Prevalence of Non-Dental Pathology in Cone Beam Computed Tomography Studies for Dental Implants

Balshi TJ, DDS, PhD, FACP, Wolfinger GJ, DMD, FACP, Wulc BA, Balshi SF, MBE

Background: Cone beam computed tomography (CBCT) technology is becoming increasingly useful in the treatment planning of surgical procedures in multiple dental specialties.  These images not only simplify surgical planning, they also provide the practitioner with an opportunity to diagnose dental and non-dental pathology visible in the oromaxillofacial region.

Methods: This retrospective review analyzed 261 consecutive CBCT scans taken at a single private practice noting the prevalence of non-dental pathology in CBCT images for dental implants. All scans taken from November 2007 to September 2011 were included in this study. One Board Certified Oral-Maxillofacial Radiologist read all images.

Results: Of these CBCT scans, 28 non-dental pathologies were diagnosed. 95% (247 of 261) of patients studied were diagnosed with non-dental pathology and 78% (193 of 247) were diagnosed with multiple pathologies.  Pathologies found ranged from the relatively innocuous chronic sinusitis, to potentially more serious findings such as intracranial calcifications, multiple myeloma, soft tissue masses, and proptosis.

Conclusion: These results suggest that the dental clinician using CBCT technology in a majority of cases will commonly image non-dental head and neck pathology.

Clinical Implications: The clinician must be familiar with the radiographic diagnosis of head and neck pathology, and/or must refer these images to an appropriate specialist for the radiographic interpretation of subadjacent tissue and identification of head and neck pathology.

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Pi Dental Center, Fort Washington, PA