INCIDENTAL FINDINGS ON CBCT AND CLASSIFICATION ACCORDING TO THEIR SIGNIFICANCE

Publication date: January 2019

Source: Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, Volume 127, Issue 1

Author(s): C. THEODORIDIS, Z. VAITSIDIS, C. ANGELOPOULOS

Background

In the future, 3-dimensional diagnostic imaging will certainly be the preferred imaging method in dentistry, with cone beam computed tomography (CBCT) featuring prominently in the management of many cases. Nevertheless, increased information that advanced imaging techniques can result in increased amounts of findings that are unrelated to the reason the examination was conducted. The prevalence rate of these occult entities on CBCT varies widely among reported studies and may exceed 50%, depending mainly on demographic factors and field of view (FOV). Additionally, utilization of incidental findings, which may give rise to both medical and legal concerns, has to be based on their clinical significance.

Objective

The objective of this study was to determine the prevalence of incidental radiologic findings on CBCT examinations. Furthermore, we attempted to classify these findings according to their clinical significance.

Materials and Methods

We retrospectively evaluated 741 CBCT examinations with extended FOV for incidental findings. Incidental radiologic findings were identified, recorded, classified on the basis of their locations and ranked according to clinical significance.

Results

The vast majority of CBCT examinations presented with at least1 incidental radiologic finding, resulting in a surprisingly high prevalence in total. If extreme anatomic variants are taken into account (nasal septum deviation, sinus septations, etc.), the cumulative prevalence exceeds 99%. The frequency of incidental entities of major significance that may require immediate attention was greater than 10%.

Discussion

Random incidental radiologic findings occur at a high frequency in CBCT examinations of patients referred for routine dental assessment. Inflammatory changes in the paranasal sinuses, as well as benign entities in the neck and the cervical spine (tonsillar calcifications and degenerative changes), are among the most frequent findings. Although the number of findings that may need immediate attention is relatively low, in a considerable number of cases, periodic evaluation is required.

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