{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T14:04:46Z","timestamp":1790949886769,"version":"4.1.0"},"reference-count":33,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Panoramic radiography is frequently performed for new patients, follow-ups and treatment in progress. This enables dental clinicians to detect pathology, view important structures, and assess developing teeth. The objective of the study was to determine prevalence of incidental pathologic findings (IPFs) from orthodontic pretreatment panoramic radiographs at a university dental hospital. A retrospective cross-sectional review was conducted of pretreatment panoramic radiographs, using data collection sheets with predefined criteria. Demographic data and abnormalities (impacted teeth, widening of periodontal ligament, pulp stones, rotated teeth, missing teeth, unerupted teeth, crowding, spacing, supernumerary teeth, and retained deciduous teeth) were reviewed. SPSS 28.0 was used to analyze data with statistical tests set at a 5% significance level. Results: One hundred panoramic radiographs were analyzed with an age range of 7 to 57 years. The prevalence of IPFs was 38%. A total of 47 IPFs were detected with altered tooth morphology predominantly (n = 17). Most IPFs occurred in males (55.3%), with 44.7% in females. A total of 49.2% were in the maxilla and 50.8% in the mandible. This difference was statistically significant (p &lt; 0.0475). Other abnormalities were detected in 76% of panoramic radiographs; 33 with IPFs and 43 without. A total of 134 other abnormalities detected showed predominantly impacted teeth (n = 49). Most of these abnormalities were in females (n = 77). Conclusions: The prevalence of IPFs was 38%, predominated by altered tooth morphology, idiopathic osteosclerosis, and periapical inflammatory lesions. Detection of IPFs from panoramic radiographs underscored the importance for clinicians to examine them for comprehensive diagnosis and treatment planning, especially in orthodontics.<\/jats:p>","DOI":"10.3390\/ijerph20043479","type":"journal-article","created":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T03:32:30Z","timestamp":1676518350000},"page":"3479","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Incidental Pathologic Findings from Orthodontic Pretreatment Panoramic Radiographs"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8052-9275","authenticated-orcid":false,"given":"Phumzile","family":"Hlongwa","sequence":"first","affiliation":[{"name":"Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mpule Annah Lerato","family":"Moshaoa","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, School of Dentistry, Faculty of Health Sciences, University of Pretoria, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charity","family":"Musemwa","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, School of Oral Health Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2050, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Razia Abdool Gafaar","family":"Khammissa","sequence":"additional","affiliation":[{"name":"Department of Periodontology and Oral Medicine, School of Dentistry, Faculty of Health Science, University of Pretoria, Pretoria 0001, South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,2,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1093\/ejo\/24.1.43","article-title":"Accuracy of linear and angular measurements on panoramic radiographs taken at various positions in vitro","volume":"24","author":"Stramotas","year":"2002","journal-title":"Eur. J. Orthod."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1093\/ejo\/cjr035","article-title":"Frequency of errors and pathology in panoramic images of young orthodontic patients","volume":"34","author":"Granlund","year":"2012","journal-title":"Eur. J. Orthod."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"9280","DOI":"10.1038\/s41598-021-88795-3","article-title":"Effectiveness of 2D radiographs in detecting CBCT-based incidental findings in orthodontic patients","volume":"11","author":"Choi","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"24","DOI":"10.5005\/jcdp-4-2-24","article-title":"Common errors on panoramic radiographs taken in a dental school","volume":"4","author":"Akarslan","year":"2003","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_5","first-page":"219708","article-title":"Does the panoramic radiography have the power to identify the gonial angle in orthodontics?","volume":"2012","author":"Aktan","year":"2012","journal-title":"Sci. World J."},{"key":"ref_6","unstructured":"Langlais, R.P., Langland, O.E., and Nortj\u00e9, C.J. (1995). Diagnostic Imaging of the Jaws, Williams & Wilkinsons."},{"key":"ref_7","first-page":"185","article-title":"Assessment of root resorption and root shape: Periapical vs panoramic films","volume":"71","author":"Sameshima","year":"2001","journal-title":"Angle Orthod."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1067\/mod.2003.4","article-title":"Pathologic findings in orthodontic radiographic images","volume":"123","author":"Kuhlberg","year":"2003","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1259\/dmfr.21.1.1397447","article-title":"Measurements of tooth length in panoramic radiographs. 1. The use of indicators","volume":"21","author":"Thanyakarn","year":"1992","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"176","DOI":"10.2319\/091306-370.1","article-title":"Cervical vertebrae anomalies\u2014Incidental findings on lateral cephalograms","volume":"78","author":"Soni","year":"2008","journal-title":"Angle Orthod."},{"key":"ref_11","first-page":"232","article-title":"Pattern of dental anomalies in orthodontic patients at a tertiary care hospital","volume":"22","author":"Rathi","year":"2013","journal-title":"J. Pak. Dent. Assoc."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S0889-5406(99)70191-5","article-title":"Prevalence of skeletal and dental anomalies and normal variants seen in cephalometric and other radiographs of orthodontic patients","volume":"116","author":"Tetradis","year":"1999","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_13","first-page":"98","article-title":"Incidental findings of pathology and abnormality in pretreatment orthodontic panoramic radiographs","volume":"76","author":"Bondemark","year":"2006","journal-title":"Angle Orthod."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1436","DOI":"10.5005\/jp-journals-10024-2700","article-title":"A comparative study of the examination pattern of panoramic radiographs using Eye-tracking software","volume":"20","author":"Bahaziq","year":"2019","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_15","first-page":"47","article-title":"Panoramic radiograph a valuable diagnostic tool in dental practice-Report of three cases","volume":"3","author":"Jose","year":"2011","journal-title":"Int. J. Dent. Clin."},{"key":"ref_16","first-page":"51","article-title":"Sample Sizes for Comparing Two Independent Proportions Using the Continuity-Corrected Arc Sine Transformation","volume":"35","author":"Dobson","year":"1986","journal-title":"J. R. Stat. Soc. Ser. D Stat. Soc."},{"key":"ref_17","first-page":"140","article-title":"Prevalence of dental developmental anomalies: A radiographic study","volume":"24","author":"Ardakani","year":"2007","journal-title":"Community Dent. Health"},{"key":"ref_18","first-page":"1539","article-title":"Incidental findings on panoramic radiographs for pre-extraction assessment of third molars","volume":"6","author":"Jadu","year":"2015","journal-title":"Asian J. Sci. Technol."},{"key":"ref_19","first-page":"49330","article-title":"Occult pathologies disclosed in panoramic radiographs: A retrospective study","volume":"9","author":"Yoga","year":"2017","journal-title":"Int. J. Curr. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"648","DOI":"10.4103\/0970-9290.147115","article-title":"Prevalence of dental anomalies on panoramic radiographs in a population of the state of Par\u00e1, Brazil","volume":"25","author":"Moda","year":"2014","journal-title":"Indian J. Dent. Res."},{"key":"ref_21","first-page":"46","article-title":"Incidental findings in pretreatment and post-treatment orthodontic panoramic radiographs","volume":"5","author":"Cral","year":"2018","journal-title":"Int. J. Radiol. Radiat. Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1111\/idj.12389","article-title":"Incidental findings in pre-orthodontic treatment radiographs","volume":"68","author":"Plaza","year":"2018","journal-title":"Int. Dent. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5624\/isd.2020.50.1.53","article-title":"Incidental findings in a consecutive series of digital panoramic radiographs","volume":"50","author":"MacDonald","year":"2020","journal-title":"Imaging Sci. Dent."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1038\/sj.dmfr.4600485","article-title":"Idiopathic osteosclerosis in the jaws of Britons and of the Hong Kong Chinese: Radiology and systematic review","volume":"28","year":"1999","journal-title":"Dentomaxillofac. Radiol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/j.1600-0528.1993.tb00716.x","article-title":"A panoramatomographic study of the teeth and jaws of Finnish university students","volume":"21","author":"Peltola","year":"1993","journal-title":"Community Dent. Oral Epidemiol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1055\/s-0040-1721294","article-title":"Evaluation of panoramic radiographs in relation to the mandibular third molar and to incidental findings in an adult population","volume":"15","author":"Cederhag","year":"2021","journal-title":"Eur. J. Dent."},{"key":"ref_27","first-page":"223","article-title":"Incidental findings on panoramic radiograph: A clinical study","volume":"4","author":"Vaseemuddin","year":"2016","journal-title":"J. Adv. Med. Dent. Sci. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e80","DOI":"10.1016\/j.tripleo.2009.10.031","article-title":"Prevalence of mucosal abnormalities of the maxillary sinus and their relationship to dental disease in panoramic radiography: Results from the Health 2000 Health Examination Survey","volume":"109","author":"Vallo","year":"2010","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"47","DOI":"10.4067\/S0718-381X2013000100008","article-title":"Alterations and pathologies prevalence in panoramic radiographs in patients attending the university dental clinic","volume":"7","year":"2013","journal-title":"Int. J. Odontostomatol."},{"key":"ref_30","first-page":"14","article-title":"Medicolegal perspective: Interpretation of pretreatment orthodontic radiographs","volume":"9","year":"2008","journal-title":"World J. Orthod."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s11282-020-00488-1","article-title":"Incidental findings detected with panoramic radiography: Prevalence calculated on a sample of 2017 cases treated at a major Italian trauma and cancer centre","volume":"37","author":"Ghassemzadeh","year":"2021","journal-title":"Oral Radiol."},{"key":"ref_32","first-page":"330","article-title":"Incidental findings in orthodontic patients studied using two dimensional images","volume":"9","author":"Indra","year":"2021","journal-title":"J. Res. Med. Dent. Sci."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"402","DOI":"10.4097\/kjae.2013.64.5.402","article-title":"The prevention and handling of the missing data","volume":"64","author":"Kang","year":"2013","journal-title":"Korean J. Anesthesiol."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3479\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T18:37:33Z","timestamp":1760121453000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/20\/4\/3479"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,2,16]]},"references-count":33,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,2]]}},"alternative-id":["ijerph20043479"],"URL":"https:\/\/doi.org\/10.3390\/ijerph20043479","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,2,16]]}}}