Pulpal Reactions Research Articles

Comparative Evaluation of Deciduous and Permanent Coronal Caries Using Polarizing Light Microscopy and Scanning Electron Microscopy.

Background: Dental caries causes mineral loss and organic damage to teeth. Understanding caries and dentin pulp reactions is crucial for effective caries management strategies. There is a lack of knowledge regarding the microscopic and ultramicroscopic changes that occur during caries destruction and reactive changes. This study used polarizing and scanning electron microscopy to compare deciduous and permanent coronal caries. Materials and Methods: The study included 30 teeth, comprising 15 primary and permanent teeth, all with coronal caries. They were also compared with 10 (5 each) noncarious primary and permanent teeth. The teeth were examined using polarizing and scanning electron microscopy to study enamel and dentin destruction, reactive dentin formation, peritubular dentin destruction, and bacterial colonization. Results: Deciduous teeth had more enamel and dentin destruction for coronal caries than permanent teeth in our study. The permanent teeth had more reactive dentin formation than primary teeth. Peritubular dentine alteration was increased in deciduous teeth, and bacterial presence on dentin was higher in permanent teeth under scanning electron microscope. Conclusion: Our findings suggest that caries destruction is more prevalent in deciduous teeth, and reactive response is more effective in permanent teeth affected by caries. These findings reflect the structural durability of the mineralized tissues and prompt reactive response of the dentin pulp complex of permanent teeth compared to deciduous teeth. Our research highlights the importance of identifying and treating decay in primary teeth at an early stage.

Histological Evaluation of Polyacid-Modified Composite Resin and Conventional Composite Resin Used for Primary Molars Restoration.

Background: The present study evaluated the histological outcomes of two dental restorative materials, polyacid-modified composite resin (compomer) and conventional composite resin, in the primary molars of puppies. Materials and Methods: Twenty sound primary molars in four puppies were used. The puppies were rendered unconscious using general anesthesia. Similar cylindrical Class V cavities were prepared in 16 of the 20 selected primary molars. The teeth were divided into three groups: Group I: Eight cavities were restored with compomer; Group II: Eight cavities were restored with conventional composite resin; Group III: Four teeth remained untreated and were used as controls. In Groups I and II, four teeth were examined histologically after 2 weeks and the other four after 6 weeks. The histological findings were analyzed and compared to determine the effects of each type of resin material on the dentine and the pulp. Results: At 6 weeks, the specimens tested for compomer showed obvious destructive changes in the central region and the region of the pulp adjacent to the cavity. The specimens tested for conventional composite resin revealed, at 6 weeks, massive destruction of the pulp tissues and abscess formation was observed. All the specimens tested in the control group showed normal cellularity, normal vascularity, and proper alignment of odontoblast cells. Conclusions: The teeth restored with compomer demonstrated more favorable pulpal reactions when compared with the teeth restored with conventional composite resin after 6 weeks.

How does orthodontic tooth movement influence the dental pulp? RNA-sequencing on human premolars.

The objective of this study is to analyse the gene expression profile of the dental pulp (DP) of human premolars subjected to 7 and 28 days of orthodontic force (OF) in vivo by using RNA sequencing. The maxillary and mandibular DP were additionally compared. Healthy patients requiring orthodontic premolar extractions were randomly assigned to one of the three groups: control (CG) where no OF was applied, 7 and 28 days, where premolars were extracted either 7 or 28 days after the application of a 50-100 g OF. Total RNA was extracted from the DP and analysed via RNA-seq. Differentially expressed genes (DEGs) were identified using a false discovery rate and fold change threshold of <0.05 and ≥1.5, respectively. Functional analysis was performed. After 7 days of OF, pulp reaction indicates immune response, hypoxia, DNA damage and epigenetic regulation. After 28 days, cell adhesion, migration, organization and tissue repair are evident. The maxillary and mandibular pulp tissues react differently to OF. The maxilla exhibits minimal alterations, mostly related to immune response at 7 days and tissue repair at 28 days, whereas the mandible shows mostly DNA damage and epigenetic regulation at 7 days and return to the original state at 28 days. This study demonstrates that the early reaction of the DP to OF is marked by immune response, hypoxia and DNA damage. In contrast, after 28 days, cell adhesion, migration, organization, tissue repair and dentine formation are observed. Maxillary and mandibular premolars react differently to OF: although the maxilla exhibits minimal alterations at both time points, the mandible mostly shows DNA damage, epigenetic regulation, and immune response at 7 days. These disparities could stem from different blood supplies or the lower maxillary bone density, potentially triggering faster biological changes. Our findings provide insights into the gene regulatory networks modulating DP response to OF.

Clinical applications and improvement of resin bonding for PEEK in resin-bonded fixed dental prosthesis: A review

Resin-bonded fixed dental prostheses (RBFDPs) are a commonly used precision treatment, such as fixed dental prosthesis (FDP) and implant-supported dentures. Full crown preparation of vital teeth, which is required for traditional FDPs, may result in a risk of pulp reaction as a large portion of the coronal tooth structure must be removed. RBFDP has been recognized as a non-invasive or minimally invasive treatment modality for the replacement of single missing teeth. RBFDPs require much less tooth preparation than conventional FDPs. These dental treatments are restorative solutions used to cover missing teeth and achieve an aesthetic smile. The biomechanical rules, aesthetics, polishability, and bond strength have been emphasized in RBFDP treatments. Polyetheretherketone (PEEK) is one of the most widely used biomaterials in dentistry. The material, which stands out especially with its acceptable aesthetics, biocompatibility and modulus of elasticity close to dentin, has enabled it to be used in RBFDP treatments. Since PEEK is lighter than metal alloys, patients experience less discomfort and a feeling closer to natural teeth. Furthermore, the thermoplastic properties of PEEK are claimed to provide a precise fit, allowing the restoration to better integrate into the natural tooth structure. In addition, its ability to be customized using different modern manufacturing techniques is thought to offer dentists and patients a reliable option for successful long-term treatment. Our review is about the use of PEEK material as an alternative material in RBFDPs with low negative effects on periodontal tissues and their bonding with resins.

Histopathological Evaluation of Pulp Reaction to Potassium Nitrate in Polycarboxylate Cement Compared with Mineral Trioxide Aggregate in Immature Dogs' Teeth

Abstract Objective The vitality of the pulp and the formation of new dentin are important for the success of direct pulp capping (DPC). Accordingly, the present study aims to histologically evaluate the pulp reaction to potassium nitrate in polycarboxylate cement (KNO3/PCA) compared with mineral trioxide aggregate (MTA) in immature dogs' teeth. DPC was done on 48 teeth in three dogs (16 for each dog, 8 for each material). Materials and Methods After 2, 3, and 4 months, a dog was euthanized at each time interval. Capped teeth were extracted, demineralized, and processed for histopathological examination based on the presence of inflammation, granulation tissue, hard tissue, and dentin bridge. Results Inflammatory changes were absent in both MTA- and KNO3/PCA-capped teeth at the three time intervals. The incidence of granulation tissue formation was higher in MTA- (75, 87.5, and 87.5%) than in KNO3/PCA-capped teeth (62.5, 75, and 75%) after 2, 3, and 4 months after DPC, respectively. Hard tissue was seen after 3 months of DPC with both MTA and KNO3/PCA. It was more evident in MTA-capped teeth with an incidence of 75 and 75%, and 12.5 and 25% in teeth capped with KNO3/PCA after 3 and 4 months, respectively. Dentin bridge was only noticed in MTA-capped teeth after 3 and 4 months intervals. Conclusion Taken all together, pulpal responses in the form of granulation and hard tissues, and dentin bridge formation are more evident in MTA-capped teeth than those capped with KNO3/PCA in immature dogs.

A paradigm shift from calcium hydroxide to bioceramics in direct pulp capping: A narrative review.

For many years, calcium hydroxide (CH) was the preferred material for direct pulp capping (DPC), occupying an elevated position. The collapse of this paradigm is due to the emergence of bioceramics with less pulpal inflammation and superior mineralization abilities than CH. The goal of the current article was directed to: (1) review the history of DPC "the idea of an exposed pulp as a hopeless organ has given way to one of healing and optimism," (2) classify the bioceramics in dentistry, and (3) explain and compare the mechanism by which dentin barriers for CH and bioceramics are formed. A comprehensive literature search of the database was conducted using PubMed, Google Scholar, and Scopus utilizing the following terms: Biodentine, calcium hydroxide, calcium aluminate, calcium phosphate, calcium silicate, direct pulp capping, NeoMTA Plus, Quick-Set2, and TotalFill. Reference mining of the selected publications was utilized to discover other studies and strengthen the results. Only works written in English were taken into consideration, and there were no restrictions on the year of publication. Bioceramic materials might be used as an intriguing substitute for CH. Compared to CH, they induced more positive pulpal reactions.

Drug sensitivity testing during dental pulp-dentin complex repair: its effect on treatment outcome and prognosis.

To assess the efficacy of targeted therapy based on drug sensitivity testing (DST) results in patients with acute pulpitis (AP). A total of 80 cases of AP were included retrospectively and divided into two groups: control (Ctrl) group (conventional drug palliative therapy, n=40) and experimental (Exp) group (DST + non-resistant drugs, n=40). The clinical data and laboratory examination data of patients, including bacterial culture data, drug sensitivity test results, Ca and P contents in dental pulp, visual analogue scale (AVS), treatment satisfaction, and dental pulp incidence, were collected and analyzed. Prevotella melaninogenica, Fusobacterium nucleatum, and Porphyromonas gingivalis exhibited higher resistance rates (RS) to penicillin and amoxicillin but no resistance to imipenem and metronidazole. The content of Ca and P in the dental pulp of the Exp group patients was significantly higher than that of the Ctrl group (P=0.006). The total response rate (95% vs. 77.5%, P=0.018) and overall patient satisfaction (92.5% vs. 80%, P=0.021) were also significantly higher in the Exp group than in the Ctrl group. Additionally, when the follow-up duration exceeded 1 year, the incidence of dental pulp reactions in the Exp group was significantly lower than that of the Ctrl group (P=0.026). These findings suggest that Gram-negative anaerobes are the predominant oral pathogens in patients with AP. Imipenem and metronidazole demonstrate the most effective anti-infective properties against these anaerobes. Utilizing DST to select non-resistant drugs for treatment prior to therapy effectively enhances clinical outcomes for patients with AP.

Evaluation of Mineral Trioxide Aggregate and Biodentine as Direct Pulp-capping Agents in Human Teeth: An Ex-Vivo Study

Introduction: Biodentine (Tricalcium Silicate based) is a modern bioactive cement that is comparable to the broadly utilized mineral trioxide aggregate (MTA). It has dentin-like mechanical properties, which can be considered appropriate material for diseased dentin-pulp complex recovery such as direct pulp capping. The present study was to compare the reaction of the pulp-dentin complex in human teeth after direct pulp capping with use of MTA and Biodentine. Objective: To assess the histomorphologic response of human dental pulps on direct pulp capping with MTA and Biodentine. Methods: Pulps of 34 maxillary permanent intact human third molars planned for extraction were mechanically exposed with sterile rotary round bur and allotted to one of the two exploratory groups, MTA or Biodentine. After four weeks, the teeth were extracted, stained with hematoxylin- eosin, and categorized by employing a preset histologic scoring framework. The histopathologic evaluations scored data were recorded and statically analyzed using SPSS where Mann-Whitney U test was used and p&lt;0.05 was considered statistically significant. Results: No inflammatory pulp reaction seen in 34 (100%) teeth whereas 19 (55.9 %) showed complete dentinal bridge arrangement. Layers of well-arranged odontoblast and odontoblast-like cells were found to make tubular dentin beneath the osteodentin. Inferential statistics using showed insignificance between the MTA and Biodentine test groups amid the perception period, showing similar outcomes. Conclusions: Biodentine had comparative adequacy in the clinical setting and may be considered an appropriate alternative to MTA as the pulp- capping agent.

ENDODONTIC MANAGEMENT OF CALCIFIC METAMORPHOSIS IN MAXILLARY CENTRAL INCISOR: A CASE REPORT

Calcific metamorphosis is a pulpal reaction to dental trauma where the root canal gets obliterated by the deposition of hard tissue within the root canal space. Calcified root canal possesses a great challenge to the endodontist as negotiating such canal is very much difficult and tiring job along with risk of iatrogenic root perforation. Negotiation of root canal during endodontic treatment is very much crucial for its success as it could affect the cleaning, shaping, disinfection and finally 3 dimensional obturation of the root canal. This case report demonstrates the clinical management of maxillary central incisor with calcified canal in a 28 years old female patient with a history of trauma 2 years back. The preoperative radiograph shows complete obliteration of the canal up to coronal 2/3rd of the root canal along with widening of the periodontal ligament space. The only way to locate and negotiate such calcified canal was to remove the calcified pulp tissue from the canal while staying centered within the root during negotiation. Control radiograph was taken to rule out any deviation from the root’s centre during negotiation. Once the calcified tissue from the coronal 3rd of the root was removed using fine ultrasonic instruments, a #08 C+ file in a watch winding motion along with alternate use of 5.25% sodium hypochlorite and 17% EDTA was then used to negotiate the remainder of the canal. After negotiation of the calcified canal of tooth #21, it was then successfully cleaned, shaped and obturated till the apical terminus.

The effect of low-level laser on the quality of dentin barrier after capping with bioceramic material: Ahistomorphometric analysis.

The study aims to investigate the quality of dentin barriers and pulp reaction to EndoSequence Root Repair Material (ERRM) combined with low-level laser application. In eight dogs, pulps were exposed via class V, half of the samples received low-level diode laser at 870nm. Thereafter, cavities were capped with fast-set or regular-set ERRM. The specimens were processed for histomorphological and immunohistochemical examination after 2weeks and 2months. Dentin bridges were observed in all samples, and 87.5% were complete. The low-level laser group had significantly more reparative dentin area than the non-lased group (p<0.05). The dentin bridges were found to have an unprecedented tubularity of 43%-89%. Tiny dentin island formation was observed within the material particles. Initial mild-to-moderate inflammatory reactions were observed, which subsided after 2months. RUNX2 and osteocalcin staining were evident for all samples at both time intervals. Low-level laser combined with bioactive ERRM is effective in inducing reparative dentin formation.

Evaluation of Two Different Types of Mineral Trioxide Aggregate Cements as Direct Pulp Capping Agents in Human Teeth

Traumatic human dental injuries involving the pulp might necessitate direct capping procedures. This clinical study aimed to analyse the histological outcomes using two different direct capping materials. Twenty patients with bilateral premolars, scheduled for orthodontic extraction, were selected. The teeth were treated either using ProRoot MTA or RetroMTA. All patients were recalled after 30 and 60 days for teeth extraction. The histopathologically stained specimens were blindly evaluated using hard tissue bridge formation, inflammatory reaction and pulpal findings criteria. Data were evaluated statistically. Results: After 60 days, only the parameter for hard tissue bridge formation showed significant difference in the ProRoot MTA group (p = 0.010), while both direct capping materials performed similarly regarding inflammatory pulp reaction and pulpal findings. Although, during the first 30 days, RetroMTA presented better results in terms of continuity, morphology, hard tissue bridge localisation, and extension/general state of the inflammatory reaction, the continuity was better at 60 days when ProRoot MTA was applied. Treatment with RetroMTA healed the pulpal tissue faster compared with ProRoot MTA but it seemed to be rather a reparative process.

Influence of the adhesive bonding protocol on the inflammatory cellular response and gelatinolytic activity in human teeth

The aim of this paper was to assess the biocompatibility and expression of metalloproteinase -9 of two dentin bonding agents in human teeth, using different methods of dentin pre-treatment and different time intervals. Deep Class I cavities were prepared on the occlusal surface of 18 sound molars. Restorations were performed with XP Bond™ (Dentsply) and Futurabond® DC (VOCO). After 30, 90 or 120 days, the teeth were extracted and processed for histological and immunohistochemical assessment. In XP Bond group, was observed a moderate inflammatory infiltrate and immunoreactivity of metalloproteinase -9 in all storage intervals. In Futurabond DC group, a slight inflammatory infiltrate was found in the first intervals. After 120 days, the inflammatory infiltrate was either slight or absent, while the tissue morphology remained normal. The immunoreactivity of metalloproteinase -9 was considered moderate, except for two specimen after 120 days, that demonstrated no immunoreactivity. Therefore, etch-and-rinse adhesives exhibited a more intense pulpal response than self-etching agents. When performing adhesive restorations in medium and deep cavities in human teeth, the use of a self-etching adhesive strategy should be considered in view of the lower induction of inflammatory and proteolytic activity. Further studies of molecular events should be conducted, taking into consideration the possible inflammatory pulp reactions that can contribute to the success of restorative procedures.

Comparision of effectiveness of calcium hyroxide and MTA when used as an indirect pulp therapy (IPT) material- A clinical and radiological assessment

: The present study assessed and compared the success of an IPT procedure both clinically and radiographically when Dycal and MTA were used as an IPT material on primary molars.Children aged 4-9 years were screened and those who fulfilled the inclusion criteria were selected. Accordingly fiftychildren were divided into 2 groups with 25 patient in each group. Cavity preparation was done and the two test materials (Dycal and MTA) were placed at the base in their respective groups and restored with RMGIC. Post-operative radiograph was taken for baseline data. Patients were assessed at Subsequent at 1 and 6 months both clinically and radiographically. Both the test materials had formed a good biological seal, arrested further caries progression and did not cause any adverse pulpal reaction. However the amount of reparative dentin formed was highest in the Dycal group followed by MTA group. Both the experimental materials Dycal and MTA showed reparative dentin formation at the end of 1 and 6 months and also formed a good biological seal and maintained vitality of the pulp which indicates both are good IPT material.

Microbiology in endodontics: A review

Root canal system acts as an ‘affluent sanctuary’ for the growth and survival of endodontic microbiota. This is attributed to the special environment which the microbes get inside the root canals. Although variety of microbes such as viruses and fungi have been isolated from the root canal system, bacteria are the most commonly found to be associated with Endodontic infections. These are the first to reach the pulp and initiate the pulpal reaction through direct pulp exposure, lateral/accessory canals or through periodontal membrane and blood stream. The oral cavity is home to multiple anatomic micro niches which may vary from birth to old age due to changes in oral environment however root canal being the closed space harbours different microbiota including gram negative and positive microorganisms. To achieve the best results with root canal therapy it becomes important to have knowledge about the residing microbiota and how to combat them.

Pulpal Response to the Combined Use of Mineral Trioxide Aggregate and Iloprost for Direct Pulp Capping

Purpose: The present study aims to assess the combined effects of mineral trioxide aggregate (MTA) and iloprost when used as a pulp capping material on pulpal inflammation and tertiary dentin formation compared with MTA and iloprost alone in rat molar teeth. Methods: Eighty maxillary first molar rat teeth were exposed and capped with iloprost solution, MTA, or MTA mixed with iloprost (MTA-iloprost). The cavities were then filled with resin-modified glass ionomer. The cavity was restored with glass ionomer without the use of pulp capping agent in the control group. The rats were sacrificed after one and four weeks. Block sections of the molar specimens were prepared and subjected to hematoxylin and eosin staining for evaluation. Statistical analysis was done using the Kruskal–Wallis test, followed by Dunnett’s test. Results: At week one, the control group showed significantly more severe pulpal inflammatory reactions than the iloprost (p = 0.00), MTA (p = 0.04), and MTA-iloprost (p = 0.00) groups. Hard tissue formation was commonly found in the iloprost, MTA, and MTA-iloprost groups. After four weeks, pulpal tissue degeneration was observed in the control group. Complete hard tissue barriers were found in 50%, 72.7%, and 77.8% of the specimens in iloprost, MTA, and MTA-iloprost groups, respectively, with no significant differences among the experimental groups. The dentinal tubule patterns were mostly regular in the MTA-iloprost group and irregular in the iloprost and MTA groups. Conclusions: The application of iloprost, MTA, and MTA-iloprost as a pulp capping material resulted in similar pulpal responses in the mechanically exposed pulp of rat molars. Therefore, mixing MTA with iloprost might not be clinically significant.

Effectiveness of Silver Diamine Fluoride when used as an indirect pulp therapy (IPT) material- A clinical and radiological assessment

Aim of the study: The present study assessed and compared the success of an IPT procedure both clinically and radiographically when Dycal, MTA and Silver Diamine Fluoride (SDF) were used as an IPT material on primary molars. Methodology: Children aged 5- 9 years were screened and those who fulfilled the inclusion criteria were selected. Accordingly seventy five children were divided into 3 groups with 25 patient in each group. Cavity preparation was done and the three test materials (Dycal, MTA and SDF) were placed at the base in their respective groups and restored with RMGIC. Post-operative radiograph was taken for baseline data. Patients were assessed at Subsequent at 1, 3 and 6 months both clinically and radiographically. Results: SDF had formed a good biological seal, arrested further caries progression and did not cause any adverse pulpal reaction. However the amount of reparative dentin formed was highest in the Dycal group followed by MTA group and SDF group.

The Monomer Elution of Bulk-Fill Sculptable Composite and Flowable Composite after Photopolymerization

Introduction: Composite resins have excellent mechanical properties, including fast polymerization,aesthetic quality, easy handling, and the ability to adhere to the enamel surfaces. However, there are alsosome disadvantages from this material, one of them is residual monomers. Bulk-fill composite resins areavailable in sculptable (solid) and flowable (liquid) form. Most composite resin matrix is aromatic oraliphatic acrylates. Bis-GMA, UDMA, and TEGDMA are the matrix monomers that are commonly used butshow a high cytotoxicity level. They also have poor mechanical properties such as wear resistance, hardness,tendency to change color, and may cause pulp reactions. Aim: The aim of this study was to investigate thenumber of residual monomers in bulk-fill sculptable and flowable composites in the submersion of 75%ethanol solution (10 minutes, an hour, and 24 hours). Methods: Sculptable and flowable composites wereused in this study. Samples (4 mm thick, 5 mm diameter) were prepared and polymerized for 10 secondswith an intensity of 1025 mW / cm2 of a light emitted diode (LED). After the sample was made, each samplewas immediately immersed in a 75% ethanol solution as an extraction liquid and stored in amber-coloredbottles at room temperature. Samples were taken as many as 7 cc at intervals of 10 minutes, an hour, and 24hours. Samples were analyzed by High-Performance Liquid Chromatography (HPLC). The data obtainedwere analyzed using the Kruskal-Wallis Test, Independent T-Test and Mann-Whitney Test at a significancelevel of p &lt;0.05. Result: The amount of elusion remaining monomers of the bulk-fill flowable compositewas higher than bulk-fill sculptable composite. UDMA composite of bulk fill flowable submersed in 75%ethanol solution for 24 hours was the highest among other monomers. Conclusion: Residual monomerseluted inside bulk-fill composite resins in all time periods and the amount of eluted monomers increaseswith time.

Pulpal Reactions After Dental Traumatic Injuries

Pulpal Reactions After Dental Traumatic Injuries

Histopathological Investigation of Dental Pulp Reactions Related to Periodontitis.

Objective:Since the 1960s, there has been contradictory evidence regarding the association between periodontal pathology and the status of the pulp. The purpose of this study was to evaluate the histopathological changes of pulp tissue with severe periodontal disease, including vertical bone loss involving the major apical foramen, and compared them with the histological pulpal status of teeth with healthy periodontium.Methods:This case-controlled study included 35 intact teeth with severe periodontitis of hopeless prognosis (test group) and 35 teeth without periodontitis extracted for orthodontic reasons (control group). For each tooth, periodontal and endodontic parameters such as probing depth and pulpal vitality were recorded, and the pulp tissue was evaluated histologically. The data were analysed with a significance level of 0.05.Results:Vital pulp was observed in all specimens of both groups (P=1). Pulpal inflammation in the apical portion was observed in 81.71% of the severe periodontitis group, whereas all teeth in the control group demonstrated no signs of pulpal inflammation. Dystrophic calcification and pulp stones were observed in 7.5% of the periodontitis group and 5.7% of the healthy group (P>0.05). Pulp fibrosis was observed in 22.8% of the periodontitis group and 2.8% of the control group (P=0.012). Pulpal necrosis was not noted in either group. In the periodontitis group, internal resorption was present in 22.8% of cases (P=0.005) and external resorption was present in 80% of cases (P<0.001). In the control group, no internal or external resorption was observed in any of the specimens. No differences were noted in the study patients with regard to sex or age.Conclusion:Periodontal disease does not significantly affect pulp vitality and pulpal calcifications. However internal and/or external resorption was significantly different between the two groups as well as apical inflammation and pulp fibrosis.

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 40years. 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 40years 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.