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

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.

Prevalence and Association of Calcified Pulp Stones with Periodontitis: A Cone-Beam Computed Tomography Study in Saudi Arabian Population

This study aimed to identify the prevalence and association of periodontitis and pulp stone (PS) along with the clinical variables. This study assessed the cone-beam computed tomography (CBCT) records to identify the presence of PS and clinical periodontitis records were used to determine the stages of periodontitis. The Chi-square test was used to evaluate the relationship between study parameters. Logistic regression was used to determine the association between PS and periodontitis. A total of 228 CBCT records were conveniently selected for this study based on the inclusion and exclusion criteria. Cohen's kappa analysis showed near to perfect scores for both examiners. The Chi-square test showed that CBCT records from the age range 41-50 years, male patients, and stage II of periodontitis prevalently showed pulp stones; however, there were no significant differences observed between the PS and clinical variables. However, gender, involvement of tooth, and stages of periodontitis showed significant distribution of the PS. Logistic regression showed that the stages of periodontitis showed no significant association with PS in patients with periodontitis. Moreover, multivariate odds ratio adjustment did not alter the outcome. Periodontitis is not associated with the presence of PS in the current population.

The prevalence of pulp stones in a Turkish paediatric cohort from the Isparta district: an 8-year retrospective radiographic study

PURPOSE

To evaluate the prevalence of pulp stones in a Turkish paediatric cohort from the Isparta district using panoramic radiographs.

METHODS

Panoramic radiographs of 19,857 children and adolescents between the ages of 9 and 18 years were retrospectively analysed to determine the prevalence and distribution of pulp stones. Teeth with pulp stones were classified in terms of dentition, location, dental status and complete or incomplete root formation. Statistical analysis was carried out by applying Chi‑square and Mann-Whitney U. Univariate logistic regression analysis was applied to determine the factors affecting pulp stone status. Differences were considered as significant when p < 0.05.

RESULTS

Out of a total of 19,857 patients, pulp stones were identified in 6.5%. Among the 548,415 teeth examined, 0.96% had pulp stones. The incidence of pulp stones in girls (7.4%) was higher than in boys (5.7%) (p < 0.001). The prevalence of pulp stones increased with age and was significantly higher in molar teeth. A significant difference existed in the incidence of pulp stones according to the jaws (p < 0.001). In both jaws, no statistically significant difference was observed in terms of teeth with pulp stones being on the right and left (p = 0.834). Of molars with pulp stones, 91.8% had completed root formation. The majority of patients (37.7%) had pulp stones in four teeth.

CONCLUSION

Knowing the incidence of pulp stones in paediatric patients by dentists, endodontists, and paediatric dentists will help prevent complications that may occur during applications by facilitating the determination of appropriate methods, especially during endodontic procedures.

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.

Three-dimensional analysis for detection of pulp stones in a Saudi population using cone beam computed tomography

PURPOSE

To assess the prevalence and distribution of pulp stones in a Saudi population.

METHODS

A cone beam computed tomography (CBCT) analysis of 150 upper and 150 lower dental arches was performed. The relationships between pulp stones and age, sex, tooth type, dental arch, orthodontic treatment, caries, and restoration were statistically examined (P < 0.05).

RESULTS

A total of 295 dental arches (98.3%) had at least one pulp stone, and the prevalence was higher in the maxillary teeth (56.2%) than in the mandibular teeth (48.1%) (P = 0.0003). Men were more likely to have pulp stones than women (P = 0.011 for the maxilla, P < 0.0001 for the mandible). Furthermore, age and orthodontic treatment had no significant effects on the incidence of pulp stones (P > 0.05). A higher occurrence of pulp stones was observed in the first molars (>91%), and in carious and restored teeth when compared to intact teeth (P < 0.05).

CONCLUSION

Pulp stones were more prevalent in the upper dental arches, first molars, and carious and restored teeth, as well as in the male population, and were not associated with age or orthodontic treatment.

Assessment of Pulp Stones Among Western Saudi Populations: A Cross-Sectional Study

BACKGROUND

The term "pulp stones" refers to conditions of calcification that can appear in any area of the dental pulp. This study aims to assess the prevalence of pulp stones and examine whether there is any connection between their occurrence and factors such as patient age, gender, tooth location, presence of decay, or dental restorations in a western Saudi subpopulation based on cone-beam computed tomography (CBCT).

METHODOLOGY

500 patients were randomly selected from the College of Dentistry, Taibah University, Madinah, Saudi Arabia, database. The study involved evaluating 2998 teeth in coronal, axial, and sagittal planes by four dental peer examiners observing and recording data (sequentially and simultaneously) that included whether pulp stones were present or absent, the teeth group (anterior, premolars, and molars), tooth location (maxillary or mandibular), presence or absence of restoration, presence or absence of caries, and the patient's gender. Chi-square tests were utilized for statistical analysis, and a significance level of p-value ≤0.05 was established.

RESULTS

Out of 500 individuals (250 females and 250 males), only 130 individuals (26%) and 278 teeth out of 2998 (9.2%) had pulp stones, with no significant statistical correlation identified between the presence of pulp stones and gender. (P = 0.459). Molars exhibited the greatest incidence of pulp stones (238; 85.6%), followed by anterior teeth (30; 10.8%), and premolars had the lowest prevalence (10; 3.6%). Teeth that showed a higher occurrence of pulp stones were associated with caries (74; 26.6%) and restorations (58; 20.9%). The association between pulpal stone and periodontal involvement was seldom significant (0.7%). A significant association was found between the presence of pulp stones and nonintact teeth (P<0.001). There was a statistically significant difference in the distribution of pulp stones between females and males in the maxillary and mandibular (74.7% and 57.3%, respectively) (P = 0.002). Additionally, the frequency of pulp stones was statistically significant when comparing the left and right sides (P<0.001) (48.9% and 51.1%, respectively).

CONCLUSION

Understanding the prevalence and distribution of pulp stones is crucial for dentists and endodontists, as it assists practitioners in devising an appropriate treatment plan for affected teeth that require root canal therapy. One-fourth of the Madinah population was confirmed to have pulp stones, with a higher incidence in molars, caries, and restored teeth. No difference was found between its occurrence and gender. The high prevalence is exhibited in individuals between 45 and 54 years old. However, further studies with equal patient distribution are needed to confirm this observation.

Effects of Orthodontic Treatment on Pulp Stone Formation: A Retrospective Study

Objective

This retrospective study was aimed at determining the incidence of dental pulp stone formation during fixed orthodontic treatment.

Materials and Methods

A total of 100 patients who received fixed orthodontic treatment were included in this study. Pre- and posttreatment panoramic radiographs of the patients were examined to identify pulp stones. The data were analyzed using McNemar's and Pearson's chi-square tests to investigate the correlations between having a dental pulp stone and gender, age, treatment type, and duration.

Results

Dental pulp stones were detected in 17% of patients on pretreatment panoramic radiographs and 35% of patients on posttreatment panoramic radiographs. The incidence of pulp stones sharply increased in the pre- and posttreatment radiographs (38%) (P < 0.001). In addition, there were associations between age, treatment duration, and the incidence of pulp stones (P < 0.05). Nevertheless, no associations were found between treatment type, gender, and the presence of pulp stones. Dental pulp stones were most frequently observed in first molars (62%), followed by second molars (36%).

Conclusion

Fixed orthodontic treatment may trigger pulp irritation and calcification, resulting in the formation of pulp stones. Although pulp stones have no serious consequences, an orthodontist must consider the probability of pulp stone formation because it can cause difficulties in endodontic treatment.

Cone-beam computed tomography study of the incidence and characteristics of the second mesiobuccal canal in maxillary permanent molars

Objective: This study aimed to review the characteristics of the second mesiobuccal canal (MB2) in the maxillary first and second permanent molars of 500 patients to analyze the incidence of MB2 and its connection with gender, age, tooth position, and mesiobuccal (MB) root length. The study also aimed to investigate the distribution of the root canal orifice on the pulp chamber floor to obtain an imaging reference for clinical practices related to maxillary molars in Fujian, China. Methods: In accordance with the enrollment criteria, cone-beam computed tomography images of the maxillofacial area were collected from 500 patients, including 1,000 maxillary first molars and 1,000 maxillary second molars. The patients were grouped according to gender and tooth position. The incidence of MB2 was observed, and the MB root length and distribution angle of the mesiobuccal-palatal-distobuccal root canal orifices were measured for statistical analysis. Results: The overall incidence of MB2 in maxillary first and second molars was 51.1% and 32.9%, respectively. The incidence of MB2 in maxillary molars was 50% in male patients and 35.45% in female patients, with a significant difference (p < 0.05). The incidence of MB2 in maxillary molars was significantly higher in subjects aged below 50 (especially in male patients) than those aged 50 and above. The MB root length of maxillary first and second molars with MB2 was longer than that without MB2, and the difference was statistically significant. An association was identified between the incidences of MB2 in contralateral molars of the same type and in ipsilateral adjacent molars. When MB2 occurred in the MB root of maxillary molars, the root canals were mostly classified as type IV, followed by type II. The angle formed by the MB-P-DB orifices on the pulp chamber floor in the maxillary first and second molars was (25.23 ± 5.20) and (20.17 ± 10.88)°respectively. Conclusion: The incidence of MB2 in maxillary molars is high in Fujian, China. The occurrence of MB2 is affected by gender, age, and length of MB root, and it occurs symmetrically in adjacent molars and in contralateral molars of the same type. In addition, the distribution law of the main root canal orifice at the pulp chamber floor is conducive to locating MB2, thereby guiding clinical operations.

Association between Periodontitis and Pulp Calcifications: Radiological Study

Objective

The presence of intrapulpal calcifications is one of the effects reported as a consequence of periodontal pathology. Although the impact of the pulp pathology on the periodontium is obvious, the contrary remains unclear and controversial. This study was conducted in order to better understand this fact and establish a potential association between periodontitis and intrapulpal calcifications and then to determine the factors associated with their occurrence.

Materials and Methods

To investigate the issue, a retrospective radiological study using periapical preoperative radiographics assessed 332 teeth taken from the records of 79 patients who received treatment for periodontitis. In the second part of the study, 81 of the sample with intact dental crowns presenting an attachment loss were compared to their contralateral with intact dental crowns without any attachment loss. The study of the association between periodontitis and intrapulpal calcifications and the factors associated with their occurrence was performed by the Chi squared and Fisher's exact tests. The significance level was set at 0.05.

Results

The results indicated that 251 (75.6%) teeth had an attachment loss while 102 (30.7%) had intrapulpal calcification. Among the 206 (62%) teeth with intact crown, only 6 (1.8%) showed calcification in the pulp cavity and 20 (6%) showed calcification in the root canals, with a statistically significant difference (p < 0.005) compared to teeth with restorations and caries. For the 32 (19.7%) teeth with coronary calcification, 18 (22.2%) presented an attachment loss versus 14 (17.2%) without attachment loss; the difference was not statistically significant (p=0.6). Similarly, only 13 (16%) of a total of 22 (13.5%) teeth with root canal calcification had attachment loss versus 9 (11.1%) without attachment loss. This difference was not statistically significant (p=0.5).

Conclusion

This radiographic study revealed no association between the presence of periodontitis and the occurrence of intrapulpal calcifications. Although intrapulpal calcifications were present in some teeth with loss of attachment, they were not necessarily the consequence of periodontal disease.

Detecting calcified pulp stones in patients with periodontal diseases using digital panoramic and periapical radiographies

Background/purpose

Pulp stones are discrete calcified masses appearing in the dental pulp of healthy, disease and unerupted teeth. They are presented freely within the pulp tissue or attached and embedded in any part of coronal and radicular dentin. Here, the purposes of this study were to identify the presence of pulp stones in periodontal patients using digital panoramic and periapical radiographies, and to determine the association with gender, age, tooth type and dental arch.

Materials and methods

This is a retrospective study on selected records of 465 dental samples obtained between January and December, 2020. Data were collected from patients diagnosed with generalized chronic periodontitis and accepted the full periodontal treatment covered by the Government's Periodontal Health Care Program. Their digital panoramic (DPR) examination and full mouth periapical radiographic (DPA) examination (including 12 periapical and 4 bitewing images) were performed at the Outpatient Clinics of the Department of Stomatology, Taichung Veterans General Hospital. Patients were segregated into various groups according to their age, gender and tooth locations. All radiographic images were examined by a dental radiologist and two dentists to identify the presence of pulp stone calcifications and their associated factors using the Sirona applications software. Records were analyzed using SPSS version 22.0 based on tests of Pearson Chi-square and McNemar correlation.

Results

From 271 males and 194 females, a total of 465 DPR and 7440 DPA radiographs were studied. Pulp stone calcifications were identified in 270 (58.0%) subjects in DPR images and 348 (74.8%) subjects in DPA images (for 1 or more teeth per subject). We detected calcified opacities in 1031 teeth with DPR images and in 1326 teeth with DPA images from a total of 12,407 teeth. The incidence of pulp stones was similar across genders, but different in tooth locations and dental arch sextant. Moreover, pulp stones were detected more often on maxillary molars and subjects of old ages (>40 years). Digital panoramic and periapical radiography showed significant differences in the detection of pulp stone calcifications (P < 0.05), and detected better with digital periapical radiography examination.

Conclusion

We found 58.0% (n = 645) of our patients with pulp stones using digital panoramic radiography, and 74.8% using digital periapical radiography. Regarding individual teeth, only 8.5% of pulp stones were observed in digital panoramic radiography and 10.6% in digital periapical radiography. Pulp stones were more often seen in maxillary molar teeth and old patients of ages >40 years old using periapical radiography examination especially in those patients with periodontally condition. As a two-dimensional imaging system, digital periapical radiography is recommended for a definitive and routine assessment in patients suspected of hard tissue abnormality and pulp calcification formation.

Clinicopathological Correlation of Pulp Stones and Its Association with Hypertension and Hyperlipidemia: An Hospital-based Prevalence Study

INTRODUCTION

Pulp stones are the discrete calcification, located in pulp tissue or attached to or embedded in dentin. It occurs in physiological and pathological conditions. The exact etiopathogenesis of various types of pulp calcifications is unknown and the prevalence varies from 8% to 90%. The histopathological identification of pulp stones is higher than the radiological identification.

OBJECTIVE

The aim of the study is to evaluate and correlate the clinical parameters and histopathological analysis of pulp stone with systemic hypertension and hyperlipidemia.

MATERIALS AND METHODS

Seventy patients were selected for the study and a detailed case history was recorded. The radiological investigations were noted down and extirpated pulp tissues were sent for processing. The results were analyzed statistically using Chi-square test.

RESULTS

Out of 70 patients studied, pulp stones were observed radiologically in 14 patients and histopathologically in 30 patients. The presence of irregular and nonlaminated type of pulp stones histopathologically was significantly correlated with hypertension and hyperlipidemia.

CONCLUSION

The patients with the histopathological presence of nonlaminated and irregular-shaped pulp should be evaluated for lipid profile and hypertension.

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.

Evaluation of the relation between the pulp stones and direct restorations using cone beam computed tomography in a Turkish subpopulation

Objectives

This study aimed to assess the presence of pulp stones through an examination of cone beam computed tomography images and correlate their prevalence with age, sex, dental arch and side, tooth type, and restoration type and depth.

Materials and Methods

Cone beam computed tomography images obtained from 673 patients and archival data on 11,494 teeth were evaluated. The associations of pulp stones with age, sex, dental arch and side, tooth type, and restoration type and depth were noted. All the measurements were subjected to a χ² test and one sample χ² test (p < 0.05).

Results

In the study group, 163 (24.2%) patients and 379 (3.3%) teeth had at least one pulp stone. The pulp stone frequency in those aged 30–39 years was significantly greater than in those aged 18–29 and ≥ 60 years, and the frequency was higher in females than in males (p < 0.05). The highest prevalence of pulp stones was found in maxillary dental arches and molar teeth (p < 0.05). Pulp stones were significantly more common in medium-depth restorations (p < 0.05).

Conclusions

Maxillary molar teeth, medium-depth restorations, individuals aged 30–39 years and females had a greater percentage of pulp stones.

Dental pulp calcifications in prehistoric and historical skeletal remains

BACKGROUND

The prevalence of hard tissue formations in the dental pulp varies considerably. Beside ageing processes and irritations of the dental pulp, etiological associations with cardiovascular disease and dietary habits have been discussed, which are of particular research interest. The aim of this pilot study is to provide new insights on structural and etiological factors involved in the development of pulp calcifications by investigating skeletal remains from different (pre)historic periods.

METHODS

The jaws of 46 skeletons excavated in central Germany, were examined for the presence of pulp stones using digital volume tomography (DVT). A total of 1122 teeth were examined with all tooth types considered. To obtain information about the three-dimensional structure of pulp calcifications, micro-CT images were taken. Thin sections of three molars were histologically analysed. Potential dietary effects were studied by analysing stable isotope ratios of nitrogen (δ¹⁵N) in bone samples collected from each individual.

RESULTS

The analysis indicates that pulp stones affect molars in particular and increase slightly with age and dental wear. The micro-CT scans and the histological analysis show that the structures are much more complex than presumed on the basis of DVT imaging. Individuals with lower δ¹⁵N-isotope values and thus with a potentially lower proportion of animal protein in their diet appear to be less affected by pulp stones.

CONCLUSION

When comparing between archaeological and recent data, DVT analysis provides qualitatively comparable results. Micro-CT and histological images illustrate the excellent preservation of pulp calcifications and their complex structure. Differences in prevalence rates and δ¹⁵N-isotope values of Neolithic and historical individuals support the assumption that dietary habits and living conditions could have an influence on the development of pulp calcifications. Due to the small sample size these results require further validation.

Incidence and distribution of pulp stones among Southern Saudi Arabian sub-population

Purpose:

To assess the incidence of pulp stones in molar and premolar teeth of Southern Saudi Arabian adult sub-population.

Materials and Methods:

Six hundred patient files were randomly selected from the database (records) of the College of Dentistry outpatient department screened by Oral Medicine and Radiology division. Orthopantomogram and bitewing radiographs using radiovisiographs of first and second maxillary and mandibular molars and premolars were interpreted by three examiners. Pulp stones were identified as definite radiopaque masses and scored as present or absent. Data were subjected to statistical analysis using SPSS version 19.

Results:

Out of total 600 patients, pulp stones were found in 88 (14.7%) patients. Females showed statistically significant higher presence of pulp stones in mandibular molars than males. The patients belonging to middle age group (31–40 years) showed statistically significant higher presence of pulp stones than the other two groups in all first and second molar teeth in both arches. The presence of pulp stones was observed to be higher in maxillary arch than mandibular arch with left side having more frequency than the right side of the arch.

Conclusion:

The prevalence of pulp stones in the study population was found to be 14.7%, and it was higher in molars than premolars. It is quite significant to know the frequency distribution of pulp stones especially for an endodontist or a dentist to plan the root canal treatment of such teeth accordingly.

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.

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.

Prevalence of pulp stones: A systematic review and meta-analysis

OBJECTIVE

During the last years, different prevalences of dental pulps had been reported from different parts of the world. Combining these original estimates will provide useful information for policymaking in the field of health, treatment and research. This study aims to estimate the global prevalence of pulp stones.

METHODS

Electronic databanks such as PubMed, Scopus, Science direct, Cochrane, and also Google scholar motor engine were searched by 2 researchers using related keywords. The heterogeneity between the results was assessed using Cochrane and I² indices. The initial estimates were represented by forest plot and were combined according to random effects models. Factors responsible for heterogeneity were investigated using meta-regression models, and studies responsible for heterogeneity were assessed following sensitivity analysis.

RESULTS

Prevalence of pulp stones had been reported in 16 studies including 14 093 subjects. The pooled prevalence (95% confidence interval) of pulp stones among the total population, men and women were estimated as of 36.53% (27.17-45.88), 32.58% (24-41.15), and 39.23% (28.73-49.73), respectively. In addition, of 193 687 teeth investigated during the primary studies, 9.57% (95% confidence interval: 7.05-12.08) were affected by pulp stones.

CONCLUSION

Our meta-analysis shows a considerable prevalence of pulp stones, especially among women.

Evaluation of the relationship between sleep bruxism and pulpal calcifications in young women: A clinico-radiological study

PURPOSE

This study was performed to investigate the relationship between sleep bruxism (SB) and pulpal calcifications in young women.

MATERIALS AND METHODS

A total of 100 female participants between 20 and 31 years of age who were referred to our radiology clinic for a dental check-up, including 59 SB and 41 non-SB patients, were sampled for the analysis. SB was diagnosed based on the American Academy of Sleep Medicine criteria. All teeth were evaluated on digital panoramic radiographs to detect pulpal calcifications, except third molars, teeth with root canal treatment, and teeth with root resorption. Binary logistic regression analysis was used to determine the risk factors for pulpal calcifications. The Spearman correlation coefficient was applied and the Pearson chi-square test was used for categorical variables. To test intra-examiner reproducibility, Cohen kappa analysis was applied. P values <.05 were considered to indicate statistical significance.

RESULTS

A total of 2800 teeth were evaluated (1652 teeth from SB patients and 1148 from non-SB patients), and 61% of patients had at least 1 dental pulpal calcification. No statistically significant relationship was found between SB and pulpal calcifications (P>0.05). In SB patients, the total number of pulpal calcifications was 129, while in non-SB patients, it was 84. Binary logistic analysis showed that SB was not a risk factor for the presence of pulpal calcifications (odds ratio, 1.19; 95% CI, 0.52-2.69, P>.05).

CONCLUSION

No relationship was found between SB and pulpal calcifications.

A comparative study of cone-beam computed tomography and digital panoramic radiography for detecting pulp stones

PURPOSE

The aim of this study was to compare cone-beam computed tomography (CBCT) and digital panoramic radiography (DPR) for the detection of pulp stones.

MATERIALS AND METHODS

DPR and CBCT images of 202 patients were randomly selected from the database of our department. All teeth were evaluated in sagittal, axial, and coronal sections in CBCT images. The systemic condition of patients, the presence of pulp stones, the location of the tooth, the group of teeth, and the presence and depth of caries and restorations were recorded. The presence of pulp stones in molar teeth was compared between DPR and CBCT images.

RESULTS

Pulp stones were identified in 105 (52.0%) of the 202 subjects and in 434 (7.7%) of the 5,656 teeth examined. The prevalence of pulp stones was similar between the sexes and across various tooth locations and groups of teeth (P>.05). A positive correlation was observed between age and the number of pulp stones (ρ=0.277, P<.01). Pulp stones were found significantly more often in restored or carious teeth (P<.001). CBCT and DPR showed a significant difference in the detection of pulp stones (P<.001), which were seen more often on DPR than on CBCT.

CONCLUSION

DPR, as a 2D imaging system, has inherent limitations leading to the misinterpretation of pulp stones. Restored and carious teeth should be carefully examined for the presence of pulp stones. CBCT imaging is recommended for a definitive assessment in cases where there is a suspicion of a pulp stone on DPR.

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.

Radiographic Assessment of the Prevalence of Pulp Stones in a Yemeni Population Sample

Objective:

To determine the prevalence and distribution of pulp stones in the posterior teeth of a sample of adult Yemeni dental patients using digital panoramic radiographs.

Methods:

In total, 913 panoramic radiographs from patients attending the hospital dental clinics of at University of Sciences and Technology, Sana’a, Yemen, from January 2013 to December 2014 were examined. The occurrence of pulp stones in the posterior teeth of adult subjects was recorded. Associations between pulp stones and gender, age, arch, side and tooth type were studied.

Results:

The overall prevalence of pulp stones was 18.6% for individuals (170 out of 913 subjects) and 3.99% for examined teeth (351 out of 8802 teeth). The pulp stone occurrence was significantly higher in the maxilla than in the mandible for each tooth type and location (P<0.001). Pulp stones occurred more often on the right side (P<0.001). First molars represented 71% of the affected teeth with the maxillary right first molar showing the highest occurrence. Fifty-six percent of the affected subjects had pulp stones in more than one tooth. No significant difference in the occurrence of pulp stones was detected between genders or among age groups (P>0.05).

Conclusion:

The prevalence of pulp stones is different among populations. Pulp stones were found in approximately one-fifth of subjects in the Yemeni population, where up to 90% of the population have a Qat-chewing habit. This habit usually causes mechanical and chemical irritation and results in pulp calcification.

The Prevalence of Pulp stones in Adult Patients of Shiraz Dental School, a Radiographic Assessment

STATEMENT OF THE PROBLEM

Pulp stones are calcifications found in the pulp chamber or pulp canals of the teeth. Its different prevalence in different population is a matter of concern.

PURPOSE

This study aimed to assess the prevalence of pulp stones in a sample of Iranian population and to report its occurrence regarding gender, dental arch, tooth type and dental status.

MATERIALS AND METHODS

Dental records of patients who attended Shiraz Dental School were selected randomly. Only bitewing and periapical radiographs of maxillary and mandibular permanent posterior teeth were studied. Teeth were classified in the case of presence or absence of pulp stones, and the prevalence was analyzed in different gender, tooth types, dental arch, and dental status (intact, carious, or restored) groups. Statistical analysis was performed using X(2) test.

RESULTS

Of the 652examined subjects, 306 (46.9%) had one or more teeth with pulp stones. Of the 8244 posterior teeth examined, 928 (11.25%) had pulp stones in the pulp chamber. These pulp stones were detected in 76(37.6%) of males and 230 (51%) of females. The frequency of pulp stones among different teeth between maxillary and mandibular arches had almost a similar pattern. Among teeth demonstrating the condition, first molars were the most prevalent, followed by second molars. In maxillary molars the frequency of occurrence (26%) was higher than mandibular molars (18.7%). No Significant difference was found between dental status and pulp stones occurrence.

CONCLUSION

The occurrence of pulp stones noted in this study was significantly higher in female, molar teeth than premolar and 1st maxillary molar than mandibular. There was no significant association between pulp stone and condition of the crown.