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Cross-sectional tomograms obtained with four panoramic radiographic units in the assessment of implant site measurements

Department of Oral Radiology, Institute of Dentistry, University of Helsinki, Finland

*Correspondence to: JS Peltola, Department of Oral Radiology, Institute of Dentistry, PO Box 41 (Mannerheimintie 172), FI-00014 University of Helsinki, Finland; Email: jaakko.peltola{at}helsinki.fi

Received 27 April 2004; revised 30 August 2004; accepted 30 August 2004

Objectives: The aim of this study was to evaluate the ability of four panoramic X-ray units to produce cross-sectional images and to assess the effect of interexaminer and intraexaminer variations on the results.

Methods: Cross-sectional tomograms of a human cadaver mandible were taken from two edentulous and one dentate area using four different X-ray units: OP-100 Ortho Trans^® (Instrumentarium Imaging Co, Tuusula, Finland), Proscan^® (Planmeca Co, Helsinki, Finland), Cranex-Tome^® and Scanora^® (Soredex, Orion Co, Espoo, Finland). Four different linear distances were measured from each radiograph. The mandible was then cut into 4 mm thick slices at three marked places. These slices were microradiographed and used as the gold standard for measurements made from each cross-sectional tomogram.

Results: Of all measurements only the thickness of the mandible in the radiographs taken with the OP-100 differed significantly (P<0.021) from the gold standard. In the interexaminer variation, the agreement was 85% and Kappa index 0.68. In the intraexaminer reproducibility, the agreement was 76.7% and Kappa indices 0.52 and 0.50.

Conclusions: The X-ray units studied were found to be similar in terms of image performance and the produced images were acceptable for dental implant placement planning. Interexaminer and intraexaminer variations can be large and the main source of error can be the interpreter him or herself.

Keywords: radiology; cross-sectional tomography; panoramic radiography; dental implantation

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