Aim: Oral and maxillofacial surgeons (OMFSs) request cone-beam computed tomography (CBCT) examinations more than any other dental specialty. The aim of the current study was to determine the frequency and type of incidental findings (IFs) from CBCT examinations specifically requested by OMFSs.
Materials and methods: The database of a university-based CBCT service was reviewed for examinations requested by an OMFS over a 1-year period. The indications for the CBCT request ranged from implant and impaction to trauma-related causes. A board-certified oral and maxillofacial radiologist (OMFR) reviewed the CBCT images and the collected data were analyzed for descriptive results.
Results: The frequency of IFs was 78%. The greatest number of IFs was found in the paranasal region followed by the cervical vertebrae and the nasopharyngeal area. Most IFs were insignificant but nearly half the cases (48%) required a follow-up or referral appointment.
Conclusion: IFs from CBCT examinations requested by OMFSs are common and a substantial number required follow-up or referral.
Clinical significance: The results of the current study highlight the importance of examining the entire volume of CBCT examinations and reporting any and all IFs. This, in turn, requires adequate knowledge and training in CBCT image interpretation or, alternatively, effective collaboration with oral and maxillofacial radiologists.
Edwards R, Altalibi M, Flores-Mir C. The frequency and nature of incidental findings in cone-beam computed tomographic scans of the head and neck region: a systematic review. J Am Dent Assoc 2013;144(2):161–170. DOI: 10.14219/jada.archive.2013.0095.
Kuhlberg AJ, Norton LA. Pathologic findings in orthodontic radiographic images. Am J Orthod Dentofacial Orthop 2003; 123(2):182–184. DOI: 10.1067/mod.2003.4.
Barghan S, Tahmasbi Arashlow M, Nair MK. Incidental findings on cone beam computed tomography studies outside of the Maxillofacial Skeleton. Int J Dent 2016;2016:9196503.
Oser DG, Henson BR, Shiang EY, et al. Incidental findings in small field of view cone-beam computed tomography scans. J Endod 2017;43(6):901–904. DOI: 10.1016/j.joen.2017.01.033.
Warhekar S, Nagarajappa S, Dasar PL. Incidental findings on cone beam computed tomography and reasons for referral by dental practitioners in indore city (m.p). J Clin Diagn Res 2015;9(2):ZC21–ZC24.
Edwards R, Alsufyani N, Heo G, et al. The frequency and nature of incidental findings in large-field cone beam computed tomography scans of an orthodontic sample. Prog Orthod 2014;15:37. DOI: 10.1186/s40510-014-0037-x.
Price JB, Thaw KL, Tyndall DA, et al. Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clin Oral Implants Res 2012;23(11):1261–1268. DOI: 10.1111/j.1600-0501.2011.02299.x.
Theodoridis CVZ, Angelopoulos C. Incidental findings on CBCT and classification according to their significance. Oral Surg Oral Med Oral Pathol Oral Radiol 2019;127:47. DOI: 10.1016/j.oooo.2018.07.046.
Cha JY, Mah J, Sinclair P. Incidental findings in the maxillofacial area with 3-dimensional cone-beam imaging. Am J Orthod Dentofacial Orthop 2007;132(1):7–14. DOI: 10.1016/j.ajodo.2005.08.041.
Drage N, Rogers S, Greenall C, et al. Incidental findings on cone beam computed tomography in orthodontic patients. J Orthod 2013; 40(1):29–37. DOI: 10.1179/1465313312Y.0000000027.
Drumond JP, Allegro BB, Novo NF, et al. Evaluation of the prevalence of maxillary sinuses abnormalities through spiral computed tomography (CT). Int Arch Otorhinolaryngol 2017;21(2):126–133. DOI: 10.1055/s-0036-1593834.
Vallo J, Suominen-Taipale L, Huumonen S, et al. Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: results from the health 2000 health examination survey. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010;109:e80–e87. DOI: 10.1016/j.tripleo.2009.10.031.
Allareddy V, Vincent SD, Hellstein JW, et al. Incidental findings on cone beam computed tomography images. Int J Dent 2012;2012:871532. DOI: 10.1155/2012/871532.
Saccomanno S, Greco F, de Corso E, et al. Eagle's Syndrome, from clinical presentation to diagnosis and surgical treatment: a case report. Acta Otorhinolaryngol Ital 2018;38:166–169.
Alexiou K, Stamatakis H, Tsiklakis K. Evaluation of the severity of temporomandibular joint osteoarthritic changes related to age using cone beam computed tomography. Dentomaxillofac Radiol 2009; 38:141–147. DOI: 10.1259/dmfr/59263880.