A case of extensive arterial calcification in the head and neck observed in panoramic radiography

Arterial calcification, which involves calcium deposits in the arterial walls, can be categorized into intimal and medial types. Intimal calcification is often linked to atherosclerotic plaques, while medial calcification is associated with aging and hypercalcemia. This case involves a 52-year-old male with severe chronic kidney disease, who is undergoing dialysis treatment. Panoramic radiography revealed arterial calcifications in common carotid, external carotid, internal carotid, lingual, facial, superior labial, and maxillary arteries, bilaterally. Such findings on a panoramic radiograph are rare but quite plausible in patients with severe chronic kidney disease. Panoramic radiographs may not always capture such calcifications, and CT or cone-beam CT might reveal more cases. When detected, the possibility of chronic kidney disease or other hypercalcemia-related conditions should be considered.