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Pantomography vs Mandibular Series for the Detection of Mandibular Fractures
Author(s) -
Guss David A.,
Clark Richard F.,
Peitz Tom,
Taub Marc
Publication year - 2000
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2000.tb00517.x
Subject(s) - medicine , mcnemar's test , radiography , dentistry , orthodontics , surgery , mathematics , statistics
. Objective: The two primary radiographic techniques used for the evaluation of mandible injury are a pantomographic series (PS) and the standard four‐view mandibular series (MS). Despite a tenuous foundation, there is apparent bias in favor of PS compared with MS. Many emergency departments do not have ready access to the specialized equipment necessary to perform a pantomographic study. The hypothesis of this study was that a high‐quality standard MS is as sensitive and specific as a PS in the detection of mandibular fractures. Methods: This was a prospective, blinded study of 54 patients presenting with acute mandibular injury comparing MS and PS. The study design used two board‐certified emergency physicians and a single staff radiologist who read a series of MS and PS films in a randomized fashion without access to clinical information or identifying patient data. The absolute number of fractures present was determined by a neuroradiologist with access to both MS and PS simultaneously as well as pertinent clinical information. Results: Thirty patients had 47 mandibular fractures. The sensitivity for fracture detection for each physician was 0.85, 0.77, and 0.89 with MS and 0.79, 0.74, and 0.83 with PS (p ≥ 0.51, p ≥ 1.00, and p ≥ 0.51, respectively, McNemar's binomial test). The specificity for fracture detection for each physician was 0.88, 0.92, and 0.96 for MS and 0.96, 1.00, and 0.92 for PS (p > 0.625, p > 0.50, and p = 1.00, respectively, McNemar's binomial test). Conclusions: A standard mandibular series is as sensitive and specific as pantomography in the detection of mandibular fractures.