Panoramic Soft Tissue Calcifications as Vascular Risk Markers in Diabetes: A Pilot Case-Control Study in Hungarians

Soft tissue calcifications on dental panoramic radiographs (PR) may reflect systemic vascular disease. Given the increased cardiovascular and cerebrovascular risk in diabetes, this study compared their prevalence in patients with diabetes and baseline-comparable nondiabetic controls and explored associations in the combined sample.

This retrospective case-control study included 56 adults with diabetes and 56 nondiabetic controls, frequency-matched by age (±5 years) and sex. Four calibrated examiners independently evaluated PRs with consensus adjudication. Outcomes were soft tissue calcification, carotid-region calcification, and stylohyoid ligament complex calcification/ossification. Crude prevalence was calculated for each group and the total sample, and multivariable logistic regression adjusted for age, sex, diabetes status, smoking, alcohol use, renal disease, and rheumatic disease.

A total of 112 participants were analysed (56 with diabetes mellitus and 56 controls), with comparable baseline characteristics between groups. In the total sample, the crude prevalence of any soft tissue calcification was 42.0%, carotid-region calcification 27.7%, and stylohyoid ligament complex calcification/ossification 35.7%. In adjusted models across the combined sample, age was independently associated with higher odds of any soft tissue calcification (per 10-year increase: aOR 1.68, 95% CI 1.23-2.29; P = 0.001) and carotid-region calcification (aOR 1.52, 95% CI 1.08-2.14; P = .016). Male sex was associated with lower odds of any soft tissue calcification (aOR 0.40, 95% CI 0.16-0.99; P = .047). Diabetes status was not independently associated with the outcomes in the fully adjusted models.

Panoramic soft tissue calcifications were common. Although diabetes was not an independent predictor, frequent detection of suspected carotid-region calcifications supports structured reporting and opportunistic vascular risk assessment on routine PR, especially in older patients.

Opportunistic identification of carotid-region calcifications on routine PR may support early cardiovascular risk assessment, particularly in patients with diabetes and older adults.