Madeleine Edmonds, Susanne Perschbacher, Iacopo Cioffi, Marco Magalhaes
{"title":"Ability of Orthodontists to Detect, Interpret and Propose Management Strategies for Incidental Findings on Pre-Treatment Panoramic Radiographs","authors":"Madeleine Edmonds, Susanne Perschbacher, Iacopo Cioffi, Marco Magalhaes","doi":"10.1111/ocr.12897","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Objectives</h3>\n \n <p>Radiographs are routinely acquired for orthodontic evaluation, and incidental findings (IFs) may be detected early as part of this routine care. This study aimed to assess the prevalence of IFs on panoramic radiographs taken for orthodontic assessment and evaluate the ability of orthodontists to detect, interpret and recommend management for IFs.</p>\n </section>\n \n <section>\n \n <h3> Materials and Methods</h3>\n \n <p>A retrospective analysis of 1756 patients aged 7–21 with a panoramic image taken for orthodontic evaluation was performed. IFs were categorised by anatomic region and assigned a significance level based on a custom-made risk assessment tool. Twelve selected images were evaluated by 30 orthodontists via a standardised online survey. Participants were tasked with reviewing each image, providing a radiological interpretation, and indicating whether a referral would be needed prior to commencing orthodontic treatment. The responses were scored against those of an expert oral and maxillofacial radiologist (OMFR). Inter-observer agreement was evaluated by computing the Cohen's <i>K</i>.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The prevalence of IFs was 30.8%. The most common findings were impacted teeth (17.7%), hypodontia (14.9%) and dense bone islands (14.7%). After applying the risk assessment tool, 35% of the findings were considered highly significant. The overall agreement between the orthodontists and OMFR was <i>k =</i> 0.32 (95% CI = 0.30–0.34). The agreement for location was 0.52 (95% CI = 0.47–0.58), whereas it was <i>k =</i> 0.45 (95% CI = 0.40–0.50) for diagnosis and <i>k =</i> 0.19 (95% CI = 0.13–0.24) for referral need.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Orthodontists may benefit from additional education and training focused on interpretation and management of IFs on panoramic radiographs.</p>\n </section>\n </div>","PeriodicalId":19652,"journal":{"name":"Orthodontics & Craniofacial Research","volume":"28 3","pages":"449-457"},"PeriodicalIF":2.4000,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Orthodontics & Craniofacial Research","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1111/ocr.12897","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives
Radiographs are routinely acquired for orthodontic evaluation, and incidental findings (IFs) may be detected early as part of this routine care. This study aimed to assess the prevalence of IFs on panoramic radiographs taken for orthodontic assessment and evaluate the ability of orthodontists to detect, interpret and recommend management for IFs.
Materials and Methods
A retrospective analysis of 1756 patients aged 7–21 with a panoramic image taken for orthodontic evaluation was performed. IFs were categorised by anatomic region and assigned a significance level based on a custom-made risk assessment tool. Twelve selected images were evaluated by 30 orthodontists via a standardised online survey. Participants were tasked with reviewing each image, providing a radiological interpretation, and indicating whether a referral would be needed prior to commencing orthodontic treatment. The responses were scored against those of an expert oral and maxillofacial radiologist (OMFR). Inter-observer agreement was evaluated by computing the Cohen's K.
Results
The prevalence of IFs was 30.8%. The most common findings were impacted teeth (17.7%), hypodontia (14.9%) and dense bone islands (14.7%). After applying the risk assessment tool, 35% of the findings were considered highly significant. The overall agreement between the orthodontists and OMFR was k = 0.32 (95% CI = 0.30–0.34). The agreement for location was 0.52 (95% CI = 0.47–0.58), whereas it was k = 0.45 (95% CI = 0.40–0.50) for diagnosis and k = 0.19 (95% CI = 0.13–0.24) for referral need.
Conclusions
Orthodontists may benefit from additional education and training focused on interpretation and management of IFs on panoramic radiographs.
期刊介绍:
Orthodontics & Craniofacial Research - Genes, Growth and Development is published to serve its readers as an international forum for the presentation and critical discussion of issues pertinent to the advancement of the specialty of orthodontics and the evidence-based knowledge of craniofacial growth and development. This forum is based on scientifically supported information, but also includes minority and conflicting opinions.
The objective of the journal is to facilitate effective communication between the research community and practicing clinicians. Original papers of high scientific quality that report the findings of clinical trials, clinical epidemiology, and novel therapeutic or diagnostic approaches are appropriate submissions. Similarly, we welcome papers in genetics, developmental biology, syndromology, surgery, speech and hearing, and other biomedical disciplines related to clinical orthodontics and normal and abnormal craniofacial growth and development. In addition to original and basic research, the journal publishes concise reviews, case reports of substantial value, invited essays, letters, and announcements.
The journal is published quarterly. The review of submitted papers will be coordinated by the editor and members of the editorial board. It is policy to review manuscripts within 3 to 4 weeks of receipt and to publish within 3 to 6 months of acceptance.