A Case of Carotid Calcification in Panoramic Radiographs during Periodontal Disease Treatment

Abstract

We report a case of calcification in the bilateral carotid arteries found on panoramic imaging in a patient receiving periodontal treatment. The patient was a male in his sixties, who noticed bleeding when brushing the teeth since several years earlier; his gums became swollen repeatedly but were neglected. Recently, the patient was concerned about fluttering teeth and discomfort upon biting down, and particular difficulty when biting hard food, and became aware of poor occlusion. In early April 200X, the patient visited the department of periodontal disease of our hospital and was diagnosed with severe periodontal disease. Basic periodontal treatment was started, and the symptoms improved approximately 1 year and 6 months later. Imaging examination for reevaluation showed calcification in the bilateral carotid arteries on panoramic imaging. The possibility of atherosclerotic disease was therefore explained to the patient and he was referred to the department of neurosurgery. As a result, a diagnosis of right carotid thrombosis and left carotid artery stenosis was made, and carotid endarterectomy （CEA） was performed. The postoperative course was good, and the patient continuously received treatments for periodontal disease at our university.