Panoramic dental radiography as an aid in detecting patients at risk for stroke.
OBJECTIVE
Atherosclerotic lesions in the region of the bifurcation of the common carotid artery and in the internal carotid artery are the most common cause of stroke. On occasion these lesions are calcified and visible on a panoramic dental radiograph.


METHODS
Six subjects receiving outpatient dental treatment and denying a history of previous transient ischemic attacks or stroke had bilateral calcified carotid arterial lesions noted on their routine panoramic dental radiograph.


RESULTS
Electronic thermography (ET) demonstrated that these patients had significant temperature differences bilaterally between their medial supraorbital region and the ipsilateral remainder of their forehead when compared with control subjects. These findings are consistent with the presence of calcified stenotic intraluminal plaques altering blood flow, tissue perfusion, and skin temperature readings. The presence of stenotic plaques was verified by Doppler spectral analysis and imaging.


CONCLUSIONS
ET of the face, currently considered an investigational procedure, demonstrates promise as an ancillary imaging system capable of confirming the diagnosis of patients at risk of stroke. Such individuals should be referred to an appropriate physician for consideration of medications and/or surgical removal of the plaque. In selected individuals, these are safe and relatively reliable methods of preventing stroke.
Friedlander
A H
AH
Department of Oral and Maxillofacial Surgery, UCLA School of Dentistry 90024.
Gratt
B M
BM
D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000517:prevention & control*; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011862:Radiography, Panoramic; D012307:Risk Factors; D013817:Thermography; D018615:Ultrasonography, Doppler, Color