(PO-043) Prevalence of Carotid Artery Calcifications on Military Veterans’ Panoramic Radiographs

Author: Claire Miles, B.A. – Dental Student, A.T. Still University Missouri School of Dentistry & Oral Health
Author: Olivia Hart, B.S. – Dental Student, A.T. Still University Missouri School of Dentistry & Oral Health
Author: Zachary Morris, B.A. – Dental Student, A.T. Still University Missouri School of Dentistry & Oral Health
Author: Parker Pearson, B.S. – Dental Student, A.T. Still University Missouri School of Dentistry & Oral Health
Author: Anitha Potluri, BDS, DMD, MDsc – Chair, University of Pittsburgh School of Dental Medicine
Author: Richard J. Vargo, D.M.D. – Director and Assistant Professor of Oral and Maxillofacial Pathology, A.T. Still University Missouri School of Dentistry & Oral Health
Submitter: Richard J. Vargo, D.M.D. – Director and Assistant Professor of Oral and Maxillofacial Pathology, A.T. Still University Missouri School of D

Objectives: Carotid artery calcifications (CACs) identified on panoramic radiographs are a risk indicator of atherosclerosis and future adverse cardiovascular events. Military veterans have been found to have poorer overall health than civilians. The study aim was to determine the CAC prevalence in military veterans treated in a dental school clinic from October 2019 – November 2020 and to characterize their demographic, social, and medical history information.

Methods: Digital panoramic radiographs (DPRs) of 264 military veterans treated from October 2019 – November 2020 were screened. Patients aged 45 years or younger at the time the DPR was taken or those with non-diagnostic DPRs were excluded. Gender, race, atherogenic risk factors, and social risk factors were recorded for patients. DPRs were reviewed to diagnose CACs. A second, blinded viewing occurred three weeks later, and agreement of diagnosis between the two viewings was evaluated. Cases with an equivocal diagnosis were sent to an expert for review.

Results: 74 military veterans met the inclusion criteria. The mean age was 67.1 (SD = 8.2). Sixty-five veterans (88%) were male. The CAC prevalence was 55.4%. The mean age of those with CACs was 68.1 (SD = 7.8). Strong interobserver agreement (κ = 0.97, CI = 0.92 - 1.0) was found between the two viewings. Neither race (χ2 = 0.15) nor gender (Fisher Exact = 0.07) was associated with the presence of CACs. In univariate analysis, tobacco (P = 0.03) was associated with the presence of CACs. In multivariate analysis, dyslipidemia (P = 0.046, OR = 3.0) and no social risk factors (P = 0.005, OR = 0.23) were associated with the presence of CACs.

Conclusion: The CAC prevalence in this military veteran cohort is high, particularly in those with dyslipidemia and no social risk factors. Dental students should be trained to identify CACs on panoramic radiographs.