A field of view-based assessment of soft tissue calcifications in cone beam computed tomography of the maxillofacial region

Soft tissue calcifications are frequently encountered in radiographic examinations. Since some of these calcifications are associated with systemic diseases and potentially serious conditions, accurate radiographic diagnosis can assist in managing the underlying pathology. This study aimed to determine the frequency and size of soft tissue calcifications in cone beam computed tomography (CBCT) scans covering either the maxilla or mandible. 420 CBCT scans with a field of view (FOV) of either the maxilla or mandible were evaluated in patients aged 6 to 82 years. Depending on the FOV type, the scans were evaluated for the presence and size of various calcifications. Furthermore, associations between calcification frequency and size with age and sex were statistically analyzed. A significance level of 0.05 was applied. Tonsilloliths were the most frequently observed calcifications in both FOV types, followed by calcified stylohyoid ligaments (CSLs), with most calcifications being of medium size. Overall, soft tissue calcifications were more frequently detected in the mandibular FOV (p = 0.01). Independent of calcification type and FOV, a significant correlation was observed between increased patient age and both higher frequency (p < 0.001) and larger size (p = 0.003) of calcifications. Tonsilloliths and CSLs are the most common calcifications observed in CBCT scans of both the maxilla and mandible. In mandibular FOVs, especially in patients ≥ 50 years, particular attention should be paid to calcifications of the carotid arteries, stylohyoid ligaments, and tonsilloliths. An FOV‑specific checklist may improve reporting consistency and referrals for appropriate medical/dental follow‑up.