Radiographic Detection of the Relationship between Tonsilloliths and Dental Plaque-Related Pathologies in a Series of Digital Panoramic Radiographs

Abstract

Objective: The purpose of this study was to analyse the prevalence of tonsilloliths and to determine radiographically whether there is a relationship between tonsilloliths and dental plaque-related pathologies in a series of digital panoramic radiographs. Materials and Methods: This retrospective study included digital panoramic radiographs of 859 patients admitted for a routine dental examination. The panoramic images were examined for both the presence of tonsilloliths and the number of decayed, missing, restored tooth and apical periodontitis. Periodontal bone loss was also measured in thirds of optimal bone height according to the root length and finally a percentage of bone loss was obtained for each panoramic radiograph evaluated. Results: Tonsilloliths were observed in 141 (16.4%) of all individuals. While there was no significant difference regarding the number of decayed teeth and restored teeth between tonsillolith cases (TT) and cases without tonsillolith (TC), the number of missing teeth and apical periodontitis in TT was significantly higher than TC (p: 0.004, p: 0.030, respectively). There was a significant difference between the groups in terms of the mean percentage of bone loss (p: 0.001; p< 0.05). In addition, cases showing bone loss between one-third and two-thirds of the optimal bone height in the TT group (52.5%) were significantly higher than those in TC (45.5%) (p: 0.035; p< 0.05). Conclusion: The relationship between dental plaque-related pathologies and tonsilloliths, observed in this retrospective study, should be confirmed by Computed Tomography studies and randomized, prospective, clinical trials conducted in a multidisciplinary manner.

Correlation between the presence of tonsilloliths and the bone defects by periodontitis on imaging analysis: a pilot study

“…Teeth with caries or periapical lesions were not excluded. Bone loss was considered when the alveolar crest was found to be 2 mm or more from the cemento-enamel junction according to Gurbuz et al [ 15 ]. Alveolar bone defects caused by periodontitis were assessed on panoramic radiographs by measuring the distance between the cement-enamel junction and the alveolar crest and between the cement-enamel junction and the root apex at two sites (mesial and distal) on each tooth ( Fig.…”

“…Very recently, a significant relationship between tonsilloliths and dental plaque-related pathologies was reported buy Gurbiuz et al using digital panoramic radiographs [ 15 ]. In addition, some of the bacteria as a foreign nidus in tonsilloliths are periodontal disease-related bacteria, such as Actinomyces, Eubacterium, Fusobacterium, Megasphaera, Porphyromonas, Prevotella, Selenomonas, and Tannerella spp.…”

“…These results seem reasonable because tonsilloliths may be involved in continuously dental plaque-related pathologies such as periodontal disease and active alteration of calcifications, which are correlated to the surrounding environment [ 10 , 15 ]. However, the report by Gurbuz et al was relatively limited because the presence or absence of tonsilloliths was judged by panoramic radiographs in that study [ 15 ]. The detection rate of tonsilloliths by panoramic radiographs was only about 13%, not approaching the nearly 50% seen on CT [ 2 , 10 , 15 ].…”

“…However, the report by Gurbuz et al was relatively limited because the presence or absence of tonsilloliths was judged by panoramic radiographs in that study [ 15 ]. The detection rate of tonsilloliths by panoramic radiographs was only about 13%, not approaching the nearly 50% seen on CT [ 2 , 10 , 15 ].…”

Reconocimiento de tonsilolitos en tomografía computarizada de haz cónico

“…Los tonsilolitos son calcificaciones distróficas de los tejidos blandos que se forman generalmente en las criptas de las amígdalas palatinas (1-6), pero también pueden aparecer en las amígdalas faríngeas y linguales (4). La etiología de estas calcificaciones aún no está clara; sin embargo, algunos autores apuntan a que se debe al resultado de infecciones recurrentes de las amígdalas (4,6,7).…”