a chronic inflammatory response to endothelial cell injury and dysfunction possibly arising from chronic dental infection. in 2010, using the previously validated mattila panoramic radiographic index to quantify the totality of dental infection (i.e., periapical and furcal lesions, pericoronitis sites, carious tooth roots, teeth with pulpal caries, and vertical bony defects), friedlander’s group determined that individuals with carotid artery atheromas on their panoramic radiographs had significantly greater amounts of dental infection/inflammation than atherogenic risk-matched controls devoid of radiographic atheromas. while the mattila index had been previously used to relate the extent of dental infection to coronary artery disease, this research is the first to link the full range of dental disease that it measures to panoramic radiographs evidencing calcified carotid artery atherosclerosis.