EC Dental Science

CBCT offers an opportunity to detect and localize soft-tissue calcifications by evaluating the scan's multiplanar representation. Diabetes mellitus is a chronic metabolic condition resulting in hyperglycemia, which we believe is associated with different soft-tissue presentations. This study aims to evaluate the presence, anatomical location, type, and size of calcifications in persons with diabetes mellitus. We hypothesize that the prevalence of specific calcifications may be associated with diabetes mellitus. This retrospective case-control study was completed by evaluating 92 large volume CBCT images of Penn Dental Medicine (PDM) patients with and without diabetes mellitus, matched for age and gender, to assess the presence, anatomical location, type, size, and distribution of calcifications. All large field of view (FOV) CBCT scans for dental patients attending PDM clinics between 2015 and 2022 were utilized. Craniofacial calcifications, including vascular, pulpal, soft tissue, ligament, and pathological calcifications, were evaluated and documented using CBCT imaging. Comparisons of categorical variables was done using the Fisher’s Exact test. A high prevalence of vascular calcifications was noticed; extracranial internal carotid artery calcification (EICAC) 29% and intracranial internal carotid artery calcification (IICAC) of the internal carotid arteries (41%), tonsiloliths (34%) and pulp calcifications (54%) were discovered. There was no statistically significant difference in race (p = 0.09), periodontal disease status (p = 0.58), or presence of hypertension (0.38) between the two groups, but the known group with diabetes was more likely to have cholesterolemia (72% vs 41%, p < 0.001). This study demonstrates a high prevalence of vascular calcifications, tonsiloliths and pulp calcification in the study sample. Further analysis to identify the cause of such calcifications and the association of the calcifications with underlying systemic conditions is needed in the future. Detecting radiographic biomarkers for diabetes will aid early institution of preventive measures to reduce morbidity and mortality, ultimately reducing the global burden of diabetes.

 Keywords: Carotid Artery Atherosclerosis; Digital Imaging; Radiology; Oral-Systemic Disease(s); Evidence-Based Dentistry; Intracranial Internal Carotid Artery Calcification (IICAC); Extracranial Internal Carotid Artery Calcification (EICAC); Health Care

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