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Clinicians should include tonsilloliths among the differential diagnoses when calcified bodies are detected on panoramic radiographs.

Carbonate apatite (COAp) is an inorganic component of bone. This study aimed to compare the composition and tissue response to of COAp (COAp-DP) fabricated by the dissolution-precipitation reaction using calcite as a precursor and Bio-Oss®, which is widely used in orthopedic and dental fields as a synthetic bone substitute. X-ray diffraction and Fourier transform infrared results showed that COAp-DP and Bio-Oss® were both B-type carbonate apatite with low crystallinity. The average sizes of COAp-DP and Bio-Oss® granules were 450 ± 58 and 667 ± 168μ m, respectively, and their carbonate contents were 12.1 ± 0.6 and 5.6 ± 0.1 wt%, respectively. COAp-DP had a larger amount of CO than Bio-Oss® but higher crystallinity than Bio-Oss®. When a bone defect made at the femur of rabbits was reconstructed with COAp-DP and Bio-Oss®, COAp-DP granules were partially replaced with bone, whereas Bio-Oss® remained at 8 weeks after implantation. COAp-DP granules elicited a significantly larger amount of new bone formation at the cortical bone portion than Bio-Oss® at 4 weeks after the implantation. The results obtained in the present study demonstrated that COAp-DP and Bio-Oss® showed different behavior even though they were both classified as COAp. The CO content in COAp played a more important role than the crystallinity of COAp for replacement to bone and high osteoconductivity.

Aim. Tonsilloliths are calcified structures that develop in tonsillar crypts. They are commonly detected in daily clinical practice. The prevalence of tonsilloliths was 16 to 24% in previous reports, but it is inconsistent with clinical experience. The aim of this study is to clarify the prevalence, number, and size distribution of tonsilloliths using computed tomography (CT) in a relatively large number of patients. Materials and Methods. We retrospectively reviewed the scans of 2,873 patients referred for CT examinations with regard to tonsilloliths. Results. Palatine tonsilloliths were found in 1,145 out of 2,873 patients (39.9%). The prevalence of tonsilloliths increased with age, and most commonly in patients of ages 50–69. The prevalence in the 30s and younger was statistically lower than in the 40s and older (P < 0.05). The number of tonsilloliths per palatine tonsil ranged from one to 18. The size of the tonsilloliths ranged from 1 to 10 mm. For the patients with multiple CT examinations,the number of tonsilloliths increased in 51 (3.9%) and decreased in 84 (6.5%) of the tonsils. Conclusions. As palatine tonsilloliths are common conditions, screenings for tonsilloliths during the diagnosis of soft tissue calcifications should be included in routine diagnostic imaging.

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