Abstract
The relevance of tonsils lies not only in local but also in systemic immunity. One of the most common ailments afflicting the tonsils are palatine tonsilloliths (PT), dystrophic calcifications found in the tonsillar crypts. PT prevalence reports have been conducted for Caucasian and Asian patients, but not for black patients. The aim of this cross-sectional study is to gauge the prevalence of PT in patients who sought treatment at two university clinics in the Dominican Republic, and to analyze any links with the race of patients. Two hundred and nine consecutive patients attending the dental services of two clinics located in different cities in the Dominican Republic, from March 1 to April 30, 2019, were selected. Computed tomography scans of patients were evaluated for a PT diagnosis. Determined prevalence of PT in this population sample was 5.85%. A non-significant relationship between occurrence of PT and race or kind of health service utilized was found. Nonetheless, more white patients used private health clinics while more black patients used the public health system. Previous tonsillitis was the only factor showing a significant correlation with the occurrence of PT. Also, PT prevalence was significantly higher in patients under 40 years of age. General prevalence of PT was significantly lower than reported in previous studies involving other countries/races. Considering the limitations of this study, when comparing it to a previous similar study and taking into account the Asian- and Caucasian-centric results obtained, a race influence on prevalence of calcifications may be suggested. Despite our results showing no racial differences within the Dominican Republic, black patients appear to present a lower prevalence of PT than Caucasian and Asian patients.
Highlights
The relevance of tonsils lies in local and in systemic immunity
Three Computed Tomography (CT) scans showed a bilateral occurrence of palatine tonsilloliths (PT) (25.00%)
The only variable showing a significant (p < 0.05) correlation with presence of PT was reported previous tonsillitis (r = 0.31). (Table 3) As a matter of fact, eleven out of twelve patients diagnosed with PT had had tonsillitis. These results suggest a relationship between PT and previous tonsillitis, in accordance with earlier studies and the presumed PT link with tonsillar infections and oral hygiene
Summary
The relevance of tonsils lies in local and in systemic immunity. One of the most common ailments afflicting the tonsils are palatine tonsilloliths (PT), dystrophic calcifications found in the tonsillar crypts. The Waldeyer’s ring is a circular structure of lymphoid tissue located in the pharynx, and its relevance lies in local and in systemic immunity It is diffusely present throughout the pharyngeal region, it has anatomically visible lymphatic masses called tonsils. One of the most frequently occurring of these are tonsilloliths, known as tonsil concretions, tonsillar calculi, tonsil stones and tonsillolithiasis: dystrophic calcifications that form in the tonsillar crypts They can be unilateral or bilateral and, when touching the affected tonsil, a hard, submucosal mass can be felt. The diagnosis is usually made based on recurrent tonsillitis and a dotted appearance with radiopaque image in the ramus zone They can be viewed in the mid-portion of the mandibular ramus, where it crosses the dorsal surface of the tongue. The use of Computed Tomography (CT) offers greater precision, as does the Cone Beam Computed Tomography (CBCT)[12]
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