Development of a systematic checklist for reviewing cone-beam computed tomography images in an orthodontic population

Abstract

Introduction

This study aimed to create a comprehensive checklist for common incidental findings (IFs) in an orthodontic population to assist orthodontists in interpreting cone-beam computed tomography (CBCT) images.

Methods

A total of 475 out of 479 consecutive CBCT images were retrospectively reviewed. The images were divided into 6 easily identifiable zones using landmarks and reference planes orthodontists commonly used for treatment planning. Findings were further classified into variations of normal anatomy, IFs, and IFs that may be considered for referral to a radiologist.

Results

A total of 2248 IFs were reported in the 475 CBCT scans (4.7 findings/scan). Zone 3, which includes the maxilla, presented the most findings (56.5%), followed by zone 5 (22.9%), which includes the mandible, zone 6 (7.0%), zone 2 (6.6%), zone 4 (5.3%), and zone 1 (1.7%). Most findings were normal variations in anatomy (62.2%). The most common finding was impacted teeth (18.8%) and concha bullosa (8.9%).

Conclusions

This study underscores the high frequency of IFs in large field of view CBCT images in an orthodontic patient population.