Frequency and Characteristics of Incidental Findings Using Cone-Beam Computed Tomography in an Orthodontic Population

• Author / Creator

  Edwards, Ryan J

• Objectives: To explore the nature and frequency of incidental findings in large field of view cone-beam computed tomography (CBCT). Additionally, to assess the agreement among orthodontic clinicians in the assessment of the impact of maxillofacial findings identified in CBCT imaging. Methods: A total of 427 consecutive CBCT radiologic reports obtained for orthodontic purposes were retrospectively reviewed. All findings were categorized into six anatomic categories for descriptive purposes. Additionally, using a sub-sample of these findings, the agreement between 3 orthodontists was assessed with respect to need for further follow-up and potential impact of the findings on orthodontic treatment. Results: A total of 842 incidental findings were reported in the 427 CBCT scans (1.97 findings/scan). The most prevalent findings were those located in the airway (42.3%), followed by the paranasal sinuses (30.9%), dentoalveolar (14.7%), TMJ (6.4%), surrounding hard/soft tissues (4.0%), and cervical vertebrae (1.3%) regions. Non-odontogenic findings represented 718 of the 842 (85.3%) findings. In terms of agreement when assessing clinical significance of the findings, subjects demonstrated “fair-to-good” inter-rater agreement regarding CBCT findings in terms of the need for further follow-up and the potential impact on future orthodontic treatment. Subjects demonstrated “excellent” intra-rater agreement in the assessment of CBCT findings regarding both need for follow-up and potential impact on future orthodontic treatment. Conclusions: This study demonstrates the high occurrence of incidental findings in large field of view CBCT scans in a sample of orthodontically referred cases. The majority are extragnathic findings, which can be normally considered outside the regions of interest of many dental clinicians, but which may still require follow-up and/or management. Specifically, incidental findings in the nasal-oral-pharyngeal and paranasal air sinuses are the most frequent. Subjects demonstrated higher levels of agreement for dentoalveolar findings compared with all other extragnathic regions when assessing clinical significance.

• Subjects / Keywords

  • CBCT
  • Incidental findings

• Graduation date

  Fall 2014

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/R30D5W

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.