23 April 2019

Carotid artery calcification – member-only free CPD hour

Read the Clinical Update article in this month's Victorian Dentist, answer at least 9/10 quiz questions correctly and obtain your free CPD hour!

Carotid Artery Calcification on Orthopantomograms (CACO Study) – is it indicative of carotid stenosis?
S Constantine, D Roach, S Liberali, A Kiermeier, P Sarkar, J Jannes, P Sambrook, P Anderson, J Beltrame
Aust Dent J 2019; 64: 4–10: doi: 10.1111/adj.12651
Compiled by Dr Aaron Martin

Orthopantomograms (OPGs) are frequently taken for the analysis of dental conditions or for screening of potential conditions. Areas distant from the areas of interest are also imaged which may present incidental findings. One such incidental finding is carotid artery calcification which may be seen in an inferior and lateral position on an OPG image around the level of C3 and C4 vertebrae. Areas are often described as discrete nodular masses but can vary in appearance.

Carotid artery calcification (CAC) is calcification of atherosclerotic plaque commonly occurring around the level where the common carotid artery bifurcates into the internal and external carotid arteries where it can be seen on radiographs. Radiographically visible calcification is not established as a marker for stroke risk in itself.

Carotid artery stenosis (CAS) is narrowing of the lumen of the carotid arteries, usually as a result of the build-up of atherosclerotic plaque. Such lesions may (or may not) show calcification. Narrowing of 50 per cent or more carries a documented risk of stroke occurring. Due to the critical areas of the head and brain supplied by the carotid arteries, interruptions to blood flow can have serious consequences ranging from transient ischaemic attacks (TIAs), to stroke and death.

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