title: Correlation between carotid area calcifications and periodontitis: a retrospective study of digital panoramic radiographic findings in pretreatment cancer patients.
abstract: OBJECTIVE
  The objective of this study was to examine the prevalence of carotid area calcifications retrospectively detected on digital panoramic radiographs of pretreatment cancer subjects, and to correlate the finding of such calcifications with radiographic evidence of periodontal bone loss in the same subjects.
  
  
  METHODS
  Digital panoramic radiographs of 201 subjects were evaluated for calcifications projected in the carotid artery bifurcation area as well as for alveolar bone loss as a result of periodontal disease. Inclusion criteria were unobscured carotid artery bifurcation regions bilaterally and sufficient index teeth present with a definable cemento-enamel junction and alveolar crest. Radiographs were independently observed for carotid area calcifications and for periodontal status. Image enhancements permitted for detection of calcifications projected in the carotid area included window/level, inverse, and emboss. Periodontal measurements were made on index teeth using proprietary imaging software and a mouse-driven measurement algorithm. A 3-factor analysis of variance was performed with 3 between-subjects comparisons. Percentage of bone loss was the dependent variable. Independent variables were age, subject sex, and the presence or absence of carotid area calcifications.
  
  
  RESULTS
  Differences measured in percentage of bone loss between sexes were not statistically significant. While bone loss did increase with age, comparison of the mean bone loss of each age category revealed no statistical significance. There was a highly significant correlation between carotid artery area calcifications visible on panoramic radiographs and percent alveolar bone loss. Radiographs showing unilateral and bilateral calcifications had a mean percent bone loss of 24.2% +/- 12.6% and 25.7% +/- 13.0% respectively, compared to those with no calcification at 10.4% +/- 9.9%.
  
  
  CONCLUSIONS
  Nearly 1 in 4 subjects in this study evidenced calcifications projected in the carotid bifurcation region. The finding of such calcifications was significantly related to the calculated percentage of alveolar bone loss.
authors.affiliation: School of Dentistry, The University of Louisville, Louisville, KY 40292, USA.
authors.forename: Brice W
authors.initials: BW
authors.lastname: Beckstrom
authors.forename: Scott H
authors.initials: SH
authors.lastname: Horsley
authors.forename: James P
authors.initials: JP
authors.lastname: Scheetz
authors.forename: Zafrulla
authors.initials: Z
authors.lastname: Khan
authors.forename: Anibal M
authors.initials: AM
authors.lastname: Silveira
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Clark
authors.forename: Henry
authors.initials: H
authors.lastname: Greenwell
authors.forename: Allan G
authors.initials: AG
authors.lastname: Farman
mesh_terms: D000367:Age Factors; D000368:Aged; D016301:Alveolar Bone Loss / Q000150:complications* / Q000000981:diagnostic imaging; D000704:Analysis of Variance; D050197:Atherosclerosis / Q000150:complications / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D016893:Carotid Stenosis / Q000150:complications* / Q000000981:diagnostic imaging* / Q000453:epidemiology; D005260:Female; D006258:Head and Neck Neoplasms / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010518:Periodontitis / Q000150:complications / Q000000981:diagnostic imaging; D015995:Prevalence; D019252:Radiography, Dental, Digital; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology