title: Prevalence and imaging characteristics of palatine tonsilloliths evaluated on 2244 pairs of panoramic radiographs and CT images.
abstract: OBJECTIVE
  Palatine tonsilloliths incidentally detected on diagnostic imaging should be differentiated from pathologic calcifications to enable correct diagnosis and treatment. The aim of this study is to clarify the prevalence and imaging characteristics of palatine tonsilloliths on panoramic radiographs.
  
  
  METHODS
  We retrospectively reviewed 2244 individuals who underwent pairs of consecutive panoramic radiography and computed tomography (CT) of the head and neck region. The imaging characteristics of palatine tonsilloliths on panoramic radiography were compared with the findings from CT, which was considered the gold standard.
  
  
  RESULTS
  Tonsilloliths were detected in 300 (13.4 %) and 914 (40.7 %) of the 2244 individuals on panoramic radiographs and CT, respectively. On panoramic radiographs, tonsilloliths were superimposed over the ramus of the mandible at the level coincident with and inferior to the soft palate in 176 (7.8 %) and 90 (4.0 %) individuals, respectively. Tonsilloliths were also superimposed over the surrounding soft tissue inferior to the body of the mandible, postero-inferior to the angle of the mandible, and posterior to the ramus of the mandible in 33 (1.5 %), 26 (1.2 %), and 28 (1.3 %) individuals, respectively. A significant correlation was observed between the detectability on panoramic radiographs and the size (Spearman r = 1.000) and number (Spearman r = 0.991) of tonsilloliths, as revealed by CT images.
  
  
  CONCLUSIONS
  The present results suggest that tonsilloliths are commonly detected on panoramic radiographs. Furthermore, they can be superimposed on both the mandible and the surrounding soft tissue.
  
  
  CONCLUSIONS
  Clinicians should include tonsilloliths among the differential diagnoses when calcified bodies are detected on panoramic radiographs.
authors.affiliation: Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan. atakahashi-dent@tokushima-u.ac.jp.
authors.forename: Akira
authors.identifier: http://orcid.org/0000-0002-2316-4345
authors.initials: A
authors.lastname: Takahashi
authors.affiliation: Department of Comprehensive Dentistry, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan.
authors.forename: Chieko
authors.initials: C
authors.lastname: Sugawara
authors.affiliation: Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan.
authors.forename: Takaharu
authors.initials: T
authors.lastname: Kudoh
authors.affiliation: Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan.
authors.forename: Go
authors.initials: G
authors.lastname: Ohe
authors.affiliation: Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan.
authors.forename: Natsumi
authors.initials: N
authors.lastname: Takamaru
authors.affiliation: Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Tamatani
authors.affiliation: Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Nagai
authors.affiliation: Department of Oral Surgery, Oral Sciences, Clinical Dentistry, Institute of Biomedical Sciences, Tokushima University Graduate School, 3-18-15 Kuramoto-cho, Tokushima, 770-8504, Japan.
authors.forename: Youji
authors.initials: Y
authors.lastname: Miyamoto
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020347:Lithiasis / Q000000981:diagnostic imaging* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D014066:Palatine Tonsil / Q000000981:diagnostic imaging*; D015995:Prevalence; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
keywords: Computed tomography; Palatine; Panoramic radiograph; Tonsillolith