Panoramic Radiograph Pathology in a Military Treatment Population

A required component of a service members dental record is the panoramic radiograph obtained during a comprehensive dental examination. This extraoral image visualizes the entire maxilla and mandible onto a single film. A clinician can grossly evaluate hard and soft tissue structure while screening for abnormal or pathologic entities making it a valuable adjunct to traditional bitewing films and diagnostic procedures. OBJECTIVES: This study monitored the incidence and distribution of radiographically detectable pathologic lesions in a first enlistment training population of United States Army personnel. METHODS: A retrospective analysis of 2,500 panoramic radiographs was conducted of personnel assigned to the Aberdeen Proving Ground (APG), Aberdeen, Maryland. Inclusion data was limited to patient age, 18-25 years old, at the time of radiographic evaluation. Demographic data collected included gender, military status (Active duty, Army National Guard and U.S. Army Reserve), and dental classification. RESULTS: Data was collected from 2,126 male and 374 female members (mean age = 22). 1,425 panoramic radiographs (57%) had radiographically detectable pathology that was not documented in the patient's record or progress notes. The most common pathologic entities detected were coronal radiolucencies (45%) followed by impacted third molar teeth (44%). Using cross-classified analysis the relationships between gender and military status (p = 0.01) as well as dental classification and military status (p = 0.001) were significant. CONCLUSION: Despite the availability of dental health care to the military trainee, a reservoir of untreated dental disease exists in this population