PREDICTIVE VALIDITY OF THE DENTAL RADIOGRAPHY FOR OROANTRAL PERFORATION DURING TOOTH EXTRACTION

Abstract

Background: In Oral Surgery, conventional dental radiography (DXR) is widely used to evaluate the tooth root and the adjacent structures. During dental extraction, if the tooth root is too close to the maxillary sinus it may be displaced into the maxillary sinus or an oroantral perforation (OAP) may be possibly established. This study aimed to determine the validity of DXR screening in detecting radiological findings compatible with the close relationship between the tooth root, the maxillary sinus and the prevalence of OAP in dental extraction.

Methods: This study examined all medical records of individuals treated at Dental School of  Ponta Grossa State University – Brazil, in the years 2016 and 2017. The inclusion criteria were: medical records with DXR; medical records with upper posterior tooth extraction. The exclusion criteria were medical records without DXR; medical records with mandibular tooth extraction; medical records with upper anterior tooth extraction; medical records without tooth extraction. The close relationship between the tooth root and the maxillary sinus were evaluated in DXR of upper posterior teeth extracted and the occurrence of OAP was clinically verified. The predictive validity of DXR for OAP was measured. The values of sensitivity, specificity, positive predictive value and negative predictive value, likelihood ratio and odds ratio were calculated.

Results: The prevalence of OAP = 0,002. The sensitivity of DXR for OAP = 1; specificity = 0,95; accuracy = 0,95; positive predictive value = 0,038; negative predictive value = 1; positive likelihood ratio = 20; negative likelihood ratio = 0. Odds ratio = 1:499 odds ratio = 1/24.

Conclusion: The dental radiography shows relative positive predictive validity in determinate the possibility of occurring oroantral perforation during tooth extraction – indicating many false positive results. The possibility of OAP during upper posterior tooth extraction is 1 in 500 cases but if dental radiography present signs of close relationship between tooth root and maxillary sinus this possibility increase for 1:24.

Keywords: Maxillary Sinus; Tooth Extraction; Oroantral Perforation; Dental Radiography