Incidental Findings in Pretreatment and Post-Treatment Orthodontic Panoramic Radiographs

Abstract

Panoramic radiographs are the most requested imaging exams in dentistry and an essential part of the documentation used by orthodontists in treatment planning. Alterations that modify bone density and the trabecular bone pattern can be finding in panoramic radiographs before and after the orthodontic treatment. Furthermore, the transition between the mixed to the permanent dentition is a complex process that can incur in fails and odontogenic anomalies. The identification of incidental findings that may demand specific dental or medical treatment is important to provide satisfactory dental care. Material and methods: The aim of this study was to evaluate panoramic radiographs obtained before and after the orthodontic treatment in order to identify the most prevalent incidental findings. Five hundred panoramic radiographs (250 pretreatment and 250 post-treatment) from patients between eleven and eighteen-years-old obtained between 2005 and 2015 were selected from the archives of the Department of Orthodontics, Bauru School of Dentistry, and University of São Paulo. The image analysis was performed by one single examiner. Results: The incidence of impacted teeth and supernumerary teeth was significant higher in the pretreatment group (p<0.05). The incidence of root dilacerations, osteosclerosis and the presence of orthodontic retainers was significant higher in the post-treatment group (p<0.05). Apical remodeling in the incisors was observed in 180 patients in the post-treatment group. Conclusion: In conclusion, clinical relevant incidental findings were observed in both groups. Special care should be taken while evaluating post-treatment radiographs to diagnosis alterations that may require intervention or interfere in other dental treatments.