Prevalence of findings compatible with carotid artery calcifications on dental panoramic radiographs

Abstract

Cerebrovascular accidents are responsible for killing or disabling more than half a million Americans every year. They are the third leading cause of death in this country. In Germany, the annual stroke incidence reaches 182 cases per 100,000 inhabitants. Stroke there is the fourth leading cause of death. There is a need of finding cost-effective means of decreasing stroke mortality and morbidity. Instruments for early diagnosis are of great humanitarian and economic importance. All possible clinical findings should be taken into account. It is not the demand of this study to present the panoramic radiograph as a screening test method for early diagnosis of atherosclerosis. The aim is to show the potential of this radiograph used in everyday clinical dental practice by the prevalence of radiopaque findings in the carotid region. This study included panoramic dental radiographs of 2,557 patients older than 30 years of age. Fifty-nine percent of the patients were women and 41% were men. The radiographs were adjudged for signs compatible with carotid arterial calcifications appearing as a radiopaque nodular mass adjacent to the cervical vertebrae at or below the intervertebral space C3-4. Of all these radiographs, 4.8% showed radiopaque findings compatible with atherosclerotic lesions. The proportion of women reached 64.8% and that of men reached 35.2%. In accordance to recent literature, the results of this study show that about 5% of the patients show radiological findings compatible with carotid arterial calcifications. Some of these patients at risk for a cerebrovascular accident may be identified in the dentist's office by appropriate review of the panoramic dental radiograph. The suspicion of carotid artery calcifications demands an impetuous referral to an appropriate practitioner who can assist in the control of risk factors and if necessary arrange surgical removal of the carotid arterial plaque. So, the dentist should be aware of this problem and able to make a contribution to stroke prevention.

Determining the Prevalence of Carotid Artery Calcification and Associations with Medical History Using Dental Panoramic Radiographs

“…According to the present study, the prevalence of CAC, regardless of the patient's medical history, was 7.7%. This was similar to the studies of Alzoman et al [14], who reported that 5% of the population studied in Saudi Arabia had calcification of their panoramic view radiographs, Bayer et al [15] in 2011 reported the prevalence of 4.8% in Germany, Brand et al [9] in 2009 reported the prevalence of 9.4 % in Dutch, Sisman et al [8] in 2007 showed 5.1% frequency in Cappadocia region, Tamura et al [16] in 2003 showed 4.1% of samples had CAC.…”

“…In this study the prevalence of CAC, regardless of medical history of the individual, was higher in men than in women, similar to the studies of the Alzoman et al [14] in 2012 and Brand et al [9], but different in Tamura et al [16], Sisman et al [8] and Bayer [15]. The prevalence of CAC in patients with hypertension, diabetes, renal disease or cardiovascular disease was similar in male and female participants in our study.…”

La Radiografía Panorámica en La Detección Temprana De Enfermedades Cardiovasculares Asintomáticas: Revisión De La Literatura

“…Determinaron que las mujeres presentan mayor prevalencia de calcificaciones de tejidos blandos y que la ACAC fue la más prevalente en general. Bayer y colaboradores 53 tuvieron como propósito mostrar el potencial de la radiografía panorámica para detectar hallazgos radiopacos en la región carotidea. A diferencia de Vengalath hallaron un porcentaje de 4.8% de hallazgos radiopacos compatibles con lesiones ateroescleróticas.…”

Detection of carotid artery plaques in the dental setting

“…For a number of years, panoramic radiographs have been suggested as a tool for detecting carotid artery calcificationsbecause these anatomic structures are potentially within the visual field of these radiographs [1][2][3][4][5][6][7][8][9][10][11]. However, data suggest panoramic radiographs have low sensitivity and positive predictive value and are considered unreliable for detecting carotid artery calcification [12][13][14][15].…”

“…Head and neck structures are part of the scope of the dental profession and evaluation of these structures could play a role in enhancing patient care, as it has been suggested by the careful evaluation of panoramic radiographs [1][2][3][4][5][6][7][8][9][10][11]. In this work, we present data on a pilot study that aimed to evaluate the feasibility of a dentist to use an ultrasound to assess the presence of carotid artery calcifications in the dental setting and discuss the potential of this procedure being incorporated into the scope of the dental profession.…”