The objective of this study was to find out the incidence of incidental findings seen in cone beam computed tomography scans taken for orthodontic purposes and to see if these findings influence orthodontic treatment.
Subjects and method
Three hundred and twenty-nine consecutive scans carried out for orthodontic purposes using an i-CAT Classic were included in the study. Each scan was evaluated by a single radiologist and any incidental findings recorded. The incidental findings were further classified depending on whether the finding would influence orthodontic management.
Results
There were a total of 370 incidental findings in the 329 scans, with at least one incidental finding in 66% of patients. The most common incidental findings were dental (n = 120) and included retained deciduous roots (n = 24) and periapical disease (n = 15). Of the incidental findings 200 required no follow-up. A total of 168 findings required follow-up, but the overall orthodontic treatment plan was not altered. Only two findings were significant in that the orthodontic treatment was amended in light of the incidental finding.
Conclusions
Incidental findings are very common on CBCT. However the majority of these findings do not affect orthodontic treatment planning.
HornerK, IslamM, FlygareL, TsiklakisK, WhaitesE.Basic principles for use of dental cone beam computed tomography: consensus guidelines of the European Academy of Dental and Maxillofacial Radiology. Dento-Maxillo-Facial Radiol2009; 38: 187–95.
OberoiS, ChigurupatiR, GillP, HoffmanWY, VargervikK.Volumetric assessment of secondary alveolar bone grafting using cone beam computed tomography. Cleft Palate Craniofac J2009; 46: 503–11.
4.
KauCH, PanP, GalleranoRL, EnglishJD. A novel 3D classification system for canine impactions-the KPG index. Int J Med Robot2009; 5: 291–96.
5.
LiuD, ZhangW, ZhangZ, WuY, MaX.Localization of impacted maxillary canines and observation of adjacent incisor resorption with cone-beam computed tomography. Oral Surg Oral Med Oral Pathol Oral Radiol Endod2008; 105: 91–98.
6.
PopatH, DrageN, DurningP.Mid-line clefts of the cervical vertebrae — an incidental finding arising from cone beam computed tomography of the dental patient. Br Dent J2008; 204: 303–6.
7.
RogersSA, DrageN, DurningP.Incidental findings arising with cone beam computed tomography imaging of the orthodontic patient. Angle Orthod2011; 81: 350–55.
8.
MilesDA. Occult pathology detected in cone beam data volumes. Alpha Omegan2010; 103: 146–50.
9.
PazeraP, BornsteinMM, PazeraA, SendiP, KatsarosC.Incidental maxillary sinus findings in orthodontic patients: a radiographic analysis using cone-beam computed tomography (CBCT). Orthod Craniofac Res2011; 14: 17–24.
10.
PliskaB, DeRocherM, LarsonBE. Incidence of significant findings on CBCT scans of an orthodontic patient population. Northwest Dent2011; 90: 12–16.
11.
ChaJY, MahJ, SinclairP.Incidental findings in the maxillofacial area with 3-dimensional cone-beam imaging. Am J Orthod Dentofacial Orthop2007; 132: 7–14.
12.
ScarfeWC, FarmanAG. What is cone-beam CT and how does it work?Dent Clin North Am2008; 52: 707–30.
13.
LimWK, RamB, FasulakisS, KaneKJ. Incidental magnetic resonance image sinus abnormalities in asymptomatic Australian children. J Laryngol Otol2003; 117: 969–72.
14.
HavasTE, MotbeyJA, GullanePJ. Prevalence of incidental abnormalities on computed tomographic scans of the paranasal sinuses. Arch Otolaryngol Head Neck Surg1988; 114: 856–59.
15.
GordtsF, ClementPA, BuisseretT.Prevalence of sinusitis signs in a non-ENT population. ORL J Otorhinolaryngol Relat Spec1996; 58: 315–19.
16.
McNeillE, O'HaraJ, CarrieS.The significance of MRI findings for non-rhinological disease. Clin Otolaryngol2006; 31: 292–96; discussion 296.
17.
LeeDH, JunBC, ParkJO, YeoSW. Magnetic resonance imaging of the mastoid cavity and middle ear: prevalence and clinical significance of incidental abnormal findings in a nonotolaryngologic adult and pediatric population. J Otolaryngol2006; 35: 13–18.
18.
PhanN, MarrasC, MidhaR, RowedD.Cervical myelopathy caused by hypoplasia of the atlas: two case reports and review of the literature. Neurosurgery1998; 43: 629–33.
19.
DorneHL, LanderPH. CT recognition of anomalies of the posterior arch of the atlas vertebra: differentiation from fracture. Am J Neuroradiol1986; 7: 176–77.
20.
PickRY. Cleft arch of atlas simulating fracture of the odontoid process. Spine1981; 6: 419–22.
21.
GeipelP.Zur Kenntnis der Spaltbildungen das Atlas und Epistropheus. Teil IV. Zentralbl Allg Pathol1955; 94: 19–84.
22.
TrijoletJP, ParmentierJ, SuryF, GogaD, MejeanN, LaureB.Cemento-ossifying fibroma of the mandible. Eur Ann Otorhinolaryngol Head Neck Dis2011; 128: 30–33.
