Soft tissue calcifications and ossifications observed by means of panoramic radiography_West China Medical Journal

Authors：

SHI Yuchao , LIU Yuanyuan , DIAO Qilin , WANG Hu ,  YOU Meng

State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Radiology, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

YOU Meng, Email: 228945075@qq.com

Keywords：

Panoramic radiography; Soft tissue calcifications; Soft tissue ossifications

DOI：

10.7507/1002-0179.201901097

Video：

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Soft tissue opacities are often found by chance during radiographic examinations, especially in panoramic radiography. Because of the diversity of locations and causes, it is easily overlooked by dentists and even radiologists. Even if abnormal calcification is detected, it is difficult to identify its category and clinical relevance. For some soft tissue opacities associated with high-risk diseases, misdiagnosis is likely to delay treatment. Through reviewing the literature and screening the panoramic images from the disease database of West China Hospital of Stomatology, Sichuan University, this review summarizes and classifies the soft tissue opacities appearing in panoramic images, and discusses the clinical correlation to provide the reference for diagnosis, treatment, and prevention of related diseases.

Citation： SHI Yuchao, LIU Yuanyuan, DIAO Qilin, WANG Hu, YOU Meng. Soft tissue calcifications and ossifications observed by means of panoramic radiography. West China Medical Journal, 2019, 34(6): 698-705. doi: 10.7507/1002-0179.201901097 Copy

1.	Freire V, Moser TP, Lepage-Saucier M. Radiological identification and analysis of soft tissue musculoskeletal calcifications. Insights Imaging, 2018, 9(4): 477-492.
2.	Monsour PA, Romaniuk K, Hutchings RD. Soft-tissue calcifications in the differential-diagnosis of opacities superimposed over the mandible by dental panoramic radiography. Aust Dent J, 1991, 36(2): 94-101.
3.	White SC, Pharoah MJ. Oral radiology: principles and interpretation. 7 ed. St. Louis: Elsevier Mosby, 2014: 524-541.
4.	Çağlayan F, Sümbüllü MA, Miloğlu Ö, et al. Are all soft tissue calcifications detected by cone-beam computed tomography in the submandibular region sialoliths?. J Oral Maxillofac Surg, 2014, 72(8): 1531.e1-1531.e6.
5.	Wu GM, Sun XM, Ni SL, et al. Typical nodal calcifications in the maxillofacial region: a case report. Int J Clin Exp Med, 2014, 7(9): 3106-3109.
6.	Garay I, Netto HD, Olate S. Soft tissue calcified in mandibular angle area observed by means of panoramic radiography. Int J Clin Exp Med, 2014, 7(1): 51-56.
7.	Bamgbose BO, Ruprecht A, Hellstein J, et al. The prevalence of tonsilloliths and other soft tissue calcifications in patients attending oral and maxillofacial radiology clinic of the university of Iowa. ISRN Dent, 2014, 2014: 839635.
8.	Friedlander AH, Manesh F, Wasterlain CG. Prevalence of detectable carotid artery calcifications on panoramic radiographs of recent stroke victims. Oral Surg Oral Med Oral Pathol, 1994, 77(6): 669-673.
9.	Bengtsson VW, Persson GR, Berglund J, et al. Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases: a long-term follow-up study. Clin Oral Investig, 2019, 23(3): 1171-1179.
10.	Huoh KC, Eisele DW. Etiologic factors in sialolithiasis. Otolaryngol Head Neck Surg, 2011, 145(6): 935-939.
11.	Lowe LH, Marchant TC, Rivard DC, et al. Vascular malformations: classification and terminology the radiologist needs to know. Semin Roentgenol, 2012, 47(2): 106-117.
12.	Mulliken JB, Fishman SJ, Burrows PE. Vascular anomalies. Curr Probl Surg, 2000, 37(8): 517-584.
13.	Eivazi B, Ardelean M, Baeumler W, et al. Update on hemangiomas and vascular malformations of the head and neck. Eur Arch Otorhinolaryngol, 2009, 266(2): 187-197.
14.	Missias EM, Nascimento EHL, Pontual MLA, et al. Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT. Oral Dis, 2018, 24(4): 628-637.
15.	Ahmad M, Madden R, Perez L. Triticeous cartilage: prevalence on panoramic radiographs and diagnostic criteria. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005, 99(2): 225-230.
16.	Aoun G, Nasseh I. Calcified triticeous cartilage detected on digital panoramic radiographs in a sample of lebanese population. J Clin Imaging Sci, 2018, 8(1): 16.
17.	Walsh JS, Fairley JA. Calcifying disorders of the skin. J Am Acad Dermatol, 1995, 33(5 Pt 1): 693-706; quiz 707-710.
18.	Kerr ND. Hypercalcemia and metastatic calcification. Cardiovasc Res, 1997, 36(3): 293-297.
19.	Tecilla M, Bielli M, Savarino P, et al. Mesenteric heterotopic ossificans in a ferret (mustela putorius furo): a rare cause of soft tissue ossification. J Exotic Pet Med, 2018, 27(2): 108-112.
20.	Kan LX, Kessler JA. Animal models of typical heterotopic ossification. J Biomed Biotechnol, 2011, 2011: 309287.
21.	Camarda AJ, Deschamps C, Forest D. I Stylohyoid chain ossification: a discussion of etiology. Oral Surg Oral Med Oral Pathol, 1989, 67(5): 508-514.
22.	Ilguy M, Ilguy D, Guler N, et al. Incidence of the type and calcification patterns in patients with elongated styloid process. J Int Med Res, 2005, 33(1): 96-102.
23.	Camarda AJ, Deschamps C, Forest D. II Stylohyoid chain ossification: a discussion of etiology. Oral Surg Oral Med Oral Pathol, 1989, 67(5): 515-520.
24.	Omnell KA, Gandhi C, Omnell ML. Ossification of the human stylohyoid ligament: a longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1998, 85(2): 226-232.
25.	Ledesma-Montes C, Carlos Hernandez-Guerrero JA. Length of the ossified stylohyoid complex and Eagle syndrome. Eur Arch Otorhinolaryngol, 2018, 275(8): 2095-2100.
26.	Grandhe N, Dogra S, Saikia U, et al. Acquired perforating primary osteoma cutis. Acta Derm Venereol, 2004, 84(6): 489-490.
27.	Chabra IS, Obagi S. Evaluation and management of multiple miliary osteoma cutis: case series of 11 patients and literature review. Dermatol Surg, 2014, 40(1): 66-68.
28.	Abdelkarim AZ, Lozanoff S, Abu El Sadat SM, et al. Osteoma cutis and tonsillolith: a cone beam computed tomography study. Cureus, 2018, 10(7): e3003.
29.	Safi Y, Valizadeh S, Vasegh S, et al. Prevalence of osteoma cutis in the maxillofacial region and classification of its radiographic pattern in cone beam CT. Dermatol Online J, 2016, 22(1): 2.
30.	Kransdorf MJ, Meis JM. From the archives of the AFIP. Extraskeletal osseous and cartilaginous tumors of the extremities. Radiographics, 1993, 13(4): 853-884.
31.	Lacout A, Jarraya M, Marcy PY, et al. Myositis ossificans imaging: keys to successful diagnosis. Indian J Radiol Imaging, 2012, 22(1): 35-39.
32.	Raudenbush BL, Mccalla D, Mesfin A, et al. Myositis ossificans of the longus coli muscle following cervical spine fracture-dislocation. J Spinal Cord Med, 2017, 40(3): 372-376.
33.	Walczak BE, Johnson CN, Howe BM. Myositis ossificans. J Am Acad Orthop Surg, 2015, 23(10): 612-622.
34.	Hoth P, Amendola A. Contusions, myositis ossificans, and compartment syndrome of the thigh// Kaeding C, Borchers J. Hamstring and quadriceps injuries in athletes. Boston, MA: Springer, 2014: 95-102.
35.	Fité-Trepat L, Martos-Fernández M, Alberola-Ferranti M, et al. Myositis ossificans of the masseter muscle: a rare location. Report of a case and review of literature. J Clin Exp Dent, 2016, 8(2): e210-e213.
36.	Kransdorf MJ, Meis JM, Jelinek JS. Myositis ossificans: MR appearance with radiologic-pathologic correlation. AJR Am J Roentgenol, 1991, 157(6): 1243-1248.
37.	Jiang Q, Chen MJ, Yang C, et al. Post-infectious myositis ossificans in medial, lateral pterygoid muscles: a case report and review of the literature. Oncol Lett, 2015, 9(2): 920-926.
38.	Boffano P, Zavattero E, Bosco G, et al. Myositis ossificans of the left medial pterygoid muscle: case report and review of the literature of myositis ossificans of masticatory muscles. Craniomaxillofac Trauma Reconstr, 2014, 7(1): 43-50.
39.	Pignolo RJ, Shore EM, Kaplan FS. Fibrodysplasia ossificans progressiva: clinical and genetic aspects. Orphanet J Rare Dis, 2011, 6: 80.

1. Freire V, Moser TP, Lepage-Saucier M. Radiological identification and analysis of soft tissue musculoskeletal calcifications. Insights Imaging, 2018, 9(4): 477-492.
2. Monsour PA, Romaniuk K, Hutchings RD. Soft-tissue calcifications in the differential-diagnosis of opacities superimposed over the mandible by dental panoramic radiography. Aust Dent J, 1991, 36(2): 94-101.
3. White SC, Pharoah MJ. Oral radiology: principles and interpretation. 7 ed. St. Louis: Elsevier Mosby, 2014: 524-541.
4. Çağlayan F, Sümbüllü MA, Miloğlu Ö, et al. Are all soft tissue calcifications detected by cone-beam computed tomography in the submandibular region sialoliths?. J Oral Maxillofac Surg, 2014, 72(8): 1531.e1-1531.e6.
5. Wu GM, Sun XM, Ni SL, et al. Typical nodal calcifications in the maxillofacial region: a case report. Int J Clin Exp Med, 2014, 7(9): 3106-3109.
6. Garay I, Netto HD, Olate S. Soft tissue calcified in mandibular angle area observed by means of panoramic radiography. Int J Clin Exp Med, 2014, 7(1): 51-56.
7. Bamgbose BO, Ruprecht A, Hellstein J, et al. The prevalence of tonsilloliths and other soft tissue calcifications in patients attending oral and maxillofacial radiology clinic of the university of Iowa. ISRN Dent, 2014, 2014: 839635.
8. Friedlander AH, Manesh F, Wasterlain CG. Prevalence of detectable carotid artery calcifications on panoramic radiographs of recent stroke victims. Oral Surg Oral Med Oral Pathol, 1994, 77(6): 669-673.
9. Bengtsson VW, Persson GR, Berglund J, et al. Carotid calcifications in panoramic radiographs are associated with future stroke or ischemic heart diseases: a long-term follow-up study. Clin Oral Investig, 2019, 23(3): 1171-1179.
10. Huoh KC, Eisele DW. Etiologic factors in sialolithiasis. Otolaryngol Head Neck Surg, 2011, 145(6): 935-939.
11. Lowe LH, Marchant TC, Rivard DC, et al. Vascular malformations: classification and terminology the radiologist needs to know. Semin Roentgenol, 2012, 47(2): 106-117.
12. Mulliken JB, Fishman SJ, Burrows PE. Vascular anomalies. Curr Probl Surg, 2000, 37(8): 517-584.
13. Eivazi B, Ardelean M, Baeumler W, et al. Update on hemangiomas and vascular malformations of the head and neck. Eur Arch Otorhinolaryngol, 2009, 266(2): 187-197.
14. Missias EM, Nascimento EHL, Pontual MLA, et al. Prevalence of soft tissue calcifications in the maxillofacial region detected by cone beam CT. Oral Dis, 2018, 24(4): 628-637.
15. Ahmad M, Madden R, Perez L. Triticeous cartilage: prevalence on panoramic radiographs and diagnostic criteria. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 2005, 99(2): 225-230.
16. Aoun G, Nasseh I. Calcified triticeous cartilage detected on digital panoramic radiographs in a sample of lebanese population. J Clin Imaging Sci, 2018, 8(1): 16.
17. Walsh JS, Fairley JA. Calcifying disorders of the skin. J Am Acad Dermatol, 1995, 33(5 Pt 1): 693-706; quiz 707-710.
18. Kerr ND. Hypercalcemia and metastatic calcification. Cardiovasc Res, 1997, 36(3): 293-297.
19. Tecilla M, Bielli M, Savarino P, et al. Mesenteric heterotopic ossificans in a ferret (mustela putorius furo): a rare cause of soft tissue ossification. J Exotic Pet Med, 2018, 27(2): 108-112.
20. Kan LX, Kessler JA. Animal models of typical heterotopic ossification. J Biomed Biotechnol, 2011, 2011: 309287.
21. Camarda AJ, Deschamps C, Forest D. I Stylohyoid chain ossification: a discussion of etiology. Oral Surg Oral Med Oral Pathol, 1989, 67(5): 508-514.
22. Ilguy M, Ilguy D, Guler N, et al. Incidence of the type and calcification patterns in patients with elongated styloid process. J Int Med Res, 2005, 33(1): 96-102.
23. Camarda AJ, Deschamps C, Forest D. II Stylohyoid chain ossification: a discussion of etiology. Oral Surg Oral Med Oral Pathol, 1989, 67(5): 515-520.
24. Omnell KA, Gandhi C, Omnell ML. Ossification of the human stylohyoid ligament: a longitudinal study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 1998, 85(2): 226-232.
25. Ledesma-Montes C, Carlos Hernandez-Guerrero JA. Length of the ossified stylohyoid complex and Eagle syndrome. Eur Arch Otorhinolaryngol, 2018, 275(8): 2095-2100.
26. Grandhe N, Dogra S, Saikia U, et al. Acquired perforating primary osteoma cutis. Acta Derm Venereol, 2004, 84(6): 489-490.
27. Chabra IS, Obagi S. Evaluation and management of multiple miliary osteoma cutis: case series of 11 patients and literature review. Dermatol Surg, 2014, 40(1): 66-68.
28. Abdelkarim AZ, Lozanoff S, Abu El Sadat SM, et al. Osteoma cutis and tonsillolith: a cone beam computed tomography study. Cureus, 2018, 10(7): e3003.
29. Safi Y, Valizadeh S, Vasegh S, et al. Prevalence of osteoma cutis in the maxillofacial region and classification of its radiographic pattern in cone beam CT. Dermatol Online J, 2016, 22(1): 2.
30. Kransdorf MJ, Meis JM. From the archives of the AFIP. Extraskeletal osseous and cartilaginous tumors of the extremities. Radiographics, 1993, 13(4): 853-884.
31. Lacout A, Jarraya M, Marcy PY, et al. Myositis ossificans imaging: keys to successful diagnosis. Indian J Radiol Imaging, 2012, 22(1): 35-39.
32. Raudenbush BL, Mccalla D, Mesfin A, et al. Myositis ossificans of the longus coli muscle following cervical spine fracture-dislocation. J Spinal Cord Med, 2017, 40(3): 372-376.
33. Walczak BE, Johnson CN, Howe BM. Myositis ossificans. J Am Acad Orthop Surg, 2015, 23(10): 612-622.
34. Hoth P, Amendola A. Contusions, myositis ossificans, and compartment syndrome of the thigh// Kaeding C, Borchers J. Hamstring and quadriceps injuries in athletes. Boston, MA: Springer, 2014: 95-102.
35. Fité-Trepat L, Martos-Fernández M, Alberola-Ferranti M, et al. Myositis ossificans of the masseter muscle: a rare location. Report of a case and review of literature. J Clin Exp Dent, 2016, 8(2): e210-e213.
36. Kransdorf MJ, Meis JM, Jelinek JS. Myositis ossificans: MR appearance with radiologic-pathologic correlation. AJR Am J Roentgenol, 1991, 157(6): 1243-1248.
37. Jiang Q, Chen MJ, Yang C, et al. Post-infectious myositis ossificans in medial, lateral pterygoid muscles: a case report and review of the literature. Oncol Lett, 2015, 9(2): 920-926.
38. Boffano P, Zavattero E, Bosco G, et al. Myositis ossificans of the left medial pterygoid muscle: case report and review of the literature of myositis ossificans of masticatory muscles. Craniomaxillofac Trauma Reconstr, 2014, 7(1): 43-50.
39. Pignolo RJ, Shore EM, Kaplan FS. Fibrodysplasia ossificans progressiva: clinical and genetic aspects. Orphanet J Rare Dis, 2011, 6: 80.

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