Detection of  Carotid Artery Atheromas in Periodontitis

Objectives: Digital Panoramic Radiography use in patients with chronic periodontitis in dentistry. The relationship between periodontitis with CAA and some risk factors, allowing the dentist to estimate the presence of CAA in the region of the 3rd and 4th cervical vertebrae in panoramic radiograph, which is expected to be contributed in preventing strokes related to the CAA. Methods: Seventy one patients with severe chronic adult generalized periodontitis chosen as subjects with 142 study regions, carried out clinical and laboratory risk factors examination. Panoramic radiographs using the conventional and the digital equipment of the subjects were then taken. Radiographic density changes in the 3rd – 4th cervical region then evaluated by two observers. Results: Women subjects were found more than men (60.6% and 39, 4%), aged in range of women and men between 38-60 years and 35-58 years respectively. The inter and intra observer agreement were found very good (kappa > 0.8). Risk factors included in the regression equation model along with the value of conventional radiographic grading in estimating the presence of carotid artery atheroma are the levels of hsCRP, LDL and blood sugar (adjusted R square 0.861). Conclusions:If periodontal patients suspected to bear these factors, by evaluating the radiographic density change in the 3rd-4th cervical vertebrae region from conventional panoramic radiograph, a dentist could estimate the presence of CAA in the radiometric value.