Digital subtraction radiography in TMJ imaging: A critique

To the Editor: I am writing in response to a recent article published in the June issue of Imaging Science in Dentistry by Demirturk Kocasarac and Celenk titled “Effectiveness of digital subtraction radiography in detecting artificially created osteophytes and erosions in the temporomandibular joint.” The authors compared the diagnostic efficacy of panoramic radiography and panoramic digital subtraction radiography (DSR) in the detection of simulated osteophytes and erosions in the mandibular condyles. The authors concluded, “In the current study, the diagnostic accuracy of DSR was found to be higher than the accuracy of panoramic imaging for the detection of erosions.” I note the following flaws in the study that make such a conclusion questionable.