[How to detect opacities in the orofacial soft tissue on a panoramic radiograph? Idiopathic calcifications]

Opacities not in the bone but in the orofacial soft tissue, are frequently seen on panoramic radiographs. The differential diagnosis of these opacities is diverse and concerns frequently occurring disorders but also rare ones. Due to the diversity of diagnoses, the clinical interpretation of a soft tissue opacity is often difficult. A distinction is made among heterotopic calcifications, heterotopic ossifications, and foreign bodies. Heterotopic calcifications are subdivided into 3 groups, i.e. dystrophic calcifications, idiopathic calcifications, and metastatic calcifications. In this article, stress is placed on the radiographic and clinical characteristics ofidiopathic calcifications and how they can be recognised on a panoramic radiograph. Besides this, attention will be paid to the need for possible additional imaging techniques and indications regarding treatment options. Idiopathic calcification results from deposition of calcium salts in healthy tissue without an apparent cause. Calcium and phosphate levels in the serum are normal in these cases.