Dental pulp stones as an independent predictor for extracranial carotid artery calcification: a cross-sectional cone-beam computed tomography analysis

Abstract

Vascular calcification is a key indicator of cardiovascular risk, and dental imaging allows its visualization. Dental pulp calcifications (pulp stones) have been suggested as markers of systemic mineralization. This study aimed to assess the association between pulp stones and extracranial carotid artery calcification (ECAC) using cone-beam computed tomography (CBCT). In this retrospective cross-sectional study, CBCT scans of 250 adults (124 men, 126 women; aged 20–81 years) from a university dental radiology department were evaluated. ECAC were bilaterally graded (0–4), and pulp stones were recorded as present or absent. Images were standardized to the Frankfurt horizontal plane and examined by a blinded observer. Descriptive statistics summarized demographics, while Chi-square and regression analyses explored associations. ECAC was detected in 53 participants (21.2%), with prevalence increasing with age ( p ≤ 0.008). Women showed higher rates than men (27.0% vs. 15.3%, p = 0.036). Pulp stones were more frequent in women (41.3% vs. 20.2%, p < 0.001) and older individuals ( p = 0.001). Multivariable analysis indicated pulp stones as an independent predictor of ECAC (OR = 5.94; 95% CI: 2.97–11.85, p < 0.001). Pulp stones detected on CBCT were significantly associated with ECAC, suggesting their potential as adjunctive indicators of cardiovascular risk.