Incidental Pathology and Anatomic Variations in Oral and Maxillofacial Cone-beam Computed Tomographic Scans
E. N. Kihara *
Division of Dental and Maxillofacial Radiology, Department of Oral and Maxillofacial surgery, Oral Pathology and Oral Medicine, University of Nairobi, Kenya.
T. J. Ochola
Division of Dental and Maxillofacial Radiology, Department of Oral and Maxillofacial surgery, Oral Pathology and Oral Medicine, University of Nairobi, Kenya.
M. L. Chindia
Department of Oral and Maxillofacial surgery, Oral Pathology and Oral Medicine, University of Nairobi, Kenya.
M. E. Parker
Department of Diagnostics and Radiology, University of Western Cape, Cape Town, South Africa.
*Author to whom correspondence should be addressed.
Abstract
Aims: To determine the occurrence of incidental pathological and anatomical findings in CBCT scans.
Study Design: Retrospective cross sectional descriptive study which was done at a private imaging center from 2010 to 2012.
Methodology: 97 CBCT scans of the oral and maxillofacial area were reviewed.
Results: Scans of the maxilla were the commonest 60 (62%) and only 37 (38%) were mandibular scans. There were 55 (57%) scans whose indication for imaging could be ascertained. These were used to study the incidental findings. Majority (36, 65%) of the examinations were done on female patients while 19 (35%) were for males. Most 32 (58%) of the scans were required for implant site assessment. There were incidental findings in 40 (73%) scans, 35 (64%) had pathologies while 9 (16%) had significant anatomical findings. The highest overall rate of incidental pathological finding was in the airway area (18, 33%), followed by dental (16, 29%), periapical (13, 24%), periodontal lesions (7, 13%) and foreign bodies (2, 4%). Scans with incidental anatomical findings included variations in root canal morphology (6, 11%), nerve foramina (2, 4%) and dental roots protruding into the maxillary antrum (2, 4%).
Conclusion: Various incidental findings in CBCT images are to be expected. Pathological findings were the commonest while airway findings were the majority. A thorough review of CBCT scans will ensure early diagnosis and management of incidental pathologies while a good documentation of significant anatomical variations will provide important pre-operative information.
Keywords: Cone-beam CT, incidental, maxillofacial, oral pathology.