A comparison of panoramic radiography and cone beam CT in the detection of osteosynthesis complications in sheep mandibular angle fractures

Publication date: Available online 16 October 2018

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Author(s): Yigit Sirin, Senem Yildirimturk, Emre Aytugar, Sirmahan Cakarer, Sinan Horasan, Koray Guven

Abstract

Objective

To compare the diagnostic efficacy of panoramic radiography (PANO) and cone beam computed tomography (CBCT) in detecting simulated complications of plate osteosynthesis applied to mandibular angle fractures (MAFs).

Study Design

Unfavorable MAFs were created in 100 fresh sheep hemimandibles. Fractures were fixed with 4-hole titanium miniplates and screws. Bone necrosis around the screws, penetration of the screw into the inferior alveolar canal, screw loosening, and plate breakage were simulated. Diagnostic efficacy of the imaging techniques was compared by intra- and inter-observer agreement scores and area under the receiver operating characteristic curve (AUC) values. Examination time (ET), confidence scores (CS) and planar preference (PP) in CBCT evaluation were assessed.

Results

Intra- and inter-observer agreement scores varied between 0.61 and 0.91. AUCs for screw penetration into the IAC and screw loosening were significantly higher in CBCT than PANO (p < .05). CBCT presented significantly higher ET and CS values than PANO (p < .05). PP showed significant differences among types of complications (p < .05).

Conclusions

PANO provided acceptable outcomes in the detection of bone necrosis and broken plates around the screw, but CBCT was more likely to enable detection of all simulated types of complications with higher confidence.

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