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Rofo 2023; 195(09): 809-818
DOI: 10.1055/a-2064-9407
Head/Neck

Unexpected metallic foreign bodies on panoramic scans – a narrative review

Article in several languages: English | deutsch
Hans Ulrich Brauer
1   Policlinic, Dental Academy for Continuing Professional Development, Karlsruhe, Germany
,
Andreas Bartols
1   Policlinic, Dental Academy for Continuing Professional Development, Karlsruhe, Germany
2   Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University Kiel, Kiel, Germany
,
Daniel Hellmann
1   Policlinic, Dental Academy for Continuing Professional Development, Karlsruhe, Germany
3   Department of Prosthetic Dentistry, Julius Maximilians University Würzburg, Würzburg, Germany
,
Julian Boldt
3   Department of Prosthetic Dentistry, Julius Maximilians University Würzburg, Würzburg, Germany
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Abstract

Background The digital panoramic radiograph (orthopantomogram, OPG) is the standard radiographic technique for basic diagnostics in dental practice. A correctly taken image provides a good overview of teeth and jaw, whereas radiopaque foreign materials, e. g. metal, can obscure relevant findings.

Methods A literature review on unexpected metallic foreign bodies in OPG was performed to determine the spectrum of metallic foreign bodies that may cause radiopaque areas on panoramic radiographs in routine clinical use.

Results and Conclusion A total of 37 different unexpected metallic foreign bodies were found. They can be categorized as jewelry, clothing, personal protective equipment, medical devices, iatrogenic foreign bodies, and rare incidental findings. Radiopaque foreign materials in the OPG are often relatively easy to recognize as artifacts because of their location, and they are avoidable in most cases. If unclear, a three-dimensional radiograph was helpful for determining the location. Radiopaque areas caused by foreign bodies can lead to misinterpretation or partial or complete non-evaluability and should therefore be avoided.

Key Points: 

  • The OPG is the standard radiograph for dentists, oral surgeons, and oral and maxillofacial surgeons.

  • Foreign bodies made of metal can lead to non-evaluability of panoramic radiographs. Based on a review of the literature and exemplary radiographs, this article provides an overview of rare but typical metallic foreign bodies in OPG, thus addressing the problem of the subfield of radiography by making radiologists more familiar with these images.

  • The spectrum of unexpected metallic foreign bodies includes unremoved earrings with the typical ghost images on the contralateral side, piercings, hearing aids, acupuncture needles, rare iatrogenic foreign bodies, incidental findings in infants in the nose and external auditory canal, vascular clips after surgical interventions, and ritual subcutaneous foreign materials.

Citation Format

  • Brauer HU, Bartols A, Hellmann D et al. Unexpected metallic foreign bodies on panoramic scans – a narrative review. Fortschr Röntgenstr 2023; 195: 809 – 818

Key words

panoramic radiograph - orthopantomogram - incidental finding - foreign body - maxilla - mandibula


Publication History

Received: 09 December 2022

Accepted: 16 March 2023

Article published online:
09 May 2023

© 2023. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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