Imaging of Tonsilloliths: A Comparative Analysis of Representation Across Different Radiological Modalities

Tonsilloliths are calcifications commonly formed within the palatine tonsils, with a prevalence ranging from 10% to 40%. While typically asymptomatic, tonsilloliths can occasionally lead to complications. This case report presents a 50-year-old male with incidental bilateral radiopacity in the mandibular angle region detected on an orthopantomogram with no clinical symptoms. Advanced imaging modalities, including 3-T magnetic resonance imaging (MRI), cone-beam computed tomography (CBCT), and MR-based cinematic rendering (CR), were employed for differential diagnosis of the observed radiopacity and preprocedural planning of extractions and implant placement in the context of the patient's dental pathology. The consistent visualization of tonsilloliths across various imaging modalities highlights the unique strengths of each technique in diagnosing, visualizing, and differentiating these calcifications. This multimodal approach can provide valuable insights for accurate diagnosis, effective surgical planning, and improved diagnostic confidence, even in asymptomatic patients with incidental findings.