Calcified carotid artery atheroma on standard dental panoramic radiographs in a dental school population : a retrospective study

Objectives: We aimed to determine the prevalence of CCAA detected on DPR’s of individuals over 30 years of age. We assessed if student dentists were able to identify CCAA on DPRs in UBC Dental clinic. Additionally, to associate CCAA on DPR with pre-existing statin indicated conditions, age, sex, hypertension, diabetes mellitus, history of smoking and periodontal bone loss. Methods: In this retrospective study, we reviewed the charts of 700 consecutive subjects over the age of 30 with a DPR from October 2018 to April 2021 from UBC Dental Clinic. We reviewed patients’ medical histories for pre-existing statin-indicated conditions as outlined by the Canadian Cardiovascular Society 2021 Guidelines. We also examined patients’ standard dental panoramic radiographs to determine the prevalence of CCAAs. The proportion of patients on lipid lowering therapy (LLT) was also assessed. Results: Out of 700 consecutive charts reviewed with a DPR, 657 were unique subjects. Since subjects had a DPR acquired more than once, only the most recent DPR was included. Of the 657 DPRs, 358 (55.9%) were considered diagnostic for evaluation of CCAA. 16 were excluded due to undocumented or incomplete medical history. Out of the 641 subjects, 289 (45.1%) were females and 352 (54.9%) were males. The mean age was 60.4±16.0 years for females and 60.9±16 years for males. There was evidence of CCAA on 82 (22.9%) of the 358 DPRs; however only 6 (7%) were identified by the student dentist based on the chart review. In patients with CCAAs, 17/82 (20.7%) were already on LLT for a pre-existing condition and 15/82 (18.3%) were not on LLT despite a pre-existing condition, for the remaining 50/82 (61%) CCAA on DPR was the first evidence of atherosclerosis. Therefore, CCAA on DPR constituted a new diagnosis of atherosclerosis in 61% of subjects. With chi square test, a statistically significant association of CCAA found with increasing age (p<0.05), male sex (p<0.05), pre-existing condition (p<0.05), history of smoking and hypertension (p