Clinical significance of carotid artery calcification detected by panoramic radiographs

Purpose: This study aimed to investigate the prevalence of clinically significant stenosis (the luminal occlusion of internal carotid artery of 50% or more) in Korean dental patients with carotid artery calcification (CAC) detected on panoramic radiographs.

Materials and methods: The presence of CAC was retrospectively interpreted on computed tomography angiography (CTA) and panoramic radiographs of 204 dental patients 50 years and older. The involved arteries were defined and the degree of the luminal stenosis was measured on CTA. An oral and maxillofacial radiologist evaluated the axial images of the spiral CT data sets to determine CAC and its involvement of internal carotid artery. After interpretation, twenty-eight sides of the neck in 22 patients (6 bilateral and 16 unilateral involvement; 20 males, 2 female; average age 66.8, age range 50-84) which were diagnosed positive in both CTA and panoramic radiographs were used as a study group. The narrowest diameter of the residual lumen was compared with the luminal diameter of the internal carotid well beyond the bulb. Percentage of stenosis was determined by calculating these two measurements. The clinical significance of CAC was determined when the stenosis was 50% or more.

Results: The internal carotid artery was involved in 75% of the study group, the stenosis of internal carotid artery was found in 19 sides (67.8%). There was only one side (3.5%) with clinically significant stenosis (66% stenosis).

Conclusion: The detection of carotid atheroma is not always related with the luminal stenosis of internal carotid artery and the prevalence of clinically significant stenosis with CAC detected on panoramic radiographs is very low in Korean dental patients.