Panoramik Radyografinin Temporomandibular Eklem Kemik Değişikliklerini Belirlemedeki Etkinliğinin Değerlendirilmesi

Abstract

Objective: To investigate the utility of panoramic radiography in determining bony changes in temporomandibular joint (TMJ) based on cone-beam computed tomography (CBCT) images. Material and Methods: Two hundred eight TMJs on panoramic radiography and CBCT images of 104 (55 male, 49 female) patients were examined. Erosion, flattening, subcortical sclerosis or cyst, osteophyte, loose joint bodies, generalized sclerosis and deviation in form on the mandibular condyle, flattening, subcortical sclerosis and erosion of the articular eminence and articular fossa were evaluated both on CBCT and panoramic images. Data were scored as follows: false positive, false negative, true positive and true negative, and statistically analyzed with SPSS software using chi-square test (p<0.05), Cohen's kappa, receiving operating characteristic curve analysis. Results: Flattening (51.4% on CBCT, 24% on panoramic) and erosion (50% on CBCT, 15.9% on panoramic) was most commonly detected on the condylar head (p˂0.05). In the articular eminence, flattening in 2.4% and erosion in 12.5% and the articular fossa flattening in 1% and erosion in 20.2% were detected on CBCT. Flattening and erosion of the articular eminence and articular fossa could not be determined by panoramic radiography. Bony change that the most (38.5%) scored as the false negative was erosion. Accuracy values of panoramic radiography for the detection of any osseous change was poor compared with CBCT images (≤50%). Conclusion: Panoramic radiography was inadequate for detecting bony changes in TMJ especially in articular eminence and articular fossa. Therefore, radiological examination should be supported with more reliable imaging modalities like CBCT to examine hard tissues of TMJ.