Incidental findings of the nose and paranasal sinuses in orthodontic patients in the age of development: a retrospective study on CBCTs

Aim Nowadays, the use of CBCT in orthodontics and paediatric dentistry is constantly increasing. Since it allows a precise 3D visualisation of the entire head, CBCT can be used to identify alterations and pathologies of the jaws, but also of the sinonasal complex. Despite that, literature lacks studies focusing on the sinonasal complex of healthy orthodontic paediatric patients. Therefore, the aim of this cross-sectional retrospective study is to analyse the prevalence of incidental findings and anatomic variations of the nose and paranasal sinuses in orthodontic patients in the age of development. Methods The 61 CBCTs that respected all inclusion criteria (patient’s age under 15 years old and CBCT scans showing the entire sinonasal complex, data in DICOM format) were searched for: nasal septum deviation, Onodi cells, Haller cells, concha bullosa, sinus underdevelopment, sinus mucosal thickening, sinus cysts or polypoid formations. CBCTs were evaluated by two different orthodontists and their findings were then compared and statistically analysed. Results The patients’ median age was 11 years old. A high prevalence of anatomic variations and incidental findings was found, with the most frequent finding being nasal septum deviation, followed by thickening of the mucosa on the left side and on the right side of the maxillary sinus. No significant association between findings was found. The agreement level of the different analysis was very high. Conclusion Considered the high prevalence of incidental findings, prescription of a CBCT to paediatric patiens seems crucial in order to to detect conditions that would require referral to a specialist