Incidental pathological findings in panoramic radiographs: An institution-based study

ABSTRACT Background: Panoramic radiography or orthopantomography is a widely used extraoral imaging technique that offers a comprehensive visualization of the maxillofacial complex and aids in detecting pathologies. Its wide anatomical coverage often reveals incidental findings (IF) – abnormalities unrelated to the primary imaging indication. Early detection of such findings is essential for better prognosis and lower morbidity. Aims: The aim of the study was to determine the prevalence of IFs in panoramic radiographs of patients attending a dental institution. Settings and Design: The study was designed as a cross-sectional retrospective analysis and was conducted in a private dental institution. Subjects and Methods: The study analyzed 1880 panoramic radiographs retrieved from the radiology department archives over 6 months (April–October 2023). Eligible radiographs were evaluated for IFs by calibrated examiners. Statistical Analysis Used: Data normality was assessed using the Shapiro–Wilk and Kolmogorov–Smirnov tests. Descriptive statistics were presented as mean ± standard deviation, and associations between demographics and IFs were evaluated using the Chi-square test, with significance set at P < 0.05. Results: Of 1880 panoramic radiographs assessed, 471 IFs were identified in 400 images, yielding an overall prevalence of 25.05% indicating that nearly one in four panoramic radiographs revealed an IF. The most prevalent IF was impacted teeth (33.5%), followed by elongated styloid process (31.6%). Conclusion: The high prevalence of IF in panoramic radiographs highlights the need for systematic evaluation in dental and maxillofacial practice. The expertise of oral and maxillofacial radiologists ensures accurate detection of hidden pathologies, facilitating early intervention and improved outcomes.