Kieferorthopädische Röntgendiagnostik - Prävalenz von Nebenbefunden in Abhängigkeit des Patientenalters
Age effect in the analysis of orthodontic radiographs - Prevalence of incidental findings in relation to patient age
von Charlotte Vehring
Datum der mündl. Prüfung:2021-11-24
Erschienen:2021-11-24
Betreuer:Prof. Dr. Philipp Meyer-Marcotty
Gutachter:Prof. Dr. Philipp Meyer-Marcotty
Gutachter:Prof. Dr. Wieland Staab
Dateien
Name:Vehring_Charlotte_Dissertation20.11.2021für ediss.pdf
Size:18.4Mb
Format:PDF
Description:Dissertation
Zusammenfassung
Englisch
Background: Panoramic radiographs and lateral cephalogram open a great diagnostic yield to detect occult pathologic events outside the dental area. Frequent pathological abnormalities were depicted in several clinicoradiological studies. Does an aging of orthodontic population effect an enhancement of secondary findings, that can be read in orthodontic radiographs? The aim of the study is to proof the age effect regarding to the prevalence of incidental in orthodontic radiographs outside the dental region. Methods: The retrospectiv study included 600 pretreatment orthodontic radiographs of 150 infantile and 150 adult patients with ages ranging from 6 to 72 years. The mean age was 19.46 years, with a standard deviation of 10.71 years. All scans were evaluated by three experienced dentists and each incidental finding was further classified along nine locations and by its pathological character. Results: These studies evidenced a positiv age effect of incidental findings in different extradental locations within the appraisal of orthodontic radiographs. A total of 1458 incidental findings were reported. On average 2.6 incidental findings were observed in each panoramic radiograph. The lateral cephalogram performed on average 2.2 pathological abnormalities. Apart of the dentition (n = 497), the most common affected regions were the para- nasal sinus (n = 266), mandibula (n = 174), cranial base (n = 160), soft-tissue (n = 130) and maxilla (n = 124). Adult radiographs embodied a statistically significant higher amount of incidental findings in the following localizations: dentition, maxilla, mandibula, paranasal sinus and temporomandibular joint (p < 0,001). In the lateral cephalogram adults tended to show pathological events in the regions cranial base and cervical spine more frequently (p < 0,05). Thirty-three percent of all findings needed follow up for further diagnostics, as the circumstances required medical attendance before orthodontic treatment. Conclusions: This study confirms the higher prevalence of incidental findings in the sample of adults. Since incidental findings are common and can be easily detected in orthodontic radiographs, orthodontics should be aware of the multiplicity of secondary findings outside the dental area. The current studies proposed a standardized approach in diagnostic radiology before orthodontic treatment. Common incidental findings are discussed and their clinical relevance is explained.
Keywords: Incidental findings; lateral cephalogram; panoramic radiograph