Assessment of Carotid Artery Calcifications
Condition: Carotid Artery Calcification; Periodontal Diseases
MeSH terms: Periodontal Diseases; Carotid Artery Diseases; Arteriosclerosis; Calcinosis
Study type: Observational

Summary: 
      The aim of the study was to determine retrospectively the presence of carotid artery
      calcification (CAC) detected on digital panoramic radiographs (DPRs) and correlate the
      finding of such calcifications with gender, smoking status, medical history and periodontal
      status.The authors hypothesized that more CACs could observed in DPRs of individuals with
      periodontitis and CACs may correlate with the various risk factors included age, gender,
      smoking status, medical history.DPRs, periodontal status, medical (hypertension, diabetes,
      hyperlipidemia, cardiovascular disease) and smoking stories of 1101 patients (576 males, 525
      females) were evaluated. The patients were divided into two groups as CAC detected in dental
      DPRs [CAC(+)] and those who were not [CAC (-)]. Periodontal status categorized as gingivitis,
      periodontitis and gingivitis with reduced periodontium.
    

Detailed description: 
      The first aim of the study was to determine retrospectively the presence of CACs detected on
      digital panoramic radiographs (DPRs) and second to correlate the finding of such
      calcifications with gender, smoking status, medical history and periodontal status. The
      authors hypothesized that more CACs could observed in DPRs of individuals with periodontitis
      and CACs may correlate with the various risk factors included age, gender, smoking status,
      medical history.

      DPRs, periodontal status and medical stories of 1101 patients (576 males, 525 females)
      referred to Baskent University, Faculty of Dentistry, Department of Periodontology, during
      2016-2018 were evaluated in this retrospective, cross-sectional study. This study was
      approved by Baskent University Institutional Review Board and supported by Baskent University
      Research Fund. All study procedures were performed in accordance with the Declaration of
      Helsinki and Research Committee Regulations.

      Medical histories included gender, age, hypertension, diabetes, cardiovascular diseases,
      hyperlipidemia and smoking status. All data were obtained from the hospital records of the
      patients. Periodontal status of the participants also were determined based on hospital
      records.

      All digital panoramic images were acquired using the same machine , with the following
      exposure parameters: 64-66 kVp; 6-9 mA; and 10 s. An observer with 7 years of experience at
      the Dentomaxillofacial Radiology department of the investigator's university evaluated the
      images on 2 different dates and 30 days apart by using the ClearCanvas program on an LED
      monitor under low light. Suspected CACs findings were defined as one or more radiopaque mass
      adjacent to the cervical vertebrae at or below the intervertebral space between C3 and C4 on
      the DPR .18 The CAC's were scored as present (+) or absent (-) by the dentomaxillofacial
      radiologist.Statistical analysis Whether the distributions of continuous variables were
      normally or not being determined by Kolmogorov Smirnov test. Levene test was used for the
      evaluation of homogeneity of variances. While, categorical data were shown as number of cases
      and percentages, otherwise, descriptive statistics for continuous variables were expressed as
      mean ± SD or median (min-max) percentiles, where applicable.

      While, the mean differences between groups were compared by Student's t test, otherwise, Mann
      Whitney U test was applied for comparisons of not normally distributed data. Categorical data
      were analyzed by Continuity Corrected Chi-square or Fisher's Exact test, where appropriate.

      Determining the best predictor(s) which effect on the existence of carotid artery
      calcification was evaluated by Multiple Logistic Regression Analysis. Any variable whose
      univariable test had a p value <0.25 was accepted as a candidate for the multivariable model
      along with all variables of known clinical importance. Odds ratios, 95% confidence intervals
      and Wald statistic for each independent variable were also calculated.Data analysis was
      performed by using IBM SPSS Statistics version 17.0 software. p value less than 0.05 was
      considered as statistically significant.
    

Intervention name(s): diagnosis of carotid artery calcification on digital panoramic radiograph
Intervention type(s): Other
Intervention description(s): Suspected carotid arty calcifications findings were defined as one or more radiopaque mass adjacent to the cervical vertebrae at or below the intervertebral space between C3 and C4 on the DPR.
Observational model: Other
Time perspective: Cross-Sectional
Sampling method: Probability Sample
Study population: 
        Baskent University, Faculty of Dentistry, Department of Periodontology
      
Keywords: carotid artery calcification; panoramic radiography; periodontitis; periodontal disease; systemic diseases