Assessment of incidental Findings and the Need for Alteration of Treatment Plan after Cone Beam Computer Tomography – A Descriptive Cross - sectional Study

Abstract

Background: Cone beam computed tomography (CBCT) is commonly used for guidance in radiotherapy and computed tomography (CT) machines. It gives a rapid acquisition of a certain dataset involving a complete view of the area under study. CBCT has attained a great importance in the diagnosis and clinical treatment planning in dentistry in recent times. Aim and objectives: To assess the frequency of different incidental findings on CBCT and the need to alter the treatment plan after a radiological interpretation accordingly. Methods: Ninety-three CBCT reports by a single radiologist in Hamdan Bin Mohamed College of Dental Medicine were collected. Each report was analysed by a single maxillofacial radiologist, for any of the incidental findings that were recorded. These findings were broadly classified depending on their location, nature, and necessity of further intervention, alteration of treatment plan as well as patient age group and gender, and the reason for the scan. At 95% confidence intervals, statistical analysis was performed, using Chi-square test having a p value <0.05 as significant. Results: Our study findings showed that 86 CBCT was taken during the study period (2013 – 2019) showed incidental findings on the scan. A total of 66% of patients demonstrated a minimum of one type of incidental finding. Other findings including root fragments, dental abnormalities, inflammatory bone changes & non-inflammatory TMJ abnormalities were reported in 36 subjects (41.9%). Conclusions: This descriptive study concludes that approximately 66% of patients showed a minimum of one incidental finding on the CBCT scan and about 1% of these findings were instrumental in actually altering the proposed treatment plan. Therefore, it's recommended that a trained-personnel in interpretation techniques of CBCT, must report in all the images to avoid misdiagnosis.