ReviewAnnals of maxillofacial surgery
Efficacy of CBCT and Conventional Radiography in Identifying Bone Invasion in Oral Cancer - A Comparative Systematic Review.
Review in Annals of maxillofacial surgery. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Bone invasion critically influences staging and surgical planning in oral squamous cell carcinoma (OSCC). Accurate pre-operative imaging is essential to detect cortical and medullary involvement. Objective: The study was to compare the diagnostic efficacy of cone-beam computed tomography (CBCT) versus conventional radiography for detecting bone invasion in OSCC. Data Sources: PubMed, Embase, Scopus, Web of Science and Cochrane Library. Study Eligibility Criteria: Comparative or observational studies evaluating CBCT and/or conventional radiography for OSCC bone invasion, using histopathology or intraoperative findings. Participants and Interventions: Patients with OSCC undergoing preoperative imaging; index tests included CBCT and conventional panoramic/periapical radiography. Study Appraisal and Synthesis Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-2020 and PRISMA-DTA compliant review with PROSPERO registration. Two reviewers independently screened, extracted data and assessed quality using Quality Assessment of Diagnostic Accuracy Studies-2. Owing to heterogeneity and incomplete 2 × 2 data, findings were narratively synthesised; a summary area under the curve (AUC) was estimated where possible. Results: Nineteen studies (sample sizes 14-197) were included. CBCT showed higher sensitivity (84.8%-100%) and specificity (60%-100%) than conventional radiography (sensitivity 24%-74.1%; specificity 68%-75%). CBCT facilitated earlier detection of cortical and trabecular changes and performed comparably to CT for osseous invasion, while magnetic resonance imaging (MRI) remained superior for soft-tissue and marrow evaluation. Across studies with extractable data, the summary AUC was 0.59, reflecting modest overall discrimination. Limitations: Substantial heterogeneity in methodology and CBCT protocols, observer variability and risk of bias limited pooling and generalisability. Conclusions: CBCT outperforms conventional radiography for detecting OSCC-related bone invasion, which should be considered in pre-operative evaluation, complemented by MRI where soft-tissue involvement is suspected. Standardised protocols and artificial intelligence-driven CBCT analysis warrant future validation.
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