Prevalence, Laterality and Age‐Related Distribution of Incidental Findings on Digital Panoramic Radiographs: A Retrospective Cross‐Sectional Study

ABSTRACT Objective To determine the prevalence, laterality and age‐related distribution of incidental findings detected on digital panoramic radiographs in the South Asian population. Methods In this retrospective cross‐sectional study, 250 digital panoramic radiographs acquired between January 2023 and December 2024 were retrieved from the institutional radiographic archive and independently reviewed by two calibrated oral and maxillofacial radiologists. Incidental findings were classified by type, laterality (unilateral, bilateral, or not lateralisable) and anatomical location. Binary logistic regression was used to assess the association of age and sex with the presence of incidental findings. Results Of 250 radiographs (142 male, 108 female; mean age 37.8 ± 14.2 years), 154 (61.6%) exhibited at least one incidental finding, yielding a total of 264 individual findings across 22 categories. The most prevalent findings were idiopathic osteosclerosis (15.9%), impacted third molars (13.3%) and impacted supernumerary teeth (9.1%), together accounting for 38.3% of all findings. Unilateral findings predominated (45.5%), followed by not lateralisable (35.7%) and bilateral (18.8%). Binary logistic regression showed that age was a significant predictor (OR = 1.02 per year, 95% CI: 1.00–1.04, p = 0.038), whereas sex was not ( p = 0.412). The model had an AUC of 0.548 (95% CI: 0.474–0.622). Conclusion Incidental findings are highly prevalent on digital panoramic radiographs. Systematic full‐field review is recommended to ensure that clinically significant findings beyond the primary dental indication are not overlooked.