Problem-based learning in dentistry: Diagnostic capability of dentists in the detection of calcified carotid artery atheroma on digital panoramic radiographs

Authors

DOI:

https://doi.org/10.33448/rsd-v9i11.10451

Keywords:

Radiography, Panoramic; Plaque, Atherosclerotic; Data Accuracy; Problem-based learning method; Teaching.

Abstract

Objective: The aim of this study was to evaluate the diagnostic capability of dentists in the identification of suggestive images of calcified carotid artery atheroma (CCAA) on panoramic radiographs (PRs) before and after using a problem-based learning method (PBL). Methodology: Five dentists (no specialists in oral and maxillofacial radiology) analyzed 102 digital PRs divided into: PRs with suggestive images of CCAA (n=51) and without suggestive images of CCAA (n=51). After the first analysis, the examiners attended an activity on soft tissue calcifications using the PBL method. Afterwards, they analyzed the 102 PRs again. The results of the analysis were calculated using the Cohen's Kappa Test and the Receptor Operational Characteristic Curves (ROC). Results and Discussion: Regarding examiners’ performance before and after the activity, the intra-examiner test showed reasonable Kappa coefficients (0-0.40). For inter-examiner agreement after the activity, the Kappa coefficient was almost perfect (> 0.80). When comparing examiners’ performance after the activity with a template performed by an experienced radiologist, the Kappa Coefficient was > 0.80 with significant agreement (p<0.05). Conclusion: The precision and the probability of correctly detecting suggestive images of CCAA on PRs increased when the examiners participated in the active pedagogical method. The continuing education of the dentist and how it can make a difference in the systemic health of patients should be considered.

References

Ahmad, M., Madden, R., & Perez, L. (2005). Triticeous cartilage: Prevalence on panoramic radiographs and diagnostic criteria. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, 99(2), 225–230. https://doi.org/10.1016/j.tripleo.2004.06.069

Al-Madi, E. M., Celur, S. L., & Nasim, M. (2018). Effectiveness of PBL methodology in a hybrid dentistry program to enhance students’ knowledge and confidence. (a pilot study). BMC Medical Education, 18(1), 1–6. https://doi.org/10.1186/s12909-018-1392-y

American Dental Association (2004). The selection of patients for dental radiographic examinations. American Dental Association, Chicago, 0-19.

American Dental Association Council on Scientific Affairs (2006). The use of dental radiographs: update and recommendations. J Am Dent Assoc, 137, 1304-12.

Bayer, S., Helfgen, E. H., Bös, C., Kraus, D., Enkling, N., & Mues, S. (2011). Prevalence of findings compatible with carotid artery calcifications on dental panoramic radiographs. Clinical Oral Investigations, 15(4), 563–569. https://doi.org/10.1007/s00784-010-0418-6

Bayram, B., Uckan, S., Acikgoz, A., Müderrisoǧlu, H., & Aydinalp, A. (2006). Digital panoramic radiography: A reliable method to diagnose carotid artery atheromas? Dentomaxillofacial Radiology, 35(4), 266–270. https://doi.org/10.1259/dmfr/50195822

Carter, L. C. (2000). Discrimination between calcified triticeous cartilage and calcified carotid atheroma on panoramic radiography. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontics, 90(1), 108–110. https://doi.org/10.1067/moe.2000.106297

Ertas, E. T., & Sisman, Y. (2011). Detection of incidental carotid artery calcifications during dental examinations: Panoramic radiography as an important aid in dentistry. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, 112(4), e11–e17. https://doi.org/10.1016/j.tripleo.2011.02.048

Gaba, K., & Bulbulia, R. (2019). Identifying asymptomatic patients at high-risk for stroke. Journal of Cardiovascular Surgery, 60(3), 332–344. https://doi.org/10.23736/S0021-9509.19.10912-3

Henriques, J. C., Kreich, E. M., Baldani, M. H., Luciano, M., Castilho, J. C. (2011). Panoramic Radiography in the Diagnosis of Carotid Artery Atheromas and the Associated Risk Factors. The Open Dentistry Journal, 5(3), 79–83. https://doi.org/10.1016/j.tripleo.2003.08.025

Kamikawa, R. S. S. (2009). Pesquisa de Calcificação em tecido mole na região cervical por meio das técnicas radiográficas panorâmica e telerradiografia. 75.

Landis, J. R., & Koch, G. G. (1977). The Measurement of Observer Agreement for Categorical Data. Biometrics, 33(1), 159–174.

MacDonald, D., Chan, A., Harris, A., Vertinsky, T., Farman, A. G., & Scarfe, W. C. (2012). Diagnosis and management of calcified carotid artery atheroma: Dental perspectives. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 114(4), 533–547. https://doi.org/10.1016/j.oooo.2012.06.020

Madden, R. P., Hodges, J. S., Salmen, C. W., Rindal, D. B., Tunio, J., Michalowicz, B. S., & Ahmad, M. (2007). Utility of panoramic radiographs in detecting cervical calcified carotid atheroma. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology and Endodontology, 103(4), 543–548. https://doi.org/10.1016/j.tripleo.2006.06.048

Monteiro, I. A., Ibrahim, C., Albuquerque, R., Donaldson, N., Salazar, F., & Monteiro, L. (2018). Assessment of carotid calcifications on digital panoramic radiographs: Retrospective analysis and review of the literature. Journal of Stomatology, Oral and Maxillofacial Surgery, 119(2), 102–106. https://doi.org/10.1016/j.jormas.2017.11.009

Moreira, E. E. P., Oliveira, S. M. C. de, & Oliveira, J. V. P. de. (2020). Contributes and challenges of problem-based learning in medical training. Research, Society and Development, 9(8), e639985361. https://doi.org/10.33448/rsd-v9i8.5361

Oderinu, O. H., Adegbulugbe, I. C., Orenuga, O. O., & Butali, A. (2019). Comparison of students’ perception of problem-based learning and traditional teaching method in a Nigerian dental school. European Journal of Dental Education, November 2019, 207–212. https://doi.org/10.1111/eje.12486

Roldán-Chicano, R., Oñate-Sánchez, R. E., López-Castaño, F., Cabrerizo-Merino, M. C., & Martínez-López, F. (2006). Panoramic radiograph as a method for detecting calcified atheroma plaques. Review of literature. Medicina Oral, Patología Oral y Cirugía Bucal, 11(3), 261–266.

Schroder, A. G. D., de Araujo, C. M., Guariza-Filho, O., Flores-Mir, C., de Luca Canto, G., & Porporatti, A. L. (2019). Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery atheroma: a meta-analysis. Clinical Oral Investigations. https://doi.org/10.1007/s00784-019-02880-6

Stojanović, M., Apostolović, M., Stojanović, D., Milošević, Z., Toplaović, A., Lakušić, V. M., & Golubović, M. (2014). Understanding sensitivity, Specificity and predictive values. Vojnosanitetski Pregled, 71(11), 1062–1065. https://doi.org/10.2298/VSP1411062S

Tamblyn, R. M., & Se, B. N. (1981). Problem-Based Learning: An Approach to Medical Education. American Journal of Occupational Therapy, 35(8), 539–539. https://doi.org/10.5014/ajot.35.8.539b

Wakabayashi, I. (2010). Associations between alcohol drinking and multiple risk factors for atherosclerosis in smokers and nonsmokers. Angiology, 61(5), 495–503. https://doi.org/10.1177/0003319709358694

World Health Organization (2017). Pan American Health Organization: Cardiovascular Diseases. Retrieved from: https://www.paho.org/bra/index.php?option=com_content&vie w=article&id=5253:doencas-cardiovasculares&Itemid=1096

Yoon, S. J., Yoon, W., Kim, O. S., Lee, J. S., & Kang, B. C. (2008). Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery. Dentomaxillofacial Radiology, 37(2), 104–108. https://doi.org/10.1259/dmfr/86909790

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Published

01/12/2020

How to Cite

FELIPE, B. C.; YAMASHITA, F. C.; YAMASHITA, A. L.; PASSONI, A. C. C.; SILVA, B. G. da; TOLENTINO, E. de S.; CHICARELLI, M.; IWAKI, L. C. V. . Problem-based learning in dentistry: Diagnostic capability of dentists in the detection of calcified carotid artery atheroma on digital panoramic radiographs. Research, Society and Development, [S. l.], v. 9, n. 11, p. e70991110451, 2020. DOI: 10.33448/rsd-v9i11.10451. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/10451. Acesso em: 23 apr. 2024.

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Section

Education Sciences