Defined shapes of carotid artery calcifications on panoramic radiographs correlate with specific signs of cardiovascular disease on ultrasound examination

Abstract

ObjectiveThe aim was to optimize diagnostics for carotid artery calcifications (CACs) on panoramic radiographs (PRs) to identify cardiovascular disease (CVD) by investigating how four defined CAC shapes are associated with ultrasound (US) findings indicating CVD. Study DesignThe study included 414 participants (802 neck sides) from the Malmö Offspring Dental Study, examined with PRs. The PRs were assessed for CAC shapes stratified into four categories: single, scattered, vessel-width defining, and vessel-outlining. The carotid arteries were examined with US for signs of CVD: presence of plaques, largest individual area of a plaque, number of plaques, and percentage reduction of the lumen. Associations between the different CAC categories and US characteristics were analyzed. ResultsAll categories of CAC were significantly associated with a higher degree of US findings indicating CVD compared with no CAC (P<0.001). The most significant difference was found for vessel-outlining CAC, with the mean of the largest individual plaque area of 17.9 vs. 2.3 mm2, mean number of plaques 1.6 vs. 0.2, and mean percentage reduction of the lumen 24.1% vs. 3.5% (all P<0.001). ConclusionsIndependent of shape, CACs detected on PRs were associated with a higher degree of US findings of CVD. This was most pronounced for vessel-outlining CAC. With refined differential diagnostics of CACs in PRs, dentists may contribute to an improved identification of patients in need of cardiovascular prevention.