How many times, Doctor, while reviewing a panoramic radiograph or a CBCT scan for a patient, have your eyes caught something unusual outside the immediate jaw area? Perhaps some opaque, whitish structures in the soft tissues of the neck, prompting you to wonder, “What are these? And do they have any relevance to my dental work?”
Today, we’re going to discuss one of these incidental discoveries that might just be the most significant finding you ever make in your patient’s life: Arterial Calcifications.
What Exactly are Arterial Calcifications?
Simply put, Doctor, these are calcium deposits located within the walls of arteries. This phenomenon is broadly categorized into two main types:
-
Monckeberg’s Medial Calcinosis (Arteriosclerosis): This involves calcification within the tunica media of arteries.
-
Calcified Atherosclerotic Plaque: These are calcified deposits formed within atherosclerotic plaques, typically found in the tunica intima.
Their Radiographic Features: What to Look For
To quickly spot them on a radiograph, it’s essential to be familiar with their distinct characteristics.
Location
-
Carotid Artery Bifurcation: This is the most common site where we encounter them. On CBCT scans, they appear at the level of the C3-C4 cervical vertebrae. On panoramic radiographs, they are typically visible near the region of the greater horn of the hyoid bone.
-
Facial Artery: Occasionally, they might be observed superior to the posterior mandible area.
Edge
Their borders are typically well-defined.
Shape
Their morphology can present in one of two ways:
-
Linear to curved: Following the anatomical course of the artery.
-
Or they might appear as irregular masses with a vertical orientation.
Internal Structure
Their most characteristic appearance is as two radiopaque lines with a central radiolucent core, remarkably resembling a bony canal.
Occasionally, they might exhibit a mixed radiopaque/radiolucent pattern or even be completely radiopaque.
Number
They can be found unilaterally (on one side) or bilaterally (on both sides).
Key Points to Remember
-
There are two primary types: Monckeberg’s medial calcinosis and calcified atherosclerotic plaque.
-
They are predominantly incidental findings, meaning we usually discover them by chance on our radiographs.
Clinical Significance: Why This Matters
Now, Doctor, this is where it gets really important. Your discovery could genuinely be life-saving.
-
The presence of these calcifications can serve as a significant indicator of an increased risk for future cardiovascular events.
-
It is absolutely crucial that you inform the patient’s physician about your findings so that further evaluation and examinations can be conducted.
-
As dental professionals, we do not directly treat this condition. Our role is primarily detection and referral.
-
Their presence could potentially influence the dental treatment plan in certain scenarios, especially if the patient has other existing health risks.
A Final Note, Doctor: While it’s true that as dentists, we don’t diagnose or directly treat arterial calcifications, merely recognizing them on radiographs and informing the patient and their physician can profoundly contribute to the patient’s overall health. Connecting what we observe radiographically with the patient’s medical history and referring them for further medical evaluation is an absolutely critical and immensely important step.
