Abstract: PURPOSE: To evaluate the diagnostic sensitivity and specificity of panoramic radiography in detection of maxillary teeth roots projecting into the maxillary sinus. METHODS: Paired panoramic radiographs and cone-beam CT (CBCT) images of maxilla from 110 subjects were analyzed. 42 males and 68 females (15~36 years old) with the second molars erupted completely were included. The 2 radiographic techniques were used to observe if the roots of maxillary teeth project into the sinus, including canine, the first premolar, the second premolar, the first molar and the second molar. With CBCT as a gold standard, the diagnostic sensitivity and specificity of panoramic radiography were evaluated, as well as the accuracy, prevalence, positive likehood ratio, and negtive likehood ratio. RESULTS: The sensitivity for canine, the first premolar, the second premolar, the first molar, and the second molar was 100%, 100%, 96%, 99%, and 96%, respectively. The specificity for canine, the first premolar the second premolar, the first molar, and the second molar was 94%, 92%, 84%, 67%, and 67%, respectively. CONCLUSIONS: Panoramic radiography has a high diagnostic sensitivity in detection of the teeth roots projecting into the maxillary sinus for maxillary teeth. However, it can't afford sufficient proof for orthodontic anchorage design because of low specificity, especially for the second premolar, the first molar and the second molar.

Key words: Panoramic radiography, Cone-beam CT, Maxillary sinus, Sensitivity, Specificity