134
  6. Raustia AM, Pyhtinen J, Virtanen KK. Examination of the temporomandibular joint by direct sagittal computed tomography. Clin Radiol 1985; 36 : 291-6. https://doi.org/10.1016/S0009-9260(85)80067-2
  7. Christiansen EL, Thompson JR, Hasso AN. CT evaluation of trauma to the temporomandibular joint. J Oral Maxillofac Surg 1987; 45 : 920-3. https://doi.org/10.1016/0278-2391(87)90441-1
  8. Chayra GA, Meador LR, Laskin DM. Comparison of panoramic and standard radiographs for the diagnosis of mandibular fractures. J Oral Maxillofac Surg 1986; 44 : 677-9. https://doi.org/10.1016/0278-2391(86)90034-0
  9. Nair MK, Nair UP. Imaging of mandibular trauma: ROC analysis. Acad Emerg Med 2001; 8 : 689-95. https://doi.org/10.1111/j.1553-2712.2001.tb00186.x
  10. Reiner SA, Schwartz DL, Clark KF, Markowitz NR. Accurate radiographic evaluation of mandibular fractures. Arch Otolaryngol Head Neck Surg 1989; 115 : 1083-5. https://doi.org/10.1001/archotol.1989.01860330073020
  11. Lee JH, Jung YH, Cho BH, Hwang DS. Diagnostic ability of panoramic radiographs for mandibular fractures. Korean J Oral Maxillofac Radiol 2010; 40 : 33-8.
  12. Zachariades N, Mezitis M, Mourouzis C, Papadakis D, Spanou A. Fractures of the mandibular condyle: a review of 466 cases. Literature review, reflections on treatment and proposals. J Craniomaxillofac Surg 2006; 34 : 421-32. https://doi.org/10.1016/j.jcms.2006.07.854
  13. Wilson IF, Lokeh A, Benjamin CI, Hilger PA, Hamlar DD, Ondrey FG, et al. Prospective comparison of panoramic tomography (zonography) and helical computed tomography in the diagnosis and operative management of mandibular fractures. Plast Reconstr Surg 2001; 107 : 1369-75. https://doi.org/10.1097/00006534-200105000-00008
  14. Yamaoka M, Furusawa K, Iguchi K, Tanaka M, Okuda D. The assessment of fracture of the mandibular condyle by use of computerized tomography. Incidence of sagittal split fracture. Br J Oral Maxillofac Surg 1994; 32 : 77-9. https://doi.org/10.1016/0266-4356(94)90131-7
  15. Cohen J. A coefficient of agreement for nominal scales. Educ Psychol Meas 1960; 20 : 37-46. https://doi.org/10.1177/001316446002000104
  16. Moilanen A. Primary radiographic diagnosis of fractures in the mandible. Int J Oral Surg 1982; 11 : 299-303. https://doi.org/10.1016/S0300-9785(82)80029-X
  17. Wilson IF, Lokeh A, Benjamin CI, Hilger PA, Hamlar DD, Ondrey FG, et al. Contribution of conventional axial computed tomography (nonhelical), in conjunction with panoramic tomography (zonography), in evaluating mandibular fractures. Ann Plast Surg 2000; 45 : 415-21. https://doi.org/10.1097/00000637-200045040-00011
  18. Assael LA. Clinical aspects of imaging in maxillofacial trauma. Radiol Clin North Am 1993; 31 : 209-20.
  19. Lee CY, McCullon C 3rd, Blaustein DI, Mohammadi H. Sequelae of unrecognized, untreated mandibular condylar fractures in the pediatric patient. Ann Dent 1993; 52 : 5-8.
  20. Rowe NL. Fractures of the facial skeleton in children. J Oral Surg 1968; 26 : 505-15. https://doi.org/10.1016/0030-4220(68)90331-9
  21. Hovinga J, Boering G, Stegenga B. Long-term results of nonsurgical management of condylar fractures in children. Int J Oral Maxillofac Surg 1999; 28 : 429-40. https://doi.org/10.1016/S0901-5027(99)80056-3

피인용 문헌

  1. Dental students' ability to detect maxillary sinus abnormalities: A comparison between panoramic radiography and cone-beam computed tomography vol.49, pp.3, 2019, https://doi.org/10.5624/isd.2019.49.3.191