Pulp calcification in traumatized primary teeth: prevalence and associated factors

Prevalence of pulp canal obliteration after traumatic dental injuries: a systematic review and meta-analysis

This systematic review aimed to answer the following question: What is the estimated prevalence of pulp canal obliteration in subtypes of traumatic dental injury (TDI) in deciduous and permanent teeth? The searches were conducted in PubMed, Embase, Scopus, Web of Science, LILACS, Grey Literature, and Google Scholar, and complemented by a manual search, until April 16th, 2023. Observational studies were selected based on population, exposure, and outcome (PEO) (P, deciduous or permanent teeth; E, TDI; O, pulp canal obliteration). Two reviewers (kappa 0.90) applied the eligibility criteria, extracted qualitative data, and assessed the methodological quality using the Newcastle-Ottawa tool. A meta-analysis was performed using MedCalc 17.2. Thirty-four articles were selected after screening. The methodological quality was moderate to high. The estimated prevalence of pulp canal obliteration was 27.6% (95%CI: 18.7-37.7) and 21.9% (95%CI:16.0-28.4), for permanent and deciduous teeth, respectively. Considering the TDI subtypes, the prevalence of pulp canal obliteration was higher in root fractures of the permanent teeth (78.6 %, 95%CI: 62.8-90.9) and lateral luxation injuries in deciduous teeth (29.4%, 95%CI:19.1-41.0). Our review of 34 articles of moderate and high methodological quality found that the prevalence of pulpal canal obliteration ranges from 21.9% to 27.6%. Pulp canal obliteration was most frequently detected following lateral luxation injuries of the deciduous teeth and root fractures of the permanent teeth (PROSPERO CRD42020179438).

Generalized pulp canal obliteration in a patient on long-term glucocorticoids: a case report and literature review

BACKGROUND

The calcification of the tooth pulp is a pathological condition that occurs in response to various factors. A uncommon haematological condition known as paroxysmal nocturnal haemoglobinuria (PNH) is characterized by bouts of haemolysis, and it requires long-term use of glucocorticoids (GCs).

CASE PRESENTATION

A female patient who was diagnosed with PNH and had a history of long-term use of GCs came to our department for root canal therapy (RCT) for teeth 25, 26, and 27. The radiographs showed generalized pulp canal obliteration (PCO) in most of the patients. None of these teeth (25, 26, or 27) were sensitive to percussion, and they did not respond to thermal or electrical sensitivity tests. A diagnose of pulp necrosis was made for these teeth. RCT was carried out with the help of an oral microscope, and then a prosthodontic procedure was created for the teeth.

CONCLUSIONS

Based on the patient's long history use of GCs and a series of related studies, we conclude that the long-term usage of GCs contributes significantly to the onset of PCO.

Multiple pulp stones in primary and developing permanent dentition: a report of 4 cases

Pulp stones are foci of calcification or discrete calcifications in the dental pulp. They are frequently found on bitewing and periapical radiographs, but their occurrence in entire dentition is unusual. We are reporting four cases in which the occurrence of pulp stones ranged from their presence in just primary teeth (Cases 1 and 2) to involvement of young permanent teeth also (Case 3) and even unerupted permanent teeth (Case 4). In all the cases, dental, medical, and family histories as well as the findings from the clinical examination of the patient were not contributory. Histopathological report revealed true denticle. Metabolic evaluation of patients through liver function test, kidney function test, and blood investigation did not show any metabolic disorders. Patients were also evaluated for any systemic, syndromic, or genetic involvement, but this was also noncontributing. Therefore, it is suggested that these unusual cases may be of idiopathic origin.