Policlinic, Dental Academy for Continuing Professional Development, Karlsruhe, Germany.
Clinic for Conservative Dentistry and Periodontology, Christian-Albrechts-University Kiel, Kiel, Germany.
Rofo. 2023 Sep;195(9):809-818. doi: 10.1055/a-2064-9407. Epub 2023 May 9.
The digital panoramic radiograph (orthopantomogram, OPG) is the standard radiographic technique for basic diagnostics in dental practice. A correctly taken image provides a good overview of teeth and jaw, whereas radiopaque foreign materials, e. g. metal, can obscure relevant findings.
A literature review on unexpected metallic foreign bodies in OPG was performed to determine the spectrum of metallic foreign bodies that may cause radiopaque areas on panoramic radiographs in routine clinical use.
A total of 37 different unexpected metallic foreign bodies were found. They can be categorized as jewelry, clothing, personal protective equipment, medical devices, iatrogenic foreign bodies, and rare incidental findings. Radiopaque foreign materials in the OPG are often relatively easy to recognize as artifacts because of their location, and they are avoidable in most cases. If unclear, a three-dimensional radiograph was helpful for determining the location. Radiopaque areas caused by foreign bodies can lead to misinterpretation or partial or complete non-evaluability and should therefore be avoided.
· The OPG is the standard radiograph for dentists, oral surgeons, and oral and maxillofacial surgeons.. · Foreign bodies made of metal can lead to non-evaluability of panoramic radiographs. Based on a review of the literature and exemplary radiographs, this article provides an overview of rare but typical metallic foreign bodies in OPG, thus addressing the problem of the subfield of radiography by making radiologists more familiar with these images.. · The spectrum of unexpected metallic foreign bodies includes unremoved earrings with the typical ghost images on the contralateral side, piercings, hearing aids, acupuncture needles, rare iatrogenic foreign bodies, incidental findings in infants in the nose and external auditory canal, vascular clips after surgical interventions, and ritual subcutaneous foreign materials..
· Brauer HU, Bartols A, Hellmann D et al. Unexpected metallic foreign bodies on panoramic scans - a narrative review. Fortschr Röntgenstr 2023; 195: 809 - 818.
数字化全景放射（orthopantomogram，OPG）是牙科临床基本诊断的标准放射技术。正确拍摄的图像可以很好地显示牙齿和颌骨，而不透射线的异物，例如金属，可能会掩盖相关的发现。
对 OPG 中意外金属异物的文献进行了回顾，以确定在常规临床使用中可能导致全景放射图像出现不透射线区域的金属异物谱。
共发现 37 种不同的意外金属异物。它们可以分为珠宝、衣物、个人防护设备、医疗器械、医源性异物和罕见的偶然发现。OPG 中的不透射线异物通常因其位置而很容易被识别为伪影，在大多数情况下是可以避免的。如果不清楚，可以使用三维射线照相术来确定位置。异物引起的不透射线区域可能导致误诊或部分或完全无法评估，因此应予以避免。
· OPG 是牙医、口腔颌面外科医生和口腔颌面外科医生的标准射线照片。
· 金属制成的异物会导致全景射线照片无法评估。基于对文献的回顾和示例射线照片，本文概述了 OPG 中罕见但典型的金属异物，从而通过使放射科医生更熟悉这些图像来解决射线照相术的子领域问题。
· 意外金属异物的范围包括未取出的耳环在对侧出现典型的鬼影、穿孔、助听器、针灸针、罕见的医源性异物、婴儿在鼻子和外耳道的偶然发现、手术后的血管夹和仪式皮下异物。
· Brauer HU, Bartols A, Hellmann D 等。全景扫描中的意外金属异物 - 叙述性综述。Fortschr Röntgenstr 2023; 195: 809-818.
