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      Dental students’ levels of understanding normal panoramic anatomy

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          Abstract

          Background/purpose

          In dentistry, panoramic radiography is an important examination technique. The Faculty of Dentistry at Tokushima University educates students about panoramic radiographic anatomical landmarks. The purpose of this study was to investigate differences in the understanding of each panoramic anatomical landmark among students.

          Materials and methods

          This study analyzed the results of 40 fifth- and 79 sixth-year faculty students who had taken a written examination to clarify their knowledge of anatomical landmarks in 28 panoramic radiographic regions. Anatomical landmarks were classified into 3 categories: <bone structure>, <soft tissue/air layer>, and <ghost images > to compare correct answer rates.

          Results

          The mean overall correct answer rate by the 119 students for the 28 regions was 53%. The rate did not vary between the 2 academic years. On comparison of the 3 categories, significant differences were only observed between <bone structure> and <soft tissue/air layer>, as the values for the latter were lower. Among the anatomical landmarks, the rates for the condylar head, hyoid bone, panoramic innominate line, styloid process, and nasopalatine line were higher, and those for ghost images of the contralateral nasopalatine line, the cervical vertebrae, mandibular foramen, mastoid air cell, and posterior pharyngeal wall were lower. The values for <soft tissue/air layer>, such as the dorsum of tongue, middle and inferior nasal conche, and middle and inferior nasal meatuses, were also lower.

          Conclusion

          These results indicate the necessity of improving educational approaches for regions with lower rates of correct answers.

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          Most cited references3

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          Can dental students be taught to use dental radiographs for osteoporosis screening?

          This study investigated the possibility of teaching dental students to detect radiographic changes suggestive of osteoporosis. Twenty-five panoramic radiographs from dental school patients with a history of osteoporosis and radiographic changes suggestive of the disease and twenty-five normal panoramic radiographs were selected by a clinician from the database of the College of Dentistry, University of Tennessee Health Science Center. Twenty students were taught to use the mandibular cortical index (MCI) and detect changes suggestive of osteoporosis. Students also used a five-point scale to determine the diagnostic accuracy of panoramic images for osteoporosis. Intraclass Correlation Coefficient (ICCC) and Cronbach's alpha internal coefficiency statistical tests were used to evaluate interrater reliability among the twenty students and between the students and the radiologist. To test for differences in diagnosis between the gold standard (dental clinician) and the oral radiologist, we performed a McNemar's chi-square test for matched data. The interrater consistency was excellent for both the students (α=0.902) and between the students and the radiologist (α=0.909). The diagnostic accuracy of panoramic images was moderate (Az=0.81). No statistically significant difference between radiographic and clinical evaluations (McNemar's chi-square=3.063; p=0.0801) was observed. Teaching dental students to recognize radiographic changes suggestive of osteoporosis in routine panoramic radiographs should be emphasized to improve their awareness and identification of this disease.
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            The reliability of tablet computers in depicting maxillofacial radiographic landmarks

            Purpose This study was performed to evaluate the reliability of the identification of anatomical landmarks in panoramic and lateral cephalometric radiographs on a standard medical grade picture archiving communication system (PACS) monitor and a tablet computer (iPad 5). Materials and Methods A total of 1000 radiographs, including 500 panoramic and 500 lateral cephalometric radiographs, were retrieved from the de-identified dataset of the archive of the Section of Oral and Maxillofacial Radiology of the University Of Connecticut School Of Dental Medicine. Major radiographic anatomical landmarks were independently reviewed by two examiners on both displays. The examiners initially reviewed ten panoramic and ten lateral cephalometric radiographs using each imaging system, in order to verify interoperator agreement in landmark identification. The images were scored on a four-point scale reflecting the diagnostic image quality and exposure level of the images. Results Statistical analysis showed no significant difference between the two displays regarding the visibility and clarity of the landmarks in either the panoramic or cephalometric radiographs. Conclusion Tablet computers can reliably show anatomical landmarks in panoramic and lateral cephalometric radiographs.
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              Assessment of the knowledge of graduating American dental students about the panoramic image.

              The objective of this study was to assess the capability of graduating dental students to identify the causes of undiagnostic panoramic images and to interpret anatomic landmarks on panoramic films. Seventeen dental schools were represented by 311 students. A radiology faculty member at each institution completed a questionnaire that addressed lecture time and experience provided to students in panoramic radiography. The faculty member administered a test instrument comprised of several panoramic radiographs that demonstrated one or more labeled anatomic structures, technical errors, or projection artifacts and multiple choice questions that addressed each entity. The mean percentage correct for the tested population on the entire test instrument was 72.9%. The mean percentage correct for questions addressing anatomy, error and artifact recognition, and error correction was 84.0%, 61.4% and 45.2%, respectively. Factors that significantly (p or = 1) taken of patients did not significantly affect student performance on the test instrument.
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                Author and article information

                Contributors
                Journal
                J Dent Sci
                J Dent Sci
                Journal of Dental Sciences
                Association for Dental Sciences of the Republic of China
                1991-7902
                2213-8862
                29 August 2018
                December 2018
                29 August 2018
                : 13
                : 4
                : 374-377
                Affiliations
                [1]Department of Oral and Maxillofacial Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
                Author notes
                []Corresponding author. Department of Oral and Maxillofacial Radiology, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima City, Tokushima, 770-8504, Japan. maeda@ 123456tokushima-u.ac.jp
                Article
                S1991-7902(18)30148-X
                10.1016/j.jds.2018.08.002
                6388826
                aaf8b3c8-6890-437e-aab6-ee139a2e4f09
                © 2018 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 21 February 2018
                : 22 March 2018
                Categories
                Original Article

                panoramic radiograph,anatomical landmark,ghost image,education

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