Prevalence of calcified carotid artery atheromas in panoramic radiographs of HIV-positive patients undergoing antiretroviral treatment: a retrospective study

Evaluation of the Prevalence of Atherosclerosis Within the Course of Internal Carotid Artery in Cone Beam Computed Tomography Images

The aim of the present study was to retrospectively evaluate the gender-related and age-related prevalence and severity of calcifications within the segments of the internal carotid artery in cone beam computed tomography (CBCT). By using a documented visual scale, out of 400 CBCT examinations a total of 304 CBCT scans of adult patients over 40 years old were evaluated as to the prevalence and severity of intracranial calcifications within the segments of the internal carotid artery. Calcifications were found in 117 CBCT scans. These calcifications were detected along the extracranial (C1: 53%), petrous (C2: 22.2%), Lacerum (C3:27%), cavernous (C4: 94%), and ophthalmic-clinoid (C5/C6: 65%) segments. The Friedman test showed significant differences in the severity of calcifications among the internal carotid artery segments. The McNemar test showed no significant differences between calcifications on the right or left side segments. The Chi square test showed no significant differences in the prevalence of calcifications between men and women; it also showed that the prevalence of calcifications increased with increase in age (P < 0.05). In this study, the frequency and severity of calcifications decreased throughout the C4, C5/C6, and C1 segments in a descending order; moreover, an increased incidence of calcifications by increase in age was documented irrespective of gender.

Detection of calcified atheromas on panoramic radiographs of cirrhotic patients

BACKGROUND

The present study aimed to investigate the prevalence of calcified atheromas in carotid arteries (CACA) on panoramic radiographs of patients with liver cirrhosis (LC).

METHODS AND RESULTS

A case-control study of 67 individuals with LC (case group) and 67 healthy individuals (control group), matched by gender and age, was performed. In addition to demographic information, data on LC were also collected for the case group. Panoramic radiographs were evaluated by two previously calibrated examiners. The sample consisted predominantly of male individuals (n = 50; 74.62%), with mean age of 55 years old. In the case group, the mean value for the model of end-stage liver disease was 16, and the major aetiology of LC was alcoholism (n = 26; 38.8%). Thirteen (19.4%) LC patients had CACA, whereas only four (5.9%) healthy patients had this condition. LC patients are 3.72 times more likely to have CACA compared to healthy individuals (P = .02). The presence of nephropathies increases the risk of development of atheromas by 18.58 times in cirrhotic individuals (P = .04).

CONCLUSIONS

Cirrhotic patients are more likely to have CACA compared to healthy patients, and this risk increases significantly when kidney disease is involved.

Craniofacial morphology of HIV-infected adolescents undergoing highly active antiretroviral therapy (HAART): An original research

OBJECTIVES:

To analyze the craniofacial morphology in child patients and adolescents by evaluating the skeletal cephalometric profile of the HIV infected patients in this age group and comparing them with the HIV-negative controls.

MATERIALS AND METHODS:

The present study was a planned case-control study which included 25 HIV-positive adolescent patients aged between 10 and 18 years (the study group) who were compared with 25 age- and sex-matched HIV-negative adolescent controls (the control group). All the patients had been HIV infected via a vertical transmission with positive serology confirmed in two different tests and had been kept on HAART since they were born. The diagnostic aids used for orthodontic documentation included facial photographs, digital orthopantomographs, lateral teleradiographs, and study models.

RESULTS:

With reference to the methodologies used for taking the cephalometric values, all the methods used were in strong agreement with each other for almost all the variables studied and had high intra-class correlation coefficient values except Co-A, SN.ANSPNS, and SNB which, too, had a good agreement of 60%. Nevertheless, the agreement was positive for these variables, too, since the P values obtained were found to be statistically significant (P < 0.05).

CONCLUSION:

Most of the measurements in the HIV-infected adolescents were found to be similar to the ones obtained for the HIV-negative controls, although, the study results highlighted the significance of further studies to be conducted in this regard, especially, the longitudinal study designs wherein the said variables can be studied on a follow-up basis in longitudinal studies to have an idea of the exact changes observed and their pattern in the included groups.

Relationship between the prevalence of soft tissue radiopacities on panoramic radiographs and medical conditions

BACKGROUND

This study aimed to describe radiographic characteristics and the prevalence of selected anatomical structures and soft tissue radiopacities on panoramic radiographs and their relationship to medical conditions.

METHODS

A retrospective cross-sectional study was conducted with 814 consecutive patients aged 35-88 years and their panoramic radiographs. Soft tissue calcifications found in the mandibular angle area were recorded according to gender, age, and bilaterally. Patient medical records were reviewed for atherogenic risk factors including hypertension, diabetes, dyslipidemia, chronic renal disease, menopause, drug usage and any other systemic condition. Data were analyzed with the χ² test and Fisher's Exact test; P<0.05 was considered statistically significant.

RESULTS

Among the 814 patients, a total of 74 (9.1%) calcified carotid artery atheromas (CCAA) were identified, of which 34 (4.17%), 40 (3.19%), and 14 (1.7%) were right, left, and bilateral, respectively. Orthopantomographic examination revealed triticeous cartilage (7.3%) in the cervical bifurcation region, asymptomatic styloid process elongation 192 (23.5%), tonsilloliths 27 (3.3%), sialoliths 37 (4.5%), calcified lymph nodes 46 (5.7%), impacted roots 109 (13.4%), and foreign radiopaque materials 23 (%2.8). There was a significant age and gender difference between type II diabetes and CCAA. A positive correlation was found between styloid process elongation and temporomandibular joint disorders and antidepressant use.

CONCLUSIONS

Soft tissue radiopacities can be a validated risk indicator of cardiovascular events or misdiagnosed pain. Dental practitioners must be aware of these atypical findings as they may be related to serious disease states and may require referral for further investigation.

Do Patients with Osteoporosis Have Higher Risk to Present Reduced Alveolar Ridge Height? An Imaging Analysis

Background

Osteoporosis and periodontitis are both diseases that induce bone resorption. The objective of this study was to verify through panoramic radiography analysis whether patients with osteoporosis have a greater risk of periodontal disease (horizontal alveolar bone defect and vertical alveolar bone defect) when compared with patients without osteoporosis.

Methods

In all, 100 women were selected: 50 with osteoporosis (T-score < -2.5 DP) and 50 without osteoporosis (T-score > -2.5 DP), using the T-score of proximal radius. Logistic regression test was performed to assess the risk of panoramic radiographic periodontal defects (horizontal and vertical bone defect), age, and bone mineral density influence.

Results

Advanced age women were three times more likely to present osteoporosis. Patients with osteoporosis have significantly higher risk (4.46 times) of presenting horizontal alveolar bone defect. Vertical alveolar bone defect results were nonsignificant.

Conclusion

Our study results corroborate the literature trend that osteoporosis may influence the progression of alveolar ridge height loss (horizontal alveolar bone defect). Panoramic radiography may be used as a screening tool to help the diagnosis of periodontal bone loss in patients with osteoporosis.

Craniofacial morphology of HIV-positive children and adolescents undergoing antiretroviral therapy: A pilot study

INTRODUCTION

In this study, we aimed to analyze craniofacial morphology by assessing the skeletal cephalometric profiles of HIV-positive patients receiving antiretroviral therapy.

METHODS

For this study, 21 HIV-positive patients aged between 6 and 17 years (study group) were selected and compared with 21 normoreactive patients (control group), paired by sex and age. The patients were also divided into 3 age ranges (6-8, 9-12, and 13-17 years) considering the pubertal growth spurt as the central event. Eighteen (linear and angular) measurements were traced on teleradiographs by using 2 methodologies. The mean values of each measurement were compared between the study and control groups by age range.

RESULTS

The majority of the measurements checked in the HIV-positive children and adolescents for the 13-to-17 year age range were diminished, but not enough to generate a statistically significant difference in craniofacial growth. Statistically significant differences (P <0.05) were found only in the inclination of the palatal plane (6-8 years) and the position of the maxilla in the anteroposterior direction (13-17 years).

CONCLUSIONS

These results led us to conclude that some cephalometric measurements of HIV-positive children and adolescents may be similar to those of normoreactive subjects.

Cone-Beam Computed Tomography Findings in the Early Diagnosis of Calcified Atheromas

PURPOSE

Computed tomograms of the mandibles of 285 patients with indications for dental implants were evaluated at a private clinic.

MATERIALS AND METHODS

This study involved the evaluation of 285 cone-beam computed tomograms of patients 50 to 75 years of age who were referred to the clinic for the evaluation for implant placement images with visible C3 and C5 vertebrae that were obtained using the same I-Cat tomographic device (Imaging Sciences-Kavo, Hatfield, PA). Atheromas in the carotid space were visualized using paraxial images.

RESULTS

Data were analyzed using Student t and χ² tests, with a significance level of a P value less than or equal to .05. Atheromas in the carotid space were observed in 17.89% of patients; a significant difference in the incidence of atheromas was observed between men (24.27%) and women (14.29%; P = .034). However, no significant correlation was found between the frequency of occurrence of atheromas and the affected side of the carotid bifurcation (right or left) in women (P = .431) or men (P = .558).

CONCLUSION

Based on these results, cone-beam computed tomography could be a useful tool for the diagnosis of atheroma.