Is the diagnosis of calcified laryngeal cartilages on panoramic radiographs possible?

PURPOSE: Detecting laryngeal cartilages (triticeous and thyroid cartilages) on panoramic radiographs is important because they may be confused with carotid artery calcifications in the bifurcation region, which are a risk factor for stroke. This study assessed the efficiency of panoramic radiography in the diagnosis of calcified laryngeal cartilages using cone-beam computed tomography (CBCT) as the reference standard. MATERIALS AND METHODS: A total of 312 regions (142 bilateral, 10 left, 18 right) in 170 patients (140 males, 30 females) were examined. Panoramic radiographs were examined by an oral and maxillofacial radiologist with 11 years of experience. CBCT scans were reviewed by 2 other oral and maxillofacial radiologists. The kappa coefficient (κ) was calculated to determine the level of intra-observer agreement and to determine the level of agreement between the 2 methods. Diagnostic indicators (sensitivity, specificity, accuracy, and false positive and false negative rates) were also calculated. P values < .05 were considered to indicate statistical significance. RESULTS: Eighty-two images were re-examined to determine the intra-observer agreement level, and the kappa coefficient was calculated as 0.709 (P < .05). Statistically significant and acceptable agreement was found between the panoramic and CBCT images (κ=0.684 and P < .05). The sensitivity, specificity, diagnostic accuracy rate, the false positive rate, and the false negative rate of the panoramic radiographs were 85.4%, 83.5%, 84.6%, 16.5%, and 14.6%, respectively. CONCLUSION: In most cases, calcified laryngeal cartilages could be diagnosed on panoramic radiographs. However, due to variation in the calcifications, diagnosis may be difficult.

Applicability of Cameriere's and Drusini's age estimation methods to a sample of Turkish adults.

OBJECTIVES: The aim of this study was to investigate the applicability of Drusini's and Cameriere's methods to a sample of Turkish people. METHODS: Panoramic images of 200 individuals were allocated into two groups as study and test groups and examined by two observers. Tooth coronal indexes (TCI), which is the ratio between coronal pulp cavity height and crown height, were calculated in the mandibular first and second premolars and molars. Pulp/tooth area ratios (ARs) were calculated in the maxillary and mandibular canine teeth. Study group measurements were used to derive a regression model. Test group measurements were used to evaluate the accuracy of the regression model. Pearson's correlation coefficients and regression analysis were used. RESULTS: The correlations between TCIs and age were -0.230, -0.301, -0.344 and -0.257 for mandibular first premolar, second premolar, first molar and second molar, respectively. Those for the maxillary canine (MX) and mandibular canine (MN) ARs were -0.716 and -0.514, respectively. The MX ARs were used to build the linear regression model that explained 51.2% of the total variation, with a standard error of 9.23 years. The mean error of the estimates in test group was 8 years and age of 64% of the individuals were estimated with an error of <±10 years which is acceptable in forensic age prediction. CONCLUSIONS: The low correlation coefficients between age and TCI indicate that Drusini's method was not applicable to the estimation of age in a Turkish population. Using Cameriere's method, we derived a regression model.