White S C, Atchison K A, Hewlett E R, Flack V F
UCLA Schools of Dentistry, Section of Oral Radiology, USA.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1995 Jul;80(1):108-14. doi: 10.1016/s1079-2104(95)80026-3.
This study compared the FDA guidelines for ordering dental radiographs to a conventional full-mouth examination for the detection of intraosseous disease and conditions affecting teeth other than caries.
We examined 490 patients and selected posterior bite-wing and periapical views as indicated by the patient's signs or symptoms. We compared the radiographic findings with the use of this selected set of radiographs to those from a full-mouth set of radiographs to determine the rates of missed disease when the FDA guidelines were used.
The most commonly missed intraosseous findings were osteosclerosis, unerupted teeth, periapical radiolucencies, and primary root tips. Periapical radiolucencies that were most probably periapical cemental dysplasia were missed in six patients. The most commonly missed dental findings were resorbed roots and pulp stones. Three instances of dens in dente were missed.
When we used the FDA guidelines, the number of missed intraosseous and dental conditions was small and most likely inconsequential given the range of variability in dental diagnosis and treatment.
本研究将美国食品药品监督管理局（FDA）关于牙科X光片检查的指南与传统的全口检查进行比较，以检测骨内疾病和除龋齿外影响牙齿的病症。
我们检查了490名患者，并根据患者的体征或症状选择了后牙咬翼片和根尖片。我们将使用这组选定X光片的影像学结果与全口X光片的结果进行比较，以确定使用FDA指南时疾病漏诊率。
最常漏诊的骨内病变是骨质硬化、未萌出牙齿、根尖透射区和乳牙牙根尖。6名患者漏诊了极有可能是根尖牙骨质发育异常的根尖透射区。最常漏诊的牙齿病变是牙根吸收和髓石。漏诊了3例牙中牙。
当我们使用FDA指南时，骨内和牙齿病症的漏诊数量很少，而且鉴于牙科诊断和治疗的变异性范围，很可能无关紧要。
