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J Am Dent Assoc, Vol 138, No 4, 483-492.
© 2007 American Dental Association
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CLINICAL PRACTICE

Calcified carotid artery atheroma and stroke

A systematic review



Muralidhar Mupparapu, DMD, MDS and Irene H. Kim, DMD, MPH

Background. Calcified carotid artery atheroma (CCAA) and its identification on panoramic radiographs have been advocated as a predictor of a cerebrovascular accident (CVA).

Types of Studies Reviewed. The authors conducted an electronic search using 11 databases to evaluate the evidence from the literature that links CCAA detection on panoramic radiographs and the precipitation of CVAs among those people. They used the Reporting Recommendations for Tumor Marker Prognostic Studies (REMARK) checklist to perform this systematic review.

Results. One study of the 54 studies the authors identified satisfied the REMARK criteria in which CCAA was associated with a negligible increased risk of stroke (95 percent confidence interval, 0 to 0.04 percent) in the population studied.

Clinical Implications. This systematic review suggests the data supporting the hypothesis that radiographically detectable CCAA is associated with an increased risk of stroke are incomplete and inconclusive. Further research is needed, as clinical guidelines for risk prediction using panoramic radiographs cannot be established on the basis of the current evidence.

Key Words: Panoramic radiography; calcified carotid artery atheroma; cardiovascular diseases; risk assessment

Abbreviations: AC: Aortic calcification • BP: Blood pressure • CCAA: Calcified carotid artery atheroma • CVA: Cerebrovascular accident • IMT: Intimamedia thickness • REMARK: Reporting Recommendations for Tumor Marker Prognostic Studies






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