Radiographic evaluation of teeth with pulp stones and pulp canal obliteration: characteristics, and associations with dental parameters.

The study aimed to radiographically assess the characteristics of pulp stones (PS) and pulp canal obliteration (PCO) in teeth and examined their associations with various dental parameters such as caries, restorations, periodontal status, and age. This cross-sectional observational study was conducted at the Faculty of Dentistry, King Abdulaziz University between September 2022, and May 2023, involved 101 patients exhibiting 402 teeth with PS or PCO. Data were collected from periapical and bitewing radiographs, and analyzed by two calibrated dentists. Multiple dental parameters were assessed, including caries level, presence and level of restorations, periodontal condition, and age of the patient. The study population consisted of 62 females and 39 males, with an age range of 18-65 years. Inter- and intra-examiner reliability were high (Kappa = 0.88 and 0.98 respectively). PS were more commonly found in molars (81.2%), while PCO were presented in only 115 teeth (23%). Age significantly affected the type of calcification (p < 0.001), with PS more common in the 20-30 age group and PCO more common in individuals over 40. Presence of caries was significantly associated with the type of calcification (p = 0.013), but restoration was not. The majority of teeth with PS (76%) or PCO (93%) had healthy periodontium. Around 40% of teeth with PCO showed signs of periapical changes, a finding significantly different from those with PS (p < 0.001). Pulp calcifications were significantly associated with various dental parameters, including caries presence, age, and periodontal status. The findings provide crucial insights into the epidemiology and aetiology of pulp calcifications.

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 Chi­square 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.

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.

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.

Radiographic Assessment of Occurrence of Pulp Stones in Molars of Selected Adult Nepalese Populations at Tertiary Care Center.

Background Pulp stones or "denticles" are a frequent finding in coronal and radicular pulp of primary and permanent dentition. These discrete calcified bodies can be seen in a healthy, diseased and sometimes even in an unerupted tooth. These calcifications are mostly present in molars as free, attached or embedded to dentine of pulp chamber or root canals. Objective To determine the occurrence of pulp stones in molars of selected adult Nepalese population using radiographs and assess the association of its occurrence gender and arch wise. Method A descriptive cross-sectional study was performed using orthopantomogram of total 380 patients (190 male and 190 females) of age group ranging from 16-30 years by convenience sampling. Data were collected through the examination of both hard and soft copies of radiographs under magnification. Pulp stones were scored as present or absent and their association with gender and dental arch were recorded. Descriptive statistics and chi square test was performed to see the prevalence and to compare the occurrence of pulp stone respectively. Result Out of 380 radiographic samples, pulp stones were present in 41.05% of the samples. The occurrence of pulp stones were found to be higher in females than in males, although the difference was not statistically significant (p=0.060).The total number of teeth with pulp stones was 238 and 61 in maxillary and mandibular arches respectively, with statistically significant difference (p<0.001). Conclusion The overall occurrence of pulp stone was found to be 41.05%. It was observed more in females (45.78%) than in males (37%) and more frequently located in maxillary molars (29.2%) than in mandibular molars (8.2%).

Prevalence of pulp stones in molars based on bitewing and periapical radiographs.

OBJECTIVE: To determine prevalence of pulp stones in molars of patients at the Institute of Dentistry Faculty of Medicine Vilnius University and to evaluate the association of pulp stones and gender, patient age, tooth condition. MATERIAL AND METHODS: Intraoral radiographs were reviewed using the Romexis program and pulp stones were assessed in molars.  Teeth were distributed into intact and non-intact. Information about patients' gender and age was collected. Data were processed using SPSS IBM (Statistical Package for the Social Sciences 22.0) program. Pearson's Chi-square test (χ2) was used. Results were considered to be statistically significant when the significance level of p<0.05. RESULTS: A total of 531 patients' bitewing and periapical radiographs of molars were evaluated. 2361 molars in total were assessed. Prevalence of pulp stones was 58.8% when pulp stones were found in at least one molar. Pulp stones were detected in 832 molars (35.24%). Patients from 18 to 93 years old were assessed. The highest pulp stones' occurrence was found in the age group from 38 years and older (71.07%). Non-intact maxillary right first molars and maxillary right and left second molars demonstrated a statistically significantly more frequent occurrence of pulp stones than intact molars (p<0.05). CONCLUSION: More than half of the participants had pulp stones in molars. Higher prevalence of pulp stones was associated with older age and decayed/filled teeth. There was no statistically significant difference between genders with regards to prevalence of pulp stones.

Prevalence of pulp stones in an Iranian subpopulation: an assessment using cone beam computed tomography.

Undetected pulp stones can complicate root canal treatment. Knowledge about the prevalence of this anomaly in specific populations can improve endodontic treatment outcomes. The objective of this study was to use cone beam computed tomography (CBCT) to assess the prevalence of pulp stones in an Iranian subpopulation. In this descriptive, analytical, cross-sectional study, the CBCT scans of 150 (75 female and 75 male) patients aged 15 to 70 years were retrieved from the 2017 to 2018 archives of an Iranian university. A total of 4200 teeth were evaluated for the presence of pulp stones by a senior dental student under the supervision of an experienced oral and maxillofacial radiologist. The panoramic radiographic views were evaluated first, and then each tooth was evaluated on sagittal, coronal, axial, cross-sectional, and multiplanar views with 0.5-mm slice thickness. Data regarding the presence of pulp stones as well as the effects of age, sex, tooth type, and jaw on the presence of pulp stones were analyzed using independent t and chi-square tests. Of 4200 teeth, 571 had pulp stones, yielding prevalence rates of 13.6% in the studied teeth and 76.0% in the study population. The prevalence of pulp stones was higher in female patients, the mandible, anterior teeth, and the mandibular left quadrant. The mandibular left central incisor (tooth 24) had the highest (38.7%) and the maxillary left second premolar (tooth 13) had the lowest (1.3%) prevalence of pulp stones. The high prevalence of pulp stones in this study population suggests that dentists should consider the possible presence of pulp stones when planning endodontic treatment for Iranian patients.

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.

Evaluación radiográfica de la frecuencia y distribución de los nódulos pulpares / Radiographic evaluation of the frequency and distribution of pulp nodules

Objetivos: Estimar la prevalencia de nódulos pulpares y agujas cálcicas en pacientes atendidos en la Cátedra de Endodoncia, Facultad de Odontología, Universidad de Buenos Aires (CEFOUBA). Se analizaron radiografías de 1866 piezas dentarias, con ápices maduros, de pacientes de ambos géneros, mayores de 15 años, tratados en CEFOUBA, en el período comprendido entre junio-noviembre de 2018. Género, edad, grupo dentario, condición del diente, presencia de patología sistémica, y ubicación anatómica, fueron las variables registradas. Se calcularon intervalos de confianza 95%, método score de Wilson. Se utilizó test z para diferencias de proporciones. El porcentaje de piezas con calcificaciones superó significativamente a piezas sin calcificaciones (z= 6,076; P<0,05). Porcentaje de piezas en mujeres fue significativamente mayor al de hombres (z=24,31; P<0,05). Porcentaje de piezas de las cuartas y quitas décadas de la vida (61%) superó significativamente a las demás décadas (39%) (z=9,88; P<0,05). El porcentaje de piezas con caries fue significativamente mayor al resto de las piezas con otras condiciones (41%) (z= 8,074; P<0,05). El porcentaje de piezas en pacientes sanos (77%) fue significativamente mayor al resto de las condiciones (23%) (z=24,310; P<0,05). El porcentaje de calcificaciones en cámara (78%) fue significativamente mayor a las del conducto (22%) (z=25,21; P<0,05). En conclusión, la presencia de este tipo de calcificaciones es frecuente en molares de pacientes femeninos y edad adulta. Es importante detectarlos radiográficamente porque complican la realización del tratamiento endodóntico, especialmente si están adheridos y obliteran la entrada de los conductos (AU)

Alteraciones dentarias en piezas sometidas a fuerzas de ortodoncia con técnica de Arco Recto / Dental alterations in pieces subjected to orthodontic forces with the straight wire technique

El objetivo fue evaluar radiográficamente las alteraciones dentarias en piezas sometidas a fuerzas ortodóncicas. Se analizaron 2871 piezas dentarias por observación radiográfica pre y post tratamiento. Variables registradas: sexo, edad, tipo de alteración, pieza dentaria y grado de reabsorción. Se calcularon intervalos de confianza 95% por método score de Wilson. Se utilizó prueba de bondad de ajuste Chi cuadrado, comparando frecuencias observadas con frecuencias esperadas bajo independencia. Se utilizó prueba de diferencia de proporciones, estadístico de Fisher y prueba Chi-cuadrado de asociación. Se concluyó que las alteraciones dentarias post tratamiento de ortodoncia son frecuentes y se originan en factores biológicos y mecánicos. La mayor tasa de prevalencia son las reabsorciones radiculares. Es responsabilidad del ortodoncista conocer todos los factores de riesgo con el fin de prevenirlas o detenerlas a tiempo (AU)

Assessing the Prevalence and Association of Pulp Stones with Cardiovascular Diseases and Diabetes Mellitus in the Saudi Arabian Population-A CBCT Based Study.

The detection of pulp stone in a patient suffering from undiagnosed systemic diseases can be an early diagnostic indicator. Thus, the aim of the study was to assess the prevalence of pulp stones in the Saudi Arabian population with cardiovascular diseases and diabetes mellitus. In a retrospective study, we included cone-beam computed tomography (CBCT) scans of 73 patients with cardiovascular disease and 76 patients with diabetes mellitus as group I and II, respectively. Group III comprised of CBCT scan of 80 healthy controls. From a total of 229 scans, 4807 teeth were screened for pulp stones throughout the arches. A chi-square test was used for comparing the prevalence of pulp stones among the groups. Univariable and multivariable analysis was done to evaluate the independent risk indicators for pulp stones. The tooth-wise prevalence of pulp stones in group I, II, and III was found to be 16.65%, 9.01%, and 3.86%, respectively. Patient-wise (p < 0.01) and tooth-wise (p < 0.01) prevalence was recorded significantly highest in the cardiovascular group followed by the diabetic group. The control group had the least prevalence. Significantly (p < 0.01) higher number of pulp stones were found in cardiovascular patients with age > 50 years compared to other groups. Similarly, a significantly increased number of pulp stones were seen in the 1st molar (p < 0.05) and the maxillary jaw (p < 0.05) of patients with cardiovascular diseases. Subjects with cardiovascular disease and diabetes were found to have 2.94 times (p < 0.001; CI 1.54-3.10) and 1.81 times (p < 0.01; CI 0.48-2.06) higher risk of having pulp stones in comparison to healthy subjects. The first molar has 2.20 times (p < 0.001; CI 0.84-2.45) increased the risk of having pulp stones compared to other tooth types. Systemic disease such as cardiovascular disease and diabetes mellitus poses a higher risk for the development of pulp stones. Among the systemic disease group, patients in the cardiovascular group showed a higher risk for pulp stones and also reported the maximum number of pulp stones compared to the diabetic and healthy subjects.

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.

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.

Prevalência de nódulos pulpares em molares: análise em tomografia computadorizada de feixe cônico / Prevalence of pulp stones in molars: a cone-bean computed tomographic evaluation

Nódulos pulpares são calcificações presentes na câmara pulpar, aderidos nas paredes dentinárias ou como nódulos soltos e podem bloquear parcialmente ou totalmente o acesso aos orifícios dos canais radiculares. Devido à limitação de estudos realizados anteriormente com radiografias, o objetivo desse trabalho foi determinar a prevalência de nódulos pulpares por meio da tomografia computadorizada de feixe cônico (TCFC) e explorar qualquer correlação potencial entre a ocorrência de nódulos pulpares com gênero, idade, dente, arcada e estado da coroa dentária. Para isso foram utilizadas TCFC de 300 pacientes, totalizando 631 molares. Todos os molares foram analisados nos planos sagital, axial e coronal e, quando presentes, os nódulos pulpares foram identificados como uma massa redonda ou oval hiperdensa. Após tabulação dos dados, a análise estatística foi realizada através da aplicação de testes de qui-quadrado. De um total de 300 pacientes, os nódulos pulpares foram identificados em 35% e em 25.5% dos 631 molares analisados. A presença dos nódulos pulpares foi mais frequente no sexo feminino (41.1%) do que no masculino (27.7%) e nos indivíduos com idade acima de 80 anos. Os primeiros molares superiores exibiram a maior incidência de nódulos pulpares. Nenhuma diferença significativa foi observada quando os arcos maxilar e mandibular e os lados foram comparados. A presença de nódulos pulpares foi elevada em molares restaurados quando comparados aos dentes íntegros (P <0,05). A Tomografia Computadorizada de Feixe Cônico é um recurso eficiente para o diagnóstico e localização dos nódulos pulpares(AU)

Pulp stones are calcifications present in the pulp chamber adhered to dentin walls or as loose nodules and can partially or totally block access to root canals entrance. Due to radiographic limitation of previous reports, the objective of this study was to determine the prevalence of pulp stones by cone beam computerized tomography (CBCT) and to explore any potential correlation between the occurrence of pulp stones with gender, age, tooth, arches and condition of the dental crown. CBCT of 300 patients were assessed, totaling 631 molars. All molars were analyzed in the sagittal, axial and coronal planes and, when present, pulp stones were identified as a round or oval hyperdense mass. After data tabulation, statistical analysis was performed using chi-square tests. Of a total of 300 patients, pulp stones were identified in 35% and in 25.5% of the 631 analyzed molars. The presence of pulp stones was most frequently found in females (41.1%) than in males (27.7%) and in individuals aged over 80 years. The first upper molars showed the highest incidence of pulp stones. No significant difference was observed when maxillary and mandibular arches were compared neither sides. The presence of pulp stones was higher in restored molars when compared to intact teeth (P <0.05). Cone Beam Computerized Tomography is an efficient resource for the diagnosis and location of pulp stones(AU)

A Retrospective Analysis of Pulp Stones in Patients following Orthodontic Treatment.

AIM: The present study aimed to find prevalence of pulp stones in known South Indian orthodontic patients and to find correlation between pulp stones and patients who underwent orthodontic treatment as well as to reveal any differences due to gender, tooth type, and dental arches. MATERIALS AND METHODS: The present retrospective study was carried out among 200 patients who underwent nonextraction orthodontic treatment. Maxillary and mandibular first and second premolar and molar teeth were selected for the purpose of the study using panoramic radiographs. A total of 3200 teeth of 200 patients were studied for the presence of pulp stones. Statistical analysis of the obtained data was carried out using Statistical Package for Social the Sciences (SPSS) version 22.0. Chi-square test was applied to find the significant value and p < 0.05 was considered as a significant value. RESULTS: In all, 11.5% of cases reported pulp stones before the commencement of the orthodontic treatment and 15.5% cases after completion of orthodontic treatment. Overall, 4% increase in cases were found which was statistically significant (p < 0.05); 5.1% of total number of teeth were evaluated in both arches before orthodontic treatment and 6.3% of teeth after orthodontic treatment revealed the presence of pulp stones. Maxillary first molar was found to be teeth with maximum number of pulp stones before and after orthodontic treatment. CONCLUSION: The present study reported the prevalence of pulp stones to be increased by 4% in the pre- and posttreat-ment radiographs, which was statistically significant. The study found the presence of pulp stones more in maxillary first molar and it was found to be teeth with maximum number of pulp stones before and after orthodontic treatment. However, further researches with larger samples are advisable. CLINICAL SIGNIFICANCE: Dentists performing endodontic treatment among patients who have undergone orthodontic treatment should be aware about the increased chances of presence of pulp stones and thus to avoid hindrances encountered during extirpating the pulp, they should thoroughly study the radiographs beforehand.

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.

Association of sickle cell haemoglobinopathies with dental and jaw bone abnormalities.

OBJECTIVE: To estimate the association between sickle cell anaemia and trait with dental and jaw bone abnormalities. SUBJECTS AND METHODS: Subjects (n = 369) were allocated to three groups: sickle cell anaemia, trait and control. Dental shape, number, size and position and changes in pulp chamber, root and periapex were analysed by intra-oral periapical radiographs. Integrity of lamina dura, quality of cancellous bone and bone trabeculation were also evaluated. Prevalence ratios (PR) were calculated (α = 0.05). RESULTS: Sickle cell anaemia had higher prevalence (PR:8.31) and number of teeth (PR:13.40) with external resorption; higher number of teeth with pulp calcification; partial and total loss of lamina dura; and higher prevalence of changes in trabecular structure of maxilla (PR:6.45) and mandible (PR:5.34). Sickle cell trait showed higher prevalence (PR:1.26) and higher number of teeth (PR:1.98) with partial loss of lamina dura; higher number of teeth with hypercementosis, changes in shape, size, periapex, total loss of lamina dura; and higher prevalence of changes in mandibular trabecular bone (PR:1.43). CONCLUSION: Pulp calcification and external resorption of the root were the most frequent dental alterations in sickle cell anaemia group, while in trait was higher frequency of changes in shape, size, periapex and root. Jaw bone changes were most prevalent in both homozygous and heterozygous subjects.

Revascularization-associated Intracanal Calcification: Assessment of Prevalence and Contributing Factors.

INTRODUCTION: Intracanal calcifications have been reported in endodontic cases after revascularization. The purpose of the current study was to determine the incidence of intracanal calcification and potential contributing factors in retrospective revascularization cases. METHODS: Among 37 patients who had undergone revascularization between 2010 and 2014, 29 cases were assessed with average follow-up period of 24.9 months. Clinical and radiographic examinations were performed to evaluate the treatment outcomes, eg, resolution of apical periodontitis (AP), root development, and occurrence of intracanal calcification. Radiographic assessment revealed varied calcification patterns, which were classified into calcific barrier or canal obliteration, collectively referred to as revascularization-associated intracanal calcification (RAIC). RESULTS: All 29 cases demonstrated resolution of AP, whereas continued root development with apical closure occurred in 23 of 29 cases (79.3%). RAIC was noted in 18 of 29 cases (62.1%), among which 5 of 18 cases (27.8%) were classified as calcific barrier and 13 of 18 cases as canal obliteration (72.2%). Higher frequency of RAIC was noted in the cases with induced bleeding (16 of 23 cases, 69.6%), whereas the 6 cases without induced bleeding showed RAIC at 33.4%. Also, RAIC occurred more frequently in cases medicated with Ca(OH)2 (10 of 13 cases, 76.9%) than in those medicated with antibiotic pastes (6 of 13 cases, 46.2%). CONCLUSIONS: This study indicated that RAIC is common (62.1%) among cases treated with revascularization. Multiple contributing factors may include the type of medicaments and induction of intracanal bleeding. Although RAIC does not interfere with resolution of AP, some cases may progress to complete obliteration of root canals and would impede normal function of dental pulp tissues.

Dental pulp stone formation during orthodontic treatment: A retrospective clinical follow-up study.

OBJECTIVE: The aim of this study was two-fold: (1) To assess the incidence of dental pulp stone formation during orthodontic treatment, and (2) to determine the correlations between the presence of dental pulp stones and age, gender, and dental arches. MATERIALS AND METHODS: A sample of 545 patients (334 girls and 211 boys, age range; 12-22 years) who had undergone nonextraction orthodontic treatment were included in this study. 8442 teeth (T1) and 8410 teeth (T2), including the first and second maxillary and mandibular premolars and molars were evaluated from the pre- (T1) and post-treatment (T2) panoramic radiographs of the patients. The Pearson Chi-square test was used to investigate the associations between the presence of dental pulp stone, gender, age, tooth type and arches. RESULTS: Dental pulp stones were detected in 3% of the teeth at pretreatment panoramic radiographs and 5.2% of the teeth at posttreatment panoramic radiographs. Pulp stone prevalence increased pointedly (2.2%) in the pre- and post-treatment radiographs (P < 0.001). Also, there was a significant difference between the age groups (P < 0.001). In the maxilla, dental pulp stones were found significantly more than that in the mandible at T1 and T2 panoramic radiographs. Maxillary first molars exhibited dental pulp stones the most frequently, followed by the maxillary second molars and mandibular first molars. CONCLUSION: Orthodontic treatment may trigger the formation of dental pulp stones. However, further studies are required to determine the relationship between the pulp stone formation and orthodontic treatment.

Assessing pulp stones by cone-beam computed tomography.

OBJECTIVES: The aim of this study was to evaluate the occurrence of pulp stones by cone-beam computed tomography (CBCT) and to correlate their prevalence with patient's gender, location of tooth (right or left of maxillary or mandibular arch), group of teeth, and restorations. MATERIALS AND METHODS: CBCT images of 382 patients randomly selected from the database of the University Oral Radiology Department were retrospectively examined. A total of 2833 tooth images obtained using the i-CAT 3D Imaging System were evaluated. Image analysis was performed with the i-CAT software, and all teeth were evaluated in sagittal, axial, and coronal views. All the measurements were subjected to chi square test, odds ratio, and Fisher's exact tests (p < 0.05). RESULTS: The prevalence of pulp stones was similar between patient's genders and tooth locations. Pulp stones were detected in 31.9% of patients and 9.5% of teeth. Maxillary and mandibular molars were the groups of teeth with the highest frequency of pulp stones. The presence of restorations increased the chance of occurrence of pulp stones by 2.1 times in all teeth examined (p < 0.0001) and by 4.7 times in maxillary teeth (p < 0.0001). CONCLUSIONS: Pulp stones had a high prevalence with molar teeth showing the highest prevalence. The presence of restorations increased the chance of occurrence of these calcifications, specifically in maxillary teeth. CLINICAL RELEVANCE: CBCT provides accurate anatomical details in three dimensions, offering the possibility to view an individual tooth in axial, sagittal, and coronal views. This study performed an investigation of the occurrence of pulp stones by CBCT.