AN ANALYSIS OF THE SCIENTIFIC BASIS FOR THE RADIOGRAPHIC GUIDELINE FOR NEW EDENTULOUS PATIENTS

The FDA Radiology Guideline for the new edentulous patient recommends an initial survey of the arches. In the process of developing this rec ommendation, the expert panel reviewed the available literature and co ncluded that there was sufficient evidence to warrant screening radiog raphy rather than selective radiography, which is the principle on whi ch all the other recommendations are based. Our evaluation of the lite rature used by the panel for the edentulous recommendation identifies critical errors in the analysis of the data. Factors such as a vague d efinition of abnormality and a geographically diverse sample populatio n might have led the expert panel to suggest a very conservative recom mendation for this group of patients. The recommendation failed to con sider the treatment impact of findings and was based simply on the lar ge number of observations, regardless of their treatment or pathologic significance. However, in studies in which treatment is considered, i t is clear that screening radiography for new edentulous patients does not yield sufficient clinically relevant information to support the g uideline.