Incidental findings on cone beam computed tomography scans in cleft lip and palate patients.

Kuijpers, Mette A R; Pazera, Andrzej; Admiraal, Ronald J; Bergé, Stefaan J; Vissink, Arjan; Pazera, Pawel (2014). Incidental findings on cone beam computed tomography scans in cleft lip and palate patients. Clinical oral investigations, 18(4), pp. 1237-1244. Springer 10.1007/s00784-013-1095-z

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OBJECTIVES Cone beam computed tomography (CBCT) is frequently used in treatment planning for alveolar bone grafting (ABG) and orthognathic surgery in patients with cleft lip and palate (CLP). CBCT images may depict coincident findings. The aim of this study was to assess the prevalence of incidental findings on CBCT scans in CLP patients. SUBJECTS AND METHODS Initial CBCTs taken from consecutive patients (n = 187; mean age 11.7 years, range 6.9-45) with a non-syndromic orofacial cleft from January 2006 until June 2012 were systematically evaluated. Twenty-eight patients (mean age 19.3 years, range 13.2-30.9) had been subjected to ABG before their first CBCT was taken; 61 patients had a CBCT before and after ABG. Sinuses, nasopharynx, oropharynx, throat, skull, vertebrae, temporomandibular joint (TMJ), maxilla and mandible were checked for incidental findings. RESULTS On 95.1 % of the CBCTs, incidental findings were found. The most prevalent were airway/sinus findings (56.1 %), followed by dental problems, e.g. missing teeth (52 %), nasal septum deviation (34 %), middle ear and mastoid opacification, suggestive for otitis media (10 %) and (chronic) mastoiditis (9 %), abnormal TMJ anatomy (4.9 %) and abnormal vertebral anatomy (1.6 %). In the 28 patients whose first CBCT was taken at least 2 years after ABG, bone was still present in the reconstructed cleft area except in 2 out of 12 patients with a bilateral CLP. The ABG donor site (all bone grafts were taken from the chin area) was still recognizable in over 50 % of the patients. Based on the CBCT findings, 10 % of the patients were referred for further diagnosis and 9 % for further treatment related to dental problems. CONCLUSION Incidental findings are common on CBCTs. Compared with the literature, CLP patients have more dental, nasal and ear problems. Thus, whenever a CBCT is available, this scan should be reviewed by all specialists in the CLP team focusing on their specific background knowledge concerning symptoms and treatment of these patients. CLINICAL RELEVANCE The high number of findings indicates that CBCT imaging is a helpful tool in the treatment of CLP patients not only related to alveolar bone grafting and orthognathic surgery but it also provides diagnostic information for almost all specialties involved in CLP treatment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > School of Dental Medicine > Department of Orthodontics

UniBE Contributor:

Pazera, Pawel

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1432-6981

Publisher:

Springer

Language:

English

Submitter:

Eveline Carmen Schuler

Date Deposited:

25 Nov 2014 14:20

Last Modified:

25 Jan 2017 12:15

Publisher DOI:

10.1007/s00784-013-1095-z

PubMed ID:

23979354

Uncontrolled Keywords:

Cone beam computed tomography, Diagnostic imaging, Cleft palate, Incidental findings

BORIS DOI:

10.7892/boris.60589

URI:

https://boris.unibe.ch/id/eprint/60589

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