Incidental findings on panoramic radiographs for pre-extraction assessment of third molars

Introduction: Panoramic radiographs are complex to mographic images that are often used to examine third molars prior to their extraction. Because of the relatively large area covered by panoramic radiographs, incidental findings are common. Objectives: The aim of this study was to report the frequency and nature of incidental findings in panoramic radiographs made specifically for pre-extraction assessment of the third molars. Materials and Methods: The cross sectional study included a total of 121 panoramic radiographs from the university-based practice of a single oral and maxillofacial surgeon over a three-month time period, from January 1st to April 1st of 2015. Data were collected from the imaging reports generated for these radiographs. The imaging reports were prepared by a board-certified specialist in oral and maxillofacial radiology. Results: Every other panoramic radiograph had incidental findings. The findings spanned a number of structures and disease categories but the most common was styloid process elongation or calcification of the stylohyoid ligament. Most findings were indolent, however, some required further investigation. Conclusions: Incidental findings on panoramic radiographs are common. Most findings were considered variations of normal, while others required immediate attention. Analyzing panoramic radiographs in a systematic fashion ensures that all incidental findings are recorded and addressed accordingly.