Prevalence of skeletal and dental anomalies and normal variants seen in cephalometric and other radiographs of orthodontic patients.

Pretreatment cephalometric radiographs may contain important incidental findings that require attention before orthodontic therapy. A review of the cephalometric and dental radiographs of 325 consecutive healthy orthodontic patients revealed 431 notable findings of the skull, cervical spine, and maxillofacial complex. Most of these findings were nonpathologic anomalies or normal variants. If recognized as such by the orthodontist, no further evaluation would be required, thus avoiding unnecessary costs and patient anxiety. However, there were 15 findings (3.5%) that required additional evaluation by physicians or oral and maxillofacial surgeons before or concurrent with the initiation of orthodontic therapy. Familiarity with the appearance and prevalence of skeletal and dental anomalies and normal variants seen in cephalometric radiographs, and the ability to separate those that require follow-up from those that do not, is an important facet of orthodontic practice.