Unveiling the Hidden: Prevalence of Dystrophic Calcification in Digital Orthopantomograph Through a Retrospective Study

Unveiling the Hidden: Prevalence of Dystrophic Calcification in Digital Orthopantomograph Through a Retrospective Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Short Report Unveiling the Hidden: Prevalence of Dystrophic Calcification in Digital Orthopantomograph Through a Retrospective Study Dr. Swasti Jain, Dr. Mohitpal Singh, Dr. Hemant Mathur This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5711430/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract OBJECTIVE- Soft tissue calcifications in the head and neck region are a rare occurrence that are frequently seen on digital panoramic radiographs. This article delves into panoptic exploration to examine and evaluate the prevalence of dystrophic calcification and other soft tissue calcifications in digital orthopantomographs across diverse patient population through a retrospective analysis. METHOD AND METHODOLOGY-A systematic analysis of a small dataset of 300 patients between the ages of 12 to 74 years were studied using their digital OPGs. These radiographs were utilized to focus on identifying and categorizing dystrophic calcifications, and other soft tissue calcifications which includes calcified stylohyoid ligament, tonsillolith, carotid artery calcification, sialolith of submandibular gland, rhinolith, phlebolith and antrolith based on prevalence according to gender, age and site using Chi square test and ANOVA test. RESULTS- Findings of the study showed that soft tissue calcifications including dystrophic calcifications are remarkably common manifestation in digital OPGs. Notably, the prevalence of these calcifications were found more in male than in female. Presence of styloid ligament calcification(28.7%) and carotid artery calcification(16.7%) were the two most common soft tissue calcifications found in oral maxillofacial region. Additionally, a significant percentage of cases showed calcifications in the carotid arteries, raising serious questions regarding vascular consequences.Other soft tissue components showed distinct patterns of calcification like sialolith, phleboliths, rhinoliths, antrolith and tonsillolith emphasize more on their potential diagnostic use. Also, the prevalence of all the calcifications increased with increase in age.[ 15 ] CONCLUSION-Soft tissue calcifications are frequently seen on panoramic radiographs. Dentists should be able to recognize it and determine the differential diagnosis of the primary soft tissue calcifications in the dentomaxillofacial region when it occurs. Early diagnosis of atherosclerotic conditions and prompt guidance regarding the patient's medical condition may be of high importance in patients’ health. Dentistry Calcification Dystrophic calcification Soft tissue Carotid Artery Calcification OPG Digital Panaromic radiographs styloid ligament calcification sialolith tonsillolith ANOVA test Chi square test Figures Figure 1 Figure 2 Figure 3 INTRODUCTION In recent years, advancements in the digital imaging technology have provided clinicians as well as researchers with better tools to detect and analyse calcifications, shedding light on their prevalence and potential diagnostic relevance. In a healthy body, the accumulation of calcium salts is known as calcification. Although heterotopic calcification can result from the uneven deposition of calcium salts, particularly calcium phosphate, in soft tissue which is crucial for bone formation. The soft tissue hardens as a result of this deposits, making it appear radiopaque on radiographs. Based on the calcification process, aetiology, and localization, heterotopic calcifications can further be classified into three subgroups: dystrophic, idiopathic, and metastatic.[ 3 ][ 4 ] The first people to report the existence of calcifications in the common carotid artery region were Friedlander and Lande, using panoramic radiographs taken as part of normal dentistry diagnostic procedures.[ 6 ] According to Friedlander and Baker, panoramic radiographs can be used to identify asymptomatic stroke patients.[ 7 ] According to Mansour et al(1991), soft tissue calcifications detected in orthopantomographs are detected as 4%.[ 9 ] This article aims to delve into the fascinating world of soft tissue calcification within the head and neck region. It will assess and analyse the prevalence and distribution of these calcified structures, the different types of calcifications that can be encountered in our day to day practice as a dentist, and the clinical implications they may carry. By gaining a deeper understanding of soft tissue calcification in dentomaxillofacial region, dental and medical professionals can enhance their diagnostic capabilities, potentially leading to earlier detection of underlying conditions and more effective patient care.[ 8 ] AIMS To assess and evaluate the prevalence of dystrophic soft tissue calcification in digital orthopantomographs through a retrospective study. OBJECTIVES OF THE STUDY To assess the prevalence of dystrophic soft tissue calcification and few other soft tissue calcification that are evident in digital orthopantomographs. To determine the prevalence of calcifications in both males and females and compare it. To assess the prevalence of soft tissue calcification according to age. To calculate the prevalence of carotid artery calcification(CAC) in digital OPGs. MATERIAL AND METHODOLOGY Data of 300 outpatients who reported at Pacific Dental College and Hospital, Debari, Udaipur, in the Department of Oral Medicine and Oral Radiology were taken into consideration for the study. The OPGs of 300 patients were collected shot in last 3 months(between June to August,2023). Patients with orthodontic braces, hyperparathyroidism, malignancy, renal failure and radiographs with artifacts were excluded from the study. Only high quality images with clear prospects were included in the study. Calcifications were classified according to the site, number, distribution and they were categorized by dividing the digital panoramic radiograph into 12 boxes arbitrarily, by a line drawn horizontally across the occlusal plane. Vertical lines were drawn along the posterior aspect of the ramus of mandible on both sides and along the midline followed by two other additional vertical lines one on each side of the mideline were drawn in between. Following criteria were used to identify different types of soft tissue calcifications which are -Calcified stylohyoid ligament, sialolith of submandibular gland, tonsillolith, carotid artery calcification, rhinolith, antrolith and phlebolith.These calcifications are explained in Table 1 . The boxes drawn arbitrarily in all 300 OPGs were numbered from 1 to 12 as shown in Fig. 1 . The design and its complete perspective was reviewed and approved by Ethical Committee of Pacific Dental College and Hospital. (PDCH/23/EC-05) Table 1 Classification of different soft tissue calcification based on location and radiographic appearance Diagnosis Location Radiographic appearance Rhinolith Common location is in the nasal cavity floor, between inferior meatus and nasal septum. Usually unilateral, solitary and densely calcified mass in the nasal cavity. Tonsillolith Lies close to mid ramus region where dorsal surface of the tongue crosses the ramus in the oropharyngeal air spaces in the image. Round single or multiple, small, ill-defined radiopacities Carotid artery calcification(CAC) Posteroinferior to the mandibular angle, adjacent to the cervical vertebrae C3, C4, or the intervertebral space of them Circular when small and vertical linear oriented when enlarged, irregular, heterogeneous radiopacities. Sialolith Submandibular sialolith; below the border of the mandible close to the region of the ramus Unilateral and diffusely calcified radiopacities with regular contours Phlebolith Common region; posterior body of the mandible Multiple, small, mixed radiolucent-radiopaque, targetoid appearance Anthrolith In the antrum of maxillary sinus Single, well-defined, smooth, or irregular radiopacity Styloid ligament calcification The styloid process measures > 30 mm from the lower border of the external auditory to the hyoid bone. Long, tapering, thin, radiopaque process that is thicker at its base and lies downward and forward Source: DOĞAN FB, AKKİTAP MP. Prevalence of Soft Tissue Calcifications in Panoramic Radiography: A Retrospective Study. EDR. 2023;1(1):12 − 5. DATA ANALYSIS Data entries was done in Microsoft Office Excel 2010 and analysis of results was done using Statistical product and service solution (SPSS) Version 22 software. Descriptive statistics such as mean and standard deviation was calculated for quantitative variables. Qualitative statistics was expressed in percentage. The p value was fixed at 0.05. Chi square test was used for finding association between demographic factors association between demographic factors like age, gender with calcification in anatomic landmarks. Chi-Square test was followed by ANOVA. RESULTS Calcifications found in this study include calcifications of the styloid ligament, rhinolith, carotid artery calcification, sialolith, tonsillolith, antrolith and phlebolith. The data entry was done in Microsoft Excel 2010. Descriptive statistics of the demographic factors were examined. Out of 300 patients, 154 patients were male and 146 were female as shown in Table 2 . From the data of 300 patients, 183 patients were found with evidence of soft tissue calcification, out of which 104 were male (57%) and 79 were female(79%) as shown in Fig. 2 . Table 2 Gender Distribution Frequency (n) Percentage (%) Patients with evidence Percentage(%) Male 154 51.3% 104 57% Female 146 48.7% 79 43% 300 100% 183 100% Out of 300 patients, 49 patients were of age in between 11–20, 73 patients were of age group 21–30 years, 42 patients were of 31–40 age group,56 patients were in between 41–50 years,80 patients were above the age of 50 years as shown in Table 3 . Table 3 Age group Distribution Frequency (n) Percentage (%) 11–20 years 49 16.3% 21–30 years 73 24.3% 31–40 years 42 14% 41–50 years 56 18.7% 51–60 years 80 26.7% 300 100% The most common calcifications evident on the digital panoramic radiographs were styloid ligament calcification(28.7%) which was present in 86 patients out of 300, carotid artery calcification was present in 50 patients out of 300 (16.7%), tonsillolith (10.3%), antrolith(10.3%) and phlebolith(8.3%) followed by sialolith(4%) and rhinolith(4%) as shown in Fig. 3 . When the presence of soft tissue calcification was analyzed based on gender, it was seen that sialolith was present more in female(12) while no evidence of it was seen in male(0) which is a highly significant finding(p < 0.001). Antrolith, carotid artery calcification and phlebolith also showed significant findings(p value as 0.001, 0.048, 0.031 respectively, while no significant finding was seen in case of styloid ligament calcification, rhinolith and tonsillolith, as shown in table 4. Table 5 Comparison of presence of calcificification gender wise Gender wise Male (N) Female (N) p value STYLOID LIGAMENT CALCIFICATION (n = 86) 37 49 p = 0.068 (NS) RHINOLITH (n = 12) 6 6 p = 0.925 (NS) TONSILLOLITH (n = 31) 12 19 p = 0.138 (NS) ANTROLITH (n = 31) 25 6 p = 0.001* SIALOLITH (n = 12) 0 12 p 0.05 – not significant *p < 0.05 – significant **p < 0.001 – highly significant) When the presence of calcification was analyzed based on age groups under 40 and over 40, a statistically significant correlation between age over 40 was discovered. No evidence of soft tissue calcifications like rhinolith, sialolith, carotid artery calcification and phlebolith was seen in age groups under 40 which is highly significant. (p-value 0.05 – not significant *p < 0.05 – significant **p < 0.001 – highly significant Age wise < 40 years N (%) 40 years N (%) p value STYLOID LIGAMENT CALCIFICATION (n = 86) 54 (62.8%) 32 (37.2%) p = 0.073 (NS) RHINOLITH (n = 12) 0 (0%) 12 (100%) p < 0.001** TONSILLOLITH (n = 31) 12 (38.7%) 19 (61.3%) p = 0.049* ANTROLITH (n = 31) 13 (41.9%) 18 (58.1%) p = 0.133 (NS) SIALOLITH (n = 12) 0 (0%) 12 (100%) p < 0.001** CAROTID ARTERY CALCIFICATION (n = 50) 0 (0%) 50 (100%) p < 0.001** PHLEBOLITHS (n = 25) 0 (0%) 25 (100%) p < 0.001** Table 7 ANOVA Comparison of presence of calcificification gender wise Sum of Squares df Mean Square F Sig. STYLOIDLIGAMENT CALCIFICATION Between Groups .451 1 .451 2.085 .150 Within Groups 64.466 298 .216 Total 64.917 299 RHINOLITH Between Groups .029 1 .029 .805 .370 Within Groups 10.568 298 .035 Total 10.597 299 TONSILLOLITH Between Groups .282 1 .282 3.240 .073 Within Groups 25.915 298 .087 Total 26.197 299 ANTROLITH Between Groups 1.439 1 1.439 15.358 .000 Within Groups 27.931 298 .094 Total 29.370 299 SIALOLITH Between Groups .486 1 .486 13.138 .000 Within Groups 11.034 298 .037 Total 11.520 299 CAROTIDARTERYCALCIFICATION Between Groups .045 1 .045 .334 .564 Within Groups 40.275 298 .135 Total 40.320 299 PHLEBOLITHS Between Groups .637 1 .637 8.218 .004 Within Groups 23.109 298 .078 Total 23.747 299 Table 8 ANOVA Comparison of presence of calcificification Age wise Sum of Squares df Mean Square F Sig. STYLOIDLIGAMENTCALCIFICATION Between Groups 4.309 6 .718 3.472 .002 Within Groups 60.608 293 .207 Total 64.917 299 RHINOLITH Between Groups 1.028 6 .171 5.245 .000 Within Groups 9.569 293 .033 Total 10.597 299 TONSILLOLITH Between Groups 1.317 6 .219 2.584 .019 Within Groups 24.880 293 .085 Total 26.197 299 ANTROLITH Between Groups 5.002 6 .834 10.024 .000 Within Groups 24.368 293 .083 Total 29.370 299 SIALOLITH Between Groups 4.663 6 .777 33.207 .000 Within Groups 6.857 293 .023 Total 11.520 299 CAROTIDARTERYCALCIFICATION Between Groups 15.369 6 2.561 30.079 .000 Within Groups 24.951 293 .085 Total 40.320 299 PHLEBOLITHS Between Groups 3.159 6 .526 7.492 .000 Within Groups 20.588 293 .070 Total 23.747 299 The ANOVA results reveal significant differences in the prevalence or severity of various medical conditions between genders and across different age groups. Between genders, significant differences were observed in Antrolith (F-statistic = 15.358, p = 0.000), Sialolith (F-statistic = 13.138, p = 0.000), and Phleboliths (F-statistic = 8.218, p = 0.004). In contrast, no significant differences were found in Styloid Ligament Calcification (F-statistic = 2.085, p = 0.150), Rhinolith (F-statistic = 0.805, p = 0.370), Tonsillolith (F-statistic = 3.240, p = 0.073), and Carotid Artery Calcification (F-statistic = 0.334, p = 0.564) between genders. Across different age groups, significant differences were observed in all medical conditions, including Styloid Ligament Calcification (F = 3.472, p = 0.002), Rhinolith (F = 5.245, p = 0.000), Tonsillolith (F = 2.584, p = 0.019), Antrolith (F = 10.024, p = 0.000), Sialolith (F = 33.207, p = 0.000), Carotid Artery Calcification (F = 30.079, p = 0.000), and Phleboliths (F = 7.492, p = 0.000). These findings suggest that age is a significant factor in the development or presence of these medical conditions, and age-specific screening and prevention strategies may be necessary. However, further research is needed to understand the underlying mechanisms and relationships between age and these medical conditions. DISCUSSION Detection of soft tissue calcification is mostly accidental as it has no signs and symptoms and it becomes even more harder to get detected in the maxillofacial region as most of the routine radiographs in a dental setup are the 2-dimensional(2D) representation of 3-dimensional(3D) structures which can cause superposition of structures in proximity resulting in false negative detection.[ 1 ] [ 2 ] [ 15 ]The clinician should seek additional diagnostic knowledge and information, consider referring the patient to a physician or adopt newer dignostic methods to confirm the diagnosis. In our retrospective study, particular radiographic appearances at specific locations were taken into consideration to note for different soft tissue calcifications. The prevalence of soft tissue calcification in this study was 61%, which is far much higher than the prevalence noted in the study of Vengalath J. et al.(8%)[ 1 ], Mansour et al. (4%) [ 9 ] and Riberio et al.(19.7%).[ 16 ] This high difference in prevalence in our study could maybe due to small sample size of 300 patients and inclusion of styloid ligament calcification[ 2 ][ 16 ] which was the most commonly observed calcification(28.7%) followed by carotid artery calcification(16.7%),tonsillolith(10.3%), antrolith(10.3%),phlebolith(8.3%),sialolith(4%) and rhinolith(4%). In present study,the second most common calcification noted was carotid artery calcification(16.7%) which was seen more in female than male and all the patients were above 40 years of age(p < 0.001).In a study by Ohba et al., 659 panoramic radiographs were acquired, of which 33 were found to contain carotid artery atheromas, 8 in males and 25 in females.[ 17 ]In most of the studies it has been showed that females are more prone to strokes post menopause due to hormonal imbalance, stress, improper diet, aging, diabetes melitus, hypertension and lack of exercise.[ 18 ] Also, phlebolith was seen to be prevalent (8.3%) of all calcifications and was majorly seen in patients above 40 years of age in our sample size,similar to Ramadurai et al. study which has reported a prevalence of 17.39% of phleboliths.Phlebolith calcification in the oral mucosa is primarily caused by inflammation, trauma, debris, and vascular malformations.[ 5 ] In this study, antrolith was found to be more common in male(80.6%) than in female(19.4%) and no significant difference was noted in both younger or older population. Unlike antrolith, rhinolith was found to be equally present in both the genders but all the patients in our sample were above the age of 40 years. Sialolith, in our study, was found significant higher in female(p < 0.001%) and all of them in our sample were above 40 yrs of age. Schrøder SA et al. reported in their study that within the North Denmark region, the highest occurrence rate was found in females between the ages of 60 and 70 years although the reason behind it is unclear.[ 19 ] CONCLUSION While it is possible to inadvertently identify soft tissue calcifications in panoramic radiographs acquired for dental applications, accidental, incidental findings of carotid artery calcification on OPGs by themselves cannot be used for determining the risk of stroke. Nonetheless, dentists should be able to recognize it and determine the main soft tissue calcifications in the dentomaxillofacial region when they are encountered. It may be crucial for patients' health to have early detection of atherosclerotic diseases and to rule out the risk of any underlying pathologies and timely advice regarding their medical situation.[ 1 ] The intriguing finding of our study was the spike of presence soft tissue calcification with advancing age.[ 5 ][ 10 ][ 13 ][ 15 ]. However, a few cases of children or young adults have also been reported.[ 11 ][ 12 ] However, styloid ligament calcification and carotid artery calcification were the two most frequent calcifications.[ 14 ] In our investigation, males were more affected than females. Research evaluating the results of long-term follow-up comparing people with and without carotid artery calcifications needs to be done with improved designs. References Vengalath J, Puttabuddi JH, Rajkumar B, Shivakumar GC (2014) Prevalence of soft tissue calcifications on digital panoramic radiographs: A retrospective study. J Indian Acad Oral Med Radiol 26:385–389 DOĞAN FB, AKKİTAP MP (2023) Prevalence of Soft Tissue Calcifications in Panoramic Radiography: A Retrospective Study. EDR 1(1):12–15 White SC, Phaorah MJ (2019) Principles and Interpretation of Oral Radiology 8th edition:Elsevier, St. Louis, Missouri Muduli M (2020) Soft Tissue Calcifications in the Orofa¬cial Region. Indian J Forensic Med Toxicol 14(4):8573–8576 Ramadurai J, Umamaheswari TN (2018) Prevalence of oral and maxillofacial soft tissue calcifications in dental panoramic radiography: A retrospective study. IP Int J Maxillofac Imaging 4(3):82–86 Friedlander AH, Lande A (1981) Panoramic radiographic identification of carotid arterial plaques. Oral Surg Oral Med Oral Pathol 52:102–104 [PubMed] [Google Scholar] Friedlander AH, Baker JD (1994) Panoramic radiography: an aid in detecting patients at risk of cerebrovascular accident. J Am Dent Assoc 125:1598–1603 [PubMed] [Google Scholar] Alves N, Deana NF, Garay I (2014) Detection of common carot¬id artery calcifications on panoramic radiographs: Prevalence and reliability. Int J Clin Exp Med 7:1931–1939 Mansour PA, Romanuik K, Hutchings RD (1991) Soft tissue calcifications in the differential diagnosis of opacities superimposed over the mandible by dental panoramic radiography. Aust Dent J 36:94–101 Hubar JS (1999) Carotid artery calcification in the black population:A retrospective study on panoramic radiographs. DentomaxillofacRadiol 28:348–350 Thakur J, Minhas R, Thakur A, Sharma D, Mohindroo N (2008) Giant tonsillolith causing odynophagia in a child: a rare case report. Cases J 1:50 [PMC free article] [PubMed] [Google Scholar] Garay I, Netto HD, Olate S (2014) Soft tissue calcified in mandibular angle area observed by means of panoramic radiography. Int J Clin Exp Med 7(1):51–56 Maia PRL, Tomaz AFG, Maia EFT, Lima KC, Oliveira PT (2022) Prevalence of soft tissue calcifications in panoramic radiographs of the maxillofacial region of older adults. Gerodontology 39(3):266–272. 10.1111/ger.12578 Epub 2021 Jun 24. PMID: 34169567 Öztaş B, Orhan K (2012) Investigation of the incidence of stylohyoid ligament calcifications with panoramic radiographs. J Investig Clin Dent 3(1):30–35. 10.1111/j.2041-1626.2011.00081.x Epub 2011 Aug 5. PMID: 22298518 İçöz D, Akgunlu F (2019) Prevalence of detected soft tissue calcifications on digital panoramic radiographs. SRM J Res Dent Sci 10:21. 10.4103/srmjrds.srmjrds6018 Ribeiro A, Keat R, Khalid S et al (2018) Prevalence of calcifications in soft tissues visible on a dental pantomogram: A retrospective analysis. J Stomatol Oral Maxillofac Surg 119(5):369–374 Ohba T, Takata Y, Ansai T, Morimoto Y, Tanaka T, Kito S et al (2003) Evaluation of calcified carotid artery atheromas detected by panoramic radiograph among 80-year-olds. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:647–650 Taguchi A, Suei Y, Sanada M, Higashi Y, Ohtsuka M, Nakamoto T et al (2003) Detection of vascular disease risk in women by panoramic radiography. J Dent Res 82:838–843 Schrøder SA, Andersson M, Wohlfahrt J, Wagner N, Bardow A, Homøe P (2017) Incidence of sialolithiasis in Denmark: a nationwide population-based register study, vol 274. European Archives of Oto-Rhino-Laryngology, pp 1975–1981 Additional Declarations The authors declare no competing interests. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5711430","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Short Report","associatedPublications":[],"authors":[{"id":394331327,"identity":"9b165fd0-bfab-47c5-9b34-188fda2bb0c8","order_by":0,"name":"Dr. Swasti 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technology have provided clinicians as well as researchers with better tools to detect and analyse calcifications, shedding light on their prevalence and potential diagnostic relevance.\u003c/p\u003e \u003cp\u003eIn a healthy body, the accumulation of calcium salts is known as calcification. Although heterotopic calcification can result from the uneven deposition of calcium salts, particularly calcium phosphate, in soft tissue which is crucial for bone formation. The soft tissue hardens as a result of this deposits, making it appear radiopaque on radiographs. Based on the calcification process, aetiology, and localization, heterotopic calcifications can further be classified into three subgroups: dystrophic, idiopathic, and metastatic.[\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e][\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e] The first people to report the existence of calcifications in the common carotid artery region were Friedlander and Lande, using panoramic radiographs taken as part of normal dentistry diagnostic procedures.[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e] According to Friedlander and Baker, panoramic radiographs can be used to identify asymptomatic stroke patients.[\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e] According to Mansour et al(1991), soft tissue calcifications detected in orthopantomographs are detected as 4%.[\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThis article aims to delve into the fascinating world of soft tissue calcification within the head and neck region. It will assess and analyse the prevalence and distribution of these calcified structures, the different types of calcifications that can be encountered in our day to day practice as a dentist, and the clinical implications they may carry. By gaining a deeper understanding of soft tissue calcification in dentomaxillofacial region, dental and medical professionals can enhance their diagnostic capabilities, potentially leading to earlier detection of underlying conditions and more effective patient care.[\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]\u003c/p\u003e\n\u003ch3\u003eAIMS\u003c/h3\u003e\n\u003cp\u003eTo assess and evaluate the prevalence of dystrophic soft tissue calcification in digital orthopantomographs through a retrospective study.\u003c/p\u003e "},{"header":"OBJECTIVES OF THE STUDY","content":"\u003cp\u003eTo assess the prevalence of dystrophic soft tissue calcification and few other soft tissue calcification that are evident in digital orthopantomographs.\u003c/p\u003e\u003cp\u003eTo determine the prevalence of calcifications in both males and females and compare it.\u003c/p\u003e\u003cp\u003eTo assess the prevalence of soft tissue calcification according to age.\u003c/p\u003e\u003cp\u003eTo calculate the prevalence of carotid artery calcification(CAC) in digital OPGs.\u003c/p\u003e"},{"header":"MATERIAL AND METHODOLOGY","content":"\u003cp\u003e Data of 300 outpatients who reported at Pacific Dental College and Hospital, Debari, Udaipur, in the Department of Oral Medicine and Oral Radiology were taken into consideration for the study. The OPGs of 300 patients were collected shot in last 3 months(between June to August,2023). Patients with orthodontic braces, hyperparathyroidism, malignancy, renal failure and radiographs with artifacts were excluded from the study. Only high quality images with clear prospects were included in the study. Calcifications were classified according to the site, number, distribution and they were categorized by dividing the digital panoramic radiograph into 12 boxes arbitrarily, by a line drawn horizontally across the occlusal plane. Vertical lines were drawn along the posterior aspect of the ramus of mandible on both sides and along the midline followed by two other additional vertical lines one on each side of the mideline were drawn in between. Following criteria were used to identify different types of soft tissue calcifications which are -Calcified stylohyoid ligament, sialolith of submandibular gland, tonsillolith, carotid artery calcification, rhinolith, antrolith and phlebolith.These calcifications are explained in Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The boxes drawn arbitrarily in all 300 OPGs were numbered from 1 to 12 as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. The design and its complete perspective was reviewed and approved by Ethical Committee of Pacific Dental College and Hospital. (PDCH/23/EC-05)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eClassification of different soft tissue calcification based on location and radiographic appearance\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDiagnosis\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLocation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRadiographic appearance\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRhinolith\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCommon location is in the nasal cavity floor, between inferior meatus and nasal septum.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUsually unilateral, solitary and densely calcified mass in the nasal cavity.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTonsillolith\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLies close to mid ramus region where dorsal surface of the tongue crosses the ramus in the oropharyngeal air spaces in the image.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRound single or multiple, small, ill-defined radiopacities\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCarotid artery calcification(CAC)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePosteroinferior to the mandibular angle, adjacent to the cervical vertebrae C3, C4, or the intervertebral space of them\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCircular when small and vertical linear oriented when enlarged, irregular, heterogeneous radiopacities.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSialolith\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSubmandibular sialolith; below the border of the mandible close to the region of the ramus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eUnilateral and diffusely calcified radiopacities with regular contours\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhlebolith\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCommon region; posterior body of the mandible\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMultiple, small, mixed radiolucent-radiopaque, targetoid appearance\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnthrolith\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIn the antrum of maxillary sinus\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSingle, well-defined, smooth, or irregular radiopacity\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStyloid ligament calcification\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe styloid process measures\u0026thinsp;\u0026gt;\u0026thinsp;30 mm from the lower border of the external auditory to the hyoid bone.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLong, tapering, thin, radiopaque process that is thicker at its base and lies downward and forward\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eSource: DOĞAN FB, AKKİTAP MP. Prevalence of Soft Tissue Calcifications in Panoramic Radiography: A Retrospective Study. EDR. 2023;1(1):12\u0026thinsp;\u0026minus;\u0026thinsp;5.\u003c/p\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eDATA ANALYSIS\u003c/h2\u003e \u003cp\u003eData entries was done in Microsoft Office Excel 2010 and analysis of results was done using Statistical product and service solution (SPSS) Version 22 software. Descriptive statistics such as mean and standard deviation was calculated for quantitative variables. Qualitative statistics was expressed in percentage. The p value was fixed at 0.05. Chi square test was used for finding association between demographic factors association between demographic factors like age, gender with calcification in anatomic landmarks. Chi-Square test was followed by ANOVA.\u003c/p\u003e \u003c/div\u003e"},{"header":"RESULTS","content":"\u003cp\u003eCalcifications found in this study include calcifications of the styloid ligament, rhinolith, carotid artery calcification, sialolith, tonsillolith, antrolith and phlebolith. The data entry was done in Microsoft Excel 2010. Descriptive statistics of the demographic factors were examined. Out of 300 patients, 154 patients were male and 146 were female as shown in Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. From the data of 300 patients, 183 patients were found with evidence of soft tissue calcification, out of which 104 were male (57%) and 79 were female(79%) as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eGender Distribution\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePatients with evidence\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003ePercentage(%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e154\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e51.3%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e104\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e57%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e146\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e48.7%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e43%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e183\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e100%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eOut of 300 patients, 49 patients were of age in between 11\u0026ndash;20, 73 patients were of age group 21\u0026ndash;30 years, 42 patients were of 31\u0026ndash;40 age group,56 patients were in between 41\u0026ndash;50 years,80 patients were above the age of 50 years as shown in Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAge group Distribution\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency (n)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage (%)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e11\u0026ndash;20 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e21\u0026ndash;30 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24.3%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e31\u0026ndash;40 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e41\u0026ndash;50 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e51\u0026ndash;60 years\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.7%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e300\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e100%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe most common calcifications evident on the digital panoramic radiographs were styloid ligament calcification(28.7%) which was present in 86 patients out of 300, carotid artery calcification was present in 50 patients out of 300 (16.7%), tonsillolith (10.3%), antrolith(10.3%) and phlebolith(8.3%) followed by sialolith(4%) and rhinolith(4%) as shown in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e \u003cp\u003eWhen the presence of soft tissue calcification was analyzed based on gender, it was seen that sialolith was present more in female(12) while no evidence of it was seen in male(0) which is a highly significant finding(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). Antrolith, carotid artery calcification and phlebolith also showed significant findings(p value as 0.001, 0.048, 0.031 respectively, while no significant finding was seen in case of styloid ligament calcification, rhinolith and tonsillolith, as shown in table 4.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of presence of calcificification gender wise\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender wise\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003cp\u003e(N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003cp\u003e(N)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSTYLOID LIGAMENT CALCIFICATION (n\u0026thinsp;=\u0026thinsp;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.068 (NS)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRHINOLITH (n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.925 (NS)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTONSILLOLITH (n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.138 (NS)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANTROLITH (n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSIALOLITH (n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCAROTID ARTERY CALCIFICATION (n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.048*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePHLEBOLITHS (n\u0026thinsp;=\u0026thinsp;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.031*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e(p\u0026thinsp;\u0026gt;\u0026thinsp;0.05 \u0026ndash; not significant *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 \u0026ndash; significant **p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 \u0026ndash; highly significant)\u003c/p\u003e \u003cp\u003eWhen the presence of calcification was analyzed based on age groups under 40 and over 40, a statistically significant correlation between age over 40 was discovered. No evidence of soft tissue calcifications like rhinolith, sialolith, carotid artery calcification and phlebolith was seen in age groups under 40 which is highly significant. (p-value\u0026thinsp;\u0026lt;\u0026thinsp;0.001) as shown in Table \u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e6\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of presence of calcificification age wise p\u0026thinsp;\u0026gt;\u0026thinsp;0.05 \u0026ndash; not significant *p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 \u0026ndash; significant **p\u0026thinsp;\u0026lt;\u0026thinsp;0.001 \u0026ndash; highly significant\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge wise\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;40 years\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40 years\u003c/p\u003e \u003cp\u003eN (%)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSTYLOID LIGAMENT CALCIFICATION (n\u0026thinsp;=\u0026thinsp;86)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e54 (62.8%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e32 (37.2%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.073 (NS)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRHINOLITH (n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTONSILLOLITH (n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e12 (38.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19 (61.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.049*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANTROLITH (n\u0026thinsp;=\u0026thinsp;31)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e13 (41.9%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18 (58.1%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.133 (NS)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSIALOLITH (n\u0026thinsp;=\u0026thinsp;12)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCAROTID ARTERY CALCIFICATION (n\u0026thinsp;=\u0026thinsp;50)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePHLEBOLITHS (n\u0026thinsp;=\u0026thinsp;25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0 (0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25 (100%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ep\u0026thinsp;\u0026lt;\u0026thinsp;0.001**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eANOVA Comparison of presence of calcificification gender wise\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSum of Squares\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMean Square\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSig.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSTYLOIDLIGAMENT CALCIFICATION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.451\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.451\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.150\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64.466\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.216\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e64.917\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eRHINOLITH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.029\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.805\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.370\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.568\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.035\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10.597\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eTONSILLOLITH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.282\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.240\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.073\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25.915\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.087\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e26.197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eANTROLITH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.439\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.439\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e15.358\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.931\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.094\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.370\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSIALOLITH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.486\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.486\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e13.138\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.037\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11.520\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCAROTIDARTERYCALCIFICATION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.045\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.334\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.564\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.275\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.135\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40.320\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePHLEBOLITHS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.637\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.637\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e8.218\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e298\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.078\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.747\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eANOVA Comparison of presence of calcificification Age wise\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSum of Squares\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003edf\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMean Square\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eF\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSig.\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSTYLOIDLIGAMENTCALCIFICATION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.309\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.718\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.472\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e60.608\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e64.917\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eRHINOLITH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e5.245\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.569\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.033\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.597\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eTONSILLOLITH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.317\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.219\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e2.584\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.019\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.880\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e26.197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eANTROLITH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.834\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e10.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.368\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.083\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e29.370\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eSIALOLITH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.663\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.777\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e33.207\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.857\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.023\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e11.520\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eCAROTIDARTERYCALCIFICATION\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e15.369\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.561\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e30.079\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e24.951\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.085\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e40.320\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePHLEBOLITHS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBetween Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.159\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.526\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.492\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.000\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWithin Groups\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e20.588\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e293\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.070\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e23.747\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e299\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eThe ANOVA results reveal significant differences in the prevalence or severity of various medical conditions between genders and across different age groups.\u003c/p\u003e \u003cp\u003eBetween genders, significant differences were observed in Antrolith (F-statistic\u0026thinsp;=\u0026thinsp;15.358, p\u0026thinsp;=\u0026thinsp;0.000), Sialolith (F-statistic\u0026thinsp;=\u0026thinsp;13.138, p\u0026thinsp;=\u0026thinsp;0.000), and Phleboliths (F-statistic\u0026thinsp;=\u0026thinsp;8.218, p\u0026thinsp;=\u0026thinsp;0.004). In contrast, no significant differences were found in Styloid Ligament Calcification (F-statistic\u0026thinsp;=\u0026thinsp;2.085, p\u0026thinsp;=\u0026thinsp;0.150), Rhinolith (F-statistic\u0026thinsp;=\u0026thinsp;0.805, p\u0026thinsp;=\u0026thinsp;0.370), Tonsillolith (F-statistic\u0026thinsp;=\u0026thinsp;3.240, p\u0026thinsp;=\u0026thinsp;0.073), and Carotid Artery Calcification (F-statistic\u0026thinsp;=\u0026thinsp;0.334, p\u0026thinsp;=\u0026thinsp;0.564) between genders.\u003c/p\u003e \u003cp\u003eAcross different age groups, significant differences were observed in all medical conditions, including Styloid Ligament Calcification (F\u0026thinsp;=\u0026thinsp;3.472, p\u0026thinsp;=\u0026thinsp;0.002), Rhinolith (F\u0026thinsp;=\u0026thinsp;5.245, p\u0026thinsp;=\u0026thinsp;0.000), Tonsillolith (F\u0026thinsp;=\u0026thinsp;2.584, p\u0026thinsp;=\u0026thinsp;0.019), Antrolith (F\u0026thinsp;=\u0026thinsp;10.024, p\u0026thinsp;=\u0026thinsp;0.000), Sialolith (F\u0026thinsp;=\u0026thinsp;33.207, p\u0026thinsp;=\u0026thinsp;0.000), Carotid Artery Calcification (F\u0026thinsp;=\u0026thinsp;30.079, p\u0026thinsp;=\u0026thinsp;0.000), and Phleboliths (F\u0026thinsp;=\u0026thinsp;7.492, p\u0026thinsp;=\u0026thinsp;0.000). These findings suggest that age is a significant factor in the development or presence of these medical conditions, and age-specific screening and prevention strategies may be necessary. However, further research is needed to understand the underlying mechanisms and relationships between age and these medical conditions.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eDetection of soft tissue calcification is mostly accidental as it has no signs and symptoms and it becomes even more harder to get detected in the maxillofacial region as most of the routine radiographs in a dental setup are the 2-dimensional(2D) representation of 3-dimensional(3D) structures which can cause superposition of structures in proximity resulting in false negative detection.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e] [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e] [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]The clinician should seek additional diagnostic knowledge and information, consider referring the patient to a physician or adopt newer dignostic methods to confirm the diagnosis.\u003c/p\u003e \u003cp\u003eIn our retrospective study, particular radiographic appearances at specific locations were taken into consideration to note for different soft tissue calcifications. The prevalence of soft tissue calcification in this study was 61%, which is far much higher than the prevalence noted in the study of Vengalath J. et al.(8%)[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e], Mansour et al. (4%) [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e] and Riberio et al.(19.7%).[\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] This high difference in prevalence in our study could maybe due to small sample size of 300 patients and inclusion of styloid ligament calcification[\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e][\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e] which was the most commonly observed calcification(28.7%) followed by carotid artery calcification(16.7%),tonsillolith(10.3%), antrolith(10.3%),phlebolith(8.3%),sialolith(4%) and rhinolith(4%).\u003c/p\u003e \u003cp\u003eIn present study,the second most common calcification noted was carotid artery calcification(16.7%) which was seen more in female than male and all the patients were above 40 years of age(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001).In a study by Ohba et al., 659 panoramic radiographs were acquired, of which 33 were found to contain carotid artery atheromas, 8 in males and 25 in females.[\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]In most of the studies it has been showed that females are more prone to strokes post menopause due to hormonal imbalance, stress, improper diet, aging, diabetes melitus, hypertension and lack of exercise.[\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eAlso, phlebolith was seen to be prevalent (8.3%) of all calcifications and was majorly seen in patients above 40 years of age in our sample size,similar to Ramadurai et al. study which has reported a prevalence of 17.39% of phleboliths.Phlebolith calcification in the oral mucosa is primarily caused by inflammation, trauma, debris, and vascular malformations.[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eIn this study, antrolith was found to be more common in male(80.6%) than in female(19.4%) and no significant difference was noted in both younger or older population. Unlike antrolith, rhinolith was found to be equally present in both the genders but all the patients in our sample were above the age of 40 years.\u003c/p\u003e \u003cp\u003eSialolith, in our study, was found significant higher in female(p\u0026thinsp;\u0026lt;\u0026thinsp;0.001%) and all of them in our sample were above 40 yrs of age. Schr\u0026oslash;der SA et al. reported in their study that within the North Denmark region, the highest occurrence rate was found in females between the ages of 60 and 70 years although the reason behind it is unclear.[\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eWhile it is possible to inadvertently identify soft tissue calcifications in panoramic radiographs acquired for dental applications, accidental, incidental findings of carotid artery calcification on OPGs by themselves cannot be used for determining the risk of stroke. Nonetheless, dentists should be able to recognize it and determine the main soft tissue calcifications in the dentomaxillofacial region when they are encountered. It may be crucial for patients' health to have early detection of atherosclerotic diseases and to rule out the risk of any underlying pathologies and timely advice regarding their medical situation.[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe intriguing finding of our study was the spike of presence soft tissue calcification with advancing age.[\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e][\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e][\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e][\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. However, a few cases of children or young adults have also been reported.[\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e][\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] However, styloid ligament calcification and carotid artery calcification were the two most frequent calcifications.[\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e] In our investigation, males were more affected than females. Research evaluating the results of long-term follow-up comparing people with and without carotid artery calcifications needs to be done with improved designs.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eVengalath J, Puttabuddi JH, Rajkumar B, Shivakumar GC (2014) Prevalence of soft tissue calcifications on digital panoramic radiographs: A retrospective study. J Indian Acad Oral Med Radiol 26:385\u0026ndash;389\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDOĞAN FB, AKKİTAP MP (2023) Prevalence of Soft Tissue Calcifications in Panoramic Radiography: A Retrospective Study. EDR 1(1):12\u0026ndash;15\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWhite SC, Phaorah MJ (2019) Principles and Interpretation of Oral Radiology 8th edition:Elsevier, St. Louis, Missouri\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMuduli M (2020) Soft Tissue Calcifications in the Orofa\u0026not;cial Region. Indian J Forensic Med Toxicol 14(4):8573\u0026ndash;8576\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRamadurai J, Umamaheswari TN (2018) Prevalence of oral and maxillofacial soft tissue calcifications in dental panoramic radiography: A retrospective study. IP Int J Maxillofac Imaging 4(3):82\u0026ndash;86\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFriedlander AH, Lande A (1981) Panoramic radiographic identification of carotid arterial plaques. Oral Surg Oral Med Oral Pathol 52:102\u0026ndash;104 [PubMed] [Google Scholar]\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFriedlander AH, Baker JD (1994) Panoramic radiography: an aid in detecting patients at risk of cerebrovascular accident. J Am Dent Assoc 125:1598\u0026ndash;1603 [PubMed] [Google Scholar]\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAlves N, Deana NF, Garay I (2014) Detection of common carot\u0026not;id artery calcifications on panoramic radiographs: Prevalence and reliability. Int J Clin Exp Med 7:1931\u0026ndash;1939\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMansour PA, Romanuik K, Hutchings RD (1991) Soft tissue calcifications in the differential diagnosis of opacities superimposed over the mandible by dental panoramic radiography. Aust Dent J 36:94\u0026ndash;101\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHubar JS (1999) Carotid artery calcification in the black population:A retrospective study on panoramic radiographs. DentomaxillofacRadiol 28:348\u0026ndash;350\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThakur J, Minhas R, Thakur A, Sharma D, Mohindroo N (2008) Giant tonsillolith causing odynophagia in a child: a rare case report. Cases J 1:50 [PMC free article] [PubMed] [Google Scholar]\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGaray I, Netto HD, Olate S (2014) Soft tissue calcified in mandibular angle area observed by means of panoramic radiography. Int J Clin Exp Med 7(1):51\u0026ndash;56\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMaia PRL, Tomaz AFG, Maia EFT, Lima KC, Oliveira PT (2022) Prevalence of soft tissue calcifications in panoramic radiographs of the maxillofacial region of older adults. Gerodontology 39(3):266\u0026ndash;272. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/ger.12578\u003c/span\u003e\u003cspan address=\"10.1111/ger.12578\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003eEpub 2021 Jun 24. PMID: 34169567\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003e\u0026Ouml;ztaş B, Orhan K (2012) Investigation of the incidence of stylohyoid ligament calcifications with panoramic radiographs. J Investig Clin Dent 3(1):30\u0026ndash;35. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1111/j.2041-1626.2011.00081.x\u003c/span\u003e\u003cspan address=\"10.1111/j.2041-1626.2011.00081.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003eEpub 2011 Aug 5. PMID: 22298518\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eİ\u0026ccedil;\u0026ouml;z D, Akgunlu F (2019) Prevalence of detected soft tissue calcifications on digital panoramic radiographs. SRM J Res Dent Sci 10:21. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.4103/srmjrds.srmjrds6018\u003c/span\u003e\u003cspan address=\"10.4103/srmjrds.srmjrds6018\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eRibeiro A, Keat R, Khalid S et al (2018) Prevalence of calcifications in soft tissues visible on a dental pantomogram: A retrospective analysis. J Stomatol Oral Maxillofac Surg 119(5):369\u0026ndash;374\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOhba T, Takata Y, Ansai T, Morimoto Y, Tanaka T, Kito S et al (2003) Evaluation of calcified carotid artery atheromas detected by panoramic radiograph among 80-year-olds. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 96:647\u0026ndash;650\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTaguchi A, Suei Y, Sanada M, Higashi Y, Ohtsuka M, Nakamoto T et al (2003) Detection of vascular disease risk in women by panoramic radiography. J Dent Res 82:838\u0026ndash;843\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSchr\u0026oslash;der SA, Andersson M, Wohlfahrt J, Wagner N, Bardow A, Hom\u0026oslash;e P (2017) Incidence of sialolithiasis in Denmark: a nationwide population-based register study, vol 274. European Archives of Oto-Rhino-Laryngology, pp 1975\u0026ndash;1981\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"Pacific Dental College and Hospital, Debari, Udaipur, Rajasthan","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Calcification, Dystrophic calcification, Soft tissue, Carotid Artery Calcification, OPG, Digital, Panaromic radiographs, styloid ligament calcification, sialolith, tonsillolith, ANOVA test, Chi square test","lastPublishedDoi":"10.21203/rs.3.rs-5711430/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5711430/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eOBJECTIVE- Soft tissue calcifications in the head and neck region are a rare occurrence that are frequently seen on digital panoramic radiographs. This article delves into panoptic exploration to examine and evaluate the prevalence of dystrophic calcification and other soft tissue calcifications in digital orthopantomographs across diverse patient population through a retrospective analysis.\u003c/p\u003e \u003cp\u003eMETHOD AND METHODOLOGY-A systematic analysis of a small dataset of 300 patients between the ages of 12 to 74 years were studied using their digital OPGs. These radiographs were utilized to focus on identifying and categorizing dystrophic calcifications, and other soft tissue calcifications which includes calcified stylohyoid ligament, tonsillolith, carotid artery calcification, sialolith of submandibular gland, rhinolith, phlebolith and antrolith based on prevalence according to gender, age and site using Chi square test and ANOVA test.\u003c/p\u003e \u003cp\u003eRESULTS- Findings of the study showed that soft tissue calcifications including dystrophic calcifications are remarkably common manifestation in digital OPGs. Notably, the prevalence of these calcifications were found more in male than in female. Presence of styloid ligament calcification(28.7%) and carotid artery calcification(16.7%) were the two most common soft tissue calcifications found in oral maxillofacial region. Additionally, a significant percentage of cases showed calcifications in the carotid arteries, raising serious questions regarding vascular consequences.Other soft tissue components showed distinct patterns of calcification like sialolith, phleboliths, rhinoliths, antrolith and tonsillolith emphasize more on their potential diagnostic use. Also, the prevalence of all the calcifications increased with increase in age.[\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eCONCLUSION-Soft tissue calcifications are frequently seen on panoramic radiographs. Dentists should be able to recognize it and determine the differential diagnosis of the primary soft tissue calcifications in the dentomaxillofacial region when it occurs. Early diagnosis of atherosclerotic conditions and prompt guidance regarding the patient's medical condition may be of high importance in patients\u0026rsquo; health.\u003c/p\u003e","manuscriptTitle":"Unveiling the Hidden: Prevalence of Dystrophic Calcification in Digital Orthopantomograph Through a Retrospective Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-12-27 07:25:39","doi":"10.21203/rs.3.rs-5711430/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"b3bc9348-9386-45cd-b621-a647df69a2b0","owner":[],"postedDate":"December 27th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":42051662,"name":"Dentistry"}],"tags":[],"updatedAt":"2024-12-27T07:25:39+00:00","versionOfRecord":[],"versionCreatedAt":"2024-12-27 07:25:39","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-5711430","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5711430","identity":"rs-5711430","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}