Dental and Maxillofacial Cone Beam CT—High Number of Incidental Findings and Their Impact on Follow-Up and Therapy Management
Cone beam computed tomography (CBCT) is increasingly used for dental and maxillofacial imaging. The occurrence of incidental findings has been reported, but clinical implications of these findings remain unclear. The study’s aim was to identify the frequency and clinical impact of incidental finding...
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MDPI AG
2022-04-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/5/1036 |
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| author | Michael J. Braun Thaddaeus Rauneker Jens Dreyhaupt Thomas K. Hoffmann Ralph G. Luthardt Bernd Schmitz Florian Dammann Meinrad Beer |
| author_facet | Michael J. Braun Thaddaeus Rauneker Jens Dreyhaupt Thomas K. Hoffmann Ralph G. Luthardt Bernd Schmitz Florian Dammann Meinrad Beer |
| author_sort | Michael J. Braun |
| collection | DOAJ |
| description | Cone beam computed tomography (CBCT) is increasingly used for dental and maxillofacial imaging. The occurrence of incidental findings has been reported, but clinical implications of these findings remain unclear. The study’s aim was to identify the frequency and clinical impact of incidental findings in CBCT. A total of 374 consecutive CBCT examinations of a 3 year period were retrospectively evaluated for the presence, kind, and clinical relevance of incidental findings. In a subgroup of 54 patients, therapeutic consequences of CBCT incidental findings were queried from the referring physicians. A total of 974 incidental findings were detected, involving 78.6% of all CBCT, hence 2.6 incidental findings per CBCT. Of these, 38.6% were classified to require treatment, with an additional 25.2% requiring follow-up. Incidental findings included dental pathologies in 55.3%, pathologies of the paranasal sinuses and airways in 29.2%, osseous pathologies in 14.9% of all CBCT, and findings in the soft tissue or TMJ in few cases. Clinically relevant dental incidental findings were detected significantly more frequently in CBCT for implant planning compared to other indications (60.7% vs. 43.2%, <i>p</i> < 0.01), and in CBCT with an FOV ≥ 100 mm compared to an FOV < 100 mm (54.7% vs. 40.0%, <i>p</i> < 0.01). Similar results were obtained for paranasal incidental findings. In a subgroup analysis, 29 of 54 patients showed incidental findings which were previously unknown, and the findings changed therapeutical management in 19 patients (35%). The results of our study highlighted the importance of a meticulous analysis of the entire FOV of CBCT for incidental findings, which showed clinical relevance in more than one in three patients. Due to a high number of clinically relevant incidental findings especially in CBCT for implant planning, an FOV of 100 × 100 mm covering both the mandible and the maxilla was concluded to be recommendable for this indication. |
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| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-10T03:04:12Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj.art-bca3182a0f3c4f479989fb334b3f252f2023-11-23T10:38:23ZengMDPI AGDiagnostics2075-44182022-04-01125103610.3390/diagnostics12051036Dental and Maxillofacial Cone Beam CT—High Number of Incidental Findings and Their Impact on Follow-Up and Therapy ManagementMichael J. Braun0Thaddaeus Rauneker1Jens Dreyhaupt2Thomas K. Hoffmann3Ralph G. Luthardt4Bernd Schmitz5Florian Dammann6Meinrad Beer7Division of Neuroradiology, Department of Diagnostic and Interventional Radiology, University Hospital Ulm, 89081 Ulm, GermanyDepartment of Dentistry, University Hospital Ulm, 89081 Ulm, GermanyInstitute of Epidemiology and Medical Biometry, University Ulm, 89081 Ulm, GermanyDepartment of ENT, University Hospital Ulm, 89081 Ulm, GermanyDepartment of Dentistry, University Hospital Ulm, 89081 Ulm, GermanyDivision of Neuroradiology, Department of Diagnostic and Interventional Radiology, University Hospital Ulm, 89081 Ulm, GermanyUniversitätsinstitut für Diagnostische, Interventionelle und Pädiatrische Radiologie (DIPR), University Hospital Bern, 3010 Bern, SwitzerlandDepartment of Diagnostic and Interventional Radiology, University Hospital Ulm, 89081 Ulm, GermanyCone beam computed tomography (CBCT) is increasingly used for dental and maxillofacial imaging. The occurrence of incidental findings has been reported, but clinical implications of these findings remain unclear. The study’s aim was to identify the frequency and clinical impact of incidental findings in CBCT. A total of 374 consecutive CBCT examinations of a 3 year period were retrospectively evaluated for the presence, kind, and clinical relevance of incidental findings. In a subgroup of 54 patients, therapeutic consequences of CBCT incidental findings were queried from the referring physicians. A total of 974 incidental findings were detected, involving 78.6% of all CBCT, hence 2.6 incidental findings per CBCT. Of these, 38.6% were classified to require treatment, with an additional 25.2% requiring follow-up. Incidental findings included dental pathologies in 55.3%, pathologies of the paranasal sinuses and airways in 29.2%, osseous pathologies in 14.9% of all CBCT, and findings in the soft tissue or TMJ in few cases. Clinically relevant dental incidental findings were detected significantly more frequently in CBCT for implant planning compared to other indications (60.7% vs. 43.2%, <i>p</i> < 0.01), and in CBCT with an FOV ≥ 100 mm compared to an FOV < 100 mm (54.7% vs. 40.0%, <i>p</i> < 0.01). Similar results were obtained for paranasal incidental findings. In a subgroup analysis, 29 of 54 patients showed incidental findings which were previously unknown, and the findings changed therapeutical management in 19 patients (35%). The results of our study highlighted the importance of a meticulous analysis of the entire FOV of CBCT for incidental findings, which showed clinical relevance in more than one in three patients. Due to a high number of clinically relevant incidental findings especially in CBCT for implant planning, an FOV of 100 × 100 mm covering both the mandible and the maxilla was concluded to be recommendable for this indication.https://www.mdpi.com/2075-4418/12/5/1036CBCTincidental findingsimpact on therapeutic management |
| spellingShingle | Michael J. Braun Thaddaeus Rauneker Jens Dreyhaupt Thomas K. Hoffmann Ralph G. Luthardt Bernd Schmitz Florian Dammann Meinrad Beer Dental and Maxillofacial Cone Beam CT—High Number of Incidental Findings and Their Impact on Follow-Up and Therapy Management Diagnostics CBCT incidental findings impact on therapeutic management |
| title | Dental and Maxillofacial Cone Beam CT—High Number of Incidental Findings and Their Impact on Follow-Up and Therapy Management |
| title_full | Dental and Maxillofacial Cone Beam CT—High Number of Incidental Findings and Their Impact on Follow-Up and Therapy Management |
| title_fullStr | Dental and Maxillofacial Cone Beam CT—High Number of Incidental Findings and Their Impact on Follow-Up and Therapy Management |
| title_full_unstemmed | Dental and Maxillofacial Cone Beam CT—High Number of Incidental Findings and Their Impact on Follow-Up and Therapy Management |
| title_short | Dental and Maxillofacial Cone Beam CT—High Number of Incidental Findings and Their Impact on Follow-Up and Therapy Management |
| title_sort | dental and maxillofacial cone beam ct high number of incidental findings and their impact on follow up and therapy management |
| topic | CBCT incidental findings impact on therapeutic management |
| url | https://www.mdpi.com/2075-4418/12/5/1036 |
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