Prevalence of Soft Tissue Calcifications in Panoramic Radiography: A Retrospective Study

Abstract

Aim: Soft tissue calcifications in the dentomaxillofacial region are unusual and relatively asymptomatic. They are often found incidentally on panoramic radiographs during routine examination. The aim of the present study was to evaluate the prevalence of soft tissue calcifications of the dentomaxillofacial region in panoramic radiography in relation to demographic features and localization of the jaws. Material and method: Panoramic x-ray images of 1000 patients (558 females, 442 males) aged 12-74 years were used in the study. The presence of calcified lymph node, tonsillolith, calcified atherosclerotic plaque, sialolith, phlebolith, anthrolith and styloid ligament calcification were examined. The findings were subjected to statistical analysis to examine the relationship with the gender and age parameters. Results: While the most common calcification was styloid ligament calcification (8.4%), phlebolith was never found. The most common calcification was styloid ligament calcification (8.4%), followed by tonsillolith (2.1%) and carotid plaque calcification (1.5%). Conclusion: Soft tissue calcifications are rarely seen on panoramic radiographs. However, when it is encountered, dentists should be able to identify and establish the differential diagnosis of the main soft tissue calcifications in the dentomaxillofacial region, which may be of high importance in patients’ health.

Keywords

• Calcification
• Soft tissue
• Panoramic radiography
• Prevalence
• Radiology

References

1. Çaglayan F, Sümbüllü MA, Miloglu Ö, Akgül HM. Are all soft tissue calcifications detected by cone-beam computed tomography in the submandibular region sialoliths? J Oral Maxillofac Surg 2014;72(8):1531.e1-6.
2. Nasseh I, Sokhn S, Noujeim M, Aoun G. Considerations in. detecting soft tissue calci cations on panoramic radiography. J Int. Oral Health 2016;8(6):742-746.
3. White SC, Phaorah MJ. Principles and Interpretation of Oral Radiology 6th edition: Mobsy Elsevier; St. Louis, Missouri 2009.
4. Muduli M. Soft Tissue Calcifications in the Orofacial Region. Indian Journal of Forensic Medicine & Toxicology 2020;14(4):8573-8576.
5. Vengalath J, Puttabuddi JH, Rajkumar B, Shivakumar GC. Prevalence of soft tissue calcifications on digital panoramic radiographs: A retrospective study. J Indian Acad Oral Med Radiol 2014;26:385-9.
6. Noffke CE, Raubenheimer EJ, Chabikuli NJ. Radiopacities in soft tissue on dental radiographs: Diagnostic considerations. South Afr Dent J 2015;70:53-9.
7. Ramadurai J, Umamaheswari TN. Prevalence of maxillofacial soft tissue calcifications in dental panoramic radiography: A retrospective study. IP Int J Maxillofac Imaging 2018;4:82 6.
8. Icoz D, Akgunlu F. Prevalence of detected soft tissue calcifications on digital panoramic radiographs SRM J Res Dent Sci. 2019;10:21–5.

9. Bamgbose BO, Ruprecht A, Hellstein J, Timmons S, Qian F. The prevalence of tonsilloliths and other soft tissue calcifications in patients attending oral and maxillofacial radiology clinic of the university of Iowa. ISRN Dent 2014;2014:839635.
10. Ribeiro A, Keat R, Khalid S, et al. Prevalence of calcifications in soft tissues visible on a dental pantomogram: A retrospective analysis. J Stomatol Oral Maxillofac Surg. 2018;119(5):369-374.
11. Saati S, Eskandarloo A, Falahi A, Tapak L, Hekmat B. Evaluation of the efficacy of the metal artifact reduction algorithm in the detection of a vertical root fracture in endodontically treated teeth in cone-beam computed tomography images: an in vitro study. Dent Med Probl. 2019;56(4):357-63.
12. Alves N, Deana NF, Garay I. Detection of common carotid artery calcifications on panoramic radiographs: Prevalence and reliability. Int J Clin Exp Med 2014;7:1931-9.
13. Sutter W, Berger S, Meier M, et al. Cross-sectional study on the prevalence of carotid artery calcifications, tonsilloliths, calcified submandibular lymph nodes, sialoliths of the submandibular gland, and idiopathic osteosclerosis using digital panoramic radiography in a Lower Austrian subpopulation. Quintessence Int 2018; 22:231-42.
14. Andretta M, Tregnaghi A, Prosenikliev V, Staffieri A. Current opinions in sialolithiasis diagnosis and treatment. Acta Otorhinolaryngolo Ital. 2005;25:145-149.
15. El Deeb M, Holte N, Gorlin RJ. Submandibular salivary gland sialoliths perforated through the oral floor. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1981;51:134-139.
16. 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; 36:92-6.
17. Andrade K, Rodrigues C, Watanabe P, Mazzetto M. Styloid process elongation and calcification in subjects with tmd: clinical and radiographic aspects. Brazilian Dental Journal. 2012;23(4):443-450.
18. Lins C, Tavares R, Silva C. Use of Digital Panoramic Radiographs in the Study of Styloid Process Elongation. Anatomy Research International. 2015;2015:1-7.
19. Kamikua RS, Pereira MF, Fernandes R, Meurer MI. Study of the loacalization of radiopacities similar to calcified carotid ateroma by means of psnorsmic radiography. Oral Surg Oral Med Oral pathol Oral Radiol Endodo 2006; 101:374-8.
20. Magat G, Ozcan S. Evaluation of styloid process morphology and calcification types in both genders with different ages and dental status. J Istanb Univ Fac Dent 2017; 51(2):29-36.
21. Öztaş B, Orhan K. Investigation of the incidence of stylohyoid ligament calcifications with panoramic radiographs. J Investig Clin Dent 2012; 3(1):30-5.
22. Rizzatti‐Barbosa CM, Ribeiro MC, Silva‐Concilio LR, Di Hipolito O, Ambrosano GM. Is an elongated stylohyoid process prevalent in the elderly? A radiographic study in a Brazilian population. Gerodontology 2005; 22(2):112-5.
23. Maia PRL, Tomaz AFG, Maia EFT, Lima KC, Oliveira PT. Prevalence of soft tissue calcifications in panoramic radiographs of the maxillofacial region of older adults. Gerodontology. 2022;39:266–272.
24. Garay I, Netto HD, Olate S. Soft tissue calcified in mandibular angle area observed by means of panoramic radiography. Int J Clin Exp Med 2014;7:51 6.