{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T20:27:31Z","timestamp":1786739251260,"version":"build-2736575974"},"reference-count":20,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The interpretation of dental images extends beyond the evaluation of teeth and bone structures, allowing the identification of incidental findings with potential clinical relevance to patients\u2019 overall health. This study was conducted to investigate the prevalence of soft tissue calcifications in digital panoramic radiographs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A retrospective, observational, epidemiological study was conducted using 5,000 digital panoramic radiographs of patients aged over 18. The study investigated the presence of tonsilloliths, sialoliths, carotid artery calcification, and ossified stylohyoid complex alterations. Associations with age, sex, and affected side were analysed. Four evaluators performed the assessments in three stages to enhance diagnostic accuracy. Statistical analysis included Student\u2019s\n                      <jats:italic toggle=\"yes\">t<\/jats:italic>\n                      -test for independent samples (numerical variables) and Chi-square or Fisher\u2019s exact tests (categorical variables). A significance level of 5% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.05) was adopted.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>2202 ossified stylohyoid complex alterations (44.0%), 297 images (5.9%) suggestive of carotid artery calcification, 74 sialoliths (1.5%), and 28 tonsilloliths (0.6%) were observed, resulting in 2,601 changes. Multiple regression analysis was applied to patients presenting a positive condition for the studied variables; however, no statistical significance was revealed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>The high prevalence of incidental findings on panoramic radiographs highlights the importance of careful image interpretation for the early detection of conditions with potential local and systemic implications, reinforcing the need for integrated clinical management and appropriate referrals.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijdr.ijdr_58_26","type":"journal-article","created":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T17:00:34Z","timestamp":1779555634000},"page":"71-76","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Prevalence of Soft Tissue Calcifications in 5000 Digital Panoramic Radiographs"],"prefix":"10.4103","volume":"37","author":[{"given":"Carla G.","family":"Ermacora","sequence":"first","affiliation":[{"name":"Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gustavo","family":"de Paula Almeida","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana C. C","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiago C.","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Izabel R. F","family":"Rubira-Bullen","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Camila L.","family":"Cardoso","sequence":"additional","affiliation":[{"name":"Department of Surgery, Stomatology, Pathology and Radiology, Bauru School of Dentistry, University of S\u00e3o Paulo, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"R1-20260618","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1111\/idj.12389","article-title":"Incidental findings in pre-orthodontic treatment radiographs","volume":"68","author":"Hern\u00e1ndez","year":"2018","journal-title":"Int Dent J"},{"key":"R2-20260618","doi-asserted-by":"crossref","first-page":"e20200978","DOI":"10.1590\/1678-7757-2020-0978","article-title":"Dental and maxillomandibular incidental findings in panoramic radiography among individuals with mucopolysaccharidosis: A cross-sectional study","volume":"29","author":"Carneiro","year":"2021","journal-title":"J Appl Oral Sci"},{"key":"R3-20260618","doi-asserted-by":"crossref","first-page":"53","DOI":"10.5624\/isd.2020.50.1.53","article-title":"Incidental findings in a consecutive series of digital panoramic radiographs","volume":"50","author":"MacDonald","year":"2020","journal-title":"Imaging Sci Dent"},{"key":"R4-20260618","first-page":"e46025","article-title":"Prevalence and radiographic features of head and neck soft tissue calcifications on digital panoramic radiographs: A retrospective study","volume":"15","author":"Acikgoz","year":"2023","journal-title":"Cureus"},{"key":"R5-20260618","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1111\/ger.12578","article-title":"Prevalence of soft tissue calcifications in panoramic radiographs of the maxillofacial region of older adults","volume":"39","author":"Maia","year":"2022","journal-title":"Gerodontology"},{"key":"R6-20260618","doi-asserted-by":"crossref","first-page":"137","DOI":"10.5624\/isd.2014.44.2.137","article-title":"Interobserver agreement on the diagnosis of carotid artery calcifications on panoramic radiographs","volume":"44","author":"Yoon","year":"2014","journal-title":"Imaging Sci Dent"},{"key":"R7-20260618","doi-asserted-by":"crossref","first-page":"14056","DOI":"10.3390\/ijerph192114056","article-title":"Carotid artery calcifications on panoramic radiographs","volume":"19","author":"Janiszewska-Olszowska","year":"2022","journal-title":"Int J Environ Res Public Health"},{"key":"R8-20260618","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1186\/s13005-021-00259-1","article-title":"Sialolithiasis: Retrospective analysis of the effect of an escalating treatment algorithm on patient-perceived health-related quality of life","volume":"17","author":"Lommen","year":"2021","journal-title":"Head Face Med"},{"key":"R9-20260618","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1007\/s00784-016-1752-0","article-title":"Prevalence and imaging characteristics of palatine tonsilloliths evaluated on 2244 pairs of panoramic radiographs and CT images","volume":"21","author":"Takahashi","year":"2017","journal-title":"Clin Oral Investig"},{"key":"R10-20260618","doi-asserted-by":"crossref","first-page":"2095","DOI":"10.1007\/s00405-018-5031-3","article-title":"Length of the ossified stylohyoid complex and Eagle syndrome","volume":"275","author":"Ledesma-Montes","year":"2018","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"R11-20260618","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1259\/dmfr\/12056500","article-title":"Clinical significance and variation of the advanced calcified stylohyoid complex detected by panoramic radiographs among 80-year-old subjects","volume":"35","author":"Okabe","year":"2006","journal-title":"Dentomaxillofac Radiol"},{"key":"R12-20260618","doi-asserted-by":"crossref","first-page":"1171","DOI":"10.1007\/s00784-018-2533-8","article-title":"Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases: A long-term follow-up study","volume":"23","author":"Bengtsson","year":"2019","journal-title":"Clin Oral Investig"},{"key":"R13-20260618","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1111\/idj.12618","article-title":"Assessment of carotid artery calcifications on digital panoramic radiographs and their relationship with periodontal condition and cardiovascular risk factors","volume":"71","author":"\u00c7etin","year":"2020","journal-title":"Int Dent J"},{"key":"R14-20260618","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1007\/s11282-020-00488-1","article-title":"Incidental findings detected with panoramic radiography: Prevalence calculated on a sample of 2017 cases treated at a major Italian trauma and cancer centre","volume":"37","author":"Ghassemzadeh","year":"2021","journal-title":"Oral Radiol"},{"key":"R15-20260618","doi-asserted-by":"crossref","first-page":"e1027","DOI":"10.4317\/jced.57186","article-title":"Prevalence of morphological and structural changes in the stylohyoid chain","volume":"12","author":"Guimar\u00e3es","year":"2020","journal-title":"J Clin Exp Dent"},{"key":"R16-20260618","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1007\/s00276-013-1137-x","article-title":"Prevalence and pattern of stylohyoid chain complex patterns detected by panoramic radiographs among Turkish population","volume":"36","author":"Alpoz","year":"2014","journal-title":"Surg Radiol Anat"},{"key":"R17-20260618","doi-asserted-by":"crossref","first-page":"177","DOI":"10.15537\/1658-3175.5488","article-title":"Prevalence of carotid calcification detected on panoramic radiographs in a Saudi population from a training institute in Central Saudi Arabia","volume":"33","author":"Alzoman","year":"2012","journal-title":"Saudi Med J"},{"key":"R18-20260618","doi-asserted-by":"crossref","first-page":"29725099","DOI":"10.1259\/dmfr\/29725099","article-title":"The prevalence and correlation of carotid artery calcification on panoramic radiographs and peripheral arterial disease in a population from the Republic of Korea: The Dong-gu study","volume":"42","author":"Lee","year":"2013","journal-title":"Dentomaxillofac Radiol"},{"key":"R19-20260618","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1016\/j.tripleo.2005.03.030","article-title":"Study of the localization of radiopacities similar to calcified carotid atheroma by means of panoramic radiography","volume":"101","author":"Kamikawa","year":"2006","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol Endod"},{"key":"R20-20260618","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1186\/s12880-025-01719-9","article-title":"Detection of carotid artery calcifications using artificial intelligence in dental radiographs: A systematic review and meta-analysis","volume":"25","author":"Arzani","year":"2025","journal-title":"BMC Med Imaging"}],"container-title":["Indian Journal of Dental Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/ijdr.ijdr_58_26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,14]],"date-time":"2026-08-14T19:27:15Z","timestamp":1786735635000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/ijdr.ijdr_58_26"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026]]}},"URL":"https:\/\/doi.org\/10.4103\/ijdr.ijdr_58_26","relation":{},"ISSN":["0970-9290","1998-3603"],"issn-type":[{"value":"0970-9290","type":"print"},{"value":"1998-3603","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2026-01-20","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-09","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}