Identification of Carotid Artery Calcifications on Digital Panoramic Radiograph in a Group of South Indian population: A Retrospective Study

Abstract

Background: Stroke had been the leading cause of death in industrialized countries, following cardiovascular disease and cancer. Aim and Objective: The present study aims to evaluate the fact that dental practitioners as health care providers ought to play their part in the early detection of patients at risk of having a cerebrovascular stroke. Materials and Methods: Initial study design consisted of 1000 panoramic radiographs (PRs), which were taken for patients visiting the department of Oral Medicine and Radiology. Two examiners reviewed all the radiographs. Sixty-one patients were found to have suspected carotid artery calcifications. Out of them, only 43 patients were subjected to Doppler ultrasound for confirmation of the carotid artery calcifications (CAC's). Results: Out of the 61 patients suspected of having carotid calcifications, 30 were male (49.2%) and 31 were female (50.8%) P value=0.844.Patients with age group between 51-61 had higher incidence of calcifications on orthopanograph (OPG). Mean age of the patients with calcifications on OPG was 56.67 ± SD of 10.15 (p=0.004). Of the final 43 subjects, only 11 patients were confirmed to have positive carotid calcifications in Doppler ultrasonography study. Out of 11 patients, only 9 patients had atherosclerotic plaques that were not hemodynamically important and 2 patients had less than 50% carotid artery stenosis. Based on the Kappa value of 0.397, the level of agreement would be moderate with p value <0.001. Conclusion: Our study suggests that panoramic radiography can be a significant measure for detecting stroke prone patient. The role of Dental practitioners can be extended further, and overcome certain obstacles before panoramic radiography can be implemented as a new screening method for patients at risk of having a stroke.