Prevalence and characteristics of tonsillar calcifications visible in dental panoramic radiographs in a sample of Polish population

Introduction
Calcifications found in the crypts of palatal tonsils, called tonsilloliths, are considered an incidental finding in panoramic radiographs. Dentists and radiologists should be aware of their radiological appearances in order to avoid diagnosis of different calcifications.

Objectives
The objective of the research was to examine the prevalence and characteristics of tonsillar calcifications visible in panoramic radiographs in a sample of Polish population.

Material and methods
The study included one thousand consecutive digital dental panoramic radiographs taken with Planmeca Prostyle X-ray machine in 577 females and 423 males aged from 5 to 88 years. The presence of tonsilloliths, their characteristics (single or multiple) as well as localization according to 6 regions (1-3 shadows cast on the mandibular ramus above, at and below the level of soft palate, 4 – below mandible, 5 – below and posterior to mandibular angle, 6 – posterior to mandibular ramus) were assessed.

Results
Tonsilloliths were detected in over 24% of panoramics. Prevalence in females and males was comparable. Findings were more prevalent in the following age groups: 30-39 years, 50-59 years (37.5%), and 40-49 years (35%). They were far less frequent in patients below 30 years of age. Tonsillar calcifications were found in 511 regions in 242 patients, and in 116 cases they were single. Almost 30% of calcifications were detected in region 2 and 25% in region 3. Over 65% of tonsilloliths were found bilaterally.

Conclusions
Tonsilloliths are frequent incidental finding in X-rays. About one-quarter of analyzed panoramics revealed the presence of stones.