Reporting rates and presence of dental pathology on CT brain examinations at a tertiary hospital in Johannesburg, South Africa

Authors

  • Evidence Ndou-Van Zyl Diagnostic Radiology Department, University of the Witwatersrand, Johannesburg, South Africa https://orcid.org/0000-0001-7621-3537
  • Daniel Nicholas Prince Department of Diagnostic Radiology. University of the Witwatersrand, South Africa.
  • Suma Rajan Letterkenny University Hospital, Department of Emergency Medicine, Galway University, Ireland.

DOI:

https://doi.org/10.17159/sadj.v78i10.17032

Keywords:

burden, retrospective

Abstract

South Africa is burdened by a high prevalence of dental pathology. It is common to encounter this dental pathology on computed tomography (CT) brain scans.
Aims and objectives
To determine the presence of dental pathology on CT brain scans performed in a tertiary hospital and to assess whether radiologists reported on the encountered pathology. The study aimed to raise awareness among radiologists on
reporting dental pathology and highlight the impact this has on oral and general health.
Design
A retrospective observational study.
Methods
Reports of CT brain scans performed between September 2019 and October 2019 were reviewed for dental findings. Two radiologists, Reader 1 and Reader 2, blinded to the reports’ findings, reevaluated the corresponding CT images.
Their findings were compared with the findings of the reports.
Results
None of the 160 reports reviewed had dental findings. Reader 1 and Reader 2, respectively, reported dental pathology in 92% and 79% of the CT scans. The most common dental findings were dental caries (79% and 53%), followed by missing teeth (66% and 53%), periodontal disease (59% and 38%), periapical disease (54% and 29%), odontogenic sinusitis (19% and 3%), restorations (11% and 9%) and dental injuries (4% and 4%).
Conclusions
Radiologists do not report on dental pathology encountered on CT brain scans. Recognition of dental findings may alter
patient management and reduce related morbidity and mortality.

Downloads

Download data is not yet available.

References

Bhayat A, Chikte U. Human resources for oral health care in South Africa: A 2018 update. Int J Environ Res Public Health . 2019 May 14;16(10):1668. https://doi.org/10.3390/ijerph16101668

Ranchod S, Adams C, Burger R, et al. South Africa’s hospital sector: old divisions and new developments. South Africa Health Review. 2017. https://journals.co.za/doi/pdf/10.10520/EJC-c80f3c5a8

National Department of Health (NDoH). 2030 human resources for health strategy: investing in the health workforce for universal health coverage. Pretoria: Government Printers, 2020

Strachan B, Zabow T, van der Spuy Z. More doctors and dentists are needed in South Africa. S Afr Med J. 2011 Jul 25;101(8):523-528. doi:10.7196/SAMJ.4894

Govender V, Chersich MF, Harris B, et al. Moving towards universal coverage in South Africa? Lessons from a voluntary government insurance scheme. Glob Health Action. 2013 Dec 24;6(1):19253. https://doi.org/10.3402/gha.v6i0.19253

Singh S. Dental caries rates in South Africa: implications for oral health planning. South African J Epidemiol Infect. 2011 Jan 15;26(4):259-261. https://doi.org/10.1080/10158782.2011.11441463

Hammoud K, Lanfranchi M, Adams D, Bedi HS, Mehan WA. Prevalence and reporting rates of incidental dental disease on head CT examinations. Acad Radiol. 2018 Oct 1;25(10):1318-1324. https://doi.org/10.1016/j.acra.2018.01.017

AAPM - American Association of Physicists in Medicine. Adult routine head CT protocols. Vol. 2, American Association of Physicist in Medicine. 2016. http://www.aapm.org

Scheinfeld MH, Shifteh K, Avery LL, Dym H, Dym RJ. Teeth: what radiologists should know. RadioGraphics. 2012 Nov;32(7):1927-1944. https://doi.org/10.1148/rg.327125717

Meyer HJ, Schramm D, Bach AG, Eckert A, Surov A. Dental trauma on whole body trauma CT – an underreported finding. Eur J Trauma Emerg Surg. 2022 Apr 15;48(2):1055-1060. https://doi.org/10.1007/s00068-021-01633-z

Thema LK, Singh S. Epidemiological profile of patients utilising public oral health services in Limpopo province, South Africa. African J Prim Heal Care Fam Med. 2017 Jul 12;9(1):1-5. https://doi.org/10.4102/phcfm.v9i1.1206

Mthethwa JM, Mahomed OH, Yengopal V. Epidemiological profile of patients utilising dental public health services in the eThekwini and uMgungundlovu districts of KwaZulu-Natal province, South Africa. South African Dent J. 2020 Nov 1;75(10):541-547. http://dx.doi.org/10.17159/2519-0105/2020/v75no10a2

Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C. The global burden of oral diseases and risks to oral health. Bull World Health Organ. 2005 Sep;83(9):661-669

Abid A, Maatouk F, Berrezouga L, et al. Prevalence and severity of oral diseases in the Africa and Middle East Region. Adv Dent Res. 2015 Jul 22;27(1):10-17 https://doi.org/10.1177/0022034515582062

Eno Belinga LE, Bell Ngan W, Lemougoum D, et al. Association between periodontal diseases and cardiovascular diseases in Cameroon. J Public Health Africa. 2018 Jul 6;9:1-4. https://doi.org/10.4081/jphia.2018.761

Diouf M, Basse A, Ndiaye M, Cisse D, Lo CM, Faye D. Stroke and periodontal disease in Senegal: case–control study. Public Health. 2015 Dec;129(12):1669-1673. https://doi.org/10.1016/j.puhe.2015.02.033

Chapman MN, Nadgir RN, Akman AS, et al. Periapical lucency around the tooth: radiologic evaluation and differential diagnosis. RadioGraphics. 2013 Jan;33(1):E15-E32. https://doi.org/10.1148/rg.331125172

Pokorny A, Tataryn R. Clinical and radiologic findings in a case series of maxillary sinusitis of dental origin. Int Forum Allergy Rhinol. 2013 Dec;3(12):973-979. https://doi.org/10.1002/alr.21212

Norman R, Matzopoulos R, Groenewald P, Bradshawa D. The high burden of injuries in South Africa. Bull World Health Organ. 2007 Jan;85(9):695-702. https://doi.org/ 10.2471/BLT.06.037184

Goldstein LN, Dawadi S, Viljoen IM. CT utilisation in a level one trauma center in South Africa. Cureus. 2022 Sep 11;14(9):4-11. doi:10.7759/cureus.29041

Loureiro RM, Naves EA, Zanello RF, Sumi D V, Gomes RLE, Daniel MM. Dental emergencies: a practical guide. RadioGraphics. 2019 Oct;39(6):1782-1795. https://doi.org/10.1148/rg.2019190019

Naidoo S, Sheiham A, Tsakos G. Traumatic dental injuries of permanent incisors in 11- to 13-year-old South African schoolchildren. Dent Traumatol. 2009 Apr;25(2):224-228.http://doi.wiley.com/10.1111/j.1600-9657.2008.00749.x

Whaites E, Hons BDS, Edin F, Eng F. Essentials of dental radiography and radiology Sixth Edition. London,UK: Elsevier Limited; 2020. 599-600

Landis JR, Koch GG. The Measurement of Observer Agreement for Categorical Data. Biometrics. 1977:33(1):159-174. https://doi.org/2529310

Bland M. An introduction to medical statistics. Fourth Edition. New York: Oxford University Press; 2015. p. 319

Bulbul E, Yanik B, Demirpolat G. Detection of dental pathologies in routine paranasal CT scans: a retrospective study. J Clin of Diagn Res. 2017 Jul;11(7):TC17-TC20. https://www.doi.org/10.7860/JCDR/2017/27461/10287

Chikte U, Pontes CC, Karangwa I, et al. Dental caries in a South African adult population: findings from the Cape Town vascular and metabolic health study. Int Dent J. 2020 Jun;70(3):176-182. https://doi.org/10.1111/idj.12538

Brandfass JT, Ulano AC, Nickerson JP, Bazylewicz MP. Dental caries on CT in the ER population: prevalence and reporting practices. Emerg Radiol. 2019 Jan; 26(3):263-267. https://doi.org/10.1007/s10140-018-01663-y

Alves IDS, Vendramini DFV, Leite CDC, Gebrim EMMS, Passos UL. Dental findings on face and neck imaging. Radiol Bras. 2021 Apr;54(2):107-114. https://doi.org/10.1590/0100-3984.2019.0104

Assiri H, Dawasaz AA, Alahmari A, Asiri Z. Cone beam computed tomography (CBCT) in periodontal diseases: a systematic review based on the efficacy model. 2020 Jul;20(1):191. https://doi.org/10.1186/s12903-020-01106-6

Loureiro RM, Sumi DV, Tames HLVC, et.al. Cross-sectional imaging of third molar related abnormalities. Am J Neuroradiol. 2020 Sept;41(11):1966-1974. https:// doi.org/10.3174/ajnr.A6747

Tibúrcio-Machado CS, Michelon C, Zanatta FB, Gomes MS, Marin JA, Bier CA. The global prevalence of apical periodontitis: a systematic review and meta-analysis. Int Endod J. 2021 May 22;54(5):712–735. https://doi.org/10.2214/AJR.12.9616

Bomeli SR, Branstetter BF, Ferguson BJ. Frequency of a dental source for acute maxillary sinusitis. Laryngoscope. 2009 Mar;119(3):580-584. https://doi.org/10.1002/lary.20095

Abrahams JJ, Glassberg RM. Dental disease: a frequently unrecognised cause of maxillary sinus abnormalities? Am J Roentgenol. 1996 May;166(5):1219-1223. https://doi.org/10.2214/ajr.166.5.8615273

Craig JR. Odontogenic sinusitis: A state-of-the-art review. World J Otorhinolaryngol Head Neck Surg. 2022 Mar;8(1):8-15. https://doi.org/10.1002/wjo2.9

Chaudhary S, Singh H, Gharti A, Adhikari B. Evaluation of clinical and radiographic findings among patients with traumatic dental injuries seeking delayed treatment. Int J Dent. 2021 Aug 23;2021:1-8. https://doi.org/10.1155/2021/9549508

Li F, Li J, Zhang D, Wu F. Role of computed tomography scan in dental trauma: a cross-sectional study. Dose-Response. 2018 Jul 1;16(3). https://doi.org/10.1177/1559325818789837

Petersen PE, Ogawa H. The global burden of periodontal disease: towards integration with chronic disease prevention and control. Periodontol 2000. 2012 Oct;60(1):15-39. https://doi.org/10.1111/j.1600-0757.2011.00425.x

Gerritsen AE, Allen PF, Witter DJ, Bronkhorst EM, Creugers NHJ. Tooth loss and oral health-related quality of life: a systematic review and meta-analysis. Health Qual Life Outcomes. 2010;8(1):126. https://doi.org/10.1186/1477-7525-8-126

Kimmie-Dhansay F, Pontes CC, Chikte UME, et al. Impacts of tooth loss on OHRQoL in an adult population in Cape Town, South Africa. Int J Environ Res Public Health. 2021 May 8;18(9):4989. https://doi.org/10.3390/ijerph18094989

Downloads

Published

2024-02-20

How to Cite

Reporting rates and presence of dental pathology on CT brain examinations at a tertiary hospital in Johannesburg, South Africa. (2024). South African Dental Journal, 78(10), 496-502. https://doi.org/10.17159/sadj.v78i10.17032