Dental Pulp Calcification Research Articles

Investigation of genetic polymorphisms in genes encoding growth factors and dental pulp calcification in orthodontic patients

Background and objectivesPulp calcification is associated with many factors and triggers, including individual genetic predisposition and orthodontic forces. This study aimed to investigate whether genetic polymorphisms in epidermal growth factor (EGF), epidermal growth factor receptor (EGFR1), transforming growth factor-beta 1 (TGFβ1), and transforming growth factor-beta receptor 2 (TGFβR2) are associated with a risk of dental pulp calcifications in orthodontic patients. Materials and methodsDigital orthopantomography (OPG) and genomic DNA from 132 patients were analyzed in this cross-sectional study. Pulp calcification was observed in the maxillary and mandibular first molars. Genomic DNA extracted from saliva cells was used to genotype eight genetic polymorphisms using real-time polymerase chain reaction: EGF (rs2237051 and rs4444903), EGFR (rs2227983 and rs763317), TGFβ1 (rs1800469 and rs4803455), and TGFβR2 (rs3087465 and rs764522). The association between pulp calcification and genetic polymorphisms was analyzed using allelic and genotypic distributions, and haplotype frequencies (P < 0.05). ResultsThe prevalence of pulp calcification was 42.4 % in 490 molars. Genotypic analysis and allelic distribution showed no statistically significant association between the evaluated growth factors and molar calcification (P > 0.05). No haplotype combinations showed a statistically significant difference (P > 0.05). ConclusionThe genetic polymorphisms investigated were not associated with dental pulp calcification in orthodontic patients. Further studies should investigate other polymorphisms in genes encoding growth factors.

Correction: The investigation of WNT6 and WNT10A single nucleotide polymorphisms as potential biomarkers for dental pulp calcification in orthodontic patients

Correction: The investigation of WNT6 and WNT10A single nucleotide polymorphisms as potential biomarkers for dental pulp calcification in orthodontic patients

Dental pulp stones and their correlation with metabolic diseases.

Dental pulp calcifications or pulp stones are calcified structures found in dental pulp, mostly around or enclosing a blood vessel. The formation of these calcifications begins with concentric layers of calcified tissue within which remnants of necrotic and calcified cells may be present. The calcifications of thrombi in blood vessels, called phleboliths, may also serve as nidi for denticles. In metabolic diseases such as diabetes, hypertension or poor periodontal health, there are obvious changes in blood vessels and vascularization. In our study, we observed histopathological sections of dental pulp and correlated systemic diseases such as diabetes and hypertension with poor periodontal health and dental pulp stones. The aim of our study was to evaluate the histopathology of dental pulp stones, their distribution among various age groups and sexes and to identify any correlations between pulp stone formation and systemic diseases such as type II diabetes and hypertension. Samples from 100 patients with metabolic diseases such as type II diabetes and hypertension were collected. The pulp was extirpated from the teeth that were undergoing root canal treatment, and the teeth were extracted. The collected pulp sample was fixed in 10% formaline neutral buffer, subjected to routine histopathological procedures and stained with haematoxylin and eosin. The pulp of teeth extracted for orthodontic treatment was considered a control for patients with no metabolic disease. There was a definite relationship between increased pulp stones and metabolic diseases such as type II diabetes and hypertension; likewise, poor periodontal health was significantly related to pulp stones.

The investigation of WNT6 and WNT10A single nucleotide polymorphisms as potential biomarkers for dental pulp calcification in orthodontic patients.

The aim of this study is to evaluate if single nucleotide polymorphisms (SNPs) in WNT6 and WNT10A are associated with the risk of dental pulp calcification in orthodontic patients. This cross-sectional study followed the "Strengthening the Reporting of Genetic Association Studies" (STREGA) guidelines. Panoramic radiographs (pre- and post-orthodontic treatment) and genomic DNA from 132 orthodontic patients were studied. Dental pulp calcification (pulp stones and/or pulp space narrowing) was recorded in upper and lower first molars. The SNPs in WNT6 and WNT10A (rs7349332, rs3806557, rs10177996, and rs6754599) were assessed through genotyping analysis using DNA extracted from buccal epithelial cells. The association between pulp calcification and SNPs were analyzed using allelic and genotypic distributions and haplotype frequencies (p<0.05). Prevalence of dental pulp calcification was 42.4% in the 490 studied molars. In the genotypic analysis, the SNPs in WNT10A showed a statistically significant value for molar calcification (p = 0.027 for rs1017799), upper molar calcification (p = 0.040 for rs1017799) (recessive model), and molar calcification (p = 0.046 for rs3806557) (recessive model). In the allelic distribution, the allele C of the SNP rs10177996 in WNT10A was associated with molar calcifications (p = 0.042) and with upper first molar calcification (p = 0.035). Nine combinations of haplotypes showed statistically significant value (p<0.05). The findings of this study indicates that SNPs in WNT10A and WNT6 are associated with dental pulp calcification in molars after orthodontic treatment and may be considered as biomarkers for dental pulp calcification.

Prevalence of Development of Dental Pulp Calcifications in Molars following Orthodontic Treatment - A Clinical Retrospective Study

Abstract Aim: This study aims to find the prevalence of pulp calcifications and their correlations with age, gender, tooth type, dental arches, or their location in patients following orthodontic treatment. Materials and Methods: The sample comprised 150 patients (15–25 years) who underwent orthodontic treatment. Pre- and posttreatment panoramic radiographs were evaluated to detect pulp calcification. Pearson Chi-square test was used to investigate the associations between pulp calcification and gender, age, tooth type, dental arches, and their location. Results: The statistical analysis showed that pulp calcification increased significantly from 35.30% to 50% (P &lt; 0.05). They were significantly higher in mandibular molars than in maxillary molars. Radicular and coronal calcifications were present concomitantly in maximum cases followed by radicular and coronal pulp calcification occurring independently. Conclusion: The results of this study showed that the number of dental pulp calcification increased significantly after orthodontic treatment.

Pulpal calcifications in orthodontically moved teeth: Scoping review.

The application of forces during orthodontic treatment can induce pulpal calcifications, characterized by the deposition of mineralized tissue in the pulp cavity space, there may be repercussions on dental procedures, especially endodontic treatment. The objective of this article is to map the scientific evidence and any gaps in knowledge regarding the relationship between orthodontics and dental pulp calcifications. The study comprised a scoping review whose guiding question was: "What is the scientific evidence of the association between pulpal calcifications and orthodontic treatment?" Two independent reviewers searched the PubMed, Scopus, and Web of Science databases and the grey literature. Original articles and observational and clinical trials, which addressed the repercussions on the pulp cavity of teeth submitted to orthodontic treatment, were included. There was no language restriction or limitation of the year of publication until October 2022. After critical reading and applying the eligibility criteria, 11 studies were included in this scoping review: six observational and five experimental studies. A statistically significant association of orthodontic treatment with changes in pulp cavity volume and increased incidence of pulp stones was observed among the studies findings. The orthodontic force can promote changes in the dental pulp that may cause direct implications in other dental treatments, especially endodontic treatment. Key words:Dental pulp calcifications, pulp node, pulp obliteration, orthodontic treatment, orthodontics.

Causes, diagnosis and treatment strategies for dental pulp calcification

Dental pulp calcification can lead to root canal stenosis or obliteration. It is usually difficult to negotiate the root canal if the affected tooth needs to be treated and intraoperative complications are easily brought about during the root canal treatment. The etiologies of dental pulp calcification are complicated and careful considerations should be given to the diagnosis and treatment. Only by weighing the advantages and disadvantages can appropriate treatment plan be chosen. Based on the literature and authors' clinical experiences, the present article summarizes the causes, pathogenesis, diagnosis and treatment strategies of dental pulp calcification, in order to provide some references in diagnosis and treatment for the dental clinicians.

The Relationship between Coronary Atherosclerosis and Dental Pulp Calcification

Modern Research in Dentistry The Relationship between Coronary Atherosclerosis and Dental Pulp Calcification Helen Rushdi Ayoubi* Assistant Professor, Department of Endodontics and Operative Dentistry, Faculty of Dentistry, Damascus University, Damascus, Syria *Corresponding author:Helen Rushdi Ayoubi, Department of Endodontics and Operative Dentistry, Faculty of Dentistry, Damascus University, Fayez Mansour Street, P.O. BOX: 30621, Mazzeh Highway, Damascus, Syria Submission: August 06, 2021;Published: September 02, 2021 DOI: 10.31031/MRD.2021.06.000646 ISSN:2637-7764Volume6 Issue5

Hyperphosphatemic Familial Tumoral Calcinosis Hidden in Plain Sight for 73 Years: A Case Report

While dental pulp calcifications and root anomalies may be inconsequential incidental findings in dental radiographs, they can, especially in combination, represent a clue, hidden in plain sight, for the diagnosis of hyperphosphatemic familial tumoral calcinosis (HFTC). HFTC is an autosomal recessive disease of mineral metabolism characterized by sometimes massive, painful calcification around large joints, systemic inflammation, dental pulp calcification, and thistle-shaped roots. This paper describes a woman with HFTC who endured not only the symptoms of HFTC for decades, but also the frustration of not knowing the cause. The diagnosis was finally made at the age of 73 years, when the connection between a large right shoulder calcification and hyperphosphatemia was made. The dental findings were likely present on her initial radiographs taken in childhood. Increased awareness of the association between characteristic dental findings and HFTC may allow for earlier diagnosis and interventions to improve the care of patients with this rare condition.

Effects of advanced glycation end products on dental pulp calcification.

The main aim of this study was to elucidate the effects of advanced glycation end products (AGEs) on the calcification of cultured rat dental pulp cells (RDPCs) and to investigate the crystallisation ability of glycated collagen. AGEs were prepared via non-enzymatic glycation of a dish coated with type I collagen using dl-glyceraldehyde. To investigate the effects of AGEs on RDPCs, we performed WST-1 and lactate dehydrogenase assays; alkaline phosphatase, Alizarin Red S and immunohistochemical staining; and real-time quantitative reverse transcription PCR. In addition, we performed crystallisation experiments on glycated collagen. All microstructures were analysed using scanning electron microscopy/energy-dispersive X-ray spectroscopy and transmission electron microscopy/diffraction pattern analysis. AGEs did not affect the proliferation or differentiation of RDPCs, but enhanced the calcification rate and cytotoxicity. No major calcification-related genes or proteins were involved in these calcifications, and glycated collagen was found to exhibit a negative polarity and form calcium phosphate crystals. Cytotoxicity due to drastic changes in the concentration of pericellular ions led to dystrophic calcification, assumed to represent an aspect of diabetic pulp calcifications. Glycated collagen-containing AGEs provide a nurturing environment for crystallisation and have a significant effect on the early calcification of RDPCs.

Dental pulp calcifications in prehistoric and historical skeletal remains

BackgroundThe 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. MethodsThe 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. ResultsThe 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. ConclusionWhen 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.

Endodontic treatment of a hypertaurodontic mandibular left second molar in a patient with many taurodonts combined with multiple pulp stones

Taurodontism is a rare embryologic anomaly of teeth, defined by an apical displacement of the furcation of roots and enlarged pulp chambers. Taurodontism has been classified as hypo-, meso- or hypertaurodontism according to the severity of the anomaly. The aim of this case report was to illustrate a clinical case with multiple bilateral taurodonts and to describe the endodontic management of the hypertaurodontic mandibular left second molar with a C-shaped canal and extensive dental pulp calcifications. A healthy 20-year-old male patient was referred for the endodontic treatment of his lower left second molar. Cone beam computed tomography revealed a C-shaped root canal configuration and several dental pulp calcifications in this tooth. The endodontic treatment was performed in two appointments under an operating dental microscope. A panoramic radiograph, made during the 18months follow-up appointment, revealed nine other taurodontic molars, most of them associated with dental pulp calcifications.

Age-related morphological, histological and functional changes in teeth.

Throughout lifetime, the teeth are continuously exposed to numerous chemical and physical impacts, which cause the wear of the dental hard tissues, gingival recession and other oral changes with sometimes subsequent problems. Age-related wear of tooth surfaces reduces the dental enamel thickness and exposes deeper layers of enamel, which have different physical and chemical properties than the surface enamel. Gingival recession is the main causal factor of root caries and dentine hypersensitivity. Age-related changes in dentine include the formation of secondary dentine and the reduction in tubular lumen diameter (dentine sclerosis), which lead to a reduction in the volume of the pulp chamber. In addition to the reduction in the volume of pulp chamber, changes to the dental pulp also include dental pulp calcifications. The age-related physiological changes to the teeth should be carefully distinguished from pathological changes, especially when they induce pain or a negative impact on the oral health-related quality of life (OHRQoL) of the older individuals. Therefore, regular oral examinations coupled with early preventive measures should aim at maintaining oral health until old age.

Use of Raman spectroscopy for diagnosis of disease in dental tissue

Raman spectra of samples of tooth enamel, dentin, and cement were obtained using an experimental unit for noninvasive study of tooth surfaces, carious cavities, and dental pulp calcifications. This spectral analysis enabled us to study the distribution of mineral and organic components in solid tooth tissue, both under healthy conditions and when teeth are damaged by caries, as well as to investigate tooth pulp calcification. We developed criteria for the identification of these pathologies. The ratio of the intensities at 1069 and 870 cm−1 remains constant in solid tissues, even in the event of caries formation, while tooth calcifications that include pulp degeneration typically show an increase in the ratio of the intensities at these wave numbers; this increase may be used in the diagnosis of fibrotic pulpite. Enamel typically shows elevated replacement of the hydroxyl group by the (CO3)2− anion in apatite, with reduced substitution of the PO43− anion by (CO3)2−. The opposite process is observed in pathological processes such as caries and calcification.

Pulp Obliteration in a Patient with Sclerodermatous Chronic Graft-versus-Host Disease

Dental pulp calcification is a common finding associated with localized dental trauma, genetic disorders, and systemic inflammatory diseases. Chronic graft-versus-host disease (cGVHD) is a frequent complication after allogeneic hematopoietic cell transplantation (allo-HCT) characterized by immune-mediated injury to the skin, mouth, eyes, liver, and other tissues, resulting in significant disability and reduced quality of life. We report a patient with sclerodermatous cGVHD who presented with general pulp calcification in all teeth 5 years after allo-HCT. A review of full mouth dental radiographs obtained just before allo-HCT revealed normal-appearing pulp chambers. Based on prior reports of generalized pulp calcification associated with progressive systemic sclerosis, we hypothesized that the etiology was likely related to the presence of cGVHD with associated vascular and fibrotic tissue changes within the pulp vasculature. Clinicians should consider cGVHD in the differential diagnosis of generalized pulp calcification.

Prevalence of pulp stones in patients with history of cardiac diseases

Background: Calcification of dental pulp is said to have a similar pathogenesis as calcified atheromas in the artery. Pulp stones are discrete calcifications found in the coronal or radicular pulp. They contain organic material upon which calcium is deposited to form carbonate apatite, which is also the material found in calcifications in the vascular walls. Objective: The objective of the study is to report the correlation of pulp stones with that of cardiovascular diseases by radiographs. Materials and methods: Radiographs were collected from Saveetha Dental College and from the dental clinic of Frontier Lifeline Hospital. The study involved estimating the prevalence rates of pulp stones in radiographs of 30 cardiac patients and 30 other randomly collected radiographs (control group). Results: Pulp stones were present in 43.33% of cardiac patients. The prevalence was 40% in the control group. Conclusion: The prevalence of pulp stones in cardiac patients is moderately higher than that in the control group. Positive correlation is found between pulp stones and cardiovascular diseases.

Advanced glycation end products increase expression of S100A8 and A9 via RAGE-MAPK in rat dental pulp cells.

Advanced glycation end products (AGE) are involved in the progression of diabetic complications. Although our previous reports show that AGE increased dental pulp calcification, AGE accumulation is also associated with inflammation. This study examined AGE effect on the expression of inflammation factors using rat dental pulp tissues and cell cultures. Receptor for AGE (RAGE), S100A8, S100A9, and interleukin (IL)-1β were selected as inflammation parameters. Rat dental pulp cells were cultured and treated with AGE, and the effects were determined by real-time PCR. An anti-RAGE antibody or MAPK pathway inhibitors (PD98059, SB203580, and SP60012) were used to investigate AGE signaling pathway. The mRNA levels of RAGE, S100A8, S100A9, and IL-1β were higher in diabetic pulp tissues. AGE increased mRNA expressions of S100A8, S100A9, and IL-1β in cultured dental pulp cells. In the presence of anti-RAGE antibody, AGE did not increase in S100A8 or S100A9 expressions. The AGE-induced increases in S100A8 and S100A9 were inhibited by PD98059 and SB203580, respectively. Advanced glycation end products increased mRNA expression of S100A8, S100A9, and IL-1β under diabetic pulp conditions, and AGE-induced increases in S100A8 and S100A9 expressions may be associated with the RAGE-MAPK signaling pathway.

Conservative esthetic treatment of a discoloured calcified permanent tooth: five-year clinical evaluation

Objective: Pulp calcification can compromise toothcolor and negatively affect esthetics. Definitivetreatment for discolored anterior teeth withcalcification is usually provided by endodontictreatment with the use of internal and externalbleaching agents, as necessary. This article presentsthe conservative management of a vital tooth withan obliterated pulp chamber that led to changes intooth color. The benefits and limitations of the use ofin-office and home supervised bleaching techniquesare discussed.KeywordsTooth bleaching; Dental pulp calcification.

Potential Correlation between Statins and Pulp Chamber Calcification

Introduction3-Hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) are the first-line pharmaceuticals for the prevention and treatment of dyslipidemia. A recent investigation has shown that statins induced odontoblastic differentiation of dental pulp stem cells. Statins enhance the differentiation of human dental pulp cells by up-regulating mineralization nodules and odontogenic markers. This study tested the hypothesis that the systemic administration of statins results in increased dental pulp calcification. MethodsThis retrospective case-control study used digital bitewing radiographs of mandibular molars. Subjects (N = 90) aged ≥60 years were assigned to either test (n = 45) or control (n = 45) groups based on the systemic use of statins. The dimensions of the pulp chambers were measured using a standardized method for height and mesiodistal distances. The chi-square test was used to analyze the data. Multiple linear regression model analysis was performed to explore the association between statin intake and pulp calcification. ResultsThree of the 45 mandibular molars in the test group exhibited almost complete pulp chamber obliteration. There was a significant reduction in pulp chamber height ratio shown in the statin group compared with the control group (P < .0001). When the mesiodistal width was compared between the 2 groups, there was no significant difference (P = .3730). ConclusionsThe significant increase of calcification and loss of vertical height of the pulp chamber observed in mandibular molars in patients on statin medication indicated a possible increased odontoblastic activity. Therefore, systemic statins could be a contributing factor for pulp chamber calcification.

Idiopathic dental pulp calcifications in a tertiary care setting in South India

Background:Dental pulp calcifications are unique and represent the dental pulp regenerative process. Dental pulp calcifications are sometimes routine findings in oral radiographs and may later serve as an important diagnostic criterion for a hidden aspect of systemic illness.Objective:The purpose of this study was to assess the patterns and prevalence of idiopathic dental pulp calcifications in a tertiary care setting in South India.Materials and Methods:A total of 227 patients were included in the study fulfilling the inclusion criteria. Age range of the study population was from 15 to 70 years. Teeth were examined under digital panoramic radiograph. The presence or absence of pulp stones was recorded. The presence of pulp stone were categorized according to the types classified as Type I, Type IA, Type II, Type IIA, Type II B, and Type III. The frequency of occurrence of pulp stones with sex, tooth type, dental arches, and types were compared with the types of calcification.Results:Total no. of patients with pulpal calcification were 227 [females 133 (58.59%) and males 94 (41.40%)]. The most common type between both sexes was Type I (48%). Total no. of teeth with calcification was 697; maxilla (48%), mandible (52%). The prevalence of pulp stone was found to be higher in the molars in both the arches. Most no. of pulp stones are reported at the third and fourth decade of life.Conclusion:Idiopathic dental pulp calcifications are incidental radiographic findings of the pulp tissue and also may be an indicator of underlying disease.