Panoramic radiography for detection of bilateral carotid calcified atheroma: An unusual Case Report

  • Maximiliano Bravo-Valenzuela Pontifical Catholic University of Chile, Santiago, Chile.
  • Javiera Reyes-Velásquez Dentistry School, Pontifical Catholic University of Chile, Santiago, Chile.
  • Salvador Valladares-Pérez Pontifical Catholic University of Chile, Santiago, Chile.  El Carmen Metropolitan Clinical Hospital, Maipú, Santiago, Chile.

Abstract

Introduction: Atherosclerosis is a progressive inflammatory disease that can trigger serious medical consequences like acute myocardial infarction or stroke. Case Report: The purpose of this study is to report an unusual case of finding calcified atheromatous plaques in the carotid arteries bilaterally using a panoramic radiography (PR). A 75-year-old female with a morbid history, attends the Teaching Dental Clinic of the Pontifical Catholic University with complementary exams. PR showed well-defined radiopaque structures adjacent to C4. Using a Doppler ultrasound, the presence of calcified atheromas in the right and left carotid arteries were confirmed. The patient was informed of these findings and is currently under medical follow-up. Conclusion: PR is a useful complementary resource in the detection of atherosclerotic plaques of the upper carotid region.

References

1. Encuesta Nacional de Salud. Primeros Resultados, 2016-2017. Disponible en: https://www.minsal.cl/wp-content/uploads/2017/11/ENS-2016-17_PRIMEROS-RESULTADOS.pdf.
2. Brito AC, Nascimento HA, Argento R, Beline T, Ambrosano GM, Freitas DQ. Prevalence of suggestive images of carotid artery calcifications on panoramic radiographs and its relationship with predisposing factors. Cien Saude Colet. 2016;21(7):2201-8.
3. Friedlander AH, Lande A. Panoramic radiographic identification of carotid arterial plaques. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1981;52102-104.
4. Lee UK, Chang TI, Garrett N, Friedlander AH. Males with Rheumatoid Arthritis Often Evidence Carotid Atheromas on Panoramic Imaging: A Risk Indicator of Future Cardiovascular Events. J Oral Maxillofac Surg. 2018;76(7):1447-1453.
5. Departamento de Estadísticas e Información en Salud (DEIS). Base de Datos de egresos hospitalarios y defunciones. MinSal, Chile, 2015.
6. Bayer S, Helfgen EH, Bös C, Kraus D, Enkling N, Mues S. Prevalence of findings compatible with carotid artery calcifications on dental panoramic radiographs. Clin Oral Investig. 2010;15(4):563–9.
7. Kumagai M, Yamagishi T, Fukui N, Chiba, M. Carotid artery calcification seen on panoramic dental radiographs in the Asian population in Japan. Dentomaxillofac Radiol. 2007;36(2):92-6.
8. Borba DL, Hipólito UV, Pereira YCL. Early diagnosis of atherosclerosis with panoramic radiographs: a review. J Vasc Bras. 2016;15(4):302–7.
9. Magat G, Tuncdemir AR. Assessment of calcified carotid artery plaques on digital panoramic radiographs of middle-aged and older asymptomatic persons in a Turkish subpopulation and associated risk factors. Iran Red Crescent Med J. 2018; 20:0–6.
10. Monteiro IA, Ibrahim C, Albuquerque R, Donaldson N, Salazar F, Monteiro L. Assessment of carotid calcifications on digital panoramic radiographs: Retrospective analysis and review of the literature. J Stomatol Oral Maxillofac Surg. 2018;119(2):102-6.
11. Kansu O, Ozbek M, Avcu N, Gençtoy G, Kansu H, Turgan C. The prevalence of carotid artery calcification on the panoramic radiographs of patients with renal disease. Dentomaxillofac Radiol. 2005; 34:16-9.
12. Friedlander AH, El Saden SM, Hazboun RC, Chang TI, Wong WK, Garrett NR. Detection of carotid artery calcification on the panoramic images of post-menopausal females is significantly associated with severe abdominal aortic calcification: a risk indicator of future adverse vascular events. Dentomaxillofac Radiol. 2015;44(7):20150094.
13. Baber U, Mehran R, Sartori S, Schoos MM, Sillesen H, Muntendam P, Garcia MJ, Gregson J, Pocock S, Falk E, Fuster V. Prevalence, impact, and predictive value of detecting subclinical coronary and carotid atherosclerosis in asymptomatic adults: the BioImage study. J Am Coll Cardiol. 2015;65(11):1065-74.
14. Mathiesen EB, Johnsen SH, Wilsgaard T, Bønaa KH, Løchen ML, Njølstad I. Carotid plaque area and intima-media thickness in prediction of first-ever ischemic stroke: a 10-year follow-up of 6584 men and women: the Tromsø Study. Stroke. 2011;42(4):972-8.
15. Rundek T, Arif H, Boden-Albala B, Elkind MS, Paik MC, Sacco RL. Carotid plaque, a subclinical precursor of vascular events: the Northern Manhattan Study. Neurology. 2008;70(14):1200-7.
16. Sillesen H, Sartori S, Sandholt B, Baber U, Mehran R, Fuster V. Carotid plaque thickness and carotid plaque burden predict future cardiovascular events in asymptomatic adult Americans. 2017;1–9.
17. Deng F, Mu C, Yang L, Li H, Xiang X, Li K, Yang Q. Carotid plaque Magnetic Resonance Imaging and Recurrent stroke Risk: a systematic review and meta-analysis. Medicine. 2020;99:13(e19377)
18. MacDonald D, Chan A, Harris A, Vertinsky T, Farman AG, Scarfe WC. Diagnosis and management of calcified carotid artery atheroma: dental perspectives. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012; 114(4):533-47.
19. Barona-Dorado C, Gutierrez-Bonet C, Leco-Berrocal I, Fernández-Cáliz F, Martínez-González JM. Relation between diagnosis of atheromatous plaque from orthopantomographs and cardiovascular risk factors. A study of cases and control subjects. Med Oral Patol Oral Cir Bucal. 2016;21(1):e66-e71.
20. Ahmad M, Madden R, Perez L. Triticeous cartilage: Prevalence on panoramic radiographs and diagnostic criteria. Oral Surgery, Oral Med Oral Pathol Oral Radiol Endodontology. 2005;99(2):225–30.
21. Bengtsson VW, Perssonn GR, Berglund J, Renvert S. Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases: a long-term follow-up study. Clin Oral Investig. 2018;23(3):1171–9.
22. Schroder AGD, de Araujo CM, Guariza-Filho O, Flores-Mir C, Luca Canto G, Porporatti AL. Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery atheroma: meta-analysis. Clin Oral Investig. 2019;23(5):2021‐2040.
Published
2020-11-30
How to Cite
BRAVO-VALENZUELA, Maximiliano; REYES-VELÁSQUEZ, Javiera; VALLADARES-PÉREZ, Salvador. Panoramic radiography for detection of bilateral carotid calcified atheroma: An unusual Case Report. Journal of Oral Research, [S.l.], v. 9, n. 6, p. 511-515, nov. 2020. ISSN 0719-2479. Available at: <http://joralres.com/index.php/JOR/article/view/joralres.2020.097>. Date accessed: 24 feb. 2021. doi: https://doi.org/10.17126/joralres.2020.097.