This study focused on three different aspects in our analysis—PAN, PAN and CBCT, as well as the influence of the different clinical and radiological experience (examples in Figs. 1 and 2).

Panoramic radiography (PAN)

When assessing PAN, the ratings were significantly lower at “good visible and can be evaluated” (9.9%) compared to “visible but cannot be evaluated” (39.5%; p < 0.001) and compared to “not visible” (50.6%; p < 0.001) ratings (Table 1). An additional CBCT was needed in most cases (“required” (28%) and “reasonable” (63.3%) versus “not required” (8.7%; Table 2)). All examiners found an average number of 1.7 ± 1.3 additional findings in PAN (Table 3). The three most common findings were retained third molars with putative follicular cysts (22% of all findings), followed by radiological insufficient root filling (21%) and caries/insufficient filling of teeth (19%; Table 4).

Cone beam computed tomography (CBCT)

The majority of the answers indicated the usefulness of an additional sFOV-CBCT. Whereas it only “showed no additional information” in 10.1% and was “useful” in 32.4% of cases, an additional CBCT was rated as “affecting therapy” in 57.5% of cases (Table 5).

Overall, the examiners observed an average number of 0.6 ± 0.6 additional incidental findings (Table 3). The findings were radiological caries/insufficient filling of teeth (88%) as well as insufficient root filling (22%).

Influence of examiners’ clinical background

In PAN, MS1 (51.8%) and MS2 (39.3%) rated significantly less for “not visible” when compared to GPs (60.7%; p < 0.001). The difference was significant between MS1 and MS2 as well (p < 0.05). Significantly more “good visibility” ratings were obtained for MS2 (15.5%) when compared to MS1 (8.9%; p = 0.021) and GP (5.4%; p < 0.001; Table 1). A significant higher number of additional incidental findings in PAN was seen in MS2 (mean = 2.1 ± 1.5) versus GP (mean = 1.5 ± 1.3; p = 0.021) as well as in MS2 versus MS1 (mean = 1.6 ± 1.1; p = 0.048; Table 3).

GPs rated an additional CBCT significantly less often to be “not required” (1.8%) when compared to MS1 (5.4%; p = 0.038) and to MS2 (19%; p = 0.006). Moreover, GPs rated significantly more for a CBCT to be “reasonable” or “required” (98.2%) when compared to MS1 (94.6%; p = 0.002) and compared to MS2 (80.9%; p = 0.001; Table 2). Also, in the GP group, the additional CBCT was seen significantly more often to be “affecting therapy” (67.8%) when compared to MS1 (50%) and to MS2 (53.8%; all p < 0.001; Table 5). Between the groups, there was no difference in the average number of additional incidental diagnoses in sFOV-CBCT scans (GD, average = 0.7 ± 0.5; MS1, average = 0.6 ± 0.5; MS2, average = 0.7 ± 0.7; p = 0.912, Table 3).