Ability of Orthodontists to Detect, Interpret and Propose Management Strategies for Incidental Findings on Pre-Treatment Panoramic Radiographs

IF 2.4 3区 医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE
Madeleine Edmonds, Susanne Perschbacher, Iacopo Cioffi, Marco Magalhaes
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引用次数: 0

Abstract

Objectives

Radiographs are routinely acquired for orthodontic evaluation, and incidental findings (IFs) may be detected early as part of this routine care. This study aimed to assess the prevalence of IFs on panoramic radiographs taken for orthodontic assessment and evaluate the ability of orthodontists to detect, interpret and recommend management for IFs.

Materials and Methods

A retrospective analysis of 1756 patients aged 7–21 with a panoramic image taken for orthodontic evaluation was performed. IFs were categorised by anatomic region and assigned a significance level based on a custom-made risk assessment tool. Twelve selected images were evaluated by 30 orthodontists via a standardised online survey. Participants were tasked with reviewing each image, providing a radiological interpretation, and indicating whether a referral would be needed prior to commencing orthodontic treatment. The responses were scored against those of an expert oral and maxillofacial radiologist (OMFR). Inter-observer agreement was evaluated by computing the Cohen's K.

Results

The prevalence of IFs was 30.8%. The most common findings were impacted teeth (17.7%), hypodontia (14.9%) and dense bone islands (14.7%). After applying the risk assessment tool, 35% of the findings were considered highly significant. The overall agreement between the orthodontists and OMFR was k = 0.32 (95% CI = 0.30–0.34). The agreement for location was 0.52 (95% CI = 0.47–0.58), whereas it was k = 0.45 (95% CI = 0.40–0.50) for diagnosis and k = 0.19 (95% CI = 0.13–0.24) for referral need.

Conclusions

Orthodontists may benefit from additional education and training focused on interpretation and management of IFs on panoramic radiographs.

正畸医师对治疗前全景x线片意外发现的检测、解释和提出处理策略的能力。
目的:正畸评估通常需要x线片,作为常规护理的一部分,可以早期发现偶然发现(if)。本研究旨在评估用于正畸评估的全景x线片上IFs的患病率,并评估正畸医师检测、解释IFs并建议治疗IFs的能力。材料与方法:回顾性分析1756例7 ~ 21岁患者的正畸评价全景影像。IFs按解剖区域分类,并根据定制的风险评估工具分配显著性水平。30名正畸医生通过标准化的在线调查对12张选定的图像进行评估。参与者的任务是审查每张图像,提供放射学解释,并指示在开始正畸治疗之前是否需要转诊。对专家口腔颌面放射学家(OMFR)的回答进行评分。通过计算Cohen’s k来评估观察者间的一致性。结果:IFs患病率为30.8%。最常见的表现是埋伏牙(17.7%)、牙下畸形(14.9%)和密集的骨岛(14.7%)。应用风险评估工具后,35%的发现被认为是高度显著的。正畸医生和OMFR之间的总体一致性k = 0.32 (95% CI = 0.30-0.34)。地点一致性为0.52 (95% CI = 0.47-0.58),而诊断一致性为k = 0.45 (95% CI = 0.40-0.50),转诊需求一致性为k = 0.19 (95% CI = 0.13-0.24)。结论:正畸医生可能受益于额外的教育和培训,重点是全景x线片上IFs的解释和管理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Orthodontics & Craniofacial Research
Orthodontics & Craniofacial Research 医学-牙科与口腔外科
CiteScore
5.30
自引率
3.20%
发文量
65
审稿时长
>12 weeks
期刊介绍: Orthodontics & Craniofacial Research - Genes, Growth and Development is published to serve its readers as an international forum for the presentation and critical discussion of issues pertinent to the advancement of the specialty of orthodontics and the evidence-based knowledge of craniofacial growth and development. This forum is based on scientifically supported information, but also includes minority and conflicting opinions. The objective of the journal is to facilitate effective communication between the research community and practicing clinicians. Original papers of high scientific quality that report the findings of clinical trials, clinical epidemiology, and novel therapeutic or diagnostic approaches are appropriate submissions. Similarly, we welcome papers in genetics, developmental biology, syndromology, surgery, speech and hearing, and other biomedical disciplines related to clinical orthodontics and normal and abnormal craniofacial growth and development. In addition to original and basic research, the journal publishes concise reviews, case reports of substantial value, invited essays, letters, and announcements. The journal is published quarterly. The review of submitted papers will be coordinated by the editor and members of the editorial board. It is policy to review manuscripts within 3 to 4 weeks of receipt and to publish within 3 to 6 months of acceptance.
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