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Diagnostic agreement between panoramic radiographs and color doppler images of carotid atheroma
Romano-Sousa, Claudia Maria;Krejci, Laís;Medeiros, Flavilene Marchioro Martins;Graciosa-Filho, Ricardo Gomes;Martins, Maria Fernanda Fonseca;Guedes, Vanessa Novaes;Fenyo-Pereira, Marlene;
Journal of Applied Oral Science , 2009, DOI: 10.1590/S1678-77572009000100009
Abstract: the aim of this study was to investigate the agreement between diagnoses of calcified atheroma seen on panoramic radiographs and color doppler images. our interest stems from the fact that panoramic images can show the presence of atheroma regardless of the level of obstruction detected by color doppler images. panoramic and color doppler images of 16 patients obtained from the archives of the health department of the city of valen?a, rj, brazil, were analyzed in this study. both sides of each patient were observed on the images, with a total of 32 analyzed cervical regions. the level of agreement between diagnoses was analyzed using the kappa statistics. there was a high level of agreement, with a kappa value of 0.78. in conclusion, panoramic radiographs can help detecting calcifications in the cervical region of patients susceptible to vascular diseases predisposing to myocardial infarction and cerebrovascular accidents. if properly trained and informed, dentists can refer their patients to a physician for a cardiovascular evaluation in order to receive proper and timely medical treatment.
Prevalence of calcified carotid artery on panoramic radiographs in postmenopausal women
Jamileh Beigom Taheri,Mahkameh Moshfeghi
Journal of Dental Research, Dental Clinics, Dental Prospects , 2009,
Abstract: Background and aims. This study was designed to evaluate the prevalence of calcified carotid artery in 50 year-old and older postmenopausal dental outpatients for early diagnosis of individuals at risk of stroke. Materials and methods. This is a descriptive study of 200 panoramic radiographs. These radiographs included postmenopausal women referring to the Department of Oral Medicine at Shahid Beheshti Faculty of Dentistry during 2006-2007. The x-ray machine, developer and film type were the same for all the radiographs. Statistical analysis included chi-square test and Fisher’s exact test. Results. We found 22 calcified carotid arteries. The left and right carotid arteries were involved in 7 and 9 cases, respectively. In 6 cases both carotid arteries were calcified. Four individuals had no vascular risk factor excluding age and others had at least one risk factor. We found significant statistical correlation between hypertension, past history of myocardial infarction, and hypercholesterolemia with calcified carotid artery on panoramic radiographs. Conclusion. Under the limitations of the present study, prevalence of calcified carotid arteries is 11.0 % in 50 year-old and older postmenopausal dental outpatients.
Clinical Applications of Reverse Panoramic Radiography
Sujatha S Reddy,Atul Kaushik,Surya Prakash DR
Dental Hypotheses , 2011,
Abstract: The essence of oral and maxil-lofacial radiology is not only to be an important tool in the diagnostic assessment of dental patients but also to equip the clinician with the ability to interpret images of certain maxillocraniofacial structures of importance to dental, medical and surgical practices. Although combinations of several conven-tional x-ray projections can be adequate in a number of clinical situations, radiographic assessment of certain craniofacial structures some-times needs to be facilitated by other imaging modalities. A not-so-recent development called reverse panoramic radiography may be a useful adjuvant to such a situation, at least in the near future. It is essentially a technique where the patient is placed backwards in the panoramic machine in a reverse position in such a way that x-ray beam is directed through the patient’s face and the exit beam then passes through the patient’s head on the opposite side where it is captured on the receptor. The following manuscript is an attempt to throw light on this technique and the impact it may have on dental, medical and surgical practices. The advantages and disadvantages of reverse panoramic radiography and it’s comparison to conventional panoramic radiographs and other skull views are also dis-cussed.
Ultrasound screening for asymptomatic carotid stenosis in subjects with calcifications in the area of the carotid arteries on panoramic radiographs: a cross-sectional study
Elias P Johansson, Jan Ahlqvist, Maria Garoff, Kjell Karp, Eva J?ghagen, Per Wester
BMC Cardiovascular Disorders , 2011, DOI: 10.1186/1471-2261-11-44
Abstract: This was a cross-sectional study. Carotid ultrasound examinations were performed on consecutive persons, with findings of calcifications in the area of the carotid arteries on panoramic radiography that were otherwise eligible for asymptomatic carotid endarterectomy.Calcification in the area of the carotid arteries was seen in 176 of 1182 persons undergoing panoramic radiography. Of these, 117 fulfilled the inclusion criterion and were examined with carotid ultrasound. Eight persons (6.8%; 95% CI 2.2-11.5%) had a carotid stenosis - not significant over the 5% pre-specified threshold (p = 0.232, Binomial test). However, there was a significant sex difference (p = 0.008), as all stenoses were found in men. Among men, 12.5% (95%CI 4.2-20.8%) had carotid stenosis - significantly over the 5% pre-specified threshold (p = 0.014, Binomial test).The incidental finding of calcification in the area of the carotid arteries on panoramic radiographs should be followed up with carotid screening in men that are otherwise eligible for asymptomatic carotid endarterectomy.The study was registered at http://www.clinicaltrials.gov webcite; NCT00514644In patients with asymptomatic carotid stenosis, carotid endarterectomy (CEA) reduces the net risk of stroke and perioperative events at 5 [1] and 10 years follow-up [2]. Patients ≥ 75 years of age do not benefit from asymptomatic CEA [2]. The benefit of asymptomatic CEA has come into question since a lower risk of stroke without CEA has been shown in recent observational studies compared to the randomized studies [3]. This can, at least in part, be explained by that lipid lowering medications were less commonly used during the time period of these randomized trials [3]. Current guidelines suggest that asymptomatic CEA should only be performed when the perioperative risk is low [4-6]. One ongoing randomized study will determine if patients with statin and other cardiovascular preventive treatment benefit from asymptomatic CEA [7]. There is l
Evaluation of the Accuracy of Panoramic Radiography in Linear Measurements of the Jaws  [PDF]
S.H. Hoseini Zarch,A. Bagherpour,A. Javadian Langaroodi,A. Ahmadian Yazdi
Iranian Journal of Radiology , 2011,
Abstract: Background/Objective: Panoramic radiography has a great place among imaging techniques because of its enormous advantages. One of the characteristics of an ideal imaging technique is to supply precise measurement. The purpose of the current study was to evaluate the accuracy of linear measurements of the jaws on panoramic radiographs.Patients and Methods: In this study, the vertical distances between the metal markers were measured by panoramic radiography in seven sites of two skulls in various head positions. Then the radiographic measurements were compared with the actual values.Results: Eighty three percent of the measurements were underestimated, 8.5% were overestimated on panoramic radiography and 8.5% of the measurements had no difference with the real measurements. Overestimation was not greater than 1 mm. The difference between actual and radiographic measurements was less in the posterior areas and in the mandible . In all head positions, the greatest difference between actual and radiographic measurements occurred in the anterior area.Conclusion: Based on the results of this study, linear measurements on panoramic radiography are more reliable in the posterior areas and may be used in early clinical measurements.
Comparison of conventional panoramic radiography and panoramic digital subtraction radiography in detection of simulated lesions of mandibular condyle
Panjnoush M.,Ghoncheh Z.,Sarrafzadeh A.
Journal of Dental Medicine , 2008,
Abstract: "n "nBackground and Aim: Digital subtraction Radiography (DSR) is a method of accurate assessing condylar head changes. several studies have been carried out in applying DSR in dentistry, however there is a few number of studies in efficacy of DSR method in assesment of condylar head changes, The aim of this study was to compare panoramic radiography and DSR detecting simulated lesions of the mandibular condyl. "nMaterials and Methods: this was a process reaserch study, in which two dry human skulls with no obvious temporomandibular joint pathology were used. Osteophytic lesions were simulated using three sizes of bone chips that were placed on the medial portion of anterior and superolateral aspects of the condyle. Osteolytic lesions were simulated making 1 and 2 mm holes using round burr in the central portion of anterior aspect and Lateral pole of the condyle. Panoramic radiographs were prepared with and without the lesions in place. These paired radiographs were digitized and digital- subtraction images of the original panoramic images were obtained. Eight observers evaluated 155 images of each modality for the presence or absence and the type of simulated lesions of the mandibular condyle. Sensitivity, specificity, reliability and measure of agreement were analyzed using kappa test and crossed tables and qualitative variables were assess by chi-square and fisher's Exact test. "nResults: Specificity of panoramic and DSR methods were 15.4% and 66.7% respectively. Sensitivity of panoramic and DSR methods were 61.1% and 80.6% for osteophytic lesions and 37.5% and 83.3% for Osteolytic lesions. The percentage of correct decisions made in DSR method was significantly more than conventional panoramic method (82.6% vs 41.9%) (p<0.0001). "nConclusion: Based on the results of this study digital subtraction technique was significantly more accurate than the panoramic radiographs in detection of simulated lesions of the mandibular condyle.
Age assessment at the time of death based on panoramic radiography  [PDF]
?uri? Marija,Rako?evi? Zoran,Rankovi? Nenad
Vojnosanitetski Pregled , 2005, DOI: 10.2298/vsp0508557d
Abstract: Background. The determination of age at the time of death is an important method in forensic anthropology and paleodemography. The possible postmortem investigation of the teeth and jaws enables the determination of age at the time of death, as the bones and teeth are both resistant to degradation in soil and characterized by age-related morphological changes. The aim of this study was to determine whether the age-related changes visible on panoramic radiography correlated with age, and enabled the assessment of individual age. Methods. Seven radiographic parameters were used in the study: tooth loss, occlusal tooth wear, pulp stones, carious teeth, periapical disease, tooth restoration, and alveolar bone loss associated with periodontal disease. Results. The material comprised 314 dental panoramic tomograms of living patients of both sexes with documented age (18 to 77 years). Multiple regression equations were constructed for the age estimation, including four parameters (the number of missing teeth, the number of intact teeth, the distance of cement-enamel junction from the alveolar ridge, the number of abraded teeth). The nature of data treated by regression analysis required the careful choice of parameters, appropriate functional model for each parameter, and the experience of the investigator. With the four parameters included in equations, the error was ± 2.55 years. Conclusion. This preliminary analysis showed that the conventional regression technique could be appropriate for the age estimation based on panoramic radiography, and that an additional study with a larger sample and on wider population was required.
Parameters in panoramic radiography for differentiation of radiolucent lesions
Raitz, Ricardo;Assun??o Júnior, José Narciso Rosa;Correa, Luciana;Fenyo-Pereira, Marlene;
Journal of Applied Oral Science , 2009, DOI: 10.1590/S1678-77572009000500006
Abstract: objective: the aims of this study were to establish parameters in panoramic radiography for interpretation of unilocular radiolucent lesions, and to compare the accuracy of diagnoses given by examiners before and after using these parameters. material and methods: in part i, 12 specialists analyzed 24 images and the diagnostic criteria used by each examiner to make correct diagnoses were used to build a list of basic radiographic parameters for each pathology (ameloblastoma, keratocystic odontogenic tumor, dentigerous cyst, and idiopathic bone cavity). in part ii, this list was used by 6 undergraduate students (un), 8 recently graduated dentists (d), 3 oral pathologists, 3 stomatologists, 3 oral radiologists, and 3 oral surgeons to diagnose the corresponding pathologies in the other set of 24 panoramic radiographs (t2). the same analysis occurred without using this list (t1). the method of generalized estimating equations (gee) was used in order to estimate the probability of making a correct diagnosis depending on the specialty of the examiner, type of lesion, and moment of the evaluation, t1 or t2 (before or after they had access to the list of parameters, respectively). results: higher values were obtained for the probability (gee) of making a correct diagnosis on t2; the group un presented the highest improvement (14.6 %); no differences between the probabilities were observed either between un and d, or among the different groups of specialists. conclusions: the use of panoramic radiographic parameters did allow improving the diagnostic accuracy for all groups of examiners.
Comparison Ultrasound, Indirect Digital Panoramic Radiography in Differentional Radiolucent Mandible Lesions
Mojdeh Mehdizadeh,Bijan Movahedian,Mahshid Mehdizadeh,Mansoure Babasafari,Parisa Mohammadi
Research Journal of Biological Sciences , 2012,
Abstract: Comparing the accuracy of ultrasound and indirect digital panoramic radiography in diagnosis cystic and tumoral radiolucent mandible lesions. Ten patients aged between 12 and 50 years with jaw bone lesion were selected and consented for the study. Panoramic radiography was obtained and scanned to digital form. Measurements and provisional diagnoses of lesions were made. Preoperative ultrasound and color doppler with probe examination 12 MHz were preformed. Lesion observed for the size, contents, vascular supply and provisional diagnosis made as to whether the lesion was a cyst or tumor. Surgery was performed and histopathological investigation was made which provided the gold standard diagnosis. All measurements and findings compare and analyzed with spss 0.3 software test. Existing all lesions in panoramic radiography were significant. In areas which cortical bone was inadequate thin, ultrasound imaging was significant. In 8 cases: (6 cysts and 2 tumors) ultrasound results ware agreed with histopathological gold standard. But in two cases which cortical bone was not enough thin ultrasound could not diagnose the lesion there was no statistical difference between measurements in two techniques. Ultrasound is an established valuable diagnostic tool for lesions and is noninvasive although panoramic is able to diagnose the existing the legions but can not provide accurate information on the pathological nature of lesions.
Common positioning and technical errors in panoramic radiography  [PDF]
S Pandey,KM Pai,A Dhakal
Journal of Chitwan Medical College , 2014, DOI: 10.3126/jcmc.v4i1.10844
Abstract: Panoramic radiograph is one of the routinely used investigations in dentistry. The value of panoramic radiograph is reduced when they are of poor diagnostic quality. Therefore, the aim of the study is to be aware of the common positional and tech-nical errors so as to minimize such errors occurring in the department. Panoramic radiographs of all the patients, who were taking radiographs for their own diagnostic purpose, were examined. All Radiographs taken for a 3 months period were 1010. All panoramic radiographs examined for various errors. Data were analyzed for the frequency of some common faults, both technical and processing errors, which directly contributed to failure of the radiographs. Total 1010 radiographs were analyzed for errors. 27.5% (n=278) were showing errors which ranged from technical errors 11.3% ( n=14) to positional errors 16.2% (n=164) and 72.5% of radiographs were error free. Most common technical error was density/dark radiographs which were 45% (n=51) and the most common positional error found was tongue not resting against the palate, 20% (n=32). Dark radiograph and tongue not resting against the palate were found common errors. Fewer errors are likely to be made when a quality assurance regimen and proper training, which includes the recognition and correction of errors, is followed DOI: http://dx.doi.org/10.3126/jcmc.v4i1.10844 Journal of Chitwan Medical College 2014; 4(1): 26-29
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