Accuracy of digital panoramic radiography in the diagnosis of temporal bone pneumatization: A study in vivo using cone-beam-computed tomography

PurposeThe objective of the study was to determine the diagnostic accuracy of panoramic radiographs in the evaluation of pneumatization of the temporal bone, with confirmation of the diagnosis by cone-beam-computed tomography (CBCT) images.MethodsImages of 200 patients' digital panoramic radiographies and CBCT were examined by three evaluators regarding the presence or absence of pneumatization on temporomandibular joint (TMJ) fossa and/or articular eminence. When present, the defect was classified as uni- or multilocular, and as unilateral or bilateral. Areas under the ROC curve were compared to assess the accuracy of panoramic radiograph.ResultsThe values obtained in the comparisons ranged from Az = 0.67 to 0.55 (Az = area under the ROC curve).ConclusionsThe panoramic radiograph, is not the exam of choice for detecting the presence of these air cells based on its medium to low accuracy for diagnosis of pneumatized articular eminence and TMJ fossa when compared to CBCT.