Dental Pulp Calcification Research Articles

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.

The status of dental and jaw bones in children and adolescents after kidney and liver transplantation

Systemic complications in patients after renal or liver transplantation may be localized in the oral cavity. Calcium-phosphate disturbances may affect the structure and metabolism of mandible bones, promote calcification of dental pulp, and in children may cause developmental defects of teeth. The aim of this study was to evaluate the incidence of dental and bone abnormalities in children and adolescents after kidney and liver transplantation with respect to the type of the transplanted organ and maintenance immunosuppression. Overall, 23 kidney and 25 liver recipients (mean age: 13.95±4.2 yrs) were evaluated. Twenty patients received ciclosporin A (CsA) and 28 tacrolimus (TAC). Twenty-one kidney and 14 liver recipients were treated with steroids. Mean time after transplantation was 3.62±2.98 years. The severity of caries and percentage of odontogenic abnormalities (76.0% vs. 60.86%) was higher in liver transplant recipients. Positive correlations were found between discoloration of the deciduous teeth and liver transplantation, between enamel hypoplasia and kidney transplantation, and between treatment with CsA and its dose and blood concentration (p<0.05). Pulp stones were present in 13.04% of kidney vs. 8.0% in liver recipients, more often in those treated with CsA than with TAC. Jaw bone abnormalities were present in 30.43% kidney recipients vs. 12% liver recipients. Both kidney and liver recipients present dental and bone abnormalities. The incidence of specific types of oral lesions is different in renal and liver graft recipients; however, it is also correlated with specific immunosuppression.

Evaluation of the interaction between calcifying nanoparticles and human dental pulp cells: a preliminary investigation

Calcifying nanoparticles (CNPs, previously called nanobacteria) are self-propagating, cultivable macromolecular complexes. Their extraordinary characteristic is that they can aggregate carbonate apatite on their envelope from soluble calcium and phosphorus at physiologic concentrations and display cytotoxic effects on murine and human fibroblast cell lines. The question arises whether CNPs contribute to the degeneration of pulp tissue and thus result in clinically significant human dental pulp stones as nidies. This study evaluates CNPs’ effects upon human dental pulp cells (HDPCs, the host cells in pulp tissue). We observed the ultrastructural variation of HDPCs attacked by CNPs. The spatial relationship of HDPCs and CNPs after coculture was also identified by immunofluroscence staining. Furthermore, it was verified by MTT viability assay that CNPs isolated from dental pulp stones exerted cytotoxic effect on HDPCs. Therefore, it could be concluded that the existence of CNPs might interfere with the normal physiologic function of the cells, and that might lead to dental pulp calcification. Elucidation of the cytotoxic characteristics of CNPs may offer a new perspective for understanding the etiology of human dental pulp stones.

High Glucose Levels Increase Osteopontin Production and Pathologic Calcification in Rat Dental Pulp Tissues

Introduction Pulp stones are frequently formed as a pathologic calcification product in dental pulp tissues, but the pathogenesis is poorly understood. We previously found that osteopontin (OPN) was produced by dental pulp cells, and its expression was associated with formation of the pulp stone matrix. It was reported that amorphous calcification appeared in the dental pulp of diabetic patients. The aim of this study was to determine the relationship between OPN expression and pathologic calcification in rat diabetic pulp. Methods The effect of glucose on OPN production and alkaline phosphatase activity in cultured rat dental pulp cells (RPC-C2A) was investigated, and then dental pulp calcification and OPN expression in diabetic rats were determined and compared with those in healthy rats by histologic and immunohistochemical analyses. Results In RPC-C2A cells, biochemical analysis showed that a high concentration of glucose (50 mmol/L) increased OPN protein production and alkaline phosphatase activity 1.3-fold and 1.5-fold, respectively. Histologic observations showed more calcified particles in dental pulp tissues in diabetic than in nondiabetic rats. Moreover, a thickened layer of predentin was formed in the radicular pulp of diabetic rats. OPN was more strongly stained around the calcified particles and in the odontoblast zone under the thickened predentin in diabetic rats. Conclusions OPN might be a key molecule involved in the increase of pathologic pulp calcifications, which are frequently observed in diabetic patients.

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

The aim of this study was to determine the relationship between the presence of pulp calcification and carotid artery calcification on dental panoramic radiographs in end-stage renal disease (ESRD) patients on haemodialysis and renal transplant recipients. A total of 60 nephrology patients (29 haemodialysis patients and 31 renal transplant recipients) participated in this study. For all patients, both panoramic and periapical radiographs were evaluated twice by three examiners to determine the presence or absence of narrowing of the dental pulps and pulp stones in pulp chambers and canals. The kappa coefficient was used for intervariable agreement, and interexaminer reliability was evaluated by the intraclass correlation coefficient. Panoramic radiographs were also evaluated to determine carotid calcification. Ultrasound examination confirmed radiographic findings of carotid calcification on panoramic radiographs. Carotid calcifications were detected in 11 patients (6 haemodialysis patients and 5 transplant recipients). 48 patients (22 haemodialysis patients, 26 transplanted recipients) had dental pulp narrowing, and 8 patients (5 haemodialysis patients, 3 transplant recipients) had pulp stones. There was no statistical relation between pulp narrowing and carotid artery calcification (CAC) in the haemodialysis patient group and renal transplant recipients. There was also no statistical relation between pulp stones and CAC in haemodialysis patients and renal transplant recipients. In our study, no relationship was found between the presence of pulpal calcification and CAC in ESRD patients on haemodialysis and renal transplant recipients. Therefore, the presence of pulp calcification does not seem to serve as a diagnostic marker for carotid atherosclerosis.

A retrospective study of pulp healing after luxation injuries

To evaluate the prognosis of luxated permanent teeth and analyze the associated factors of pulp healing after luxation injuries. The dental records of patients presented for treatment due to luxation injuries at the Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology from January 2000 to December 2006 were collected, and the follow-up period was not shorter than six months. The following information was recorded, age and gender; type of injury; location of injured tooth; stage of root development; time elapsed between the injury and the first dental care; emergency treatment or not; pulp healing. Logistic regression was used to compare qualitative data and determine the associated factors of pulp healing after luxation injuries. The study was comprised of 157 patients with 238 luxated permanent teeth. The frequency of pulp necrosis was 16.0%, dental pulp calcification 2.1% and pulp survival 81.9%. The frequency of pulp necrosis was highest in intrusion (66.7%). The factors significantly affecting pulp healing were stage of root development and type of injury. The risk of pulp necrosis was greatest in intrusion. The stage of root development and the type of injury were significant factors related to pulp healing after luxation injuries.

Morphological and Histological Observation of Dental Pulp Calcification

Morphological and Histological Observation of Dental Pulp Calcification

Pilot Study of Correlation of Pulp Stones with Cardiovascular Disease

We propose that calcification of dental pulp may have a similar pathogenesis as calcified atheromas and could lead to use of routine dental radiographs as a rapid screening method for early identification of potential cardiovascular disease (CVD). Fifty-five dental patients ages 20 to 55 were chosen because pulp stones in pulpally noninflamed teeth were not expected in this age group. They completed a questionnaire regarding their CVD status and that of their parents and siblings. Entry criteria included at least one asymptomatic, minimally restored, noncarious molar and no history of gout, renal disease, or renal lithiasis. Patients’ periapical radiographs of record were viewed to determine the presence of pulp stones. There was a significant relationship between pre-existing CVD and pulp stones (odds ratio of 4.4 with a 95% confidence interval of 1.1, 18.7), but no relationship was found for family history of CVD and pulp stones (odds ratio of 1.7 with a 95% confidence interval of 0.5, 5.5). Seventy-four percent (14/19) of patients with reported CVD had detectable pulp stones while only 39% (14/36) of patients without a history of CVD had pulp stones. This pilot study demonstrates that patients with CVD have an increased incidence of pulp stones in teeth with noninflamed pulps compared to patients with no history of CVD. No relationship was found between presence of pulp stones and family history of CVD. The findings suggest that dental radiographic determination of the presence or absence of pulp stones may have possibilities for use in CVD screening.