Arterial Plaque on Digital Panoramic Radiographs in a Dutch Population

Objectives: There is evidence that arterial plaques as indicator for cardiovascular problems, can be detected on panoramic radiographs (OPG). The objective of the current study was to further examine the feasibility of digital OPGs as a screening instrument for the detection of arterial plaque in a Dutch patient group.

Methods: Patients over the age of 60 with a recent digital OPG taken were selected. All patients where screened for one or more risk factors in their medical history related to hart and vascular diseases. All OPGs were examined for signs of carotid calcifications. Importance of the risk factors for the prediction of presence of carotid calcifications was statistically analyzed (at α=0.05).

Results: 440 patients satisfied the selection criteria. 418 OPGs of these patients showed the region of interest properly. Carotid calcifications (left, right or both sides) were visible on 73 (17.5%) of them. 80 patients (18% of the total) had known cardiovascular risk factors in the medical history. 22 of them (27.5%) showed carotid calcifications. The difference of the number of calcifications in the total group and the group selected by risk factors was not statistically significant. Although women showed more calcifications than man, this difference was not statistically significant. Calcifications were located at the left side in 30%, at the right side in 44% and at both sides in 26% of the cases.

Conclusion: The relative incidence of calcifications found in our study is higher than in other studies. Reasons could be the older age group in our study and the benefit of the digital OPG's enabling real time contrast and brightness optimization. It seems that the presence of risk factors in the medical history is of importance, but cannot replace the information collected from panoramic radiographs with regard to potential cardiovascular problems.