DOI: 10.3390/app16136344 ISSN: 2076-3417

Beyond Teeth and Jaws: Non-Odontogenic Findings on Panoramic Radiography and Their Relevance to Dental Practice

Domenico De Falco, Nicol Macripò, Margot Ringold, Francesca Sodero, Mario Kohlstetter, Massimo Petruzzi

Background: Panoramic radiography is one of the most widely used imaging examinations in dental practice, providing a broad view of the jaws and adjacent head and neck structures. Although primarily prescribed for odontogenic assessment, its field of view may reveal non-odontogenic findings with potential clinical significance. Methods: A structured narrative review was conducted according to SANRA criteria. A literature search was performed in PubMed/MEDLINE, Embase, Scopus, and Web of Science for English-language publications from January 2010 to May 2026. Backward and forward citation tracking of relevant articles, key reviews, and reference textbooks was also performed. Eligible studies and authoritative sources addressing non-odontogenic findings detectable on panoramic radiographs were qualitatively synthesized. Results: The review focuses on carotid artery calcifications, maxillary sinus abnormalities, mandibular radiomorphometric signs related to low skeletal bone mineral density, elongation or calcification of the stylohyoid complex, sialoliths, tonsilloliths, calcified lymph nodes, phleboliths, and laryngeal cartilage calcifications. These findings range from benign anatomical variants to radiographic indicators that may require medical or specialist evaluation. Conclusions: Panoramic radiography should be regarded as a tool for recognition and clinical suspicion rather than definitive diagnosis of extraoral or systemic disease. Dentists play a central role in systematically assessing the entire image, documenting relevant abnormalities, correlating them with patient history and risk factors, and initiating appropriate referral when indicated.

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