Lim L Z, Koh P S F, Cao S, Wong R C W. Can carotid artery calcifications on dental radiographs predict adverse vascular events? A systematic review. Clin Oral Investig 2020; DOI: 10.1007/s00784-020-03696-5. Online ahead of print.

Dentists must be able to recognise carotid artery calcifications on panoramic radiographs and make appropriate referrals.

This study investigated the predictive value of carotid artery calcifications (CACs) seen on dental imaging for future adverse events related to cerebrovascular and cardiovascular diseases. Electronic databases and selected grey literature were searched. Outcomes included stroke, transient ischaemic attack (TIA), myocardial infarction (MI), angina, heart failure, future interventional revascularisation procedures and death. Five studies were selected from 1,011 records. Results were heterogeneous but showed that patients with CACs on panoramic radiographs (PANs) were more likely to experience strokes, TIA, MI and future revascularisation procedures compared to control groups. The differences between groups were not all found to be statistically significant. Bilateral vessel-outlining CACs were an independent risk marker for future vascular events. Patients who are not currently being managed for cardiovascular risk factors should be referred for further evaluation. Those already being treated for atherosclerosis may not benefit from additional investigations. The authors concluded the evidence for the predictive value of CACs on PANs for adverse future vascular events is equivocal but can help to identify at-risk patients who require further evaluation.