Radiographic Characteristics of Soft Tissue Calcification on Digital Panoramic Images

Abstract

To assess the prevalence of soft tissue calcifications and their panoramic radiographic characteristics. Material and Methods: This descriptive retrospective study evaluated 2027 panoramic radiographs. The type and location of calcifications and the age and gender of patients were evaluated by two radiologists. Data were analyzed via SPSS and the Chi-square, Fisher's exact and Kappa tests were used to compare the categorical demographic variables among the groups. The confidence interval was set to 95% and p<0.05 was considered statistically significant. Results: The prevalence of calcified stylohyoid ligament was 11.24%. This value was 3.99% for tonsillolith, 1.33% for calcified carotid plaque, 0.69% for antrolith, 0.39% for calcified lymph node, 0.29% for phleboliths, and 0.19% for sialoliths. The prevalence of these conditions had no significant association with gender or age (p=0.102). The prevalence of bilateral calcified stylohyoid ligament, tonsillolith, and a calcified carotid plaque was significantly higher (p<0.001). The most prevalent type of calcified stylohyoid ligament, according to O'Carroll's classification, belonged to types 1, 4, 3 and 2 (p<0.001). The most commonly observed radiographic pattern was multiple, well-defined tonsilloliths (75.3%, p<0.001). Conclusion: The prevalence of soft tissue calcifications on panoramic radiographs was relatively low in this Iranian population. The most calcifications were respectively calcified stylohyoid ligament, tonsillolith, calcified carotid plaque, antrolith, calcified lymph node, phleboliths and sialoliths. Calcified stylohyoid ligament, tonsillolith and calcified carotid plaque were more bilaterally. Thereby panoramic imaging can help in primary assessment, epidemiologic and screening evaluation of these calcifications.

Prevalence and features of elongated styloid process on imaging studies: a systematic review and meta-analysis

“…As mentioned previously, the included studies showed great variability regarding the intervals of age considered to evaluate the prevalence of ESP. Thus, to carry out the subgroup analysis of the age, only studies that allowed obtaining data from the total sample and the affected patients were included [2,4,14,22,36,40]. The patients were divided into two groups considering the following intervals: less than or equal to 40 years old (encompassing younger patients) and greater than 40 years old (encompassing older patients).…”

“…A prevalence of 38.8% was observed for patients with ≤ 40 years old (n = 1554; I 2 = 99.73%, CI = 99.67 to 99.78, p < 0.001) and a prevalence of 47.7% was observed for patients with > 40 years old (n = 1765; I 2 = 99.75%; CI = 99.70 to 99.79, p < 0.001). If only patients with ESP are considered, which could be extracted from six studies [2,4,14,22,36,40], the distribution of the cases is 46.8% for patients ≤ 40 years old and 53.2% for patients > 40 years old.…”

“…2, the overall mean percentage of "yes" was 48.4%. There were 11 articles with 50% of score "yes" (lines values) [17,19,20,22,24,26,27,36,38,39,44], eight articles with 37.5% [2,5,12,23,34,[41][42][43], six articles with 25% [11,14,16,25,29,33], six articles with 75% [10,13,15,18,32,37], five articles with 62.4% [4,21,28,31,45], two articles with 12.5% [30,40], and one article with 87.5% [35]. The topics about the participants sampled and adequate sample size in an appropriate way were the least marked with 7 [15,16,19,35,39,43,44] and 4 articles …”

Prevalence of soft tissue calcifications in the maxillofacial region

“…We found that the majority of calcifications within the soft tissues were more common in middle-aged (44.1%) population followed by young adults (40.7%). These 3,17,21 . Women were more typically affected in the post-menopausal period (>50 years) owing to the diminished oestrogen levels.…”

“…Panoramic radiography (OPG) is an imaging modality that can aid in simultaneous preliminary radiographic examination of both maxillary and mandibular jaws. Despite being a two-dimensional radiograph, OPG is one of the frequent radiographic investigations employed in maxillofacial radiology due to its low cost and reduced patient radiation exposure 17 . Thereby, given its popularity, dental clinicians should be familiar with the typical patterns and characteristic radiographic features of various soft-tissue calcifications that are encountered in the maxillofacial region.…”