Osseous abnormalities of the mandibular condyle: diagnostic reliability of cone beam computed tomography compared with helical computed tomography based on an autopsy material

Objectives: We compared the diagnostic reliability of cone beam computed tomography (3DX) and helical computed tomography (helical CT) for the detection of osseous abnormalities of the mandibular condyle, using macroscopic observations as the gold standard. Methods: Twenty-one temporomandibular joint autopsy specimens underwent imaging with 3DX and helical CT. The specimens were macroscopically evaluated for cortical erosion or osteophytosis and sclerosis. The images were independently assessed for the same osseous abnormalities. Observations with the two imaging modalities were compared with the macroscopic observations using the McNemar test. Results: According to the macroscopic observations, 10 of the 21 mandibular condyles and one fossa showed osseous abnormalities. 3DX detected abnormalities in eight of these condyles and helical CT identified abnormalities in seven, giving a sensitivity of 0.80 for 3DX and 0.70 for helical CT. The specificity of the condyle assessment was 1.0 for both 3DX and helical CT and hence, the accuracy was 0.90 and 0.86, respectively. No significant differences were detected between the 3DX and helical CT for assessment of osseous abnormalities of the mandibular condyle (P = 0.286). Conclusions: The cone beam CT equipment 3DX is a dose-effective and a cost-effective alternative to helical CT for the diagnostic evaluation of osseous abnormalities of the mandibular condyle.