Radiological evaluation of maxillofacial soft tissue calcifications with cone beam computed tomography and panoramic radiography

Abstract

The maxillofacial region is composed of various anatomical structures that are observed as different densities on radiographs. In addition to teeth, bones and soft tissues, variations and pathological conditions also contribute to this density range. Radiographic interpretation may challenge practitioners to determine an exact diagnosis. It is difficult to diagnose calcifications caused by pathological conditions, especially areas that neighbour teeth and bone. 1,2 Idiopathic and dystrophic calcifications are seen in maxillofacial soft tissues. Dystrophic calcifications are the most common type. 3,4 Calcifications visualised on dental images are tonsilloliths, sialoliths, phleboliths, artery calcifications, adenoliths and lymph node calcifications. Tonsilloliths are composed of calcium and magnesium salts; the exact pathogenesis is not defined. 5 They are sometimes in concordance with clinical symptoms but may be asymptomatic. 6 Sialoliths are idiopathic calcifications in salivary glands. The submandibular gland is a favoured location because of its mucous secretions, narrowed orifice and opposite flow to gravity. 7 Phleboliths in the head and neck region can be observed in all age groups. Vascular malformation areas and thrombosis provide bases for their formation, with deposition of calcium phosphate and carbonate. In extreme examples, they may cause aesthetic problems, disrupt blood flow and lead to harmful inflammation, although they are generally

The Evaluation of Incidentally Detected Head and Neck Region Soft Tissue Calcifications and Ossifications on Computed Tomography Images

“…Demographic characteristics differ in patients with soft tissue calcifications/ossifications according to the population. In literature, some studies indicate that soft tissue calcification/ossification is more common in female [12,17], in some other studies is more common in male [18,19], while some other studies it is reported to no difference between the genders [8,16]. Soft tissue calcifications/ossifications are generally seen in patients over the age of 40, but they can also be seen in children [6,20].…”

“…Soft tissue calcifications/ossifications are generally seen in patients over the age of 40, but they can also be seen in children [6,20]. In three recent studies examining patients in Turkey, the mean age of patients with soft tissue calcification/ossification was 52.12 ± 17.62, 44.17 ± 16.04, 51.2 ± 15.6, respectively [8,12,19]. In these studies, it was reported that the patients with soft tissue calcification/ossification were mostly 40 years and older.…”

“…In studies evaluating the prevalence of tonsilloliths on CT images have reported that the prevalence ranged from 16% to 46.1% [11,21,24,25,26,27], while the prevalence of tonsilloliths on CBCT images ranged from 4.9% to 34.1% [15,23,28]. In some studies, it has been reported that tonsilloliths are seen more frequently in men [24,26,27] and in some studies it is more common in female [21,25,28], there is also a study that found no difference between the genders [19]. While in our study, the prevalence of tonsilloliths was found to be 13.3% [in 120 of 917 patients].…”

“…In cases such as old age, genetic disorders, and some systemic diseases, calcification may occur in the vessels [3]. Arterial calcifications are an important risk factor in cardiovascular diseases [19]. Calcified atherosclerotic plaque is often observed in the spaces between the cervical third vertebrae or adjacent to the greater cornu of the hyoid bone on panoramic radiographs.…”

Reconocimiento de tonsilolitos en tomografía computarizada de haz cónico

“…En ella, se puede realizar un análisis multiplanar dinámico que proporciona valiosa información para identificar de una forma más precisa estas calcificaciones, las cuales se identifican en la TCHC como pequeñas imágenes hiperdensas similares al hueso. Estas calcificaciones también se pueden observar en radiografías panorámicas, aunque la interpretación se hace compleja por la superposición de estructuras óseas (2,6,8).…”