Evaluation of mandibular calcification on 3D volume images

Abstract

Objectives Bone and soft-tissue calcifications are often coincidentally diagnosed on digital panoramic radiographs (DPRs). As the use of three-dimensional (3D) images has increased in the past decade for diagnostics in the mandibular region, we evaluated 3D volume images derived from 2D panoramic images to determine if this method is suitable for early detection of calcifications in this region. Methods In this study, three investigators retrospectively and independently evaluated 822 DPRs. If one or more calcifications were present, the 3D volume image from that patient was retrospectively evaluated to confirm the incidental findings. A radiographic system with a low-dose mode and a high-resolution 3D-image function was used. The investigators focussed on the most common calcifications, including tonsilloliths (TL), idiopathic osteosclerosis (IO) of the mandible, carotid artery calcifications (CAC), calcified submandibular lymph nodes (hereafter, CSL), and sialoliths of the submandibular salivary gland (SSG). Results One or more calcifications were identified in 415 (50.5%) DPRs. In total, 718 calcifications were detected, 30.2% of which were TL, 16.3% IO, 11.3% CAC, 8.8% CSL, and 1.7% SSG. Only 287 (39.97 %) of the calcifications were confirmed on 3D volume images; of these, 29.2% were TL, 58.5% IO, 0.2% CAC, and 1.4% SSG. No CSLs were detected. Conclusions Not all areas shown on the DPRs were visible in the retrospectively obtained 3D volume images. Whereas DPRs are used to diagnose calcifications such as IO, TL, SSG, CAC, and CSL, the 3D volume images were only useful for confirming the existence of IO, TL, and SSG calcifications.

Sialoliths: A Retrospective Radiological Study

“…No sublingual sialolith were detected. This is in line with previous reports that showed predominance of sialoliths to the submandibular gland and extremely rare sublingual sialoliths (2,(16)(17)(18).…”

Prevalence and characteristics of tonsillar calcifications visible in dental panoramic radiographs in a sample of Polish population

“…Twodimensional examination may be used for early diagnosis of calcifications, but in order to confirm the findings, more detailed imaging is needed. Three dimensional scans are a good option to provide precise diagnosis of calcifications, especially symptomatic ones [1]. Schreiner-Tiefenbacher et al [1] examined panoramic radiographs and cone-beam computed tomography (CBCT) scans of 822 patients.…”

“…Three dimensional scans are a good option to provide precise diagnosis of calcifications, especially symptomatic ones [1]. Schreiner-Tiefenbacher et al [1] examined panoramic radiographs and cone-beam computed tomography (CBCT) scans of 822 patients. If one or more calcifications in panoramic radiograph were found, CBCT was evaluated.…”

“…They may be asymptomatic or cause dysphagia, globus sensation, halitosis, otalgia, peritonsil-lar abscess, swelling in the tonsillar fossa, glossopharyngeal neuralgia, orofacial pain, upper airway obstruction, and sleep breathing disorders. They may be incidentally found in three-and two-dimensional radiological examinations [1][2][3][4][5][6][7][8][9][10][11][12][13]. TLs appear as small opacities, overlapping the middle portion of mandible ramus, or as multiple poorly defined radio-opacities, which may be oval, round, or irregular in shape, superimposed on the soft tissues' shadows.…”

“…The most important features of diagnostic evaluation are location, distribution, number, size, and shape of the calcifications [16]. Differential diagnosis for radiological image of TLs in maxillofacial region include sialoliths of the submandibular glands, carotid artery calcifications, calcified submandibular lymph nodes, or other foci of idiopathic osteosclerosis [1,11,16].…”