Performance of panoramic radiography compared with computed tomography in the evaluation of pathological changes in the maxillary sinuses: a systematic review and meta-analysis

Abstract

Objective: A systematic review was performed to evaluate the performance of panoramic radiography (PR) vs CT or cone beam CT (CBCT) in the diagnosis of pathological maxillary sinuses. Methods: This review was registered in the PROSPERO database under the number CRD42020211766. Observational studies that compared PR with CT/CBCT were used to evaluate pathological changes in the maxillary sinuses. A complete search of seven primary databases and gray literature was carried out. The risk of bias was assessed according to the Newcastle-Ottawa tool, and the GRADE tool was used to assess the quality of evidence. A binary meta-analysis was performed to assess the effectiveness of evaluating pathological alterations in the maxillary sinuses in PR and CT/CBCT. Results: Seven studies were included in our study, out of which four were included in a quantitative analysis. All studies were classified as low risk of bias. Five studies compared PR with CBCT and two studies compared PR to CT. The most common pathological alteration in maxillary sinuses reported was mucosal thickening. CT/CBCT was seen to be the most effective method for assessing pathological changes in the maxillary sinus when compared to PR (RR = 0.19, 95% confidence interval [CI] = 0.05 to 0.70, p = 0.01). Conclusion: CT/CBCT are the most appropriate imaging methods to evaluate pathological changes in the maxillary sinuses, while PR is still limited in the evaluation of these changes being considered only for initial diagnosis.