The relationship between diabetes and carotid artery calcifications detected by dental cone beam computed tomography in patients presenting for implant treatment planning

Abstract

<h3>Objective</h3> For patients receiving cone beam computed tomography (CBCT) scans as part of implant treatment planning, incidental findings such as carotid artery calcifications (CAC) may provide opportunities to suspect the presence of undetected systemic diseases such as diabetes, and refer the patients to physicians for further evaluation. The aim of this study was to investigate the association of CAC with a positive diabetic status. <h3>Study Design</h3> Two patient groups were identified from the patient population at Stony Brook University School of Dental Medicine: 1) positive CAC based on CBCT and 2) positive diabetic status. One researcher (AM) collected data. In addition to demographics, data including diabetic status and presence/type/absence of CAC was obtained. <h3>Results</h3> To satisfy the <i>a priori</i> power analysis, records between 2010 and 2021 were used. For the positive CAC group, data was obtained from 288 patients (171 males, 117 females). The mean age was 68.7 ± 7.85. Of this total, 68 patients (24%) had a positive diabetic status at the time of the CBCT (p<0.001). Chi-squared (χ²) analyses revealed that there were significantly more males than females (χ²=9.9; p=0.002). The most common location for CAC was the carotid artery bifurcation (44, or 65%) followed by multiple sites (11, or 16%), intracranial (9, or 13%), and bifurcation/intracranial (4 or 6%). For the positive diabetic group, data was obtained from 225 patients (149 males, 76 females). The mean age was 68.0 ± 8.62. Of these patients, 100 (44%) had an identifiable CAC. χ² analyses revealed there were significantly more males (χ²=21.2; p< 0.001) than females. The most common CAC location was the bifurcation (45, or 20%), followed by intracranial (23, or 10%), multiple (13, or 6%) and bifurcation/intracranial (3, or 1%), with 16 patients exhibiting lesions in other locations (7%), <h3>Conclusion</h3> CAC was found in 44% of positive diabetics while 24% of positive CAC patients had a positive diabetic status; there were significantly more males than females in both groups. Thus, individuals with CAC may be at risk for having undiagnosed diabetes and require heightened awareness on the potential impact(s) during implant treatment planning. <b>Statement of Ethical Review</b> Ethical review was sought and study was exempted from ethical review