Research Article
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Panoramik radyografilerde karotid arter kalsifikasyonunun değerlendirilmesi

Year 2025, Volume: 8 Issue: 6, 1006 - 1010, 25.10.2025
https://doi.org/10.32322/jhsm.1769306

Abstract

Amaç: Bu çalışmada, panoramik radyografilerde karotis arter kalsifikasyonunun (KAK) prevalansını değerlendirmek ve yaş, cinsiyet ve sistemik hastalıklarla ilişkisini araştırmak amaçlanmaktadır.
Yöntemler: Kliniğimize başvuran 599 hastadan alınan panoramik radyografiler retrospektif olarak incelendi. C3-C4 servikal vertebra seviyesinde yer alan düzensiz, heterojen radyoopak kitleler KAK'yi düşündürecek şekilde değerlendirildi ve ayırıcı tanı diğer kalsifiye anatomik veya patolojik yapılarla yapıldı. Hastaların yaşı, cinsiyeti ve sistemik durumları (kardiyovasküler hastalık, diyabet) kaydedildi. KAK ile klinik değişkenler arasındaki ilişkiyi değerlendirmek için ki-kare testleri ve lojistik regresyon analizleri kullanıldı.
Bulgular: KAK 19 hastada tespit edildi ve %3,2'lik bir prevalansa karşılık geldi. Prevalans yaşla birlikte artmıştır: 18-35 yaş grubunda %0,9, 36-60 yaş grubunda %6,3 ve ≥61 yaşındaki hastalarda %4,9. Lojistik regresyon analizi, yaşın KAK için bağımsız bir risk faktörü olduğunu belirlemiştir (p < 0,05). Cinsiyet veya sistemik hastalıklar açısından anlamlı bir fark gözlenmemiştir; ancak KAK prevalansı kardiyovasküler hastalığı olan hastalarda nispeten daha yüksekti (%7,7), diyabetik hastalarda ise hiçbir vaka gözlenmemiştir.
Sonuçlar: Panoramik radyografilerde tesadüfen tespit edilen KAK prevalansı, önceki çalışmalarda bildirilen aralıktadır. Yaşın bağımsız bir risk faktörü olduğu doğrulanırken, cinsiyet ve sistemik komorbiditeler arasında anlamlı bir ilişki görülmemiştir. Panoramik radyografiler, rutin diş hekimliği pratiğinde KAK'nin tesadüfen tespit edilmesi için yararlı bir araç olabilir.

References

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  • Özemre MÖ, Seçgin CK, Gülşahı A. Yumuşak doku kalsifikasyonları ve ossifikasyonları: derleme. Acta Odontol Turcica. 2016;33:166-175. doi:10.17214/aot.55965
  • Altindag A. Investigation of calcified atherosclerotic plaques on panoramic radiographs. Ann Med Res. 2024;31(1):66-70. doi:10.5455/annalsmedres.2023.12.323
  • Aydınyurt HŞ, Taşkın C. Doğu Anadolu Bölgesi’nde karotis arter kalsifikasyonlarının sıklığının belirlenmesi. Van Dent J. 2020;1(1):1-6.
  • Altındağ A, Yüksel İ. Panoramik radyografide yumuşak doku kalsifikasyon ve ossifikasyonları. Necmettin Erbakan Uni Dent J. 2021; 3(2):62-69. doi:10.51122/neudentj.2021.18
  • Yıldırım D, Bilgir E. Baş boyun bölgesindeki yumuşak doku kalsifikasyon ve ossifikasyonları. Atatürk Univ Dis Hek Fak Derg. 2015; 25(13):82-90. doi:10.17567/dfd.53076
  • Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med. 1999; 340:115-126. doi:10.1056/NEJM199901143400207
  • Gusev E, Sarapultsev A. Atherosclerosis and inflammation: insights from the theory of general pathological processes. Int J Mol Sci. 2023; 24(9):7910. doi:10.3390/ijms24097910
  • Yang SS, Woo SY, Kim DI. Analysis of atherosclerotic plaque distribution in the carotid artery. Clin Cardiol. 2022;45(12):1272-1276. doi:10.1002/clc.23903
  • Global Stroke Collaboration, Neurology. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet Neurol. 2021;20(10):795. doi:10.1016/S1474-4422(21)00252-0
  • Feigin VL, Brainin M, Norrving B, et al. World stroke organization: global stroke fact sheet 2025. Int J Stroke. 2025;20(2):132-144. doi:10. 1177/17474930241308142
  • Tugnait A, Clerehugh D, Hirschmann P. Survey of radiographic practices for periodontal disease in UK and Irish dental teaching hospitals. Dentomaxillofac Radiol. 2000;29(6):376-381. doi: 10.1038/sj/dmfr/4600561
  • Balkan EP, Deniz HA, Kurt MH, Samunahmetoğlu E, Karahan S. Application of fractal analysis in detecting trabecular bone characteristics around mandibular impacted third molars on dental panoramic radiographs. Eur Ann Dent Sci. 2024;51(2):67-73. doi:10. 52037/eads.2024.0008
  • Izzetti R. Basic knowledge and new advances in panoramic radiography imaging techniques: a narrative review on what dentists and radiologists should know. App Sci. 2021;11(17):7858.
  • Altındağ A, Cora AH. Evaluation of maxillofacial soft tissue calcifications in edentulous patients on panoramic radiographs. Geriatrik Bil Derg. 2023;6(2):103-113. doi:10.47141/geriatrik.1292936
  • Schroder AGD, de Araujo CM, Guariza-Filho O, Flores-Mir C, de Luca Canto G, Porporatti AL. Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery atheroma: a meta-analysis. Clin Oral Invest. 2019;23(5):2021-2040. doi:10.1007/s00784-019-02880-6
  • Friedlander AH, Lande AJ. Panoramic radiographic identification of carotid arterial plaques. Oral Surg Oral Med Oral Pathol. 1981;52(1):102-104. doi:10.1016/0030-4220(81)90181-X
  • Sarı AH, Mağat G. Prevalence of carotid artery calcification in hemodialysis patients: a case-control study. Van Dent J. 2025;6(1):1-13.
  • Ghassemzadeh S, Sbricoli L, Frigo AC, Bacci C. Incidental findings detected with panoramic radiography: prevalence calculated on a sample of 2017 cases treated at a major Italian trauma and cancer centre. Oral Radiol. 2021;37(3):507-517. doi:10.1007/s11282-020-00488-1
  • Almog DM, Tsimidis K, Moss ME, Gottlieb RH, Carter LC. Evaluation of a training program for detection of carotid artery calcifications on panoramic radiographs. Oral Surg Oral Med Oral Pathol. 2000;90(1):111-117. doi:10.1067/moe.2000.107056
  • Friedlander A. Identification of stroke-prone patients by panoramic and cervical spine radiography. Dentomaxillofac Radiol. 1995;24(3):160-164. doi:10.1259/dmfr.24.3.8617388
  • Kumagai M, Yamagishi T, Fukui N, Chiba M. Carotid artery calcification seen on panoramic dental radiographs in the Asian population in Japan. Dentomaxillofac Radiol. 2007;36(2):92-96. doi:10.1259/dmfr/79378783
  • Soares GC, Kurita LM. Prevalence of carotid artery calcifications among 2,500 digital panoramic radiographs of an adult Brazilian population. Med Oral Patol Oral Cir Bucal. 2018;23(3):e256. doi:10.4317/medoral.22350
  • Janiszewska-Olszowska J, Jakubowska A, Gieruszczak E, Jakubowski K, Wawrzyniak P, Grocholewicz K. Carotid artery calcifications on panoramic radiographs. Int J Environ Res Public Health. 2022;19(21): 14056. doi:10.3390/ijerph192114056
  • Hubar J. Carotid artery calcification in the black population: a retrospective study on panoramic radiographs. Dentomaxillofac Radiol. 1999;28(6):348-350. doi:10.1038/sj/dmfr/4600478
  • Ohba T, Takata Y, Ansai T, et al. Evaluation of calcified carotid artery atheromas detected by panoramic radiograph among 80-year-olds. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(5):647-650. doi:10.1016/j.tripleo.2003.07.001
  • Peters SA, Huxley RR, Woodward M. Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts, including 3,980,359 individuals and 42,401 strokes. Stroke. 2013;44(10):2821-2828. doi:10.1161/STROKEAHA.113.002342
  • Mai V, Taneja A, Larjava H, Chehroudi B, MacDonald D, Luong C. Calcified carotid artery atheroma on standard dental radiographs: a public health opportunity for cardiovascular risk reduction. Am J Prevent Cardiol. 2024;19:100714. doi:10.1016/j.ajpc.2024.100714
  • Brar A, DeColibus K, Rasner DS, et al. Carotid artery calcification detected on panoramic radiography is significantly related to cerebrovascular accident, coronary artery disease, and poor oral health: a retrospective cross-sectional study. Dentistry J. 2024;12(4):99. doi:10. 3390/dj12040099
  • Gustafsson N, Ahlqvist J, Norhammar A, et al. Association of high cardiovascular risk and diabetes with calcified carotid artery atheromas depicted on panoramic radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022;133(1):88-99. doi:10.1016/j.oooo.2021.06.006
  • Alves N, Deana NF, Garay I. Detection of common carotid artery calcifications on panoramic radiographs: prevalence and reliability. Int J Clin Exp Med. 2014;7(8):1931-1939.
  • Khosropanah S, Shahidi S, Bronoosh P, Rasekhi A. Evaluation of carotid calcification detected using panoramic radiography and carotid Doppler sonography in patients with and without coronary artery disease. Br Dent J. 2009;207(4):E8. doi:10.1038/sj.bdj.2009.762
  • Bladh M, Gustafsson N, Engström G, et al. Defined shapes of carotid artery calcifications on panoramic radiographs correlate with specific signs of cardiovascular disease on ultrasound examination. Oral Surg Oral Med Oral Pathol Oral Radiol. 2024;137(4):408-420. doi:10.1016/j.oooo.2023.12.783
  • Carter LC, Tsimidis K, Fabiano J. Carotid calcifications on panoramic radiography identify an asymptomatic male patient at risk for stroke: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85(1):119-122. doi:10.1016/S1079-2104(98)90409-7

Evaluation of carotid artery calcification on panoramic radiographies

Year 2025, Volume: 8 Issue: 6, 1006 - 1010, 25.10.2025
https://doi.org/10.32322/jhsm.1769306

Abstract

Aims: The aim of this study was to evaluate the prevalence of carotid artery calcification (CAC) on panoramic radiographs and to investigate its relationship with age, sex, and systemic diseases.
Methods: Panoramic radiographs obtained from 599 patients who referred to our clinic were retrospectively analyzed. Irregular, heterogeneous radiopaque masses located at the C3-C4 cervical vertebral level were considered indicative of CAC, with differential diagnosis performed against other calcified anatomical or pathological structures. Data on patient age, sex, and systemic conditions (cardiovascular disease, diabetes) were recorded. Information on smoking status, lipid profiles, medication use, and history of cardiovascular surgery was not recorded. Chi-square tests and logistic regression analyses were used to assess associations between CAC and clinical variables.
Results: CAC was detected in 19 patients, corresponding to a prevalence of 3.2%. The prevalence increased with age: 0.9% in the 18-35 age group, 6.3% in the 36-60 age group, and 4.9% in patients aged ≥61 years. Logistic regression analysis identified age as an independent risk factor for CAC (p<0.05). No significant differences were observed with respect to sex or systemic diseases; however, the prevalence of CAC was relatively higher in patients with cardiovascular disease (7.7%), whereas no cases were observed among diabetics.
Conclusion: The prevalence of CAC detected incidentally on panoramic radiographs was within the range reported in previous studies. Age was confirmed as an independent risk factor, while sex and systemic comorbidities showed no significant associations. Panoramic radiographs may serve as a useful tool for the incidental detection of CAC in routine dental practice

References

  • Mousa AI, Hesham NM, Hamza SA, Mohamed EM. The prevalence of carotid artery calcification detected from the panoramic radiographs of a sample of the egyptian population: a retrospective study. Egypt Dent J. 2025;71:2135-2143. doi:10.21608/edj.2025.373220.3437
  • Özemre MÖ, Seçgin CK, Gülşahı A. Yumuşak doku kalsifikasyonları ve ossifikasyonları: derleme. Acta Odontol Turcica. 2016;33:166-175. doi:10.17214/aot.55965
  • Altindag A. Investigation of calcified atherosclerotic plaques on panoramic radiographs. Ann Med Res. 2024;31(1):66-70. doi:10.5455/annalsmedres.2023.12.323
  • Aydınyurt HŞ, Taşkın C. Doğu Anadolu Bölgesi’nde karotis arter kalsifikasyonlarının sıklığının belirlenmesi. Van Dent J. 2020;1(1):1-6.
  • Altındağ A, Yüksel İ. Panoramik radyografide yumuşak doku kalsifikasyon ve ossifikasyonları. Necmettin Erbakan Uni Dent J. 2021; 3(2):62-69. doi:10.51122/neudentj.2021.18
  • Yıldırım D, Bilgir E. Baş boyun bölgesindeki yumuşak doku kalsifikasyon ve ossifikasyonları. Atatürk Univ Dis Hek Fak Derg. 2015; 25(13):82-90. doi:10.17567/dfd.53076
  • Ross R. Atherosclerosis-an inflammatory disease. N Engl J Med. 1999; 340:115-126. doi:10.1056/NEJM199901143400207
  • Gusev E, Sarapultsev A. Atherosclerosis and inflammation: insights from the theory of general pathological processes. Int J Mol Sci. 2023; 24(9):7910. doi:10.3390/ijms24097910
  • Yang SS, Woo SY, Kim DI. Analysis of atherosclerotic plaque distribution in the carotid artery. Clin Cardiol. 2022;45(12):1272-1276. doi:10.1002/clc.23903
  • Global Stroke Collaboration, Neurology. Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the global burden of disease study 2019. Lancet Neurol. 2021;20(10):795. doi:10.1016/S1474-4422(21)00252-0
  • Feigin VL, Brainin M, Norrving B, et al. World stroke organization: global stroke fact sheet 2025. Int J Stroke. 2025;20(2):132-144. doi:10. 1177/17474930241308142
  • Tugnait A, Clerehugh D, Hirschmann P. Survey of radiographic practices for periodontal disease in UK and Irish dental teaching hospitals. Dentomaxillofac Radiol. 2000;29(6):376-381. doi: 10.1038/sj/dmfr/4600561
  • Balkan EP, Deniz HA, Kurt MH, Samunahmetoğlu E, Karahan S. Application of fractal analysis in detecting trabecular bone characteristics around mandibular impacted third molars on dental panoramic radiographs. Eur Ann Dent Sci. 2024;51(2):67-73. doi:10. 52037/eads.2024.0008
  • Izzetti R. Basic knowledge and new advances in panoramic radiography imaging techniques: a narrative review on what dentists and radiologists should know. App Sci. 2021;11(17):7858.
  • Altındağ A, Cora AH. Evaluation of maxillofacial soft tissue calcifications in edentulous patients on panoramic radiographs. Geriatrik Bil Derg. 2023;6(2):103-113. doi:10.47141/geriatrik.1292936
  • Schroder AGD, de Araujo CM, Guariza-Filho O, Flores-Mir C, de Luca Canto G, Porporatti AL. Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery atheroma: a meta-analysis. Clin Oral Invest. 2019;23(5):2021-2040. doi:10.1007/s00784-019-02880-6
  • Friedlander AH, Lande AJ. Panoramic radiographic identification of carotid arterial plaques. Oral Surg Oral Med Oral Pathol. 1981;52(1):102-104. doi:10.1016/0030-4220(81)90181-X
  • Sarı AH, Mağat G. Prevalence of carotid artery calcification in hemodialysis patients: a case-control study. Van Dent J. 2025;6(1):1-13.
  • Ghassemzadeh S, Sbricoli L, Frigo AC, Bacci C. Incidental findings detected with panoramic radiography: prevalence calculated on a sample of 2017 cases treated at a major Italian trauma and cancer centre. Oral Radiol. 2021;37(3):507-517. doi:10.1007/s11282-020-00488-1
  • Almog DM, Tsimidis K, Moss ME, Gottlieb RH, Carter LC. Evaluation of a training program for detection of carotid artery calcifications on panoramic radiographs. Oral Surg Oral Med Oral Pathol. 2000;90(1):111-117. doi:10.1067/moe.2000.107056
  • Friedlander A. Identification of stroke-prone patients by panoramic and cervical spine radiography. Dentomaxillofac Radiol. 1995;24(3):160-164. doi:10.1259/dmfr.24.3.8617388
  • Kumagai M, Yamagishi T, Fukui N, Chiba M. Carotid artery calcification seen on panoramic dental radiographs in the Asian population in Japan. Dentomaxillofac Radiol. 2007;36(2):92-96. doi:10.1259/dmfr/79378783
  • Soares GC, Kurita LM. Prevalence of carotid artery calcifications among 2,500 digital panoramic radiographs of an adult Brazilian population. Med Oral Patol Oral Cir Bucal. 2018;23(3):e256. doi:10.4317/medoral.22350
  • Janiszewska-Olszowska J, Jakubowska A, Gieruszczak E, Jakubowski K, Wawrzyniak P, Grocholewicz K. Carotid artery calcifications on panoramic radiographs. Int J Environ Res Public Health. 2022;19(21): 14056. doi:10.3390/ijerph192114056
  • Hubar J. Carotid artery calcification in the black population: a retrospective study on panoramic radiographs. Dentomaxillofac Radiol. 1999;28(6):348-350. doi:10.1038/sj/dmfr/4600478
  • Ohba T, Takata Y, Ansai T, et al. Evaluation of calcified carotid artery atheromas detected by panoramic radiograph among 80-year-olds. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96(5):647-650. doi:10.1016/j.tripleo.2003.07.001
  • Peters SA, Huxley RR, Woodward M. Smoking as a risk factor for stroke in women compared with men: a systematic review and meta-analysis of 81 cohorts, including 3,980,359 individuals and 42,401 strokes. Stroke. 2013;44(10):2821-2828. doi:10.1161/STROKEAHA.113.002342
  • Mai V, Taneja A, Larjava H, Chehroudi B, MacDonald D, Luong C. Calcified carotid artery atheroma on standard dental radiographs: a public health opportunity for cardiovascular risk reduction. Am J Prevent Cardiol. 2024;19:100714. doi:10.1016/j.ajpc.2024.100714
  • Brar A, DeColibus K, Rasner DS, et al. Carotid artery calcification detected on panoramic radiography is significantly related to cerebrovascular accident, coronary artery disease, and poor oral health: a retrospective cross-sectional study. Dentistry J. 2024;12(4):99. doi:10. 3390/dj12040099
  • Gustafsson N, Ahlqvist J, Norhammar A, et al. Association of high cardiovascular risk and diabetes with calcified carotid artery atheromas depicted on panoramic radiographs. Oral Surg Oral Med Oral Pathol Oral Radiol. 2022;133(1):88-99. doi:10.1016/j.oooo.2021.06.006
  • Alves N, Deana NF, Garay I. Detection of common carotid artery calcifications on panoramic radiographs: prevalence and reliability. Int J Clin Exp Med. 2014;7(8):1931-1939.
  • Khosropanah S, Shahidi S, Bronoosh P, Rasekhi A. Evaluation of carotid calcification detected using panoramic radiography and carotid Doppler sonography in patients with and without coronary artery disease. Br Dent J. 2009;207(4):E8. doi:10.1038/sj.bdj.2009.762
  • Bladh M, Gustafsson N, Engström G, et al. Defined shapes of carotid artery calcifications on panoramic radiographs correlate with specific signs of cardiovascular disease on ultrasound examination. Oral Surg Oral Med Oral Pathol Oral Radiol. 2024;137(4):408-420. doi:10.1016/j.oooo.2023.12.783
  • Carter LC, Tsimidis K, Fabiano J. Carotid calcifications on panoramic radiography identify an asymptomatic male patient at risk for stroke: a case report. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998; 85(1):119-122. doi:10.1016/S1079-2104(98)90409-7
There are 34 citations in total.

Details

Primary Language English
Subjects Oral and Maxillofacial Radiology, Dental Public Health
Journal Section Original Article
Authors

Ali Altındağ 0000-0001-8549-5193

Ömer Altındağ 0000-0002-7035-9612

Publication Date October 25, 2025
Submission Date August 20, 2025
Acceptance Date September 18, 2025
Published in Issue Year 2025 Volume: 8 Issue: 6

Cite

AMA Altındağ A, Altındağ Ö. Evaluation of carotid artery calcification on panoramic radiographies. J Health Sci Med / JHSM. October 2025;8(6):1006-1010. doi:10.32322/jhsm.1769306

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