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The risk of affliction with atherosclerotic events in diabetic patients with dystrophic calcification is questionable. This study aimed to investigate the relative frequency of carotid calcifications and pulp stones in panoramic radiographs of diabetic patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This retrospective observational study employed a convenience sampling method involving 107 diabetic patients. For comparison, 300 panoramic views from individuals estimated to be healthy in the community were included. The samples were randomly selected from the statistical population using a random numbers table. Data analysis was conducted using descriptive statistics, including mean and standard deviation, as well as analytical tests such as the chi-square test, all performed with SPSS 17 software (Chicago, USA).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In this study, panoramic radiographs of 107 diabetic patients (67 women and 40 men) and 300 healthy individuals (196 women and 104 men) were evaluated. The age range was 25 to 64\u00a0years, with a mean age of 49.7. The frequency of carotid artery calcification was 42 (14%) in healthy individuals and 44 (41.1%) in diabetic patients. Furthermore, the relative frequency of unilateral and bilateral carotid artery calcification in diabetic patients was significantly higher than in healthy subjects (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05). The Relative Risk (RR) of pulp stones in the diabetic patient group compared to healthy individuals was 1.8. With a 95% confidence interval, the relative risk ranged from 1.3 to 2.48, which was statistically significant (<jats:italic>P<\/jats:italic>\u2009&lt;\u20090.05).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Based on the findings, the frequency of carotid artery calcification and pulp stones was higher in diabetic patients. Panoramic radiographic screening in diabetic patients is useful for early detection of carotid artery calcification and timely referral of patients to endocrinologists to prevent adverse sequelae.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/s12902-025-02005-z","type":"journal-article","created":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T16:40:21Z","timestamp":1754325621000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Could carotid artery calcifications and pulp stones be an alarm sign for diabetes mellitus? 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This research project was approved by the Ethics Committee of Yazd Shahid Sadoughi University of Medical Sciences, Yazd, Iran (IR.SSU.DENTISTRY.REC.1400.013). All methods were conducted \u00a0in accordance with  relevant guidelines and regulations. We reported our findings by\u00a0the STROBE guidelines.Written informed consents were obtained from all participants before data collection.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"191"}}