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Clin Oral Investig. 2019 May;23(5):2021-2040. doi: 10.1007/s00784-019-02880-6. Epub 2019 Mar 28.

Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery atheroma: a meta-analysis.

Author information

1
Department of Dentistry, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
2
Department of Orthodontics, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil.
3
Department of Orthodontics, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil. odilongfilho@gmail.com.
4
School of Health and Bioscience, Department of orthodontics, Pontifícia Universidade Católica do Paraná, Street Imaculada Conceição, 1155, Prado Velho, Curitiba, PR, 80215-901, Brazil. odilongfilho@gmail.com.
5
School of Dentistry, University of Alberta, Alberta, Canada.
6
Brazilian Centre for Evidence-based Research, Department of Dentistry, Federal University of Santa Catarina, Florianópolis, SC, Brazil.

Abstract

OBJECTIVE:

To determine the diagnostic accuracy of panoramic radiography (PR) in detecting calcified carotid artery atheroma (CCAA) compared with Doppler ultrasonography or angiography (the reference standard).

SOURCES:

Cochrane, LILACS, PubMed, Scopus, Web of Science, Google Scholar, Open Grey, and ProQuest were searched. The reference lists of the included studies were also screened.

DATA:

Observational studies.

METHODS:

Only studies comparing the diagnostic accuracy of PR in detecting CCAA to Doppler ultrasonography or angiography (the reference standard) were included. The primary outcome measures were sensitivity and specificity. The secondary outcomes were negative predictive values, positive predictive values, diagnostic odds ratios, likelihood ratios (positive and negative), receiver operating characteristic curves, accuracy, and Youden's index. Two reviewers independently participated in the study selection, data extraction, and risk of bias assessment without language restriction. Risk of bias was assessed thought QUADAS-2, and the level of evidence was assessed through GRADE.

RESULTS:

A total of 773 citations were identified after duplicates were removed, and 12 studies including 1002 patients were included in the final study. The sensitivity and specificity of the different selected studies varied substantially, with sensitivity ranging from 0.31 to 0.95 and specificity from 0.19 to 0.99.

CONCLUSIONS:

Most studies reported excellent sensitivity and good specificity. The diagnostic accuracy of PR was good or excellent in 50% of the studies.

CLINICAL SIGNIFICANCE:

The identification of CCAA by PR can be a risk predictor for stroke when used as a secondary screening tool.

KEYWORDS:

Atheroma; Atheromatous plaques; Panoramic radiography; Review literature; Systematic review

PMID:
30923911
DOI:
10.1007/s00784-019-02880-6

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