Diagnostic accuracy studies needed for cone beam computed tomography

Medline, Embase, CENTRAL and the reference lists of identified studies. Studies had to describe diagnostic accuracy efficacy, diagnostic thinking efficacy, therapeutic efficacy or any combination for CBCT in the diagnosis of impacted teeth or of important features associated with impactions. Criteria for the diagnosis had to be described in detail or referenced. For studies elucidating only observer performance, the analysis had to be based on a minimum of two observers. Data were extracted with the aid of protocol based on critical appraisal of diagnostic studies. Two authors independently assessed the quality and internal validity of studies using the QUADAS tool,(1) with disagreements being resolved by discussion. The results were described narratively as meta-analyses could not be conducted. The search yielded 96 titles, of which seven were included. There was only limited evidence for diagnostic efficacy expressed as sensitivity, specificity and predictive values. Only two studies compared CBCT and panoramic radiographs with a valid reference method and presented the results in terms of percentage of correct diagnoses. There is a need for diagnostic accuracy studies on CBCT where accepted methodological criteria for diagnostic thinking, efficacy and therapeutic efficacy are incorporated.