Incidental Findings in Cone-Beam Computed Tomographic Images: Calcifications in Head and Neck Region

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Ali Altındağ1 / Hakan Avsever2 / Oguz Borahan3 / Mesut Akyol4 / Kaan Orhan1

1Ankara University, Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Ankara, Turkey
2Gulhane Training&Reserach Hospital, Health Sciences University, Dentistry Center, Department of Dentomaxillofacial Radiology, Ankara, Turkey
3Marmara University, Department of Dentomaxillofacial Radiology, Istanbul, Turkey
4Yildirim Beyazit University, Department of Biostatistics, Ankara, Turkey

Summary

Background/Aim: The use of CBCT in dentistry has been increasing popularity nowadays. CBCT images provide valuable information from anatomic structures and pathologies. Images obtained with CBCT allow for more appropriate treatment planning. The purpose of this study was to assess the calcifications which were found incidentally on CBCT images and to reveal the frequency and characteristics. Material and Methods: A total of 691 CBCT images which obtained from the patients were assessed. Demographic data and calcifications which were found out of primarily interest area were noted. The incidental findings were categorized and analyzed using descriptive statistics. Results: 945 calcifications were discovered on 318(46.02%) of the 691 patients’ images. 373(53.98%) scans showed no calcificated findings. The age range of patients was from 5 to 84 years. The most common calcification was tonsillolith (86.03%), followed by stylohyoid calcifications (6.24%), antrolith and subdermal calcifications (2.33%). Conclusion: Calcified lesions in head and neck region were commonly seen in CBCT images. Although the most of the calcifications are asymptomatic and require no treatment but correct identification of these findings will reduce unnecessary further diagnostic assessments and will provide more appropriate treatment plans. It will also provide the ability comprehensively evaluation of underlying diseases and practitioners will have life-saving information by early diagnosis.

Keywords: CBCT; İncidental Findings; Calcifications; Radiology

References

  1. Scarfe WC, Farman AG. Soft tissue calcifications in the neck: Maxillofacial CBCT presentation and significance. AADMRT Newsletter, 2010;2:3-15.
  2. Price JB, Thaw KL, Tyndall DA, Ludlow JB, Padilla RJ. Incidental findings from cone beam computed tomography of the maxillofacial region: a descriptive retrospective study. Clin Oral Implants Res, 2012;23:1261-1268.
  3. Cha JY, Mah J, Sinclair P. Incidental findings in the maxillofacial area with 3-dimensional cone-beam imaging. Am J Orthod Dentofacial Orthop, 2007;132:7-14.
  4. Cağlayan F, Tozoğlu U. Incidental findings in the maxillofacial region detected by cone beam CT. Diagn Interv Radiol, 2012;18:159-163.[Web of Science]
  5. Mozzo P, Procacci C, Tacconi A, Martini PT, Andreis IA. A new volumetric CT machine for dental imaging based on the cone-beam technique: preliminary results. Eur Radiol, 1998;8:1558-1564.[Crossref]
  6. Pohlenz P, Blessmann M, Blake F, Heinrich S, Schmelzle R, Heiland M. Clinical indications and perspectives for intraoperative cone-beam computed tomography in oral and maxillofacial surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2007;103:412-417.[Crossref]
  7. De Vos W, Casselman J, Swennen GRJ. Cone-Beam Computerized Tomography (CBCT) Imaging of the Oral and Maxillofacial Region: A Systemic Review of the Literature. Int J Oral Maxillofac Surg, 2009;38:609-625.
  8. Dreiseidler T, Mischkowski RA, Neugebauer J, Ritter L, Zöller JE. Comparison of cone-beam imaging with orthopantomography and computerized tomography for assessment in presurgical implant dentistry. Int J Oral Maxillofac Implants, 2009;24:216-225.
  9. Rogers SA, Drage N, Durning P. Incidental findings arising with cone beam computed tomography imaging of the orthodontic patient. Angle Orthod, 2011;81:350-355.[Web of Science][Crossref]
  10. Pazera P, Bornstein MM, Pazera A, Sendi P, Katsaros C. Incidental maxillary sinus findings in orthodontic patients: a radiographic analysis using cone-beam computed tomography (CBCT). Orthod Craniofac Res, 2011;14:17-24.[Crossref][Web of Science]
  11. Gracco A, Parenti SI, Ioele C, Bonetti GA, Stellini E. Prevalence of incidental maxillary sinus findings in Italian orthodontic patients: A retrospective cone-beam computed tomography study. Korean J Orthod, 2012;42:329-234.[Web of Science][Crossref]
  12. Raghav M, Karjodkar FR, Sontakke S, Sansare K. Prevalence of incidental maxillary sinus pathologies in dental patients on cone-beam computed tomographic images. Contemp Clin Dent, 2014;5:361-365.[Crossref]
  13. Brüllmann DD, Schmidtmann I, Hornstein S, Schulze RK. Correlation of cone beam computed tomography (CBCT) findings in the maxillary sinus with dental diagnoses: a retrospective cross-sectional study. Clin Oral Investig, 2012;16:1023-1029.
  14. Lana JP, Carneiro PM, Machado Vde C, de Souza PE, Manzi FR, Horta MC. Anatomic variations and lesions of the maxillary sinus detected in cone beam computed tomography for dental implants. Clin Oral Implants Res, 2012;23:1398-1403.
  15. Göçmen G, Borahan MO, Aktop S, Dumlu A, Pekiner FN, Göker K. Effect of Septal Deviation, Concha Bullosa and Haller’s Cell on Maxillary Sinus’s Inferior Pneumatization; a Retrospective Study. Open Dent J, 2015;9:282-286.
  16. Rheem S, Nielsen IL, Oberoi S. Incidental findings in the maxillofacial region identified on cone-beam computed tomography scans. J Orthod Res, 2013;1:33-39.[Crossref]
  17. Allareddy V, Vincent SD, Hellstein JW, Qian F, Smoker WR, Ruprecht A. Incidental findings on cone beam computed tomography images. Int J Dent, 2012;2012:871532.
  18. Warhekar S, Nagarajappa S, Dasar PL, Warhekar AM, Parihar A, Phulambrikar T et al. Incidental findings on cone beam computed tomography and reasons for referral by dental practitioners in indore city (m.p). J Clin Diagn Res, 2015;9:ZC21-4.
  19. Drage N, Rogers S, Greenall C, Playle R. Incidental findings on cone beam computed tomography in orthodontic patients. J Orthod, 2013;40:29-37.[Crossref]
  20. Oda M, Kito S, Tanaka T, Nishida I, Awano S, Fujita Y et al. Prevalence and imaging characteristics of detectable tonsilloliths on 482 pairs of consecutive CT and panoramic radiographs. BMC Oral Health, 2013;13:54.
  21. Nass Duce M, Talas DU, Ozer C, Yildiz A, Apaydin FD, Ozgür A. Antrolithiasis: a retrospective study. J Laryngol Otol, 2003;117:637-640.[Crossref]
  22. Rege IC, Sousa TO, Leles CR, Mendonça EF. Occurrence of maxillary sinus abnormalities detected by cone beam CT in asymptomatic patients. BMC Oral Health, 2012 Aug 10;12:30.
  23. Wells AB. Incidence of soft tissue calcifications of the head and neck region on maxillofacial cone beam computed tomography. Electronic Theses and Dissertations. Paper 1545, 2011.
  24. Mahdian M, Moghaddam EJ, Alzahrani A, Rengasamy K, Tadinada A. Calcification of the stylohyoid ligament in panoramic radiography and cone beam computed tomography among patients referred for dental implant treatment planning. Implant Dent, 2014;23:508-513.[Web of Science]
  25. Shigehara H, Honda Y, Kishi K, Sugimoto T. Radiographic and morphologic studies of multiple miliary osteomas of cadaver skin. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1998;86:121-125.[Crossref]
  26. Safi Y, Valizadeh S, Vasegh Z, Aghdasi MM, Shamloo N, Azizi Z. Prevalence of osteoma cutis in the maxillofacial region and classification of its radiographic pattern in cone beam CT. Dermatol Online J, 2016;22(1):2.
  27. Kwak R, Takeuchi F, Ito S, Kadoya S. Intracranial physiological calcification on computed tomography (Part 1): Calcification of the pineal region. No To Shinkei, 1988;40:56-74.
  28. Daghighi MH, Rezaei V, Zarrintan S, Pourfathi H. Intracranial physiological calcifications in adults on computed tomography in Tabriz, Iran. Folia Morphol, 2007;66:115-119.
  29. Kıroglu Y, Callı C, Karabulut N, Oncel C. Intracranial calcifications on CT. Diagn Interv Radiol, 2010;16:263-269.[Web of Science]
  30. Sedghizadeh PP, Nguyen M, Enciso R. Intracranial physiological calcifications evaluated with cone beam CT. Dentomaxillofac Radiol, 2012;41:675-678.[Web of Science]
Citation Information: Balkan Journal of Dental Medicine, ISSN (Online) 2335-0245, DOI: https://doi.org/10.1515/bjdm-2017-0015. Export Citation

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