Assessment of fracture line in maxillofacial region using panoramic digital radiographs and panoramic inverted digital radiographs: A comparative study

Introduction: Many times fractures go undetected, if not examined properly. For initial diagnosis and proper treatment plan of facial injuries, diagnostic images play a crucial role in providing necessary information. Aims and Objectives: To compare the diagnostic accuracy of conventional digital radiography and inverted digital panoramic imaging in detecting maxillofacial fractures. Materials and Methods: A total of 50 orthopantomographs were collected from the archives of dental and maxillofacial radiology. High quality radiographs with maximum sharpness, ideal contrast, and density were only included which were made using a digital OPG machine. The digital data were saved as jpeg files. Both conventional radiographs as well as inverted digitized images were evaluated by 3 expert radiologists twice with an interval of 10 days. The presence of a radiolucent line in conventional digital radiographs and radiopaque line in inverted digital image which depicted the fracture line was classified according to a 3 point confidence scale. Statistical Analysis Used: Intra observer variation was calculated using Student t test. Inter examiner agreement was calculated by kappa statistics by point (κ). Results: All the examiners showed poor to fair agreement for mandibular fractures and displacement of fracture line in both direct digital and inverted panoramic radiograph. Conclusions: Both the imaging modalities were reliable and there was no significant difference in the diagnostic accuracy.