ANALYSIS OF INCIDENTAL FINDINGS ON PRE-ENDODONTIC CBCT SCANS

Abstract

<h3>BACKGROUND</h3> Cone beam computed tomography (CBCT) is a widely used imaging modality and is indispensable for diagnosing pathology and assuring favorable treatment outcome. <h3>CASE REPORT</h3> The incidental findings on 5 CBCT scans before endodontic treatment is presented. Patient A (71-year-old white man) reported for retreatment of tooth #3. CBCT revealed missed MB2 on tooth #3; additional findings include nasopalatine canal cyst and internal resorption on tooth #8. Patient B (46-year-old white man) reported for retreatment of tooth #30 and evaluation of tooth #32 for apical periodontitis. CBCT revealed apical radiolucency on tooth #30 and apical PDL widening on tooth #32. Additionally, tooth #27 was impacted and demonstrated external resorption; odontoma was noted distal to #27. Patient C (49-year-old African American woman) presented for retreatment of tooth #4; missed palatal canal, buccal canal with short fill, apical radiolucency, and discontinuity of the buccal cortex were evident. Apical to tooth #3 a radiopacity with a radiolucent rim was noted; the lesion displaced the inferior border of the maxillary sinus and the buccal cortex. This finding was consistent with cemento-osseous dysplasia. Patient D (75-year-old white man) reported with an abnormal feeling around tooth #4; no relevant clinical findings. CBCT revealed an ill-defined radiolucency in the area of tooth #4 and #5 with destruction of the maxillary sinus floor and the lingual and buccal cortical plates. The patient had a history of multiple myeloma. Radiographic and clinical findings were suggestive of a malignant process. Patient E (58-year-old woman) was referred for evaluation of a mandibular radiolucency. CBCT demonstrated a multilocular radiolucency involving teeth #20 to #24; expansion and thinning predominantly involved the lingual cortex. Buccal cortical thinning, expansion, and displacement was noted in the area of tooth #22. The lesion was diagnosed as ameloblastoma. <h3>DISCUSSION/CONCLUSIONS</h3> Incidental findings on CBCT scans include inflammation, cysts, benign and malignant tumors, developmental anomalies, and dystrophic calcification. Providers must be adequately trained to promptly address the abnormalities encountered to ensure the highest standard of patient care.