Volume 16, Issue 9 (December 2022)
Qom Univ Med Sci J 2022, 16(9): 702-711 |
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Barakian Y, Mohammadbeigi A, Ahmadian F, Bahrami Khandan M. Carotid Artery Calcification in Panoramic Radiography and Related Risk Factors. Qom Univ Med Sci J 2022; 16 (9) :702-711
URL: http://journal.muq.ac.ir/article-1-3482-en.html
URL: http://journal.muq.ac.ir/article-1-3482-en.html
1- Department of Oral and Maxillofacial Medicine, Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran.
2- Department of Biostatistics and Epidemiology, Research Center for Environmental Pollutants, Faculty of Health, Qom University of Medical Sciences, Qom, Iran.
3- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran.
4- General Dentist, Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran. ,enayatnoori68@gmail.com
2- Department of Biostatistics and Epidemiology, Research Center for Environmental Pollutants, Faculty of Health, Qom University of Medical Sciences, Qom, Iran.
3- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran.
4- General Dentist, Faculty of Dentistry, Qom University of Medical Sciences, Qom, Iran. ,
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Introduction
Carotid artery calcification (CAC) can lead to cerebrovascular accident (CVA). Early detection of asymptomatic patients at risk can reduce the incidence of strokes and its consequences such as hospitalization, loss of function, and the need for rehabilitation. If dentists pay attention to the presence of CAC in panoramic images, they can play an important role in saving patients’ lives and can guide them to visit the right doctor for receiving necessary medical treatments. Panoramic radiograph has been proven as a useful tool for the diagnosis of CAC. Compared to previous methods, this method is more common, cheaper, more accessible and non-invasive, and plays an important role in preventing strokes in asymptomatic patients. This study aims to determine the prevalence of CAC and its associated factors in patients aged ≥40 years in Qom, Iran.
Methods
This is a descriptive cross-sectional study. Participants were 417 eligible patients referred to a specialized oral and maxillofacial radiology center in Qom in 2021, Inclusion criteria were willingness to participate in the study and age over 40 years. Exclusion criteria were poor quality panoramic radiographs and lack of cooperation. Radiographs of patients were prepared by a panoramic machine (Cranex D, Soredex Co., Finland) with current = 10 mA and voltage= 73 and 77 kV. The CAC can be seen in panoramic images as nodular radiopaque masses or two parallel lines in the soft tissue of the neck at the lower edge of the third cervical vertebra or in the intervertebral space between third and fourth cervical vertebra [16]. The radiographs were initially evaluated for the presence of CAC and were finally approved by an oral and maxillofacial radiologist. After obtaining informed consent from the patients, they completed a questionnaire surveying demographic information and related risk factors including high blood pressure, history of cardiovascular diseases, CVA, myocardial infarction (MI), diabetes and smoking. Collected data were analyzed in SPSS software, vertion 22 using descriptive statistics (mean, standard deviation, percentage, and frequency), chi-square and t-test. The statistically significance level was set at 0.05.
Results
Of 417 participants, 276 (66.2%) were female and 141 (33.8%) were male with a mean age of 49.6 years. Of 417 patients, 49 (11.8%) had diabetes, 66 (15.8%) had high blood pressure, one (0.2%) had a history of MI, one (0.2%) had a history of CVA, and 38 (9.1%) had a history of cardiovascular diseases. Moreover, 149 (35.7%) were taking medications. The most common medications were levothyroxine (n=30), losartan (n=13) and metformin (n=12). Among 417 patients, 18 (4.3%) were smokers. The mean age of patients without CAC was 50.4 years and the mean age of patients with CAC was 51.8 years. No significant statistical difference was found between the two groups in terms of age (P=0.86). Among 417 patients, CAC was observed in the panoramic radiography of 6 patients. The patients with CAC were all female. Among them, two had a history of cardiovascular diseases and one had a history of high blood pressure. Gender (P=0.078), marital status (P=0.327), educational level (P=0.68), medication use (P=0.46), smoking (P= 0.6) had no significant relationship with CAC. Having a history of diabetes (P=0.36), blood pressure (P=0.95), MI (P=0.83), CVA (P=0.9), or other diseases (P=0.95) had no significant relationship with CAC, either. However, a statistically significant relationship was found between the history of cardiovascular diseases and CAC (P=0.03).
Discussion
The prevalence of CAC in Qom is 1.4% and it is associated with a history of cardiovascular diseases. Panoramic radiography which is widely used in dental clinics to check oral and maxillofacial conditions, is an easy, safe and affordable method to detect CAC. Dentists should be aware of these calcifications and make the necessary referrals to confirm their diagnosis and provision of treatments. Prospective studies with larger sample sizes are recommended.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Qom University of Medical Sciences (Code:IR.MUQ.REC.1399.305)
Funding
This study was funded by Qom University of Medical Sciences.
Authors contributions
All authors contributed equally in preparing all parts of the research.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors would like to thank the Vice-Chancellor for Research of Qom University of Medical Sciences and all participants for their support and cooperation.
Carotid artery calcification (CAC) can lead to cerebrovascular accident (CVA). Early detection of asymptomatic patients at risk can reduce the incidence of strokes and its consequences such as hospitalization, loss of function, and the need for rehabilitation. If dentists pay attention to the presence of CAC in panoramic images, they can play an important role in saving patients’ lives and can guide them to visit the right doctor for receiving necessary medical treatments. Panoramic radiograph has been proven as a useful tool for the diagnosis of CAC. Compared to previous methods, this method is more common, cheaper, more accessible and non-invasive, and plays an important role in preventing strokes in asymptomatic patients. This study aims to determine the prevalence of CAC and its associated factors in patients aged ≥40 years in Qom, Iran.
Methods
This is a descriptive cross-sectional study. Participants were 417 eligible patients referred to a specialized oral and maxillofacial radiology center in Qom in 2021, Inclusion criteria were willingness to participate in the study and age over 40 years. Exclusion criteria were poor quality panoramic radiographs and lack of cooperation. Radiographs of patients were prepared by a panoramic machine (Cranex D, Soredex Co., Finland) with current = 10 mA and voltage= 73 and 77 kV. The CAC can be seen in panoramic images as nodular radiopaque masses or two parallel lines in the soft tissue of the neck at the lower edge of the third cervical vertebra or in the intervertebral space between third and fourth cervical vertebra [16]. The radiographs were initially evaluated for the presence of CAC and were finally approved by an oral and maxillofacial radiologist. After obtaining informed consent from the patients, they completed a questionnaire surveying demographic information and related risk factors including high blood pressure, history of cardiovascular diseases, CVA, myocardial infarction (MI), diabetes and smoking. Collected data were analyzed in SPSS software, vertion 22 using descriptive statistics (mean, standard deviation, percentage, and frequency), chi-square and t-test. The statistically significance level was set at 0.05.
Results
Of 417 participants, 276 (66.2%) were female and 141 (33.8%) were male with a mean age of 49.6 years. Of 417 patients, 49 (11.8%) had diabetes, 66 (15.8%) had high blood pressure, one (0.2%) had a history of MI, one (0.2%) had a history of CVA, and 38 (9.1%) had a history of cardiovascular diseases. Moreover, 149 (35.7%) were taking medications. The most common medications were levothyroxine (n=30), losartan (n=13) and metformin (n=12). Among 417 patients, 18 (4.3%) were smokers. The mean age of patients without CAC was 50.4 years and the mean age of patients with CAC was 51.8 years. No significant statistical difference was found between the two groups in terms of age (P=0.86). Among 417 patients, CAC was observed in the panoramic radiography of 6 patients. The patients with CAC were all female. Among them, two had a history of cardiovascular diseases and one had a history of high blood pressure. Gender (P=0.078), marital status (P=0.327), educational level (P=0.68), medication use (P=0.46), smoking (P= 0.6) had no significant relationship with CAC. Having a history of diabetes (P=0.36), blood pressure (P=0.95), MI (P=0.83), CVA (P=0.9), or other diseases (P=0.95) had no significant relationship with CAC, either. However, a statistically significant relationship was found between the history of cardiovascular diseases and CAC (P=0.03).
Discussion
The prevalence of CAC in Qom is 1.4% and it is associated with a history of cardiovascular diseases. Panoramic radiography which is widely used in dental clinics to check oral and maxillofacial conditions, is an easy, safe and affordable method to detect CAC. Dentists should be aware of these calcifications and make the necessary referrals to confirm their diagnosis and provision of treatments. Prospective studies with larger sample sizes are recommended.
Ethical Considerations
Compliance with ethical guidelines
This study was approved by the ethics committee of Qom University of Medical Sciences (Code:IR.MUQ.REC.1399.305)
Funding
This study was funded by Qom University of Medical Sciences.
Authors contributions
All authors contributed equally in preparing all parts of the research.
Conflicts of interest
The authors declared no conflict of interest.
Acknowledgements
The authors would like to thank the Vice-Chancellor for Research of Qom University of Medical Sciences and all participants for their support and cooperation.
Type of Study: Original Article |
Subject:
دندانپزشکی
Received: 2022/05/29 | Accepted: 2022/11/2 | Published: 2022/10/2
Received: 2022/05/29 | Accepted: 2022/11/2 | Published: 2022/10/2
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