The association between carotid calcium on dental panoramic radiographs and coronary calcium score on chest computerized tomography

Abstract

Objectives: Coronary artery calcium measured by CT predicts future coronary events. Similarly, carotid artery calcium on dental panoramic radiographs has been associated with increased cardiovascular events. Pre-procedural assessment of candidates for valve replacement in our institution includes panoramic radiographs and chest tomography. We aimed to assess the association of carotid calcium on panoramic radiographs with coronary artery calcium on chest tomography. Methods: Paired pre-procedural panoramic radiographs and chest tomography scans were done in 177 consecutive patients between October 2016 and October 2017. Carotid calcium was quantified using NIH’s ImageJ. Coronary artery calcium was quantified by the Agatston score using Philips Intellispace portal, v. 8.0.1.20640. Results: Carotid calcium maximal intensity, area and perimeter were higher among patients with high coronary artery calcium. Non-zero carotid calcium was found in half of patients with high coronary artery calcium, doubling prevalence of low coronary artery calcium. Conclusion: Carotid calcium identified in panoramic radiographs was associated with high coronary artery calcium. Awareness of carotid calcium recognized by dental practitioners in low-cost, low radiation and commonly done panoramic radiographs may be useful to identify patients at risk of coronary disease with potential future cardiovascular events.

Carotid Artery Calcification Detected on Panoramic Radiography Is Significantly Related to Cerebrovascular Accident, Coronary Artery Disease, and Poor Oral Health: A Retrospective Cross-Sectional Study

“…The study by Carasso et al showed that the detection of CAC on PRs was correlated with high coronary artery calcium and tripled the probability of having a clinically significant coronary artery calcium score that warrants clinical evaluation [44]. Coronary artery calcium scoring is a widely available, specific, and readily reproducible means of assessing risk for coronary artery disease and cardiovascular events; a great assessment tool for asymptomatic individuals for planning preventive strategies.…”

Deep convolution neural network for screening carotid calcification in dental panoramic radiographs

“…It involves the injection of contrast material and exposure to X-ray ionizing irradiation which, in addition to significant financial expenses, make this test inadequate for screening purposes. Panoramic dental X-rays may provide important information on carotid artery calcification [ 26 , 38 , 39 ]. They are performed routinely and the information on possible CAC can be retrieved without additional clinical test or procedure.…”

A importância do cirurgião-dentista na detecção do ateroma e prevenção do acidente vascular cerebral: revisão de literatura

“…Para a identificação de ateromas em radiografia panorâmica requer treinamento dos profissionais para este achado, e destaca que este exame complementar é uma ferramenta que pode sugerir diagnóstico importante de CAC. Além disso, em seu estudo, demonstrou que Cirurgiões-Dentistas que foram treinados por duas semanas para identificar os achados radiopacos obteve avanço significativo no diagnóstico de CAC, com aumento da precisão diagnóstica de 41,8% para 55,7% (p=0,02) 2021) referem eficácia de 50%, justificando que a radiografia panorâmica pode ser utilizada como ferramenta de triagem, mas não de diagnóstico de CAC 33,34 . O presente estudo corrobora e evidencia a necessidade de exames específicos, como a Ultrassonografia com Doppler de carótidas, para diagnóstico final de placas de ateroma diante da suspeita levantada através de radiografias panorâmicas.…”