EVALUATION OF THE ACCURACY OF DIFFERENT IMAGING MODALITIES IN ORTHODONTIC DIAGNOSIS: A CLINICAL STUDY FROM PESHAWAR
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Keywords
Orthodontic diagnosis; Cone-beam computed tomography; Magnetic resonance imaging; Radiographs; Diagnostic accuracy; Temporomandibular joint; Impacted teeth; Airway analysis; Skeletal asymmetry
Abstract
Background: Precise imaging is essential for orthodontic diagnosis and treatment planning. Although conventional radiography are still prevalent, cone-beam computed tomography (CBCT) and magnetic resonance imaging (MRI) provide enhanced diagnostic functionalities. Nonetheless, comparative data regarding their diagnostic accuracy across several orthodontic applications is scarce.
Objective: To examine and compare the diagnostic precision of radiography, CBCT, and MRI in essential orthodontic diagnostic functions, including impacted tooth location, temporomandibular joint (TMJ) evaluation, airway analysis, and skeletal assessment.
Methods:
A prospective, comparative cross-sectional study was done to assess diagnostic accuracy among 90 orthodontic patients. All subjects received panoramic and lateral cephalometric radiographs, cone-beam computed tomography (CBCT), and magnetic resonance imaging (MRI) images. The diagnostic efficacy for impacted canines, temporomandibular joint problems, airway volume, and skeletal asymmetry was evaluated by three independent orthodontists. CBCT was utilized as the reference standard for osseous evaluations, while MRI was employed for soft tissue assessments. Diagnostic accuracy scores and inter-rater reliability were evaluated.
Results:
CBCT demonstrated the highest accuracy for impacted tooth localization (sensitivity: 98%, specificity: 95%) and skeletal assessment (sensitivity: 97%). MRI excelled in TMJ soft tissue evaluation (sensitivity: 96%), while radiographs had the lowest overall diagnostic accuracy. Inter-rater agreement was highest for CBCT (κ = 0.82–0.91), followed by MRI (κ = 0.74–0.85) and radiographs (κ = 0.66–0.79).
Conclusion:
In conclusion, CBCT offers enhanced diagnostic precision for orthodontic evaluations of hard tissues, whereas MRI is optimal for assessing TMJ soft tissues. Conventional radiographs, while beneficial for initial screening, provide restricted precision for intricate diagnostic functions. The choice of imaging modality must be determined by the particular clinical indication to enhance diagnostic results and reduce radiation exposure.
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.
Faizan Shafi
PG MDS Orthodontics, Practicing Dentist, Islamabad Dental Hospital, Pakistan
Muhammad Taaha Khan
BDS, MDS Resident Orthodontics, Sardar Begum Dental Colleges, Peshawar
Muhammad Sanan
BDS, House Officer, Sardar Begum Dental Colleges, Peshawar
Rehana Fayyaz
FCPS Orthodontics, Assistant Professor, KMU-IDS, Kohat,
Mir Hamza Khan
BDS, House Officer, Sardar Begum Dental Hospital, Peshawar
Ghayoor Ahmad
BDS, House Officer, Sardar Begum Dental Hospital, Peshawar