Purpose: Prior to cone-beam computed tomography (CBCT), orthodontic competence included radiological interpretation. Nevertheless, maxillary impacted canines (MICs), because of their position and adjacent complex anatomy, have been challenging to interpret, particularly with regard to root resorption. Although CBCT crosssectional reconstructions of MICs yielded clearer insights into its diagnosis and treatment planning, the value of simultaneously using 2 different cross-sectional or multiplanar reconstructions of the CBCT datasets - orthogonal and curved/panoramic multiplanar reconstructions - has hitherto not been considered. Materials and Methods: Both orthogonal and curved/panoramic multiplanar reconstruction series of 5 screenshots were each reconstructed from the 5 cm × 5 cm CBCT datasets of 15 separate MICs. Fifteen credentialled and experienced orthodontist volunteers reviewed 2 separate PowerPoints of 15 randomized series each, 1 week apart.Their review considered 6 factors that could affect treatment: the position and level of the MIC, the presence or absence of root resorption, ankylosis, cysts, and dilaceration. Results: All 15 orthodontists were statistically similar regarding overall years of experience and of CBCT use. Although either reconstruction alone allowed the orthodontists to determine whether ankylosis and, to a lesser extent, most of the other features were present or absent in the MIC, reviewing both reconstructions together was necessary to determine whether root resorption was present or absent in the adjacent tooth. Conclusion Reviewing both orthogonal and curved/panoramic multiplanar reconstructions was necessary to evaluate the presence or absence of root resorption in the teeth adjacent to MICs and that of many other features. (Imaging Sci Dent 2023; 53: 145-51)

PURPOSE: The aim of this study was to determine the prevalence of incidental findings (IFs) on digital dental panoramic radiographs (DPRs) of asymptomatic patients attending a general dental practice. MATERIALS AND METHODS: This was a retrospective study of 6,252 consecutive digital (photostimulatable phosphor) DPRs of patients who visited a Canadian general dental practice for a complete new patient examination. The IFs were grouped into dental-related anomalies, radiopacities and radiopacities in the jaws, changes in the shape of the condyles, and other findings in the jaws, such as tonsilloliths and mucosal antral pseudocysts. Their prevalence was determined. RESULTS: Thirty-two percent of the DPRs showed at least 1 IF. The highest prevalence was found for dental-related anomalies (29% of all DPRs), of which impacted teeth were the most prevalent finding (24% of all DPRs), followed by idiopathic osteosclerosis (6% of all DPRs). A lower prevalence was noted for tonsilloliths (3%), and the prevalence of root tips, mucosal antral pseudocysts, and anomalies in condylar shape was approximately 1% each. CONCLUSION The observed prevalence of 32.1% for IFs of any type underscores the need for a dental practitioner to review the entire DPR when a patient presents for an initial dental examination (or check-up) or for dental hygiene. Only a single IF (a central giant cell granuloma) provoked alarm, as it was initially considered malignant. Similarly, impacted teeth and suspected cysts need careful evaluation upon discovery to determine how they may be optimally managed.

Purpose: This study aimed to evaluate the quality of clinically indicated digital dental panoramic radiographs (DPRs) of children with mixed dentition. Despite the likely widespread use of this modality, recent research detailing errors on DPRs is scarce. Materials and Methods: A consecutive case series was performed, including 178 DPRs from patients aged 6 to 12years. Each DPR was reviewed for 10 distinct errors. The findings were analyzed to identify potential solutions. Results: Nearly three-quarters of the DPRs contained multiple errors. Linear regression analysis indicated that thenumber of errors decreased with increasing patient age; however, this trend was not statistically significant. Notably, 3groups of errors (2 errors each) frequently appeared together on the same DPR. When similar errors were grouped, theerror incidence decreased significantly with age. Both leftward head tilting and rightward head rotation were observed,likely attributable to the design of the DPR room and the door location. The inter-rater and intra-rater reliability agreements were deemed “substantial” or “almost perfect, beyond chance” for the detection of most errors, particularly the most frequent types, which involved the “chin,” “tongue,” and “lips-open” positions. Conclusion As a pediatric patient ages, the number of DPR errors decreases. The results suggest several pre-exposure strategies that could reduce the error rate. These include, monitoring for a “lips-open” position as an indicator of a potential “tongue” error (occluding the palate-glossal space), and implementing dry runs. Asymmetries observed on DPR must be documented and should prompt re-examination, as they may be genuine.

Purpose: This study aimed to evaluate the quality of clinically indicated digital dental panoramic radiographs (DPRs) of children with mixed dentition. Despite the likely widespread use of this modality, recent research detailing errors on DPRs is scarce. Materials and Methods: A consecutive case series was performed, including 178 DPRs from patients aged 6 to 12years. Each DPR was reviewed for 10 distinct errors. The findings were analyzed to identify potential solutions. Results: Nearly three-quarters of the DPRs contained multiple errors. Linear regression analysis indicated that thenumber of errors decreased with increasing patient age; however, this trend was not statistically significant. Notably, 3groups of errors (2 errors each) frequently appeared together on the same DPR. When similar errors were grouped, theerror incidence decreased significantly with age. Both leftward head tilting and rightward head rotation were observed,likely attributable to the design of the DPR room and the door location. The inter-rater and intra-rater reliability agreements were deemed “substantial” or “almost perfect, beyond chance” for the detection of most errors, particularly the most frequent types, which involved the “chin,” “tongue,” and “lips-open” positions. Conclusion As a pediatric patient ages, the number of DPR errors decreases. The results suggest several pre-exposure strategies that could reduce the error rate. These include, monitoring for a “lips-open” position as an indicator of a potential “tongue” error (occluding the palate-glossal space), and implementing dry runs. Asymmetries observed on DPR must be documented and should prompt re-examination, as they may be genuine.

Purpose: This study aimed to evaluate the quality of clinically indicated digital dental panoramic radiographs (DPRs) of children with mixed dentition. Despite the likely widespread use of this modality, recent research detailing errors on DPRs is scarce. Materials and Methods: A consecutive case series was performed, including 178 DPRs from patients aged 6 to 12years. Each DPR was reviewed for 10 distinct errors. The findings were analyzed to identify potential solutions. Results: Nearly three-quarters of the DPRs contained multiple errors. Linear regression analysis indicated that thenumber of errors decreased with increasing patient age; however, this trend was not statistically significant. Notably, 3groups of errors (2 errors each) frequently appeared together on the same DPR. When similar errors were grouped, theerror incidence decreased significantly with age. Both leftward head tilting and rightward head rotation were observed,likely attributable to the design of the DPR room and the door location. The inter-rater and intra-rater reliability agreements were deemed “substantial” or “almost perfect, beyond chance” for the detection of most errors, particularly the most frequent types, which involved the “chin,” “tongue,” and “lips-open” positions. Conclusion As a pediatric patient ages, the number of DPR errors decreases. The results suggest several pre-exposure strategies that could reduce the error rate. These include, monitoring for a “lips-open” position as an indicator of a potential “tongue” error (occluding the palate-glossal space), and implementing dry runs. Asymmetries observed on DPR must be documented and should prompt re-examination, as they may be genuine.

Purpose: Lateral cephalograms of orthodontic patients may contain incidental findings that could potentially lead to harm. Materials and Methods: The lateral cephalograms of 1765 consecutive 12- to 20-year-old patients, being considered for routine orthodontic treatment, were retrospectively reviewed. These patients were considered normal, because no abnormalities were found either in their medical history or on their clinical examination. Results: The overall prevalence of incidental findings was 18.8%, of which 10.3% were ponticulus posticus and 4.2% were bridging of the sella turcica. Although occipital spurs and ponticulus posticus were more prevalent in males, the size of the sella turcicas did not differ between sexes. Of the 1156 patients completing treatment about 2 years later, only one lateral cephalogram displayed progression of the ponticulus posticus in that time. Conclusion The prevalence of incidental findings on lateral cephalograms of otherwise normal orthodontic 12-to 20-year-old patients was almost a fifth, of which ponticulus posticus, vertebral fusion, and enlarged parietal foramina were clinically significant.

No abstract available.
Carotid Stenosis ; Cerebral Hemorrhage ; Endarterectomy ; Humans ; Stents