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Möst T, Winter L, Ballheimer YE, Kappler C, Schmid M, Adler W, Weber M, Kesting MR, Lutz R. Prevalence of carotid artery calcification detected by different dental imaging techniques and their relationship with cardiovascular risk factors, age and gender. BMC Oral Health 2023; 23:949. [PMID: 38037004 PMCID: PMC10691106 DOI: 10.1186/s12903-023-03564-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 10/22/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND Atherosclerosis and its secondary diseases display a major threat to patient's health. Sequelae, like carotid artery calcification (CAC), usually develop over decades and remain asymptomatic for a long time, making preventive measures to reduce mortality and morbidity extremely important. Through panoramic radiography (PR) and cone beam computed tomography (CBCT), dentists may have helpful tools in aiding the holistic care of patients. In this context, the correlation of atherosclerotic risk factors and CAC development have not yet been sufficiently investigated. Thus, the aim of this observational radiological study was to evaluate the diagnostic value of PR compared with CBCT for the detection of CAC in patients older than 60 years. The radiological findings were correlated with gender, age, and cardiac risk factors. METHODS PRs and CBCTs of N = 607 patients were used for the qualitative analysis and compared. Basic patient information such as age, gender, body mass index (BMI), smoking history as well as patient's detailed medical history, including heart disease and cardiovascular risk factors such as hypercholesterolemia, arterial hypertension and diabetes mellitus type II were documented and their relation to CAC provided by radiological data was estimated in the form of odds ratios (OR), which were calculated using logistic regression models. Proportions of CAC in different risk groups were compared using Fisher's exact test, the significance level was set to α ≤ 0.05. The interrater reliability of two physicians was estimated using Cohen's kappa. RESULTS With an accuracy of 90.6%, a sensitivity of 67.5% and a specificity of 99.5% compared to CBCT, PR was a reliable method for the diagnosis of CAC. The overall detection rate for CAC was 27.8% across all age groups. Age (OR: 1.351; p = 0.021), the male sex (OR: 1.645; p = 0.006), arterial hypertension (OR: 2.217; p = < 0.001), heart disease (OR: 1.675; p = 0.006), hypercholesterolemia (OR: 1.904; p = 0.003) and chronic obstructive pulmonary disease (OR: 2.016; p = 0.036) were statistically significant risk factors. When correlated, neither history of stroke nor nicotine abuse showed any statistical significance. CONCLUSIONS Due to the capabilities of PR in the diagnosis of CAC, dentists can play a vital role in the early diagnosis of vascular disease. Awareness should therefore be raised among dentists regarding the detection of CAC in patients over 60 years of age, with a particular focus on those with arterial hypertension and hypercholesterolaemia.
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Affiliation(s)
- Tobias Möst
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany.
| | - Linus Winter
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Yili Elisabeth Ballheimer
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Christian Kappler
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Magdalena Schmid
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Werner Adler
- Department of Medical Informatics, Biometry and Epidemiology (IMBE), University of Erlangen- Nuremberg, Erlangen, Germany
| | - Manuel Weber
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Marco Rainer Kesting
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
| | - Rainer Lutz
- Department of Oral and Maxillofacial Surgery, University Hospital Erlangen, Glückstraße 11, 91054, Erlangen, Germany
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Comparison of detection performance of soft tissue calcifications using artificial intelligence in panoramic radiography. Sci Rep 2022; 12:19115. [PMID: 36352043 PMCID: PMC9646809 DOI: 10.1038/s41598-022-22595-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 10/17/2022] [Indexed: 11/11/2022] Open
Abstract
Artificial intelligence (AI) is limited to teeth and periodontal disease in the dental field, and is used for diagnosis assistance or data analysis, and there has been no research conducted in actual clinical situations. So, we created an environment similar to actual clinical practice and conducted research by selecting three of the soft tissue diseases (carotid artery calcification, lymph node calcification, and sialolith) that are difficult for general dentists to see. Therefore, in this study, the accuracy and reading time are evaluated using panoramic images and AI. A total of 20,000 panoramic images including three diseases were used to develop and train a fast R-CNN model. To compare the performance of the developed model, two oral and maxillofacial radiologists (OMRs) and two general dentists (GDs) read 352 images, excluding the panoramic images used in development for soft tissue calcification diagnosis. On the first visit, the observers read images without AI; on the second visit, the same observers used AI to read the same image. The diagnostic accuracy and specificity for soft tissue calcification of AI were high from 0.727 to 0.926 and from 0.171 to 1.000, whereas the sensitivity for lymph node calcification and sialolith were low at 0.250 and 0.188, respectively. The reading time of AI increased in the GD group (619 to 1049) and decreased in the OMR group (1347 to 1372). In addition, reading scores increased in both groups (GD from 11.4 to 39.8 and OMR from 3.4 to 10.8). Using AI, although the detection sensitivity of sialolith and lymph node calcification was lower than that of carotid artery calcification, the total reading time of the OMR specialists was reduced and the GDs reading accuracy was improved. The AI used in this study helped to improve the diagnostic accuracy of the GD group, who were not familiar with the soft tissue calcification diagnosis, but more data sets are needed to improve the detection performance of the two diseases with low sensitivity of AI.
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Janiszewska-Olszowska J, Jakubowska A, Gieruszczak E, Jakubowski K, Wawrzyniak P, Grocholewicz K. Carotid Artery Calcifications on Panoramic Radiographs. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14056. [PMID: 36360932 PMCID: PMC9654866 DOI: 10.3390/ijerph192114056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/23/2022] [Accepted: 10/26/2022] [Indexed: 06/16/2023]
Abstract
OBJECTIVE The objective of this study was to evaluate the prevalence of carotid artery calcifications (CACs) on panoramic radiographs of Polish dental patients. METHODS Panoramic radiographs made between 2005 and 2012 in 4000 patients born between 1922 and 1958 were accessed from the server of the Department of Radiology and analyzed for the presence or absence of CACs by a group of trained dentists. RESULTS The anatomical area covered by the analysis was visible in 2189 images (54.73%). Calcifications in the carotid arteries were found in 468 (21.68%) patients, including 327 (14.94%) unilaterally and 141 (6.44%) bilaterally. CACs were found in 284 (60.68%) women and 184 (39.32%) men. CONCLUSIONS The prevalence rate of CACs detected on panoramic radiographs in patients aged 54 and older was 21.68%, which makes it an important clinical problem.
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Affiliation(s)
| | | | | | | | | | - Katarzyna Grocholewicz
- Department of Interdisciplinary Dentistry, Pomeranian Medical University in Szczecin, 70-111 Szczecin, Poland
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Cetin MB, Sezgin Y, Yılmaz MNN, Seçgin CK. Letter to the Editor: Authors' Response. Int Dent J 2022; 72:258-259. [PMID: 35131087 PMCID: PMC9275351 DOI: 10.1016/j.identj.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Mehtap Bilgin Cetin
- Baskent University, Department of Periodontology, Faculty of Dentistry, Ankara, Turkey.
| | - Yasemin Sezgin
- Baskent University, Department of Periodontology, Faculty of Dentistry, Ankara, Turkey
| | | | - Cansu Köseoǧlu Seçgin
- Baskent University, Department Of Oral And Maxillofacial Radiology, Faculty of Dentistry, Ankara, Turkey
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Antonello PR, Gamba TDO, da Silveira HLD. About Assessment of Carotid Artery Calcifications on Radiographs. Int Dent J 2021; 72:257. [PMID: 34756736 PMCID: PMC9275080 DOI: 10.1016/j.identj.2021.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/01/2021] [Accepted: 09/13/2021] [Indexed: 11/24/2022] Open
Affiliation(s)
- Pietra Rodrigues Antonello
- Oral Radiology Division, Department of Surgery and Orthopedics, Dental School, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, Porto Alegre, RS, Brazil
| | - Thiago de Oliveira Gamba
- School of Dentistry, Caxias do Sul University, Rua Francisco, Getúlio Vargas, Caxias do Sul, RS, Brazil
| | - Heraldo Luís Dias da Silveira
- Oral Radiology Division, Department of Surgery and Orthopedics, Dental School, Federal University of Rio Grande do Sul, Rua Ramiro Barcelos, Porto Alegre, RS, Brazil.
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Dewake N, Ishioka Y, Uchida K, Taguchi A, Higashi Y, Yoshida A, Yoshinari N. Association between Carotid Artery Calcification and Periodontal Disease Progression in Japanese Men and Women: A Cross-Sectional Study. J Clin Med 2020; 9:E3365. [PMID: 33092208 PMCID: PMC7589808 DOI: 10.3390/jcm9103365] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 10/18/2020] [Accepted: 10/19/2020] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE To evaluate the association between alveolar bone loss (ABL) detected on panoramic radiographs and carotid artery calcification (CAC) detected on computed tomography (CT). METHODS The study subjects included 295 patients (mean age ± SD: 64.6 ± 11.8 years) who visited the Matsumoto Dental University Hospital. The rate of ABL and the number of present teeth were measured on panoramic radiographs. Univariate analyses with t-tests and chi-squared tests were performed to evaluate the differences in age, gender, history of diseases, number of present teeth, and the ABL between subjects, with and without CAC. Moreover, multivariate logistic regression analysis, with forward selection and receiver operating characteristic curve (ROC) analysis, was performed. RESULTS The number of subjects without and with CAC was 174 and 121, respectively. Univariate analyses revealed that CAC was significantly associated with age, hypertension, osteoporosis, number of present teeth, and ABL. Multivariate logistic regression analysis adjusted for covariates revealed that the presence of CAC was significantly associated with ABL (OR = 1.233, 95% CI = 1.167-1.303). In the ROC analysis for predicting the presence of CAC, the the area under the ROC curve was the highest at 0.932 (95% CI = 0.904-0.960) for ABL, which was significant. CONCLUSIONS Our results suggest that the measurement of ABL on panoramic radiographs may be an effective approach to identifying patients with an increased risk of CAC.
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Affiliation(s)
- Nanae Dewake
- Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan; (Y.I.); (N.Y.)
| | - Yasuaki Ishioka
- Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan; (Y.I.); (N.Y.)
| | - Keiichi Uchida
- Department of Oral Sciences, Matsumoto Dental University Hospital, Shiojiri 399-0781, Japan;
| | - Akira Taguchi
- Department of Oral and Maxillofacial Radiology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan;
| | - Yukihito Higashi
- Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University, Hiroshima 734-0037, Japan;
| | - Akihiro Yoshida
- Department Oral Health Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri 399-0781, Japan;
- Department of Oral Microbiology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan
| | - Nobuo Yoshinari
- Department of Operative Dentistry, Endodontology and Periodontology, School of Dentistry, Matsumoto Dental University, Shiojiri 399-0781, Japan; (Y.I.); (N.Y.)
- Department Oral Health Promotion, Graduate School of Oral Medicine, Matsumoto Dental University, Shiojiri 399-0781, Japan;
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