Vasculature of the dental pulp of atherosclerotic monkeys: light and electron microscopic findings

How the Prevalence of Pulp Stone in a Population Predicts the Risk for Kidney Stone

Introduction:

Conflicting researches exist on relationship between pulp stones and systemic disorders. Nephrolithiasis is a common disease with severe pain and discomfort with increasing prevalence worldwide. The purpose of this study is to evaluate the correlation between pulp and kidney stones to help find a method for early detection of kidney stones.

Methods and Materials:

the sample of this case-control study comprised of 154 subjects (77 patients with and 77 patients without kidney stone approved by sonographic examination). Two oral and maxillofacial radiologists evaluated their panoramic images for the presence of pulpal stones.

Results:

A total of 42.9% of subjects showed pulp stones. Most of the teeth with pulp stone in case and control groups were molars (86.30% and 72.97%, respectively). In the group with kidney stones, pulp stones were detected in 38 patients (49.4%), while in the control group, they were detected in 28 subjects (36.4%). Although there was not a significant relationship between the presence/absence of pulp stone and kidney stone (P=0.143), there was statistically significant association between number of teeth with pulp stone in a patient and the presence of kidney stone (P<0.013). The chance of having kidney stone is 5.78 times higher in the subjects having pulp stone in three teeth or more (≥ 3 teeth).

Conclusion:

Although there is not a correlation between the presence of pulp and kidney stone, the chance of having kidney stone is 5.78 times higher in the subjects with ≥ 3 teeth having pulp stone. Thus, the number of teeth with pulp stone can serve as a predictor for possibility of having kidney stone.

Endodontics and the ageing patient

Patients are living longer and the rate of edentulism is decreasing. Endodontic treatment is an essential part of maintaining the health and well-being of the elderly. Retention of natural teeth improves the quality of life and the overall health and longevity of ageing patients. Also, teeth that might be otherwise extracted may be strategically valuable to retain a prosthesis, and elderly patients are more likely to have medical complications that may prevent dental extractions from being safely performed. The technical goals of endodontic treatment in the elderly are the same as those for younger patients. However, the pulpo-dentinal complex undergoes calcific changes over time, which may pose challenges for the clinician. The purposes of this review are to discuss age changes in the pulp and the challenges posed by diagnosing, treatment planning and treating the elderly endodontic patient.

A Radiographic Correlation between Renal and Pulp Stones

AIM

The purpose of this study was to determine the correlation between pulp stones and renal stones. This study also aims to report associations between the presence of pulp stone and gender, age, tooth type, dental arches and sides.

PATIENTS AND METHODS

Data were collected through radiographic examination of bitewing radiographs of 116 kidney stone patients and a similar number of age-matched controls, referred to the Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Erciyes University. Two oral radiologists examined the radiographs to identify pulp stones. The Chi-squared and Mann Whitney U tests were used to investigate the correlations between the presence of pulp chamber calcification and age, gender, dental status and kidney stone.

RESULTS

Pulp chamber opacities were detected in 199 (19.3%) out of the 1031 examined teeth, and in 84 (72.4%) out of the 116 kidney stone patients. There was no statistically significant difference between the study and control group (p = 0.882). The occurrence of pulp stones was significantly higher in molars than premolars and similar prevalences were found between dental arches and sides.

CONCLUSION

In this study, no correlation was found between the presence of pulp stones and kidney stones in the investigated group. Therefore, the presence of pulp stones does not seem to be correlated with that of kidney stones.

Pulp Stone, Haemodialysis, End-stage Renal Disease, Carotid Atherosclerosis

OBJECTIVES

The aim of this study was to determine the relationship between the presence of pulp calcification and carotid artery calcification on the dental panoramic radiographs in End Stage Renal Disease (ESRD) patients who were on haemodialysis.

METHODS

A total of 112 End Stage Renal Disease (ESRD) patients on who were haemodialysis participated in this study. The periapical and the panoramic radiographs for all the patients were evaluated for the presence or absence of the narrowing of the dental pulps and for pulp stones in the pulp chambers and the pulp canals. The panoramic radiographs were also evaluated to determine the carotid calcification.

RESULTS

Carotid calcifications were detected in none of the patients. 84 (74.99%) patients had dental pulp narrowing, and 38 (33.92%) patients had pulp stones. There was no statistical correlation between pulp narrowing and Carotid Artery Calcification (CAC) in the haemodialysis patient group. There was also no statistical correlation between pulp stones and CAC in the haemodialysis patients.

CONCLUSION

However, the incidental finding of CAC on a panoramic radiograph can provide life-saving information for the vascular disease patients, but in the present study, no significant relationship was found between the presence of the pulpal calcification and CAC in the ESRD patients who were on haemodialysis. Therefore, the presence of pulp calcification does not seem to serve as a diagnostic marker for carotid atherosclerosis.

The prevalence of pulp stones in a Turkish population. A radiographic survey

Objectives: The goal of this retrospective study was to determine the prevalence of pulp stones in a Turkish population. Any possible associations between pulp stones and gender, tooth type and dental arch were also evaluated. Study Design: Four hundred and sixty nine patients’ bitewing radiographs which were reached through the patient database of Erciyes University Dentistry School, Department of Oral Diagnosis and Radiology were examined. Of these 469 subjects whose mean age was 24( ± 10.7), 302 were females and 167 were males. A total of 6,926 teeth were examined during this study. Pulp stones were recorded as present or absent and any relations with gender, tooth type and dental arch were noted. Results: Pulp stones were identified in 270 (57.6 %) of the subjects and in 1,038 (15 %) of the teeth examined. Their presence were seldom found in the premolars (9.07%) but was much higher in the molars (90.92 %). Pulp stone occurrence was significantly more common in the first molars than in the second molars, and in the first premolars than in the second premolars in each dental arch. Their occurrence was higher in the maxilla than in the mandible for each tooth type. No difference between the two genders could be identified. Conclusion: Pulp stones are not only incidental radiographic findings of the pulp tissue but may also be an indicator of some serious underlying disease. On the other hand, they may provide useful information to predict about the susceptibility of patients for other dystrophic soft tissue calcifications such as urinary calculi and calcified atheromas. However, further study on this issue is needed.

Key words: Prevalence, pulp stone, Turkish population.

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

OBJECTIVES

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

An overview of the dental pulp: its functions and responses to injury

The dental pulp is a unique tissue and its importance in the long-term prognosis of the tooth is often ignored by clinicians. It is unique in that it resides in a rigid chamber which provides strong mechanical support and protection from the microbial rich oral environment. If this rigid shell loses its structural integrity, the pulp is under the threat of the adverse stimuli from the mouth, such as caries, cracks, fractures and open restoration margins, all of which provide pathways for micro-organisms and their toxins to enter the pulp. The pulp initially responds to irritation by becoming inflamed and, if left untreated, this will progress to pulp necrosis and infection. The inflammation will also spread to the surrounding alveolar bone and cause periapical pathosis. The magnitude of pulp-related problems should not be underestimated since their most serious consequence is oral sepsis, which can be life threatening, and hence correct diagnosis and management are essential. Clinicians must have a thorough understanding of the physiological and pathological features of the dental pulp as well as the biological consequences of treatment interventions.

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.