Volume 5, Issue 1, June 2019, Page: 14-18
Arteriosclerosis in Dental Radiographs: Two Case Reports
Agnes Lau, Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Boston, USA; Department of Oral and Maxillofacial Surgery, Harvard School of Dental Medicine, Boston, USA
Received: Jan. 18, 2019;       Accepted: Feb. 26, 2019;       Published: Mar. 19, 2019
DOI: 10.11648/j.ijdm.20190501.13      View  41      Downloads  9
Dentists are trained to identify atheromatous plaques of the intimal layer of the common carotid artery on panoramic radiographs, but are less familiar with medial layer arteriosclerosis, which results in “pipe-stem” calcifications that may present on intraoral as well as extraoral dental radiographs. Medial arteriosclerosis is often found in diabetics and patients with chronic kidney disease, and is a strong predictor of stroke and cardiovascular events. Two case reports are presented that illustrate the presentation of medial arteriosclerosis in facial and maxillary arteries on dental radiographs. Dentists can play an important role in identifying patients at risk for stroke and cardiovascular events.
Facial Artery, Vascular Calcification, Arteriosclerosis, Dental Radiograph
To cite this article
Agnes Lau, Arteriosclerosis in Dental Radiographs: Two Case Reports, International Journal of Dental Medicine. Vol. 5, No. 1, 2019, pp. 14-18. doi: 10.11648/j.ijdm.20190501.13
Copyright © 2019 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
M. Moshfeghi, J. B. Taheri, N. Bahemmat, M. E. Evazzadeh, and H. Hadian. Relationship between carotid artery calcification detected in dental panoramic images and hypertension and myocardial infarction. Iran J Radiol 2014 Aug; 11(3):e8714. doi: 10.5812/iranjradiol.8714. Epub 2014 Aug 1.
A. H. Friedlander, S. M. El Saden, R. C. Hazboun, T. I. Chang, W. K. Wong, and N. R. Garrett. 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. Dentomaxillofac Radiol. 2015;447(7):20150094. doi: 10.1259/dmfr.20150094. Epub 2015 May 6.
M. Rogers, C. Goettsch, and E. Aikawa. Medial and intimal calcification in chronic kidney disease: stressing the contributions. J Am Heart Assoc 2013;2:e000481. doi: 10.1161/JAHA.113.000481.
J. Griniatsos, S. Damaskos, N. Tsekouras, C. Klonaris, and S. Georgopoulos. Correlation of calcified carotid plaques detected by panoramic radiograph with risk factors for stroke development. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009; 108: 600-603.
J. R. Goncalves, J. L. Yamada, C. Berrocal, F. H. Westphalen, A. Franco, and A. Fernandes. Prevalence of pathologic findings in panoramic radiographs: calcified carotid artery atheroma. Acta Stomatol Croat. 2016 Sept;50(3):230-234.
U. K. Lee, T. I. Chang, N. Garrett, and A. H. Friedlander. Males with rheumatoid arthritis often evidence carotid atheromas on panoramic imaging: a risk indicator of future cardiovascular events. J Oral Maxillofac Surg. 2018 Jul;76(7):1447-1453. doi: 10.1016/j.joms.2018.01.006. Epub 2018 Jan 16.
Y. Atalay, F. Asutay, K. S. Agacayak, M. Koparal, F. Adali, and B. Gulsun. Evaluation of calcified atheroma on panoramic radiographs and Doppler ultrasonography in an older population. Clin Interv Aging. 2015 Jul 8;10:1121-1129. doi: 10.2147/CIA.S84683. eCollection 2015.
N. Gustafsson, J. B. Ahlqvist, U. Näslund, P. Wester, K. Buhlin, A. Gustafsson, and E. Levring Jäghagen. Calcified carotid artery atheromas in panoramic radiographs are associated with a first myocardial infarction: a case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2018 Feb;125(2):199-204.e1. doi: 10:1016/j.oooo.2017.10.009. Epub 2017 Nov 15.
N. Aghazadehsanai, T. I. Chang, N. R. Garrett, and A. H. Friedlander. Prevalence of calcified carotid artery atheromas on digital panoramic images among perimenopausal and postmenopausal African American women. Oral Surg Oral Med Oral Pathol Oral Radiol. 2017 May;123(5):621-625. doi: 10.1016/j.oooo.2017.01.011. Epub 2017 Feb 6.
N. Alves, N. F. Deana, and I. Garay. Detection of common carotid artery calcifications on panoramic radiographs: prevalence and reliability. Int J Clin Exp Med 2014; 7(8): 1931-1939.
P. Lanzer, M. Boehm, V. Sorribas, M. Thiriet, J. Janzen, T. Zeller, C. St. Hilaire, and C. Shanahan. Medial vascular calcification revisited: review and perspectives. Eur Heart J. 2014;35(23):1515-1525. doi: 10.1093/eurheartj/ehu163. Epub 2014 Apr 16.
K. J. Rocha-Singh, T. Zeller, and M. R. Jaff. Peripheral arterial calcification: prevalence, mechanism, detection, and clinical implications. Catheter Cardiovasc Interv. 2014 May 1;83(6):E212-E220. doi: 10.1002/ccd.25387. Epub 2014 Feb 10.
G. M. London, A. P. Guerin, S. J. Marchais, F. Metivier, B. Pannier, and H. Adda. Arterial media calcification in end-stage renal disease: impact on all-cause and cardiovascular mortality. Nephrol Dial Transplant 2003;18:1731-1740.
N. Abou-Hassan, E. Tantisattamo, E. T. D’Orsi, and W. C. O’Neill. The clinical significance of medial arterial calcification in end-stage renal disease in women. Kidney Int. 2015 Jan;87(1):195-199. doi: 10.1038/ki.2014.187. Epub 2014 May 28.
M. Rogers, C. Goettsch, and E. Aikawa. Medial and intimal calcification in chronic kidney disease: stressing the contributions. J Am Heart Assoc 2013;2:e000481. doi: 10.1161/JAHA.113.000481.
J. B. Hays, J. A. Gibilisco, and J. L. Juergens. Calcification of vessels in cheek of patient with medial arteriosclerosis. Oral Surg 1966;24:299-302.
M. Tahmasbi-Arashlow, S. Barghan, D. Kashtwari, and M. K. Nair. Radiographic manifestations of Mönckeberg arteriosclerosis in the head and neck region. Imaging Sci Dent 2016; 46;53-56.
L. M. Ennis and L. W. Burket. Calcified vessels of the cheeks: demonstration by means of dental roentgenograms. Ann Dent 1942;1:111-113.
D. A. Miles and R. M. Craig. The calcified facial artery: a report of the panoramic radiographic incidence and appearance. Oral Surg Oral Med Oral Pathol 1983;55:214-219.
M. M. Suarez-Cunqueiro, J. Duker, N. Leibehenschel, R. Schön, and R. Schmelzeisen. Calcification of the branches of the external carotid artery detected by panoramic radiography: a case report. Oral Surg Oral Med Oral Pathol Radiol Endod 2002;94:636-640.
K. Nitta and T. Ogawa. Vascular calcification in end-stage renal disease patients. Contrib Nephrol. 2015;185:156-167. doi: 10.1159/000380980. Epub 2015 May 19.
K. Vipattawat, C. Kitiyakara, B. Phakdeekitcharoen, S. Kantachuvesiri, V. Sumethkul, S. Jirasiritham, W. Stitchantrakul, and S. Disthabanchong. Vascular calcification in long-term kidney transplantation. Nephrology 2014;19:251-256.
A. Lindblom. Arteriosclerosis and arterial thrombosis in the lower limb. A roentgenological study. Acta Radiol. 1950;80(Suppl.):1-80.
K. Krӧger, A. Stang, J. Kondratieva, S. Moebus, E. Beck, A. Schmermund, S. Mӧhlenkamp, N. Dragano, J. Siegrist, K. Jӧckel, and R. Erbel. Prevalence of peripheral arterial disease – results of the Heinz Nixdorf recall study. Eur J Epidemiol 2006;21:279-285.
D. S. MacDonald, L. Zhang, and Y. Gu. Calcification of the external carotid arteries and their branches. Dentomaxillofacial Radiology 2012;41:615-618.
R. G. Micheletti, G. A. Fishbein, J. S. Currer, and M. C. Fishbein. Mӧnckeberg sclerosis revisited: a clarification of the histologic definition of Mӧnckeberg sclerosis. Arch Pathol Lab Med 2008;132:43-47.
Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017. Atlanta, GA: Centers for Disease Control and Prevention, U.S. Dept of Health and Human Services; 2017.
Kidney Disease Statistics for the United States (December 2016). Retrieved from https://www.niddk.nih.gov/health-information/health-statistics/kidney-disease. Accessed March 24, 2018.
G. Cianciolo, I. Capelli, M. L. Angelini, C. Valentini, O. Baraldi, M. P. Scolari, and S. Stefoni. Importance of vascular calcification in kidney transplant recipients. Am J Nephrol 2014;39:418-426.
R. C. Johnson, J. A. Leopold, and J. Loscalzo. Vascular calcification: pathobiological mechanisms and clinical implications. Circ Res 2006;99;1044-1059.
L. Niskanen, M. Suhonen, O. Siitonen, and M. Uusitupa. Medial artery calcification predicts cardiovascular mortality in NIDDM. Diabetes Care 1994;17:1-5.
I. A. Monteiro, C. Ibrahim, R. Albuquerque, N. Donaldson, F. Salazar, and L. Monteiro. Assessment of carotid calcifications on digital panoramic radiographs: retrospective analysis and review of the literature. J Stomatol Oral Maxillofac Surg. 2018 Apr;119(2):102-106. doi: 10.1016/j.jormas.2017.11.009. Epub 2017 Nov 20.
Browse journals by subject