Detektion von Nebenbefunden bei röntgenologischer Bildgebung in der kieferorthopädischen Praxis: eine fragebogenbasierte Untersuchung

by Ida Skorna
Doctoral thesis
Date of Examination:2025-05-20
Date of issue:2025-05-09
Advisor:Dr. Bernhard Wiechens
Referee:Prof. Dr. Philipp Franz Meyer-Marcotty
Referee:Prof. Dr. René Müller-Wille
Referee:Prof. Dr. Ali Seif A. H.
Persistent Address: http://dx.doi.org/10.53846/goediss-11255

 

 

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Abstract

English

Background: In orthodontic practice, radiographs with large fields of view - such as orthopantomogram (OPT) and lateral cephalogram (LC) radiographs - are routinely acquired and assessed. The reliability of identifying incidental findings on these images remains unclear, particularly regarding the influence of various factors on diagnostic accuracy and potential differences between dental and extradental regions. Methods: A questionnaire was developed using Lime Survey and pretested in a pilot phase. A total of 2,615 email addresses of orthodontic specialists and trainees across Germany were identified and invited to participate via an online survey. The questionnaire collected demographic and professional data (gender, age, experience, workplace, and training) and included four radiographs to be evaluated (one OPT and one LC each from pediatric and adult patients). Responses were categorized into dental and extradental findings and response time was recorded. Results: A total of 134 complete responses were analyzed. Overall, 39.1% of incidental findings were identified. Detection rates differed significantly between regions, with 57.9% of dental findings recognized compared to 20.3% in the extradental region (p < 0.001). A highly relevant incidental finding, suspected arteriosclerotic plaque, was detected in only 7.5% of OPT cases. More findings were identified on OPT (42.1%) than on LC images (36.0%, p < 0.001). Assessment time increased significantly with professional experience (p < 0.001) and correlated positively with the number of findings detected. Conclusion: Diagnostic accuracy in evaluating orthodontic radiographs is strongly influenced by examiner experience and the time allocated for assessment. While dental findings are detected more reliably, medically significant extradental findings are frequently overlooked. These results underscore the need for comprehensive radiographic evaluation and ongoing education, particularly in identifying findings beyond the immediate orthodontic focus.
Keywords: Lateral cephalogram; Incidental discovery; Orthopantomography; Surveys and questionnaires