Nature and clinical significance of incidental findings in maxillofacial cone-beam computed tomography: a systematic review

Abstract

Objective This systematic review was conducted to assess the types, potential clinical significance, and treatment implications of incidental findings (IFs) in CBCT diagnostic imaging of the maxillofacial region. Material and methods The authors searched several electronic databases and grey literature without time restriction for studies on the IFs in maxillofacial CBCT. Studies that classified the IFs based on their potential clinical significance were included. The methodological quality of the included studies was evaluated by the STROBE criteria. Results The online searches of the electronic databases yielded 1323 records. Five articles were included in the final qualitative analysis. The methodological quality ranged from low to moderate risk of bias. Percentages of IFs with high (requiring intervention/referral), moderate (requiring monitoring), and low clinical significance ranged from 0.3 to 31.4%, 15.6 to 28.9%, and 43.46 to 71.1%, respectively. There was an inconsistency between the studies in the clinical significance of 58.8% of the IFs identified. Conclusion Most IFs in maxillofacial CBCT are either normal variants or findings that do not require referral or treatment. There was no clear consensus on the recommended management of most common IFs. The lack of consensus on clinical significance emphasizes the importance of collaboration between medical and dental specialties to establish professional guidelines for the management of commonly encountered IFs in CBCT.