Assessment of a training program on detection of TMJ osseous changes applying pre-defined 2D multiplane CBCT reconstructions

Abstract

Objectives

Osseous changes in temporomandibular joint disorders (TMD) are common indications for cone beam computed tomography (CBCT). The number of such cases is increasing while number of qualified oral radiologists is limited. The present study investigated usefulness of a training program for general dental practitioners (GDPs) regarding temporomandibular joint (TMJ) osseous changes detection in CBCT images and evaluated the GDPs' performance in comparison to oral radiologists. A further aim was to investigate GDPs' agreement.

Methods

We selected CBCT images of 35 TMD cases and chose 5 of them to use in training seven GDPs on detecting osseous changes in the TMJ. In evaluation directly following training, GDPs assessed the 30 remaining cases. Three qualified radiologists served as reference standard. A 2-month follow-up of training comprising evaluation of the same cases. The cases are assessed according to Ahmad et al. protocol of TMJ osseous changes in CBCT images.

Results

Sensitivity and specificity of the CBCT protocol were high, except for some criteria that did not appear in the cases. Average observer sensitivity was 65% while specificity was 87%. Average correct individual response rate was 84%. Mean agreement among the GDPs was 73%. Observer performance had improved at the 2-month follow-up.

Conclusion

The present educational program could be a helpful material on recognizing possible osseous changes of TMJ and it can be used as a part of training program for GDP and for specialist candidates.

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