Unintended and unexpected incidental findings on cone beam computed tomography: A retrospective study of 1500 scans

Abstract

Introduction: Cone beam computed tomography (CBCT) has revolutionized the field of oral radiology. With the detailed three-dimensional views of dental tissues, incidental findings which were once considered abnormalities present outside the area of interest can now be recognized. Here, we report various incidental findings found on CBCT. Materials and Methods: This retrospective study consisted of 1500 CBCT scans. Different fields-of-view ranging from 5 × 5 to 11 × 13 were selected. Age group of the subjects included in the study was 5 to 89 years. All incidental findings were categorized in seven groups according to the area and nature of pathology – dento-alveolar region, cysts and tumors, nasal and sinus pathologies, supernumerary and impacted teeth, artifacts, temporomandibular joint (TMJ) region, and miscellaneous. Results: Out of 1500 patients, 723 (48.2%) were males and 777 (51.8%) were females. Mean age of patients referred for CBCT was 47.08 years. Most frequently referred patient age group was 60–69 years (19.75%). Eighty-nine percent of the subjects showed incidental findings. Total number of incidental findings was 2734. The most common area showing incidental findings was dento-alveolar area (44.3%), the least number of findings were seen in the TMJ area (0.4%). Most common finding was mucositis/mucous retention cyst (83.4%) whereas the least finding found was odontogenic keratocyst cyst and coronoid hyperplasia (0.6%). Conclusion: The full CBCT dataset should be fully examined and interpreted by Oral Maxillofacial Radiologists. Correct identification of various potentially pathological lesions outside the area of interest on CBCT scan should be reported and documented.