Background: Panoramic radiograph serves as an indispensible screening and diagnostic tool in oral and maxillofacial imaging. This study was designed to detect the frequency of occult pathologies using the panoramic radiograph. Aim and Objective: To estimate the occult pathologic findings in panoramic radiographs unrelated to the chief complaint and clinical diagnosis. Methodology: This study was conducted at the Department of Oral Medicine and Radiology in a teaching dental hospital using 1032 panoramic radiographs retrieved from May 2015 to October 2015. The images were evaluated for the presence of occult pathologic findings which were unrelated to the chief complaint and clinical diagnosis. Statistics was calculated with simple percentage analysis was done. Result: Out of 1032 panoramic radiographs examined, occult lesions unrelated to the chief complaint and clinical diagnosis were observed in 165 (15.98%) panoramic radiographs. The percentage of the incidental findings in 165 panoramic radiographs were periapical pathologies (26.67%), periodontal pathologies (23.6%), tooth anomalies (4.84%), congenitally missing teeth (5.45%), supernumerary teeth (3.63%), generalized rarefractions (9.7%), carotid artery calcifications (1.81%), cysts and tumors (7.89%), TMJ pathologies (9.1%), and styloid process elongation (3%). The study reiterates on the diagnostic utility of panoramic radiograph in routine clinical situations, school health program and forensics.
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