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A retrospective study of incidental findings occurring in a consecutive case series of lateral cephalograms of patients referred for orthodontic treatment Patel, Akash


Objectives: Lateral Cephalograms (LC) have been used as part of pretreatment records of orthodontic patients for diagnosing and treatment planning. Since LC contains many important anatomical structures, accurate examination of these areas is very important. Incidental findings of clinical significance are believed to be present very commonly on LC and thus orthodontists are more likely to encounter those. The purpose of this study was to find out prevalence of incidental findings in LC taken for orthodontic diagnosis of patients seeking orthodontic treatment at UBC Graduate Orthodontic Clinic. Methods: A total of 1765 consecutive patients’ pretreatment and follow up LCs were inspected retrospectively. The age was restricted to 12-20 years old at the start of the orthodontic treatment. All the LC were checked within Romexis- image capturing software. Each LC was examined in 3 zones in a systematic way: cranium; neck and cervical spine; and dentofacial complex. Additionally, size of Sella Turcica was also measured in Romexis. Results: Overall prevalence of incidental findings was 18.8%. Ponticulus Posticus was the most prevalent finding (10.3%) followed by bridging of Sella Turcica (4.2%). Sella turcica height ranged from 1.1-12.0mm and width ranged from 2.6-15.8mm. There is statistically significant association between incidental findings and sex (chi square statistics 16.315 and p<0.05) with males being more likely to present with them. Conclusions: Incidental findings are prevalent on LC radiographs of orthodontic patients. Thus, careful examination of LC beyond area of orthodontists’ interest is very important. Males are more likely to present with incidental findings than females. As far as the individual anomaly is concerned, only Occipital Spur was more likely to be present in males than in females. Ponticulus Posticus and Occipital Spur were highest co-occurring incidental findings in the sample. All except on follow up LC revealed no additional prevalence of incidental findings.

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