Estimation of salivary LDL in Type II Diabetic patients with calcified carotid atherosclerotic plaque

Objectives: To estimate and correlate salivary and serum LDL in calcified carotid atherosclerotic plaque in Type II diabetic patients on panoramic radiograph and to correlate salivary LDL with the appearance of calcified carotid atherosclerotic plaque. Methods: The study was carried out on 50 Type II diabetic patients with CCAP within the age range of 30-80 years The digital panoramic images were taken using NEW TOM GIANO CEFLA SC machine with exposure parameters 70-74 kVp, 10 mA, 13.6 seconds. The radiographic images were processed using NEW TOM software NNT 5.5 software version. The images were examined for the presence of nodular, punctate and linear radiopacities in the soft tissues of the neck posteroinferior to the angle of mandible at the lower margin of third and fourth cervical vertebrae (the area of bifurcation of common carotid artery).Patient positive with atheromatous plaque were further investigated for serum and salivary LDL. Results: Out of 50 subjects, 30 were female and 20 were male with an average age of 57.37 for female (Std. Deviation: 11.94) and 48.95 for male (Std. Deviation 13.18). 44 cases (88%) were unilateral and 6 cases (12%) were bilateral. Amongst 44 cases of visible unilateral calcification, 29 (58%) cases depict calcification on the right side and 15 cases (30%) on the left side. Serum LDL’s were significantly higher than their counterparts in salivary sample Interpretation: There was increased occurrence of CCAP in the right carotid artery. Female showed predominance in the identification of CCAP and all the bilateral cases were seen in females. A significant positive correlation between salivary and serum LDL was observed and salivary LDL levels were significantly lower than their counterpart in serum sample (p<0.001). Highest average value of salivary LDL were found in the age group of 50-70 years and it was more in females as compared to males. There was not much difference seen in average value of salivary LDL with the location of calcification (either left, right or bilateral) Conclusion: The study highlighted the significance of Digital panoramic radiographs which will allow early detection of calcified carotid atheroma and plays a key role in prevention of cardiovascular diseases or stroke worldwide and once they have been identified, the oral radiologists must inform and instruct patients to seek medical evaluation as soon as possible.