Owing to its small size, pineal gland measurements were difficult in the coronal and sagittal planes. Pineal gland calcification was identified as a midline calcification in the posterior cranial fossa within the cranium ( Fig. The scans were imported and evaluated in a CBCT reconstruction program, Invivo5 (Anatomage Inc., San Jose, CA, USA). The investigator had access to the patients' age and gender from the Digital Imaging in Communications and Medicine data. The selected scans were de-identified by a research assistant to remove all patient identifiers. Initially, 1000 scans were screened on the basis of the inclusion and exclusion criteria, and ultimately, 500 scans were selected based on the inclusion criteria. All scans were acquired with a single CBCT machine (Accuitomo-170 J Morita Corp., Kyoto, Japan), and scans were obtained at 90 kVp and 10 mA.
The exclusion criteria were scans that did not adequately show the pineal gland area, had image artifacts that compromised the quality of the scans, or did not have associated details such as gender and age. The inclusion criteria for the study were scans with a large FOV (170 mm×120 mm), which generally extended from the bregma (forehead) to the menton (lower tip of the bony chin) superoinferiorly and from the anterior nasal spine to the cervical spine anteroposteriorly, without any metallic or motion artifacts. An institutional review board (IRB) exemption was granted for this study by the University of Connecticut IRB. The present cross-sectional study consisted of the retrospective evaluation of CBCT scans of patients referred to the University of Connecticut School Of Dental Medicine for advanced imaging. The objective of this study was to analyze the CBCT scans of patients referred for dental implant therapy to evaluate the prevalence and extent of pineal gland calcification according to age and gender. Since most dental implant patients are middle-aged or older, the possibility of studying this phenomenon in these patients is ideal. Hence, clinicians can contribute to the early diagnosis and prevention of challenging neurodegenerative conditions. As mentioned earlier, in a large-FOV CBCT scan, pineal calcification is usually an incidental finding. The calcification is posterior and superior to the level of the sella turcica. To facilitate easy identification of the location of the gland and any associated calcification on CBCT scans, the pineal gland is usually noted as a midline calcification in the posterior cranial fossa in axial sections. 4 5 7 13 14 Patients referred for dental implant therapy usually tend to be individuals in their late 50s to early 60s, and therefore may be a vulnerable group for Alzheimer disease. Reduced melatonin production has been implicated in a variety of neurodegenerative disorders such as migraine, stroke, schizophrenia, and Alzheimer disease.
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