title: Detection of carotid artery calcification on the panoramic images of post-menopausal females is significantly associated with severe abdominal aortic calcification: a risk indicator of future adverse vascular events.
abstract: OBJECTIVE
  Outcome studies among post-menopausal females with calcified carotid artery plaque (CCAP) on their panoramic images have not been previously undertaken. We sought to compare the extent of abdominal aortic calcification (AAC) on lateral lumbar spine radiographs (LLSRs), among groups of females with (CCAP+) and without (CCAP-) carotid lesions on their panoramic images. "Severe" levels of AAC have previously been validated as a risk indicator of future adverse cardiovascular events.
  
  
  METHODS
  This cross-sectional case-control study included a "CCAP+ group" consisting of females more than 50 years of age having the carotid lesion diagnosed by their dentists and an atherogenic risk factor (age, body mass index, hypertension, diabetes and dyslipidaemia)-matched "CCAP- group". A physician radiologist, using the Framingham index, evaluated the LLSRs for the magnitude of AAC. Summary statistics for key variables were computed and conditional logistic regression techniques were considered.
  
  
  RESULTS
  Members of the CCAP+ group were significantly (p=0.038) more likely to demonstrate "severe" levels of AAC on their LLSRs than members of the CCAP group.
  
  
  CONCLUSIONS
  This is the first published study demonstrating that CCAP on panoramic images of post-menopausal females is significantly associated with "severe" levels of AACs on LLSRs independent of traditional risk factors. Given that these levels of AAC are a validated risk indicator of future myocardial infarction and stroke, dentists must evaluate the panoramic images of post-menopausal females for the presence of CCAP. Patients with carotid atheromas should be referred to their physicians for further evaluation given the systemic implications.
authors.affiliation: 1 Department of Graduate Medical Education, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.|2 Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: A H
authors.initials: AH
authors.lastname: Friedlander
authors.affiliation: 3 Imaging Service, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.|4 Department of Radiology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: S M
authors.initials: SM
authors.lastname: El Saden
authors.affiliation: 5 Dental Service, Oral and Maxillofacial Surgery Division, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
authors.forename: R C
authors.initials: RC
authors.lastname: Hazboun
authors.affiliation: 2 Department of Oral and Maxillofacial Surgery, School of Dentistry, University of California Los Angeles, Los Angeles, CA, USA.|5 Dental Service, Oral and Maxillofacial Surgery Division, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
authors.forename: T I
authors.initials: TI
authors.lastname: Chang
authors.affiliation: 6 Department of Biostatistics, School of Public Health, University of California Los Angeles, Los Angeles, CA, USA.
authors.forename: W K
authors.initials: WK
authors.lastname: Wong
authors.affiliation: 7 Dean's Office, School of Dentistry, University of California Los Angeles, CA, USA.
authors.forename: N R
authors.initials: NR
authors.lastname: Garrett
mesh_terms: D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging*; D001018:Aortic Diseases / Q000000981:diagnostic imaging*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D017698:Postmenopause; D011237:Predictive Value of Tests; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D012307:Risk Factors; D061205:Vascular Calcification / Q000000981:diagnostic imaging*
keywords: abdominal aorta; abdominal radiography; atherosclerosis; carotid arteries; panoramic radiography