Kumagai Masahiro, Yamagishi Toshio, Fukui Norimasa, Chiba Masatoshi
Department of Oral and Maxillofacial Surgery, Tohoku Kosai Hospital, Sendai, Japan.
Tohoku J Exp Med. 2007 May;212(1):21-5. doi: 10.1620/tjem.212.21.
Panoramic dental radiographs are commonly used in general dentistry and oral and maxillofacial surgery to examine upper and lower teeth, maxilla, mandible and the surroundings simultaneously. Carotid artery calcification, a specific indicator of atherosclerotic change of the carotid arteries, can be seen on the radiographs. Many studies have suggested that cigarette smoking is a risk factor of atherosclerotic change as well as cerebral infarction. We hypothesized that smoking could increase the prevalence of carotid artery calcification, and compared the radiographs of smokers and non-smokers aged 50 years and over: 146 male smokers, 165 male non-smokers, 42 female smokers and 422 female non-smokers. This is the first study to focus on carotid artery calcification seen on panoramic dental radiographs to show the connection between smoking and atherosclerotic change. In male patients, carotid artery calcification was seen in 18 (14.1%) of the smokers, and in 8 (4.8%) of the non-smokers, which clearly shows that male patients aged 50 years old or over are more likely to develop carotid artery calcification if they smoke. However, there is no significant difference between female smokers and female non-smokers in the same age group. Dentists are in a good position to find carotid artery calcification on radiographs. When this is found on a radiograph, the patient should be advised to stop smoking and be referred to a physician for further tests. Clinicians should be aware that this radiographic finding indicates the presence of atherosclerotic change of the carotid arteries.
全景牙科X光片在普通牙科以及口腔颌面外科中常用以同时检查上下牙齿、上颌骨、下颌骨及其周围结构。颈动脉钙化是颈动脉粥样硬化改变的一个特定指标，在X光片上可以看到。许多研究表明，吸烟是动脉粥样硬化改变以及脑梗死的一个危险因素。我们推测吸烟可能会增加颈动脉钙化的患病率，并比较了50岁及以上吸烟者和非吸烟者的X光片：146名男性吸烟者、165名男性非吸烟者、42名女性吸烟者和422名女性非吸烟者。这是第一项聚焦于全景牙科X光片上所见颈动脉钙化以显示吸烟与动脉粥样硬化改变之间联系的研究。在男性患者中，18名（14.1%）吸烟者出现了颈动脉钙化，8名（4.8%）非吸烟者出现了颈动脉钙化，这清楚地表明50岁及以上的男性患者如果吸烟更有可能发生颈动脉钙化。然而，在同一年龄组的女性吸烟者和女性非吸烟者之间没有显著差异。牙医很适合在X光片上发现颈动脉钙化。当在X光片上发现这种情况时，应建议患者戒烟并转诊给医生进行进一步检查。临床医生应意识到这一X光检查结果表明存在颈动脉粥样硬化改变。
