Accuracy of panoramic radiography in diagnosing maxillary sinus-root relationship: A systematic review and meta-analysis.

OBJECTIVE: To investigate the accuracy of panoramic radiography (PR) in diagnosing maxillary sinus-root relationships (SRRs). MATERIALS AND METHODS: PubMed, EMBASE, CENTRAL, Web of Science, ScienceDirect, CBM, Baidu Scholar, and SIGLE were searched. The studies comparing the diagnostic accuracy of PR and computed tomography/cone-beam computed tomography (CT/CBCT) for SRR were included. RESULTS: Eleven studies were included. Meta-analyses showed that, for type I SRR, PR had the highest specificity, positive likelihood ratio (+LR), diagnostic odds ratio (DOR), and area under the curve (AUC), with a high sensitivity and a low negative LR (-LR). For type IV, PR had a high DOR and AUC, with the highest sensitivity but a low +LR, the lowest -LR, and the lowest specificity. For type II, PR had the lowest AUC, with a low sensitivity, +LR, and DOR and a high -LR. For type III, PR had the lowest sensitivity, +LR, and DOR and the highest -LR. The distance from root tips to the maxillary sinus floor on PR was significantly longer (mean difference: -1.88 mm; 95% confidence interval: -2.19 to -1.57; P < .0001) than that on CT/CBCT. CONCLUSIONS: Currently available evidence suggests PR could be reliable for detecting type I SRR. PR has a good ability to confirm true type IV SRR but a poor ability to rule out false type IV SRR. For type II and III SRR, PR shows poor accuracy and tends to overestimate the extent of protrusion of the roots into the maxillary sinus. When PRs display type II, III, or IV SRR and related treatment is needed, CBCT should be used for further examinations.

[1]  Myria Petrou,et al.  How to Perform a Systematic Review and Meta-analysis of Diagnostic Imaging Studies. , 2018, Academic radiology.

[2]  Hyo-sang Park,et al.  Differences in distances between maxillary posterior root apices and the sinus floor according to skeletal pattern , 2017, American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics.

[3]  H. C. Kim,et al.  Anatomical relationship of maxillary posterior teeth with the sinus floor and buccal cortex , 2017, Journal of oral rehabilitation.

[4]  K. Burde,et al.  Correlation between maxillary sinus floor topography and relative root position of posterior teeth using Orthopantomograph and Digital Volumetric Tomography , 2017 .

[5]  T. V. Arx,et al.  Clinical Oral Anatomy: A Comprehensive Review for Dental Practitioners and Researchers , 2016 .

[6]  D. Freitas,et al.  Comparison of panoramic radiography and CBCT to identify maxillary posterior roots invading the maxillary sinus. , 2016, Dento maxillo facial radiology.

[7]  Jia-qiang Liu,et al.  [Condylar morphological changes before and after orthodontic treatment for angle Class I malocclusion adult patients]. , 2016, Shanghai kou qiang yi xue = Shanghai journal of stomatology.

[8]  J. Stone,et al.  Applications of Cone-Beam Computed Tomography in Oral and Maxillofacial Surgery: An Overview of Published Indications and Clinical Usage in United States Academic Centers and Oral and Maxillofacial Surgery Practices. , 2016, Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons.

[9]  B. Wei,et al.  An Analysis of the Proximity of Maxillary Posterior Teeth to the Maxillary Sinus Using Cone-beam Computed Tomography. , 2016, Journal of endodontics.

[10]  H. Oh,et al.  [Orthodontic tooth movement through the maxillary sinus in an adult with multiple missing teeth]. , 2015, L' Orthodontie francaise.

[11]  S. Kang,et al.  Proximity of Posterior Teeth to the Maxillary Sinus and Buccal Bone Thickness: A Biometric Assessment Using Cone-beam Computed Tomography. , 2015, Journal of endodontics.

[12]  A. Navab-Azam,et al.  Investigating the Correlation between Panoramic and CBCT of Roots of Posterior Upper Teeth with Maxillary Sinus Floor , 2015 .

[13]  G. Roque-Torres,et al.  2D and 3D imaging of the relationship between maxillary sinus and posterior teeth , 2015 .

[14]  M. Motoyoshi,et al.  Maxillary sinus perforation by orthodontic anchor screws. , 2015, Journal of oral science.

[15]  Raviraj Jayam,et al.  Comparison of panoramic radiograph with cone-beam computed tomography in assessment of maxillary sinus floor and nasal floor , 2015 .

[16]  M. Bornstein,et al.  Proximity of premolar roots to maxillary sinus: a radiographic survey using cone-beam computed tomography. , 2014, Journal of endodontics.

[17]  Shamshiri Ahmad Reza,et al.  ACCURACY OF PANORAMIC RADIOGRAPHS IN DETERMINING THE RELATIONSHIP OF POSTERIOR ROOT APICES AND MAXILLARY SINUS FLOOR BY CONE-BEAM CT , 2014 .

[18]  I. Rubira-Bullen,et al.  Maxillary sinus and posterior teeth: accessing close relationship by cone-beam computed tomographic scanning in a Brazilian population. , 2013, Journal of endodontics.

[19]  Y. Jung,et al.  Assessment of the relationship between the maxillary molars and adjacent structures using cone beam computed tomography , 2012, Imaging science in dentistry.

[20]  Scott D Ganz,et al.  Position statement of the American Academy of Oral and Maxillofacial Radiology on selection criteria for the use of radiology in dental implantology with emphasis on cone beam computed tomography. , 2012, Oral surgery, oral medicine, oral pathology and oral radiology.

[21]  Susan Mallett,et al.  QUADAS-2: A Revised Tool for the Quality Assessment of Diagnostic Accuracy Studies , 2011, Annals of Internal Medicine.

[22]  R. B. Howe.  First molar radicular bone near the maxillary sinus: a comparison of CBCT analysis and gross anatomic dissection for small bony measurement. , 2009, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[23]  Y. Jung,et al.  Comparison of panoramic radiography and cone beam computed tomography for assessing the relationship between the maxillary sinus floor and maxillary molars , 2009 .

[24]  D. Madjar,et al.  Correlation between maxillary sinus floor topography and related root position of posterior teeth using panoramic and cross-sectional computed tomography imaging. , 2006, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[25]  Jonathan J Deeks,et al.  The performance of tests of publication bias and other sample size effects in systematic reviews of diagnostic test accuracy was assessed. , 2005, Journal of clinical epidemiology.

[26]  K. Koh,et al.  Topographic anatomy of the inferior wall of the maxillary sinus in Koreans. , 2004, International journal of oral and maxillofacial surgery.

[27]  M. Torabinejad,et al.  A computed tomographic study of the distances between the maxillary sinus floor and the apices of the maxillary posterior teeth. , 1992, Oral surgery, oral medicine, and oral pathology.

[28]  J. D. PÉcora,et al.  Study of Anatomical Relationship between Posterior Teeth and Maxillary Sinus Floor in a Subpopulation of the Brazilian Central Region Using Cone-Beam Computed Tomography - Part 2. , 2016, Brazilian dental journal.

[29]  Shakhawan M. Ali,et al.  The Relation of Maxillary Posterior Teeth Roots to the Maxillary Sinus Floor Using Panoramic and Computed Tomography Imaging in a Sample of Kurdish People , 2013 .

[30]  Clinical recommendations regarding use of cone beam computed tomography in orthodontics. [corrected]. Position statement by the American Academy of Oral and Maxillofacial Radiology. , 2013, Oral surgery, oral medicine, oral pathology and oral radiology.

[31]  D. Moher,et al.  Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. , 2010, International journal of surgery.

[32]  H. Wehrbein,et al.  [The effect of the maxillary sinus floor on orthodontic tooth movement]. , 1990, Fortschritte der Kieferorthopadie.