J Periodontal Implant Sci.  2018 Oct;48(5):317-325. 10.5051/jpis.2018.48.5.317.

Panoramic radiography can be an effective diagnostic tool adjunctive to oral examinations in the national health checkup program

• Kweon HH
• Lee JH
• Youk TM
• Lee BA
• Kim YT

• KMID: 2424865
• DOI: http://doi.org/10.5051/jpis.2018.48.5.317

Abstract

PURPOSE
We investigated correlations between the findings of oral examinations and panoramic radiography in order to determine the efficacy of using panoramic radiographs in screening examinations.
METHODS
This study included patients who visited dental clinics at National Health Insurance Service (NHIS) Ilsan Hospital for checkups during 2009-2015 and underwent panoramic radiographic examinations within 1 year prior to the oral examinations. Among the 48,006 patients who received checkups, 1,091 were included in this study. The data were evaluated using the Cohen kappa and interrater agreement coefficients. Accuracy, sensitivity, and specificity were calculated using data from the panoramic radiographs as true positive diagnoses.
RESULTS
The interrater agreement coefficient for occlusal caries was 28.8%, and the Cohen kappa coefficient was 0.043 between the oral and panoramic radiographic examinations. Root caries and subgingival calculus were only found on the radiographs, while gingival inflammation was found only by the oral examinations. The oral examinations had a specificity for detecting occlusal dental caries of 100%, while their sensitivity for proximal dental caries and supragingival calculus was extremely low (14.0% and 18.3%, respectively) compared to the panoramic radiographic examinations. The oral examinations showed a relatively low sensitivity of 66.2% and a specificity of 43.7% in detecting tooth loss compared with panoramic radiography.
CONCLUSIONS
Panoramic radiography can provide information that is difficult to obtain in oral examinations, such as root caries, furcation involvement, and subgingival calculus, which are factors that can directly affect the survival rate of teeth. It therefore seems reasonable and necessary to add panoramic radiography to large-scale health checkup programs such as that provided by the NHIS.

Keyword

Dental radiography; Diagnosis; National Health Program; Panoramic radiography

MeSH Terms

Calculi
Dental Caries
Dental Clinics
Diagnosis
Diagnosis, Oral*
Humans
Inflammation
Mass Screening
National Health Programs
Radiography, Dental
Radiography, Panoramic*
Root Caries
Sensitivity and Specificity
Survival Rate
Tooth
Tooth Loss

Figure

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  Figure 1 Study flow diagram of patient inclusion.

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  Figure 2 Relationship between the timing of NHIS health checkups and panoramic radiography. NHIS: National Health Insurance Service.

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