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Abstract：
OBJECTIVE: To investigate the prevalence of incidental findings and need for further dental treatment and analyse the influence of size of field-of-view (FOV) and age in cone beam computed tomography (CBCT) for pre-implant planning.
METHODS: 404 CBCT scans were examined retrospectively for incidental findings and need for further dental treatment. Incidental finding-frequencies and need for further treatment were assessed for different age (< 40 years, 40-60 years, > 60 years) and FOV groups (small, medium, large). Intraexaminer and interexaminer agreements were evaluated.
RESULTS: In 82% of the scans at least one incidental finding was found, with a total of 766 overall. More incidental findings were found in scans with large FOV (98% vs. 72%, OR = 22.39 large vs. small FOV, p < 0.0001) and in scans of patients > 60 years (OR = 5.37 patient\'s age > 60 years vs. < 40 years, p = 0.0003). Further dental treatment due to incidental findings was needed in 31%. Scans with large FOV were more likely to entail further treatment (OR = 3.55 large vs. small FOV, p < 0.0001). Partial edentulism and large FOV were identified as risk factors for further treatment (p = 0.0003 and p < 0.0001). Further referral of the patient based on incidental findings was judged as indicated in 5%. Intra- and inter-examiner agreements were excellent (kappa = 0.944/0.805).
CONCLUSIONS: A considerable number of incidental findings with need for further dental treatment was found in partially edentulous patients and in patients > 60 years. In pre-implant planning of elderly patients, the selection of large FOV CBCT scans, including dentoalveolar regions not X-rayed recently, help to detect therapeutically relevant incidental findings.
METHODS: 404 CBCT scans were examined retrospectively for incidental findings and need for further dental treatment. Incidental finding-frequencies and need for further treatment were assessed for different age (< 40 years, 40-60 years, > 60 years) and FOV groups (small, medium, large). Intraexaminer and interexaminer agreements were evaluated.
RESULTS: In 82% of the scans at least one incidental finding was found, with a total of 766 overall. More incidental findings were found in scans with large FOV (98% vs. 72%, OR = 22.39 large vs. small FOV, p < 0.0001) and in scans of patients > 60 years (OR = 5.37 patient\'s age > 60 years vs. < 40 years, p = 0.0003). Further dental treatment due to incidental findings was needed in 31%. Scans with large FOV were more likely to entail further treatment (OR = 3.55 large vs. small FOV, p < 0.0001). Partial edentulism and large FOV were identified as risk factors for further treatment (p = 0.0003 and p < 0.0001). Further referral of the patient based on incidental findings was judged as indicated in 5%. Intra- and inter-examiner agreements were excellent (kappa = 0.944/0.805).
CONCLUSIONS: A considerable number of incidental findings with need for further dental treatment was found in partially edentulous patients and in patients > 60 years. In pre-implant planning of elderly patients, the selection of large FOV CBCT scans, including dentoalveolar regions not X-rayed recently, help to detect therapeutically relevant incidental findings.
摘要：
目的：调查偶然发现的发生率和进一步牙科治疗的需求，并分析锥形束计算机断层扫描（CBCT）中视野大小（FOV）和年龄对植入前计划的影响。
方法：对404个CBCT扫描进行回顾性检查，以了解偶然发现和进一步牙科治疗的需要。对不同年龄(<40岁,40-60年,>60岁)和FOV组(小型，中等,大）。评估了内部检验者和interexaminer协议。
结果：在82%的扫描中发现了至少一个偶然发现，总共766个。在大FOV的扫描中发现了更多的偶然发现(98%与72%,OR=22.39大vs.小视场,p<0.0001)和>60岁的患者扫描(OR=5.37患者年龄>60岁与<40年,p=0.0003)。由于偶然发现，31%的患者需要进一步的牙科治疗。大FOV的扫描更有可能需要进一步治疗(OR=3.55大vs.小视场,p<0.0001)。部分性脑萎缩症和大FOV被确定为进一步治疗的危险因素(p=0.0003和p<0.0001)。根据偶然发现，患者的进一步转诊被判断为5%。考试者内部和考试者之间的协议非常好（kappa=0.944/0.805）。
结论：在部分缺牙患者和60岁以上的患者中发现了大量需要进一步牙科治疗的偶然发现。在老年患者的植入前规划中，选择大视场CBCT扫描，包括最近没有做X光检查的牙槽骨区域,帮助检测治疗相关的偶然发现。
方法：对404个CBCT扫描进行回顾性检查，以了解偶然发现和进一步牙科治疗的需要。对不同年龄(<40岁,40-60年,>60岁)和FOV组(小型，中等,大）。评估了内部检验者和interexaminer协议。
结果：在82%的扫描中发现了至少一个偶然发现，总共766个。在大FOV的扫描中发现了更多的偶然发现(98%与72%,OR=22.39大vs.小视场,p<0.0001)和>60岁的患者扫描(OR=5.37患者年龄>60岁与<40年,p=0.0003)。由于偶然发现，31%的患者需要进一步的牙科治疗。大FOV的扫描更有可能需要进一步治疗(OR=3.55大vs.小视场,p<0.0001)。部分性脑萎缩症和大FOV被确定为进一步治疗的危险因素(p=0.0003和p<0.0001)。根据偶然发现，患者的进一步转诊被判断为5%。考试者内部和考试者之间的协议非常好（kappa=0.944/0.805）。
结论：在部分缺牙患者和60岁以上的患者中发现了大量需要进一步牙科治疗的偶然发现。在老年患者的植入前规划中，选择大视场CBCT扫描，包括最近没有做X光检查的牙槽骨区域,帮助检测治疗相关的偶然发现。
