Accuracy of Panoramic Radiography in Comparison With Cone-Beam Computed Tomography for the Detection of Idiopathic Osteosclerosis: An Original Cross-sectional Study

Background: The accuracy of radiography for the detection of bone lesions is a critical issue. This study aimed to assess the accuracy of panoramic radiography in comparison with cone-beam computed tomography (CBCT) for the detection of idiopathic osteosclerosis (IO). Methods: This cross-sectional study was conducted on imaging records of 201 patients who had both panoramic radiographs and CBCT scans. Panoramic radiographs of patients were evaluated for lesions suspected of IO. After two weeks, the accuracy of diagnoses was investigated by assessing the patients’ CBCT scans. The location, number, shape, internal structure, and size of lesions and their relationship with teeth were also assessed on CBCT scans using Romexis Viewer software, version 3.8.0. Data were analyzed by the chi-square test (alpha=0.05). Results: Of all, 73.4% of IO lesions were correctly diagnosed on panoramic radiographs, yielding an accuracy of 0.85 for this modality. IO lesions were detected in 51 patients (n=64 lesions, 25.73%), mainly located in the mandibular molar (45.3%) and premolar (29.7%) regions. All lesions were well-defined, and most of them were spherical (42.1%). The majority of them had a cortical internal structure (73.4%) and did not correlate with teeth (78.1%). The mean size of large and small diameters of lesions was 5.4 and 3.1 mm, respectively. Conclusions: Identifying the radiographic characteristics of common lesions such as IO can be a guide for dentists to avoid incorrect treatments and unnecessary biopsies. In this way, panoramic radiography with 0.85 accuracy helps in diagnosing these lesions.