Imaging Sci Dent.  2013 Dec;43(4):235-243. 10.5624/isd.2013.43.4.235.

Coincidence of calcified carotid atheromatous plaque, osteoporosis, and periodontal bone loss in dental panoramic radiographs

• Ramesh A
• Soroushian S
• Ganguly R

• KMID: 2229605
• DOI: http://doi.org/10.5624/isd.2013.43.4.235

Abstract

PURPOSE
This study was performed to assess the correlation of calcified carotid atheromatous plaque (CCAP), the mandibular cortical index, and periodontal bone loss in panoramic radiographs.
MATERIALS AND METHODS
One hundred eighty-five panoramic radiographs with CCAP and 234 without this finding were evaluated by 3 observers for the presence of osseous changes related to osteoporosis and periodontal bone loss. Chi-squared and Mann-Whitney U tests were used to compare the two groups for an association of CCAP with the mandibular cortical index and periodontal bone loss, respectively.
RESULTS
There was a statistically significant coincidence of CCAP and osseous changes related to osteopenia/osteoporosis, with a p-value <0.001. There was no statistically significant coincidence of CCAP and periodontal bone loss. When comparing the 2 groups, "With CCAP" and "Without CCAP", there was a statistically significant association with the mean body mass index (BMI), number of remaining teeth, positive history of diabetes mellitus, and vascular accidents. There was no statistically significant association with gender or a history of smoking.
CONCLUSION
This study identified a possible concurrence of CCAP and mandibular cortical changes secondary to osteopenia/osteoporosis in panoramic radiographs. This could demonstrate the important role of dental professionals in screening for these systemic conditions, leading to timely and appropriate referrals resulting in early interventions and thus improving overall health.

Keyword

Radiography, Panoramic; Osteoporosis; Atherosclerosis, Alveolar Bone Loss

MeSH Terms

Alveolar Bone Loss*
Body Mass Index
Calcitonin
Diabetes Mellitus
Early Intervention (Education)
Mass Screening
Osteoporosis*
Peptide Fragments
Radiography, Panoramic
Referral and Consultation
Smoke
Smoking
Tooth
Calcitonin
Peptide Fragments
Smoke

Figure

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  Figure 1 A panoramic radiograph shows bilateral linear soft tissue calcification in the cervical areas most consistent with calcified carotid atheromatous plaque. The inferior mandibular cortex represents the C2 Early stage of osteoporosis, showing semilunar defects with a normal cortical width by visual estimation.

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  Figure 2 The inferior mandibular cortex on this panoramic radiograph represents the C1 stage of osteoporosis, showing an even and sharp endaosteal margin of the cortex.

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  Figure 3 This panoramic radiograph shows the C2 Late stage of osteoporosis, showing semilunar defects extending more than half the cortical width of the inferior mandibular cortex with a very thin cortex by visual estimation.

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  Figure 4 The inferior mandibular cortex on the given panoramic radiograph appears clearly porous (C3 Stage).

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