Examination of incidental intra-cranial and extra-cranial head and neck calcifications using cone-beam computed tomography

Introduction
Increasing use of cone-beam computed tomography (CBCT) has improved the likelihood for all physicians, including dentists, to detect incidental findings (IFs) on scans.

Objective
This study aimed to evaluate the incidence and clinical significance of incidental calcifications in the head and neck region as well as vital calcifications, such as ponticulus posticus and carotid artery calcifications, on CBCT images with large field of view (FOV).

Material and methods
CBCT of 171 patients, including 95 men and 76 women, with FOV of 230 mm × 170 mm and FOV of 230 mm × 270 mm, who met the inclusion and exclusion criteria, were included in the current study. Calcifications unrelated to the purpose of CBCT request and detected in analyzed images calcifications were recorded as IFs.

Results
Incidental calcifications were found in 75.4% of the analyzed images. The incidence of calcifications in the head and neck region was 17%. The most common type of calcification was intra-cranial calcification with 69%, and ponticulus posticus calcification with 19.3%. Carotid artery calcification was found in 1.2%. Although not statistically significant, our study found that the rate of calcification was higher in men above 60 years of age (p > 0.05).

Conclusions
In our study, more than one calcification finding in the same patient’s CBCT was recorded as a common finding. The clinical significance of calcifications, especially carotid calcifications, increases with age. Therefore, this finding should be considered while performing CBCT examinations.