Comparison of the diagnostic performance of panoramic and occlusal radiographs in detecting submandibular sialoliths

Abstract

PurposeThe aim of this study was to assess and compare the diagnostic performance of panoramic and occlusal radiographs in detecting submandibular sialoliths.Materials and MethodsA total of 40 patients (20 cases and 20 controls) were included in this retrospective study. Cases were defined as subjects with a submandibular sialolith confirmed by computed tomography (CT), whereas controls did not have any submandibular calcifications. Three observers with different expertise levels assessed panoramic and occlusal radiographs of all subjects for the presence of sialoliths. Intraobserver and interobserver agreement were assessed using the kappa test. Sensitivity, specificity, accuracy, positive and negative predictive values, and the diagnostic odds ratio of panoramic and occlusal radiographs in screening for submandibular sialoliths were calculated for each observer.ResultsThe sensitivity and specificity values for occlusal and panoramic radiographs all ranged from 80% to 100%. The lowest values of sensitivity and specificity observed among the observers were 82.6% and 80%, respectively (P=0.001). Intraobserver and interobserver agreement were higher for occlusal radiographs than for panoramic radiographs, although panoramic radiographs demonstrated a higher overall accuracy.ConclusionBoth panoramic and occlusal radiographic techniques displayed satisfactory diagnostic performance and should be considered before using a CT scan to detect submandibular sialoliths.

Difficulties in Diagnosis of Sialolithiasis: A Case Series

“…A number of tools and research methods are commonly used to diagnose sialolithiasis. Both panoramic and occlusal radiographic techniques have been demonstrated to display satisfactory diagnostic screening performance 6) . Approximately 20% of sialoliths are poorly calcified, and therefore not visible on 2D radiographs 5) .…”

3D Reconstruction and Prediction of Sialolith Surgery

“…A surgical focus facilitating the removal of the lesion safely and precisely, thus decreasing the patient's morbidity and preventing injuries to adjacent tissues, should be the main objective of all operative procedures [15, 16]. With this aim, previous planning and access direction become one of the key principles for removal of the lesion, that is, the more precise it is, the better the procedure.…”

Remoção cirúrgica de sialolito em glândula submandibular: relato de caso

“…O diagnóstico desta condição na glândula submandibular é feito por meio da associação da inspeção e palpação do soalho bucal e da região submandibular. A confirmação da presença do sialólito é realizada por exames de imagem como radiografias panorâmicas e oclusais, ultrassonografia, sialografias, tomografia computadorizada e ressonância nuclear magnética 5,6 . O paciente que apresenta esta condição pode referir dores e edema no trajeto do ducto ou na glândula envolvida dependendo do local da obstrução, associados à alimentação e subsequente sialoadenite 2,5,7 .…”

“…Quando o cálculo estiver localizado no interior da glândula ou porção proximal do ducto, faz-se necessária a sialodenectomia. Esta consiste na remoção completa da glândula submandibular 5,8 . Porém outras terapias como o uso de sialogogos com massagem glandular para promover a salivação e irrigar os pequenos sialólitos para o orifício do ducto, a litotripsia que fragmenta o cálculo por meio de ondas de choque e o uso de laser de dióxido de carbono (CO2) podem ser empregadas 2,5 .…”