Indicações de radiografia panorâmica em crianças e adolescentes usando a prevalência de anomalias dentárias baseada na idade

Abstract

The aim of this study was to investigate the relationship between chronological age and the radiographic detection of developmental dental anomalies (DDAs) in Brazilian children and adolescents, estimate age thresholds for their detection, and describe their prevalence, distribution, and association with sex. This retrospective, observational, cross-sectional study included 530 panoramic radiographs of patients aged 5-18 years, without systemic, genetic, or other known clinical conditions associated with DDAs, obtained from the image database of the Oral Radiology and Imaging Laboratory at the School of Dentistry, Federal University of Juiz de Fora. The radiographs were assessed by two trained and calibrated examiners. The relationship between age and DDA detection was investigated using receiver operating characteristic (ROC) curve analysis, and associations with sex were assessed using association tests. DDAs were identified in 243 participants (45.8%), with impaction (20.8%), root dilaceration (17.5%), tooth rotation (15.1%), and hypodontia (7.0%) being the most frequently identified anomalies. For the presence of at least one DDA, the age threshold was 10.5 years, with moderate discriminatory ability (AUC = 0.748; 95% CI: 0.707-0.790), 69.5% sensitivity, and 69.3% specificity. Among individual anomalies, impaction (12.5 years; AUC = 0.807) and root dilaceration (11.5 years; AUC = 0.788) showed the highest AUC values. Associations were observed between sex and supernumerary teeth and between sex and accessory roots. Chronological age showed moderate discriminatory ability for the radiographic detection of DDAs, peaking at 10.5 years overall and varying by anomaly type. These age thresholds provide evidence-based benchmarks to guide targeted radiographic evaluation when DDAs are clinically suspected, reinforcing individualized diagnostic decision-making rather than unindicated age-based screening.