TEMPOROMANDIBULAR-JOINT IMAGING - A COMPARATIVE-STUDY OF DIAGNOSTIC-ACCURACY FOR THE DETECTION OF BONE CHANGE WITH BIPLANAR MULTIDIRECTIONAL TOMOGRAPHY AND PANORAMIC IMAGES

This in vitro investigation compares biplanar (sagittal and coronal) t emporomandibular joint images produced by multidirectional tomographic and panoramic techniques for diagnostic accuracy in the detection of simulated degenerative lesions. A series of dentin chips placed at fou r locations on the head of a temporomandibular joint condyle in a drie d human skull were imaged with tomographic and panoramic modalities. E qual numbers of images with and without chips were scored by four exam iners with the use of confidence levels for presence or absence of the lesion. To assess intra-examiner reliability, each examiner viewed on e of the modalities twice. Responses were assessed by generating recei ver operating characteristic curves and analyzing the area (A(z)) unde r the curves with analysis of variation methods. Biplanar tomography p rovided significantly more accurate assessment of condylar lesions tha n biplanar panoramic images (p = 0.007). No statistical difference by location (p = 0.592) was found. The effects of observer and repeated o bservation were marginally significant at p = 0.046 and p = 0.030, res pectively.