Incidental Findings on Panoramic Radiograph: a Clinical Study

Background: Panoramic radiography is a two-dimensional dental x-ray examination that captures the entire mouth in a single image, including the teeth, upper and lower jaws, surrounding structures and tissues. The study was conducted to report the incidental findings on panoramic radiographs. Materials & Methods: This study was conducted in the department of Oral Medicine & Radiology in year 2010. It included panoramic radiographs of 410 subjects obtained for various reasons. Patient’s information such as name, age, gender, indication of OPG was recorded. All images which were of non informative and faulty were excluded from the study. All images were taken with single digital Care stream 8000 (Kodak OPG machine). Results: Out of 410 subjects whose OPG were taken, incidental findings were seen in 200 patients with prevalence rate of 50% (males90, females -110). The difference was non significant (P>0.01). The mean age of males was 35.2 years and females 36.4 years. The difference was non significant (P>0.01) Following incidental findins were recorded such as elongated styloid process (25%), maxillary sinus pathology (105), foreign bodies (5%), soft tissue calcification (12%), dental anomalies (7%) and TMJ disorders (2%). Most common finding was elongated styloid process. The difference was significant (P<0.05). Unilateral 13% and bilateral 12% of styloid process showed elongation. Retention pseudocyst was seen in 5%, sinus opacification in 2% and mucosal thickening was seen in 3% of cases. Most commonly seen soft tissue calcifications was tonsillolith (4%), phlebolith (4%), vascular calcification (3%) and sialolith (1%). Common dental anomalies were supernumerary teeth (2%), microdontia (3%), root dilacerations and external root resorption in 1% of all cases. Commonly seen TMJ disorders such as cystic lesions and degenerative joint diseases in 1% of all cases. Conclusion: Panoramic radiograph is a preferred routine diagnostic tool for the evaluation of large lesions, cysts, tumors etc. The additional advantage is incidental findings which may remain undetected if other radiographs would be taken. Thus it can be useful in detecting hidden findings