Prevalence of calcifications in soft tissues visible on a dental pantomogram: A retrospective analysis

To determine the frequency and spectrum of soft tissues calcifications identified on Dental Pantomograms (DPT) at a University Dental Clinic in the northern region of Portugal and to compare the data obtained with those published in the literature.

We conducted a 3-year descriptive analysis (2012-2014) of DPT calcifications within soft tissues at the University Clinic (CESPU), in Oporto, Portugal. Information on gender, age, location of the lesions and the radiographic diagnosis were analysed. DPTs were interpreted by two examiners (Kappa test 0.8). Data were entered into a database and analysed with Chi-square and Fisher exact tests. Statistical analysis was performed using the Kolmogorov-Smirnov and Shapiro-Wilk test.

2375 DPTs were analysed, with 468 calcifications observed in the radiographs of 420 individuals. Calcifications of the stylohyoid and stylomandibular ligament were most common, with atheroma, sialoliths, tonsilloliths rhinoliths and antroliths also identified. A statistically significant relationship was observed between the presence of calcifications of the stylohyoid and stylomandibular ligaments, atheromatous calcifications in the carotid artery and tonsilloliths in individuals older than 40.

This is the largest sample analysis ever done in Portugal, providing useful information about the incidence and distribution of soft tissue calcifications identifiable on DPTs, allowing valuable comparison with other countries.

Despite mostly being incidental findings, panoramic radiography can be the first relevant test that aids dental practitioners in the process of requesting other imaging techniques or forwarding to the correct specialty.