Incidental Orthopantomographic Findings in Paediatric Dental Care Among Children Aged 9-16 Years: Insights from a Retrospective Cross-sectional Study

Introduction: Panoramic radiography is routinely used in paediatric dental practice to assess developing dentition and jaw structures. In addition to the primary diagnostic purpose, Orthopantomographs (OPG) often reveal incidental dental and maxillofacial findings that may remain clinically asymptomatic during childhood. Early identification of these findings is crucial for timely intervention and comprehensive treatment planning in paediatric patients. Aim: To evaluate the incidental findings of dentofacial abnormalities and their importance in overall diagnosis and treatment planning for paediatric patients. Materials and Methods: This retrospective cross-sectional study was conducted in the Department of Paediatric and Preventive Dentistry using archived panoramic radiographs retrieved from the Department of Oral Medicine and Radiology, K.M. Shah Dental College and Hospital, Vadodara, Gujarat, India, from August 2025 to January 2026. A total of 328 OPGs of children aged 9-16 years obtained over the previous 10 years were included in the study. The selected age group predominantly represented mixed and early permanent dentition stages. All radiographs were systematically evaluated for impacted teeth, supernumerary teeth, hypodontia, delayed eruption, structural anomalies, pulp/periapical pathologies, and other incidental abnormalities. Demographic parameters including age and gender were recorded. Data were analysed using Statistical Package for Social Sciences (SPSS) version 21.0. Descriptive statistics were used to calculate frequencies and percentages. Pearson’s Chi-square test was used to assess associations between categorical variables. Fisher’s-exact test was applied whenever more than 20% of cells had expected frequencies less than five. Statistical significance was set at p<0.05 Results: The mean age of participants was 12.2±2.53 years. Females constituted 172/328 (52.4%) and males 156/328 (47.6%) of the study population. Pulp or periapical pathologies were the most common incidental findings, observed in 42/328 (12.8%) radiographs, followed by hypodontia in 22/328 (6.7%), impacted permanent teeth in 18/328 (5.5%), fracture of teeth in 11/328 (3.4%), and supernumerary teeth in 8/328 (2.4%). Hypodontia showed a statistically significant association with gender (p=0.045), with higher prevalence among males. Impacted teeth (p=0.041), delayed eruption (p=0.019), and pulp or periapical pathologies (p=0.005) demonstrated significant associations with age groups. Conclusion: Orthopantomographs frequently reveal clinically significant incidental findings in paediatric patients, with pulp or periapical pathologies and hypodontia being the most common abnormalities detected in the present study. Systematic evaluation of panoramic radiographs can facilitate early diagnosis and improve comprehensive treatment planning in paediatric dental practice.