Maia P R L, Tomaz A F G, Maia E F T, Lima K C, de Oliveira P T. Prevalence of soft tissue calcifications in panoramic radiographs of the maxillo-facial region of older adults. Gerodontology 2022; 39: 266-272.

Potentially life-saving.

Examining 1,176 panoramic radiographs of people over 60 years of age, referred to a university imaging department in Brazil, 43% were found to have at least one soft tissue calcification. Twelve percent of the radiographs exhibited carotid artery calcifications (CAC), typified by 'vertical, linear oriented, irregular, heterogenous radiopacities adjacent to the spine at the level of vertebrae C3 and C4 and inferior to the mandibular angle.' CAC may be related to the high level of co-morbidities in older patients and may be an indicator of atherosclerotic disease, predisposing to stroke and myocardial infarction. Prompt referral for medical investigation is needed.

Calcification of the thyroid (round cord-like radiopacities) and triticeous (round or oval radiopacities) cartilages may also be present (significantly more frequent in women) and could be confused with CAC. If in doubt, referral is appropriate. Ten percent of radiographs exhibited tonsilloliths (significantly more frequent in men). Sialoliths, calcified lymph nodes and phleboliths were present in smaller numbers.