Use of digital panoramic radiography to detect cervical calcifications in obese individuals
DOI:
https://doi.org/10.5935/2525-5711.20170043Palavras-chave:
Obesity, Carotid Artery Diseases, Radiography, Panoramic, AtherosclerosisResumo
Introduction: Cardiovascular diseases and stroke in particular are the leading causes of death worldwide. The most common reason for this interruption is a buildup of fatty deposits on the inner walls of blood vessels; upon calcification, these deposits are termed atheromas. Objective: The aim of this study was to identify calcified atherosclerotic plaque- -like soft tissue calcifications in obese subjects using panoramic radiography. Materials and Methods: Sixty-three obese patients undergoing digital panoramic radiography in a radiology clinic in Belo Horizonte, Brazil, were selected and diagnosed with grade II obesity with comorbidities and grade III obesity according to the World Health Organiza- tion (WHO) body mass index (BMI) score table. The radiographs were examined by two trained oral and maxillofacial radiologists, and their evaluations were analyzed using the kappa test. Statistical analysis was performed using the X2 test, and the odds ratio was determined with a 95% confidence interval. A 5% significance level was used. Results: The weight and BMI (p < 0.01) differed significantly between individuals in the grade II with comorbidities and grade III groups, but no difference was observed for age and height. Of 63 radiographs, 45 (71.42%) showed calcifications in the cervical region, with no statistically significant difference between the grade II and grade III groups. Neither gender nor side was significantly correlated with the presence of soft tissue calcification. Conclusion: This study demonstrates the importance of panoramic radiography in iden- tifying calcified atheromatous plaques. Such images may have critical diagnostic value for the early detection of carotid artery atheromas in obese subjects and thus may contribute to an increase in the length and quality of life of such individuals.
Referências
Global Burden of Metabolic Risk Factors for Chronic Diseases Collaboration (BMI Mediated Effects), Lu Y, Hajifathalian K, Ezzati M, Woodward M, Rimm EB, Danaei G. Metabolic mediators of the effects of body-mass index, overweight, and obesity on coronary heart disease and stroke: a pooled analysis of 97 prospective cohorts with 1·8 million participants. Lancet. 2014;383:970-83.
World Health Organization. Cardiovascular diseases. [cited 2015 Nov 11]. Available from: www.who.int/mediacentre/factsheets/fs317/en
World Health Organization. Obesity and overweight. Fact sheet no. 311. [cited 2015 Nov 15]. Available from: www.who.int/mediacentre/factsheets/fs311/en
Jood K, Jern C, Wilhelmsen L, Rosengren A. Body mass index in mid-life is associated with a first stroke in men: a prospective population study over 28 years. Stroke. 2004;35:2764-9.
Kurth T, Gaziano JM, Berger K, Kase CS, Rexrode KM, Cook NR, et al. Body mass index and the risk of stroke in men. Arch Intern Med. 2002;162:2557-62.
Cohen SN, Friedlander AH, Jolly DA, Date L. Carotid calcification on panoramic radiographs: an important marker for vascular risk. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:510-4.
Bayram B, Uckan S, Acikgoz A, Müderrisoglu H, Aydinalp A. Digital panoramic radiography: a reliable method to diagnose carotid artery atheromas? Dentomaxillofac Radiol. 2006;35:266-70.
Griniatsos J, Damaskos S, Tsekouras N, Klonaris C, Georgopoulos S. Correlation of calcified carotid plaques detected by panoramic radiograph with risk factors for stroke development. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2009;108:600-3.
Friedlander AH, Lande A. Panoramic radiographic identification of carotid arterial plaques. Oral Surg Oral Med Oral Pathol. 1981;52:102-4.
Friedlander AH, Friedlander IK. Identification of stroke prone patients by panoramic radiography. Aust Dent J. 1998;43:51-4.
World Health Organization. Fact sheet no. 317. Media centre cardiovascular diseases (CVDs). World Heal Organ. 2013:1-5. [cited 2017 Oct 31]. Available from: http://www.who.int/mediacentre/factsheets/fs317/en/
Fayad ZA, Fuster V. Clinical imaging of the high-risk or vulnerable atherosclerotic plaque. Circ Res. 2001;89:305-16.
Gállego Pérez-Larraya J, Irimia P, Martínez-Vila E, Barba J, Guembe MJ, Varo N, et al. The influence of obesity on the assessment of carotid intima-media thickness. J Clin Ultrasound. 2012;40:479-85.
Tamura T, Inui M, Nakase M, Nakamura S, Okumura K, Tagawa T. Clinicostatistical study of carotid calcification on panoramic radiographs. Oral Dis. 2005;11:314-7.
Lee JS, Kim OS, Chung HJ, Kim YJ, Kweon SS, Lee YH, et al. The correlation of carotid artery calcification on panoramic radiographs and determination of carotid artery atherosclerosis with ultrasonography. Oral Surg Oral Med Oral Pathol Oral Radiol. 2014;118:739-45.
Carter LC, Haller AD, Nadarajah V, Calamel AD, Aguirre A. Use of panoramic radiography among an ambulatory dental population to detect patients at risk of stroke. J Am Dent Assoc. 1997;128:977-84.
Silva AIV, Nejaim Y, Manzi FR, Haiter Neto F. Diagnóstico Diferencial de Cartilagem Tritícea Calcificada com Doença Ateroesclerótica - Ateroma. Rev Odontol Bras Central. 2012;21:480-3.
Almog DM, Horev T, Illig KA, Green RM, Carter LC. Correlating carotid artery stenosis detected by panoramic radiography with clinically relevant carotid artery stenosis determined by duplex ultrasound. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:768-73.
Yoon SJ, Yoon W, Kim OS, Lee JS, Kang BC. Diagnostic accuracy of panoramic radiography in the detection of calcified carotid artery. Dentomaxillofac Radiol. 2008;37:104-8.
Damaskos S, Griniatsos J, Tsekouras N, Georgopoulos S, Klonaris C, Bastounis E, et al. Reliability of panoramic radiograph for carotid atheroma detection: a study in patients who fulfill the criteria for carotid endarterectomy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2008;106:736-42.
Abecasis P, Chimenos-Küstner E, López-López O. Orthopantomography contribution to prevent isquemic stroke. J Clin Exp Dent. 2014;6:e127-31.
Morse SA, Gulati R, Reisin E. The obesity paradox and cardiovascular disease. Curr Hypertens Rep. 2010;12:120-6.
Pacchioni A, Rossi A, Benfari G, Cicoira M, Pellegrini P, Bonapace S, et al. A higher body mass index is associated with reduced prevalence of unstable atherosclerotic plaque: a possible explanation of the obesity paradox. Int J Cardiol. 2013;168:2912-3.
Wohlfahrt P, Lopez-Jimenez F, Krajcoviechova A, Jozifova M, Mayer O, Vanek J, et al. The obesity paradox and survivors of ischemic stroke. J Stroke Cerebrovasc Dis. 2015;24:1443-50.
Hastie CE, Padmanabhan S, Slack R, Pell AC, Oldroyd KG, Flapan AD, et al. Obesity paradox in a cohort of 4880 consecutive patients undergoing percutaneous coronary intervention. Eur Heart J. 2010;31:222-6.
Johansson E, Ahlqvist J, Garoff M, Levring Jäghagen E, Meimermondt A, Wester P. Carotid calcifications on panoramic radiographs: a 5-year follow-up study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120:513-20.
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