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The present sub-study included 135 participants who had undergone PR for odontological indications within 18\u2009months before or after CUS examination. Findings of CAC on PR were compared with CUS findings of cIMT and carotid plaque. CAC features were categorized into 4 types: single, scattered, vessel width-defining, or vessel-outlining.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared to participants without CAC on PR, those with any CAC type on PR exhibited significantly more carotid plaque (80.9% vs 43.2%, P\u2009&amp;lt;\u2009.001) and a higher average cIMT score (0.83 vs 0.77\u2009mm, P\u2009=\u2009.013) on CUS. The vessel-outlining CAC group exhibited the most pronounced cIMT and carotid plaque occurrence (P\u2009=\u2009.011).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All CAC types detected on PR were associated with CVD on CUS, and vessel-outlining CAC indicated more severe CVD. By detecting CAC on PR, especially vessel-outlining CACs, dentists could contribute to the early identification of patients with asymptomatic CVD, and recommend that these patients seek medical attention for preventive treatment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>All types of CAC\u00a0detected on PR\u2014particularly the vessel-outlining type\u2014are associated with carotid ultrasound findings, including carotid intima media thickness, indicating CVD and increased risk of stroke and myocardial infarction. Thus, dentists can identify patients at increased risk of cardiovascular events by detecting CAC\u00a0 on PR, with higher diagnostic reliability in cases with vessel-outlining calcification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/dmfr\/twaf061","type":"journal-article","created":{"date-parts":[[2025,9,18]],"date-time":"2025-09-18T20:41:44Z","timestamp":1758228104000},"page":"28-36","source":"Crossref","is-referenced-by-count":2,"title":["Carotid artery calcifications on panoramic radiographs are associated with vascular disease severity on carotid ultrasound"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-4772-9928","authenticated-orcid":false,"given":"Astrid","family":"Karlsson","sequence":"first","affiliation":[{"name":"Oral and Maxillofacial Radiology, Department of Odontology, Ume\u00e5 University , SE-90187 Ume\u00e5,","place":["Sweden"]},{"name":"Department of Oral and Maxillofacial Radiology, Postgraduate Dental Education Center , SE-70115 \u00d6rebro,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1120-8993","authenticated-orcid":false,"given":"Nils","family":"Gustafsson","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Radiology, Department of Odontology, Ume\u00e5 University , SE-90187 Ume\u00e5,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0394-5096","authenticated-orcid":false,"given":"Per","family":"Wester","sequence":"additional","affiliation":[{"name":"Department of Public Health and Clinical Medicine, Ume\u00e5 University , SE-90187 Ume\u00e5,","place":["Sweden"]},{"name":"Department of Clinical Sciences, Karolinska Institutet, Danderyd Hospital , SE-18288 Stockholm,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8875-973X","authenticated-orcid":false,"given":"Liene","family":"Zamure-Damberga","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Radiology, Department of Odontology, Ume\u00e5 University , SE-90187 Ume\u00e5,","place":["Sweden"]},{"name":"Department of Conservative Dentistry and Oral Health, Faculty of Dentistry, Riga Stradins University , Riga LV-1007,","place":["Latvia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8807-3500","authenticated-orcid":false,"given":"Eva","family":"Levring J\u00e4ghagen","sequence":"additional","affiliation":[{"name":"Oral and Maxillofacial Radiology, Department of Odontology, Ume\u00e5 University , SE-90187 Ume\u00e5,","place":["Sweden"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,12]]},"reference":[{"key":"2026011303220015400_twaf061-B1","doi-asserted-by":"publisher","first-page":"2982","DOI":"10.1016\/j.jacc.2020.11.010","article-title":"Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: update from the GBD 2019 study","volume":"76","author":"Roth","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2026011303220015400_twaf061-B2","doi-asserted-by":"publisher","first-page":"S3","DOI":"10.1016\/j.amjmed.2008.10.013","article-title":"The pathology of atherosclerosis: plaque development and plaque responses to medical treatment","volume":"122","author":"Insull","year":"2009","journal-title":"Am J Med"},{"key":"2026011303220015400_twaf061-B3","doi-asserted-by":"publisher","first-page":"1461","DOI":"10.1007\/s10554-023-02868-0","article-title":"Multi-view carotid ultrasound is stronger associated with cardiovascular risk factors than presence of plaque or single carotid intima media thickness measurements in subclinical atherosclerosis","volume":"39","author":"Bengtsson","year":"2023","journal-title":"Int J Cardiovasc Imaging"},{"key":"2026011303220015400_twaf061-B4","doi-asserted-by":"publisher","first-page":"93","DOI":"10.1016\/j.echo.2007.11.011","article-title":"Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. 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