Carotid calcifications on panoramic radiographs
Abstract
Background: Advanced carotid artery atherosclerosis is a significant cause of transient ischemic attacks and ischemic strokes. Panoramic radiographs provide dentists with information of periodontal disease with assessment of alveolar bone level, and can potentially also show signs of carotid calcifications. We expect that patients with greater predisposition to carotid atherosclerosis also show greater frequency of carotid atheroma calcifications from panoramic radiographs.
Methods: The prevalence of carotid-area atherosclerotic calcifications in 193 patients on 100 useful analog panoramic radiographs was assessed retrospectively. Probing pocket depths, dental status and anamnestic data were also collected in all patients.
Results: Out of 100 subjects, <x> = 52 ±13 years old, included in the study, 31 exhibited unilateral or bilateral radiopacity in the carotid artery bifurcation area on analog radiographs. The group without atherosclerotic calcifications showed after probing less 5 and 8 mm pocket depths than group with calcifications. The scientific evidences already prove that greater average probing pocket depth is associated with greater loss of alveolar bone process. There were more unilateral and bilateral calcifications in male than female group of comparable ages (39 % against 26 %). Probing pocket depths in category 4–6 and ≥ 7 mm in men were more frequent than in women in proportion 9 % to 6 %. The increase of calcifications is markedly linear from < 50 year old group, 50–70 year old group, to group > 70 years old in proportion 16 % : 38 % : 50 %.
Conclusions: Patients with increased risk for ischemic stroke can be identified in dental office by means of panoramic radiographs. We found out 31 % neurologically asymptomatic subjects exhibiting on analog radiographs radiopacity in carotid artery bifurcation area. Detecting a calcified carotid artery atheroma on a panoramic radiograph is of major clinical significance because patients with such sclerotic plaques should be referred to appropriate physician who will assess a need for the control of risk factors, medications and preventive surgical treatment.
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