Radiographic Detection of the Relationship between Tonsilloliths and Dental Plaque-Related Pathologies in a Series of Digital Panoramic Radiographs

Objective: The purpose of this study was to analyse the prevalence of tonsilloliths and to determine radiographically whether there is a relationship between tonsilloliths and dental plaque-related pathologies in a series of digital panoramic radiographs. Materials and Methods: This retrospective study included digital panoramic radiographs of 859 patients admitted for routine dental examination. The panoramic images were examined for both the presence of tonsilloliths and the number of decayed, missing, restored teeth and apical periodontitis. Periodontal bone loss was also measured in thirds of optimal bone height according to the root length and a percentage of bone loss was obtained for each panoramic radiograph evaluated. Results: Tonsilloliths were observed in 141 (16.4%) of all individuals. While there was no significant difference regarding the number of decayed teeth and restored teeth between tonsillolith cases (TT) and cases without tonsillolith (TC), the number of missing teeth and apical periodontitis in TT was significantly higher than TC ( p : 0.004, p: 0.030, respectively). There was a significant difference between the groups in terms of the mean percentage of bone loss ( p : 0.001; p < 0.05). In addition, cases showing bone loss between one-third and two-thirds of the optimal bone height in the TT group (52.5%) were significantly higher than those in TC (45.5%) ( p : 0.035; p < 0.05). Conclusion: The relationship between dental plaque-related pathologies and tonsilloliths observed in this retrospective study should be confirmed by computed tomography studies and randomized, prospective, clinical trials conducted in a multidisciplinary manner.