Imaging Sci Dent.  2011 Jun;41(2):53-57. 10.5624/isd.2011.41.2.53.

Diagnostic performance of dental students in identifying mandibular condyle fractures by panoramic radiography and the usefulness of reference images

• Cho BH

• KMID: 1449935
• DOI: http://doi.org/10.5624/isd.2011.41.2.53

Abstract

PURPOSE
The purpose of this study was to evaluate the diagnostic performance of dental students in detection of mandibular condyle fractures and the effectiveness of reference panoramic images.
MATERIALS AND METHODS
Forty-six undergraduates evaluated 25 panoramic radiographs for condylar fractures and the data were analyzed through receiver operating characteristic (ROC) analysis. After a month, they were divided into two homogeneous groups based on the first results and re-evaluated the images with (group A) or without (group B) reference images. Eight reference images included indications showing either typical condylar fractures or anatomic structures which could be confused with fractures. Paired t-test was used for statistical analysis of the difference between the first and the second evaluations for each group, and student's t-test was used between the two groups in the second evaluation. The intra- and inter-observer agreements were evaluated with Kappa statistics.
RESULTS
Intra- and inter-observer agreements were substantial (k=0.66) and moderate (k=0.53), respectively. The area under the ROC curve (Az) in the first evaluation was 0.802. In the second evaluation, it was increased to 0.823 for group A and 0.814 for group B. The difference between the first and second evaluations for group A was statistically significant (p<0.05), however there was no statistically significant difference between the two groups in the second evaluation.
CONCLUSION
Providing reference images to less experienced clinicians would be a good way to improve the diagnostic ability in detecting condylar fracture.

Keyword

Radiography, Panoramic; Mandibular Condyle; Mandibular Fractures

MeSH Terms

Humans
Mandibular Condyle
Mandibular Fractures
Radiography, Panoramic
ROC Curve
Students, Dental

Figure

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  Fig. 1 Panoramic (A) and cone beam CT (B) images show sagittal splitting (white arrow) and condylar neck (black arrow) fracture.

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  Fig. 2 Panoramic image shows soft palate (thick white arrow), subcondylar fracture (thick black arrow), spine of sphenoid bone (thin black arrow), and pharyngeal wall (thin white arrow).

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  Fig. 3 Area under ROC curve.

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