Efetividade da radiografia panorâmica comparada com a tomografia computadorizada na avaliação de alterações patológicas nos seios maxilares em pacientes adultos: uma revisão sistemática e meta-análise

Abstract

Introduction: Pathological changes in the maxillary sinuses have a prevalence of up to 70%, with inflammatory/infectious origin being the most common. Rhinosinusitis is the term used for nasal and paranasal sinuses inflammation, and when it affects the maxillary sinuses, it is classified as odontogenic and non-odontogenic. Although the diagnosis is mainly based on clinical signs, imaging tests are valid for identifying etiological factors in order to establish correct diagnosis and treatment for these conditions. Among imaging exams, there is still no standardization of the most effective method for diagnosis, most dentists request computed tomography and panoramic radiography.Objective: A systematic review was performed to evaluate the effectiveness of panoramic radiography (PR) versus computed tomography (CT) in the diagnosis of pathological changes in the maxillary sinuses of adult patients. Material and methods: This review was registered in the PROSPERO database under the number CRD42020211766. To carry out this systematic review, observational studies that compared PR with CT were used for the evaluation of pathological changes in the maxillary sinuses. A complete search was performed via PubMeb, Scopus, Web of Science, LILACS, BBO, Cochrane Library, EMBASE, and a gray literature search was also performed. Study quality was assessed according to the Newcastle-Ottawa tool and the GRADE tool was used to assess the quality of evidence. Results: A total of 1561 studies were identified after removing duplicates. Of these, 57 studies remained after selection by titles. Finally, 07 studies remained after reading the abstracts and full texts for qualitative analysis, all with low risk of bias. Of these, only 04 studies were included in the meta-analysis. A significant difference was found between PR and CT by calculating the risk ratio, which was 0.19 (95% confidence interval [CI] = 0.05 to 0.70, p=0.01), with CT being the most effective method for assessing pathological changes in the jaws. Conclusion: This systematic review showed that CT technique is more effective and more suitable when compared to PR in the diagnosis of pathological changes in the maxillary sinuses.