Radiographical Pathological Incidental Findings before Orthodontic Treatment

Main Article Content

Mohammed Abdulaziz Mohammed Korayem
Nuha Mohammed Malibari
Mohammed Alabdrabalnabi
Ahmed Abdelaziz Mohamed Essa

Keywords

Treatment, Increase, Careful

Abstract

Background and objectives: Panoramic as well as Cephalometric radiographs, in combination with a clinical examination, are regularly used as an aid and both are considered as a cornerstone for orthodontic diagnosis and treatment planning. Due to increasing numbers of patients seeking orthodontic treatment, an increase in incidental findings on diagnostic X-rays is suspected. The objective of this study was to determine the diverse incidental pathological findings observed in radiographs taken before orthodontic treatment in Al Baha Region, Saudi Arabia. Methods: This was a cross-sectional study that investigated 358 panoramic and Cephalometric radiographs who were randomly selected from the Orthodontics Department of Al-Baha University, Faculty of Dentistry Clinic in the period between 2019 and 2022. Only those pathological findings with a possible influence on orthodontic treatment were included and then compared with the patient’s record.
Results: The most common findings were thickening of mucosal lining in sinus maxillaries, multiple impacted teeth, dental anomalies and periapical inflammatory lesions. The majority of the periapical lesions and radiopacities were found in the mandible. Both the presence and the number of findings per patient increase with age but there is no association with sex P<0.001.
Conclusion: The prevalence of incidental findings in this study was low especially those outside dental arches. In most cases, the findings had no consequence for the orthodontic treatment plan and did not require urgent dental management. Careful radiographic examination in addition to use of advanced radiographic diagnostic methods are required to rule out significant pathological findings
before orthodontic treatment.

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References

1. Baxi S, Shadani K, Kesri R, et al. Recent Advanced Diagnostic Aids in Orthodontics. Cureus. 2022; 14(11): e31921, doi 10.7759/cureus.31921
2. Bekiroglu N, Kargul B, Mete S et al. Evaluation of panoramic radiographs taken from 1,056 Turkish children. Niger J Clin Pract. 2015; 18: 8-
12.
3. Filho AG, Moda L, Oliveira R. Prevalence of dental anomalies on panoramic radiographs in a population of the state of Para, Brazil. Indian J
Dent Res. 2014; 25: 648-652.
4. German Hernandez, Plaza SP, et al. Incidental findings in pre-orthodontic treatment radiographs. Int Dent J. 2018; 68: 320-326.
5. Bondemark L, Jeppsson M, Lindh-Ingildsen L et al. Incidental findings of pathology and abnormality in pretreatment orthodontic
panoramic radiographs. Angle Orthod. 2006; 76: 98-102.
6. Sanchez T, De la Fuente H, Diaz A. Alterations and pathologies prevalence in panoramic radiographs in patients attending the University Dental Clinic. Int J Odontostomat. 2013; 7: 47- 52.
7. Saberi E, Ebrahimipour S. Evaluation of developmental dental anomalies in digital panoramic radiographs in Southeast Iranian
Population. J Int Soc Prev Community Dent. 2016; 6: 291-295.
8. Keim RG, Gottlieb EL, Nelson AH et al. JCO, Orthodontic Practice Study. Part 1. Trends. J Clin Orthod. 2013; 47: 661-680.
9. 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.
10. Lopes IA, Tucunduva RM, and Handem RH et al. Study of the frequency and location of incidental findings of the maxillofacial region in different fields of view in CBCT scans. Dentomaxillofac Radiol. 2017; 46: 20160215.
11. Pakbaznejad Esmaeili E, Ekholm M, Haukka J et al. Type and location of findings in dental panoramic tomographs in 7-12- year-old
orthodontic patients. Acta Odontol Scand. 2016; 74(4): 272-278.
12. Hernández G, Plaza SP, Cifuentes D, et al. Incidental findings in pre-orthodontic treatment radiographs. Int Dent J. 2018; 68(5): 320-326.
13. Donald PM, Nagraj SK, Pallivathukkal RG, Ismail ARB. Ponticulus posticus of atlas vertebrae: an incidental finding in Malaysian
orthodontic patients. BMJ Case Rep. 2017 Aug 21; 2017:bcr2017220851. doi: 10.1136/bcr-2017-220851. PMID: 28827299; PMCID:
PMC5623291.
14. Choi J.-Y., Oh S.H., Kim S.-H., Ahn H.-W., at al. Effectiveness of 2D radiographs in detecting CBCT-based incidental findings in orthodontic
patients. Sci. Rep. 2021; 11:9280.
15. Ristow O, Schnug G, Smielowksi M, Moratin J, Pilz M, Engel M, Freudlsperger C, Hoffmann J, Rückschloß T. Diagnostic accuracy comparing
OPT and CBCT in the detection of non-vital bone changes before tooth extractions in patients with antiresorptive intake. Oral Dis. 2021 Oct 12. doi: 10.1111/odi.14048. Epub ahead of print. PMID: 34637576.
16. Radic J, Patcas R, Stadlinger B, et al. Do we need CBCTs for sufficient diagnostics?-dentist-related factors. Int J Implant Dent. 2018; 4(1): 37.