Can dental pulp calcification serve as a diagnostic marker for carotid artery calcification in patients with renal diseases?

Pulp stones: any relevance with the levels of serum calcium, parathyroid hormone, vitamin D and uric acid

Objectives

This study evaluated the effect of serum calcium, parathyroid hormone (PTH), vitamin D, and uric acid levels on pulp stone formation.

Materials and Methods

Patients who were admitted to the Muğla Sıtkı Koçman University, Faculty of Dentistry, Department of Oral and Maxillofacial Radiology for dental complaints were registered. Among these patients, individuals who had routine biochemical tests at the same period in the Outpatient Clinics of Muğla Sıtkı Koçman University Training and Research Hospital were included in the study. The patients with at least 1 pulp stone on panoramic radiographs recorded as the "pulp stone group" while patients without any pulp stones were the "control group". Demographic data and serum levels of calcium, PTH, vitamin D, and uric acid were retrospectively evaluated in both groups. Student t-test or Mann-Whitney U test was used to evaluate the differences between the groups.

Results

Among 151 patients, dental pulp stone was detected in 53.6% of patients, and 82.7% of these patients were female. Female sex and pulp stone formation were significantly associated (p = 0.001). The mean age of the pulp stone group was 43.9, while it was 39.9 in the control group, without any significant correlation between age and pulp stone (p > 0.05). Similarly, there were no significant differences in serum levels of PTH, vitamin D, uric acid and calcium between groups (p > 0.05).

Conclusions

According to the present study, the effect of dental factors rather than systemic factors should be considered primarily in pulp stone formation.

Cone-Beam Computed Tomography-Based Investigation of the Prevalence and Distribution of Pulp Stones and Their Relation to Local and Systemic Factors in the Makkah Population: A Cross-Sectional Study

Objectives This study aimed to assess the prevalence and distribution of dental pulp stones and evaluated their possible associations with local and systemic factors in the Makkah population in Saudi Arabia. Materials and methods Archived cone-beam computed tomography (CBCT) images for 390 patients, from the electronic health records (EHR) in the Dental Teaching Hospital, Umm Al-Qura University, were used. Images were examined in all planes (coronal, sagittal, and axial) for a discrete radiopaque mass in the pulp of all teeth, in both arches. The teeth conditions (the presence of caries, restoration, the periodontal condition, and the presence of pulp stones) were recorded. Additional patient information, including age, gender, and medical condition, was obtained from the patients' archived files. The collected data were statistically analyzed using the Statistical Package for Social Sciences (SPSS) (IBM SPSS Statistics, Armonk, NY) software; a p-value of ≤ 0.05 is considered statistically significant. Results Pulp stone prevalence was 78.97% of the subjects (308 out of 390) and 15.92% of the examined teeth (1644 out of 10326). There were statistically significant differences regarding nationality (p=0.043) and age (p=0.023) but no significant difference between males and females (p=0.876), maxillary and mandibular teeth (p=0.392), and right and left sides (p=0.222) in pulp stone prevalence. Significant differences were found between pulp stone prevalence of sound versus and carious and restored teeth and between periodontally affected teeth and periodontally healthy teeth (p=0.031). Conclusion The prevalence of pulp stones in the Makkah population is high. A positive association was found between nationality, age, tooth restorations, caries, periodontal diseases, and pulp stone prevalence, but no correlation was found with patients' health or gender. The molars were the most affected teeth, while the incisors were the least.

A systematic review assessing the dental pulp stone prevalence in the Saudi Arabian population

This Systematic Review (SR) was to report on the prevalence of pulp stones in the Saudi Arabian (KSA) population. The electronic databases were searched for scientific research articles during May 2021. The data search was performed in electronic search engines like PubMed, Scopus, Web of science, and Saudi Digital Library, and 6 original research articles which fulfilled the eligibility criteria were assessed for qualitative data. The prevalence of pulp stones among the KSA population ranged from 4.6% to 50.93% among the study participants and it ranged between 10.2%-13.34% in the teeth assessed. The pulp stones were more frequently reported in decayed teeth, periodontal diseases, attrition, teeth with dental restorations, and higher in the molar teeth in comparison with the premolar teeth. The data on the prevalence of pulp stones among the Saudi population will be helpful for clinicians in planning endodontic procedures.

Assessment of the Correlation Between Systemic Conditions and Pulp Canal Calcification: A Case-Control Study

OBJECTIVE

Pulp canal calcification is a dental condition that is characterized by the deposition of mineralized tissue within the dental pulp space. While it is primarily a local phenomenon, recent studies have suggested a potential link between pulp calcification and systemic diseases. This study aimed to determine the correlation between certain systemic diseases, medications, and the presence of pulp canal calcification. Second, it aimed to estimate the prevalence of pulp calcification in the smoker population.

METHODS

A pair-matched case-control observational study was conducted from June 2022 to June 2023 at the Faculty of Dentistry, King Abdulaziz University. Digital periapical and bitewing radiographs were used for case-based sampling. Patients were categorized into two study groups: the cases group (n=100), consisting of patients with pulp canal calcification including either pulp stone, pulp canal obliteration, or both. Whereas the control group (n=100), consisted of patients without pulp canal calcification. Detailed medical histories were obtained to identify the presence of systemic diseases. Additionally, systemic medications and smoking status were documented.

RESULT

The participants were divided into two groups; cases (n=100), diagnosed with teeth calcifications and confirmed by radiographic examination, and controls (n=100), showing no evidence of teeth calcifications. Among the patients in the calcification group, 26% had a history of systemic disease compared to 17% in the control non-calcification group with no significant difference between both groups. No correlation between certain medications and pulp canal calcification. Smoking did not demonstrate a statistically significant association with teeth calcifications (p > 0.05).

CONCLUSION

Pulp calcification on routine radiographic examination could indicate an underlying unnoticed systemic disorder that demands accurate referral and subsequent therapy.

Association between the prevalence of pulp stones and calcified atherosclerotic plaques: a systematic review and meta-analysis

OBJECTIVE

To evaluate the association between the prevalence of pulp stones (PS) in permanent teeth and calcified atherosclerotic plaques (CAP).

METHODS

An electronic search was performed in 10 databases to locate observational studies that investigated the association between PS in permanent teeth and CAP, published until March 2022. Two reviewers performed the search, selection and extraction of data from eligible studies. The individual risk of bias of eligible studies was assessed using the JBI Critical Appraisal Tools. The meta-analysis was conducted using fixed and random effects and odds ratio (OR) as an effect measure with a 95% confidence interval (CI). The heterogeneity between the studies was quantified using the I² test. The certainty of evidence was evaluated using the GRADE approach.

RESULTS

The electronic search resulted in 2968 records, of which only 7 studies were considered eligible. The total sample consisted of 3770 participants from 5 countries. All studies showed biases of confounding factors and exposure assessment. Based on six studies and with very low certainty of evidence, the meta-analysis showed that patients with PS were more likely to also have CAP in carotid or coronary arteries (OR: 1.70; 95% CI: 1.21; 2.38, I² = 0%).

CONCLUSIONS

Limited evidence suggests that there is a positive association between the prevalence of PS in permanent teeth detected using panoramic radiography and CAP in the coronary or carotid arteries.

Carotid Artery Calcifications on Panoramic Radiographs

OBJECTIVE

The objective of this study was to evaluate the prevalence of carotid artery calcifications (CACs) on panoramic radiographs of Polish dental patients.

METHODS

Panoramic radiographs made between 2005 and 2012 in 4000 patients born between 1922 and 1958 were accessed from the server of the Department of Radiology and analyzed for the presence or absence of CACs by a group of trained dentists.

RESULTS

The anatomical area covered by the analysis was visible in 2189 images (54.73%). Calcifications in the carotid arteries were found in 468 (21.68%) patients, including 327 (14.94%) unilaterally and 141 (6.44%) bilaterally. CACs were found in 284 (60.68%) women and 184 (39.32%) men.

CONCLUSIONS

The prevalence rate of CACs detected on panoramic radiographs in patients aged 54 and older was 21.68%, which makes it an important clinical problem.

The association of dental pulp stones to cardiovascular and renal diseases: A systematic review and meta-analysis

BACKGROUND

Pulp stone (PS) is a dystrophic calcification in the tooth's pulp chamber and was suggested in the literature to be associated with other calcifications in the body. This study aimed to investigate the association of PS to cardiovascular diseases (CVD) and renal stones (RS).

METHODS

Three databases were searched until June 2021 in addition to manual searching of Google Scholar and grey literature. Original studies were only included and critically appraised using an adapted version of the Newcastle-Ottawa scale. The odds ratio (OR) effect measure was calculated using the Mantel-Haenszel statistical test (95% confidence interval [CI]) to investigate the association of PS with CVD and or RS (p-value ˂ 0.05).

RESULTS

The database search identified 4933 studies, and 19 studies were finally included. The risk of bias was low in thirteen studies, moderate in four studies, and high in two studies. The meta-analysis of the moderate-and-low risk of bias studies revealed a significant association between PS and CVD (OR 3.35, 95% CI 1.91-5.89, P < 0.001, I² = 65%), but no association was found between PS and RS. The results also revealed an association between PS and CVD in patients older than 40 (OR 8.78, 95% CI 3.64-21.17, P < 0.001, I² = 0%).

CONCLUSIONS

The current study results showed an association between PS and CVD, but no association was found between PS and RS. PS in patients younger than 40 years, compared to older patients (> 40 years), was associated with CVD.

Pulp Stones: Diagnostic Significance in Early Diagnosis and Radiographic Correlation with Ischemic Heart Diseases

Context and Aim Sufficient evidence exists in the literature which indicates that patients with ischemic heart diseases (IHDs) show higher degree of pulp calcifications. The present study was, therefore, planned to estimate the prevalence of pulp stones in patients diagnosed with/or undergoing treatment for IHDs. Materials and Methods The present study, which consisted of 300 subjects within the age range of 25 to 65 years, was divided into two groups: study group comprising 150 patients (113 males and 37 females) and 150 age- and sex-matched healthy controls. Pulp stones were imaged using bitewing radiographs and paralleling technique under standard conditions. Statistical Analysis Used Statistical analysis was done using IBM SPSS Statistics for Windows version 21 (IBM Corp, Armonk, USA), while independent t -test and Chi-square test were done to check the prevalence of pulp stones in the study and control groups, based on gender-, arch-, region- and side-wise distribution. p < 0.05 was considered statistically significant. Results The patients with IHDs exhibited 100% prevalence of pulp stones and the difference was found to be statistically significant, although there was a significant difference in the mean number of pulp stones observed in the study and control groups, with the study group revealing 2217 pulp stones as against 639 pulp stones observed in the control group ( p < 0.001). Furthermore, maxillary arch and posterior teeth were predominantly affected in both the groups, although the difference was not found to be statistically significant. Conclusions The findings of the present study suggested a positive correlation between pulp stones and IHDs, highlighting the significance of dental radiographic examination, which may have a possibility for an early detection of IHDs.

Analysis on the predictive value of different variables in pulp stones appearance frequency and its pulpal response to cold stimuli

This study evaluated the presence of pulp stones in a Seville population, correlating their presence and size with state of the crown and pulp response to cold stimuli, encompassing variables such as age, gender, location (arch and teeth group). The study included 1090 teeth corresponding to 146 patients. Each patient underwent a visual examination, periapical radiographs and sensibility tests. The SPSS 25 software (SSPS, Chicago, USA) was used to carry out the statistical analysis, doing logistic regression to compare variables and Chi-square with a significance level p < 0.001. Of 1090 teeth studied, 524 were molars and 566 premolars. Of the molars, 316 showed calcifications and of the 566 premolars only 6 showed pulp stones (p < 0.001). Due to the low prevalence of premolar pulp calcifications, our study included only molars. These calcifications were significantly more common in women than in men (71.5% vs. 28.5%) and in people over 40 years. Significant differences were identified between the state of the crown and the pulp response with the presence of pulp stones, although size did not influence this association. The set of independent variables has a statistically significant effect on the criterion variable (χ² = 260.25, p < 0.001). There was a significant association between the state of the crown and the type of pulp response with the presence of pulp stones, but not with the size of the calcification. In conclusion, the highest probability to find pulpal calcification was observed in women over 40 years old in upper molars, and though the pulpal reaction of teeth with pulpal calcification varies, frequently there is an immediate response to a cold stimulus. There is no correlation between the size of pulp stones and the condition of the crown, just as the sensitivity of the pulp did not correlate with the size of pulp stones.

Comparison of dental and skeletal indices between patients under haemodialysis and peritoneal dialysis with healthy individuals in digital panoramic radiography

OBJECTIVE

The aim was to compare dental and skeletal indices in panoramic radiography between patients undergoing haemodialysis, peritoneal dialysis and age- and sex-matched control group.

METHODS

In this comparative cross-sectional study, quantitative Indices including Antegonial Index (AI), Mental Index (MI), Panoramic Mandibular Index (PMI) and qualitative indices including Mandibular Cortical Index (MCI) and Trabecular Pattern (TP) were evaluated in panoramic images of 32 haemodialysis patients, 14 patients under peritoneal dialysis and 52 healthy individuals. The images were also investigated for pulp canal calcification, pulp stones, soft tissue calcification, changes in or loss of lamina dura, radiolucencies associated with brown tumour and ridge resorption. The indices were compared between the three groups and were investigated for association with the patients' blood test parameters and their diseases causing chronic renal failure (CRF). Intraobserver agreement for the 2-week interval of assessment was calculated for the indices.

RESULTS

MI (p = 0.574) and PMI (p = 0.100) were not significantly different, but AI (p = 0.01), MCI (p < 0.001) and TP (p = 0.002) were significantly different between the two case groups and the control group. The prevalence of pulp calcification (p = 0.03) and ridge resorption (p = 0.005) was higher in the haemodialysis group. Soft tissue calcification (p = 0.85) and lamina dura changes (p = 0.9) showed no significant difference. Brown tumours were observed in only one case in the haemodialysis group.

CONCLUSIONS

AI, MCI and TP showed a reduction in mineral density of the cortical and trabecular bone in CRF patients and more severely in patients under haemodialysis than those under peritoneal dialysis.

Pulp Stones as Risk Predictors for Coronary Artery Disease

Background:

Coronary artery disease (CAD) has been the leading cause of morbidity and mortality worldwide. Studies indicate that patients with CAD show higher degree of pulp calcifications. Localized pulp calcifications are microscopically apparent in more than half of the teeth in young adolescents. However, pulp stones extending to the entire dentition are infrequent and need further evaluation to predict the risk of other probabilities of associated diseases. The present study was planned to estimate the prevalence of pulp stones in patients diagnosed with or, undergoing treatment for CAD.

Methods:

The present study consisted of 300 subjects within an age range of 20-55 years who were divided into the study group consisting of 150 patients including 108 males and 42 females as well as 150 age- and sex-matched healthy controls. Pulp stones were imaged using bitewing radiographs using paralleling technique under standard conditions.

Statistical Analysis Used:

The statistical analysis was performed using IBM SPSS statistics 20 Core system software (SPSS Inc., Chicago, IL, USA) while Chi-square test was used to check the prevalence of pulp stones in patients with CAD in addition to their arch-wise and region-wise distribution. P value <0.05 was considered statistically significant.

Results:

The present study revealed 100% prevalence of pulp stones in the study group while 90% of the subjects in the control group were also afflicted with pulp stones, though the total number of pulp calcifications observed were lesser in number in the control group compared to the study group (P < 0.05). No significant difference was found, although in the gender predilection for the development of pulp stones in the study group while the control group revealed a definite male predilection with around 96.24% of the males afflicted with pulp stones (P < 0.05). Furthermore, maxillary teeth had a statistically significant predilection for the development of pulp stones in both the study as well as the control groups (P < 0.05).

Conclusions:

The patients with CAD have high chance of being affected with pulp stones. Higher prevalence of this entity in multiple teeth may warrant such an individual, in the presence of other compounding risk factors, as a candidate for CAD to be ruled out.

The Relationship between carotid artery calcification and pulp stone among hemodialysis patients: A retrospective study

The aim of this study was to determine the relationship between the presence of carotid artery calcification (CAC) and pulp stone (PS). A total of 60 chronic hemodialysis (HD) patients (30 CAC positive, 30 CAC negative) participated in this study. The mean age of patients was 54.7 ± 16.4 years, and 32 (53%) of them were male. CAC was defined as the presence of heterogeneous nodular opacities in the soft tissue in C3-C4 intervertebral area. Panoramic radiographs of the patients were evaluated for CAC and PS by two oral and maxillofacial radiologists. PS was evaluated in all healthy, decayed, and restored teeth except the third molar teeth, in the coronal, sagittal, and axial planes. The Statistical Package for the Social Sciences (version 20.0; SPSS, Inc., an IBM Company, Chicago, IL, USA) was used. A probability P <0.05 was considered statistically significant. The prevalence of PS in this study was 30% (18 patients) all group. A total of 1324 teeth were analyzed and PS was detected in 237 teeth (17.9%). The occurrence of PS in teeth in CAC-positive group (10 patients, 17.2% of 654 teeth) was similar to that in CAC-negative group (8 patient, 18.3% of 670 teeth). There was no statistical correlation between CAC and PS in chronic HD patients (P = 0.08). In the subgroup analysis, the presence of diabetes (P = 0.003), parathormone level (P = 0.02), calcium × phosphorus product (P = 0.04), and C-reactive protein levels (P = 0.002) were higher, and duration of HD (P = 0.03) was significantly longer in patients with CAC-positive and PS. In chronic HD patients, the presence of PS was not a strong predictor for the presence of CAC.

The Prevalence and Correlation of Carotid Artery Calcifications and Dental Pulp Stones in a Saudi Arabian Population

Background: This study sought to determine the prevalence of carotid artery calcifications (CACs) and pulp stones detected on panoramic radiographs (PRs) and ascertain their correlation. Methods: A total of 2013 digital PRs were retrospectively retrieved and thoroughly examined to determine the prevalence of CACs and pulp stones, their correlation with patient age and gender, and the relationship between the presence of pulps stones and radiographically detectable CACs. Results: The prevalence of CACs on PRs was 2.0%; the prevalence of pulp stones was 4.6%. There was no statistical relationship between pulp stones and CACs (p = 0.714). Older patients exhibited a significantly higher prevalence of CACs than younger patients (p < 0.001); pulp stones were statistically more prevalent in younger patients than older patients (p = 0.001). There were no significant differences between male and females in terms of the prevalence of either CACs or pulp stones (p = 0.087 and p = 0.278, respectively). Conclusions: Dentists should be trained to detect CACs on PRs belonging to patients older than 40 to exclude the presence of CACs. Moreover, pulp stones do not function as a diagnostic marker for CACs.

How the Prevalence of Pulp Stone in a Population Predicts the Risk for Kidney Stone

Introduction:

Conflicting researches exist on relationship between pulp stones and systemic disorders. Nephrolithiasis is a common disease with severe pain and discomfort with increasing prevalence worldwide. The purpose of this study is to evaluate the correlation between pulp and kidney stones to help find a method for early detection of kidney stones.

Methods and Materials:

the sample of this case-control study comprised of 154 subjects (77 patients with and 77 patients without kidney stone approved by sonographic examination). Two oral and maxillofacial radiologists evaluated their panoramic images for the presence of pulpal stones.

Results:

A total of 42.9% of subjects showed pulp stones. Most of the teeth with pulp stone in case and control groups were molars (86.30% and 72.97%, respectively). In the group with kidney stones, pulp stones were detected in 38 patients (49.4%), while in the control group, they were detected in 28 subjects (36.4%). Although there was not a significant relationship between the presence/absence of pulp stone and kidney stone (P=0.143), there was statistically significant association between number of teeth with pulp stone in a patient and the presence of kidney stone (P<0.013). The chance of having kidney stone is 5.78 times higher in the subjects having pulp stone in three teeth or more (≥ 3 teeth).

Conclusion:

Although there is not a correlation between the presence of pulp and kidney stone, the chance of having kidney stone is 5.78 times higher in the subjects with ≥ 3 teeth having pulp stone. Thus, the number of teeth with pulp stone can serve as a predictor for possibility of having kidney stone.

Pulp Stones, Prevalence and Distribution in an Iranian Population

AIM

This study determined the prevalence and distribution of pulp stones in the permanent dentition of an adult population using their periapical radiographs.

MATERIALS AND METHODS

The study followed a cross-sectional design. A total of 800 periapical radiographs collected from 412 patients attending dental clinics in Kerman, Islamic Republic of Iran, were examined using magnification.

RESULTS

Pulp stones were present in 9.6% of all permanent teeth examined, being most common in maxillary first and second molars, followed by mandibular first and second molars. They were present in 31.5% of all adult patients, with a significantly increased prevalence in females compared with males (40.5 vs 23.9%, chi-squared test p < 0.001). There was also an increased prevalence with age.

CONCLUSION

Based on the results of this study, clinicians should expect to encounter pulp stones most commonly in the pulp chambers of maxillary first and second molars, particularly in older female patients.

CLINICAL SIGNIFICANCE

Pulp stones depending on their size and location can pose challenges to endodontic treatment. They obstruct access to the canal orifices and thus complicate endodontic treatment. Knowing where and when pulp stones are likely to occur improves the quality of root canal treatments.

The prevalence and distribution of radiopaque, calcified pulp stones: A cone-beam computed tomography study in a northern Taiwanese population

Background/purpose

Presence of pulp stones increase the difficulty of locating canal orifice during endodontic treatment. This study aims to determine the prevalence of pulp stones in a northern Taiwanese population through analysis of cone beam computed tomography (CBCT).

Materials and methods

A total of 144 patients and 2554 teeth were used in the present study which were collected from a CBCT image archive. To determine the presence of pulp stones, images of pulp chamber and root canals were analyzed in the sagittal, axial and coronal planes and from the occlusal to apical direction. Correlations between pulp stones and gender, age, tooth type, dental arch or side were also examined.

Results

Of the 144 patients, 120 patients (83.3%) and 800 (31.3%) teeth were found to have one or more pulp stones through CBCT examination. Prevalence of pulp stones between dental arches and tooth types were significantly different (P < 0.001). Pulp stones were found to be the most prevalent in first molars (50.0%) and most scarce in first premolars (18.8%). There was no significant correlation between pulp stones and gender, increasing age, or dental sides.

Conclusion

Pulp stones are more frequent in maxillary teeth compared to mandibular teeth. Pulp stones in molar teeth were significantly more common than premolars and incisors. CBCT could be a sensitive tool to detect pulp stones, especially simplifying identification of pulp stones in radicular pulp. Knowledge of pulp stones distribution can aid dentists in clinical endodontic treatment.

Prevalence of and relationship between pulp and renal stones: A radiographic study

AIM

The aim of the present study was to determine the prevalence of and the relationship between pulp and renal in affected patients and in healthy adults.

MATERIALS AND METHODS

A total of 240 patients participated in the study. Group A consisted of 120 patients who had renal calculi and Group B had 120 randomly selected controls for the study. The periapical radiographs for all patients were evaluated for the presence or absence of the narrowing of dental pulp chambers and pulp canals. The radiographs were also evaluated to determine the presence or absence of pulp stones. The results were compared and analyzed using the Chi-square test (p < 0.001).

RESULTS

A total of 164 patients had pulp narrowing and 112 patients had pulp stones, which included 55 controls and 57 renal calculi patients. There was no statistical correlation between pulp narrowing and renal stones (p > 0.001) and also between pulp stones and renal stones (p > 0.001).

CONCLUSION

However, there was no significant correlation between the presence of pulp stones and renal stones, and the incidental findings of pulp stones on periapical radiographs can provide useful information in the early diagnosis of the systemic calcifications.

Endodontics and the ageing patient

Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient.

The relationship between pulp calcifications and salivary gland calcifications

Aim: Pulp stones are discrete calcified bodies found in the dental pulp. Sialolithasis is the most common salivary gland disease. The aim of the present study was to determine the relationship between the pulp stones and salivary gland stones. Material and Methods: 196 patients were randomly selected from the out patient department for the study. The periapical radiographs for all patients were evaluated for the presence or absence of the narrowing of dental pulp chambers and pulp canals. The intra oral occlusal radiographs were also evaluated to determine the presence or absence of salivary stones. The results were compared and analyzed using the Chi-square test (p<0.001). Results: Salivary gland calcifications were detected in 5 patients. 191 patients had pulp narrowing and 118 patients had pulp stones. There was no statistical correlation between pulp narrowing and salivary stones (p>0.001) and also between pulp stones and salivary gland stones (p>0.001). Conclusions: However, the incidental findings of salivary gland stones on intra oral occlusal radiographs can provide useful information in the early diagnosis of the condition, but in the present study no significant relationship was found between the presence of pulp stones and salivary gland stones.

Key words:Pulp stone, salivary gland stone, periapical radiograph, occlusal radiograph.

The osseous and dental changes of patients with chronic renal failure by CBCT

OBJECTIVES

The aim of the present study was to evaluate the osseous changes of the jaws of patients with chronic renal failure (CRF) by CBCT.

METHODS

On CBCT scans obtained from 15 patients with CRF and 15 control patients (7 males and 8 females), the mean was calculated for the antegonial index (AI), mental index (MI), panoramic mandibular index (PMI) and mandibular cortical index (MCI). The MI, AI and PMI, pulp chamber size, number of teeth with pulp calcification and lamina dura loss were compared using the paired t-test, and the MCI values were analysed using the χ(2) test.

RESULTS

There were no statistically significant differences in the PMI, MI and AI values in patients with CRF and the control group. With regard to MCI, the cortical margins of the mandible were more porous in patients with CRF than in the control group, and also soft-tissue calcifications, lamina dura loss and radiolucent defects were more common in patients with CRF. There were no statistically significant differences in pulp chamber size and pulp calcifications between patients with CRF and the control group.

CONCLUSIONS

Radiographic changes in the jawbones of patients with CRF may be commonly seen. CBCT is a valuable diagnostic tool for the evaluation of osseous findings, pulp chamber, soft-tissue calcifications and MCIs and allows indices measurement in three dimensions without any superposition.

A Radiographic Correlation between Renal and Pulp Stones

AIM

The purpose of this study was to determine the correlation between pulp stones and renal stones. This study also aims to report associations between the presence of pulp stone and gender, age, tooth type, dental arches and sides.

PATIENTS AND METHODS

Data were collected through radiographic examination of bitewing radiographs of 116 kidney stone patients and a similar number of age-matched controls, referred to the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University. Two oral radiologists examined the radiographs to identify pulp stones. The Chi-squared and Mann Whitney U tests were used to investigate the correlations between the presence of pulp chamber calcification and age, gender, dental status and kidney stone.

RESULTS

Pulp chamber opacities were detected in 199 (19.3%) out of the 1031 examined teeth, and in 84 (72.4%) out of the 116 kidney stone patients. There was no statistically significant difference between the study and control group (p = 0.882). The occurrence of pulp stones was significantly higher in molars than premolars and similar prevalences were found between dental arches and sides.

CONCLUSION

In this study, no correlation was found between the presence of pulp stones and kidney stones in the investigated group. Therefore, the presence of pulp stones does not seem to be correlated with that of kidney stones.

Reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications

Objective The present study evaluated the reliability of digital panoramic radiography in the diagnosis of carotid artery calcifications. Materials and Methods Thirty-five patients under high-risk for development of carotid artery calcifications who had digital panoramic radiography were referred to undergo ultrasonography. Thus, 70 arteries were assessed by both methods. The main parameters utilized to evaluate the panoramic radiography reliability in the diagnosis of carotid artery calcifications were accuracy, sensitivity, specificity and positive predictive value of this method as compared with ultrasonography. Additionally, the McNemar's test was utilized to verify whether there was a statistically significant difference between digital panoramic radiography and ultrasonography. Results Ultrasonography demonstrated carotid artery calcifications in 17 (48.57%) patients. Such individuals presented with a total of 29 (41.43%) carotid arteries affected by calcification. Radiography was accurate in 71.43% (n = 50) of cases evaluated. The degree of sensitivity of this method was 37.93%, specificity of 95.12% and positive predictive value of 84.61%. A statistically significant difference (p < 0.001) was observed between the methods evaluated in their capacity to diagnose carotid artery calcifications. Conclusion Digital panoramic radiography should not be indicated as a method of choice in the investigation of carotid artery calcifications.

Incidence and distribution of pulp stones found in radiographic dental examination of adult Turkish dental patients

Background:

Pulp stones (PS) are discrete calcified masses found in the dental pulp, in the pulp tissue or become attached to or embedded into the dentine. The formation of pulp stones is still something of an enigma, leading to existence of some epidemiological gaps.

Aim:

To determine the prevalence and distribution of pulp stones in posterior tooth group by using panoramic radiograph.

Materials and Methods:

Panoramic radiographs from 6912 patients attending Kirikkale University Dental Faculty Hospital, Kirikkale, Turkey during the period from July 2009 to August 2011 were reviewed for the presence of pulp stones. The overall incidence of pulp stones in the patients and their correlations between female and male patients and between the right-side and left-side occurrences were analyzed by computer program, SPSS 15. (SPSS Inc. Chicago, USA) with using the χ² test. Differences were considered as significant when P < 0.05.

Results:

Pulp stones were detected in 879 out of 6912 patients (person prevalence 12.7%). Pulp stones were detected in 2009 teeth out of a total of 96240 teeth to give a tooth prevalence of 2.1%. Their occurrence was higher in the maxilla than in the mandible for each tooth type. Pulp stones were found to involve the right side more (1224/2009) (61%) than the left side (785/2009)(39%) and they were significantly more common in females than males (P < 0.001).

Conclusions:

Attention should be paid to the presence of pulp stones and the treatment problems associated with them.

Pulp Stone, Haemodialysis, End-stage Renal Disease, Carotid Atherosclerosis

OBJECTIVES

The aim of this study was to determine the relationship between the presence of pulp calcification and carotid artery calcification on the dental panoramic radiographs in End Stage Renal Disease (ESRD) patients who were on haemodialysis.

METHODS

A total of 112 End Stage Renal Disease (ESRD) patients on who were haemodialysis participated in this study. The periapical and the panoramic radiographs for all the patients were evaluated for the presence or absence of the narrowing of the dental pulps and for pulp stones in the pulp chambers and the pulp canals. The panoramic radiographs were also evaluated to determine the carotid calcification.

RESULTS

Carotid calcifications were detected in none of the patients. 84 (74.99%) patients had dental pulp narrowing, and 38 (33.92%) patients had pulp stones. There was no statistical correlation between pulp narrowing and Carotid Artery Calcification (CAC) in the haemodialysis patient group. There was also no statistical correlation between pulp stones and CAC in the haemodialysis patients.

CONCLUSION

However, the incidental finding of CAC on a panoramic radiograph can provide life-saving information for the vascular disease patients, but in the present study, no significant relationship was found between the presence of the pulpal calcification and CAC in the ESRD patients who were on haemodialysis. Therefore, the presence of pulp calcification does not seem to serve as a diagnostic marker for carotid atherosclerosis.