Radiographic assessment of pulp stones: a retrospective study

Background: Pulp stones are discrete calcifications and can be identified in periapical and bitewing radiographs. Stones may exist freely within the pulp tissue or attached to or embedded in dentine. They are more frequently present in the coronal than in the radicular portion of the pulp with a predominating tendency to appear in the maxillary teeth especially the maxillary first molar. Pulp stones have been noted in patients with systemic diseases like cardiovascular, diabetes mellitus and hypertension or in genetic diseases like dentine dysplasia, dentinogenesisimperfecta and Van der Woude syndrome. Etiopathogenesis of pulp stone is still not clear inspite of many microscopic and histochemical studies. Objective: This retrospective study was planned to correlate the association of pulp stones with age, gender, location, dental or systemic disorders. Methods:.The material for this study was obtained by retrospective review of the case files of Annoor Dental College, Muvattupuzha from March 2016 to April 2018, a span of 2 years. A total of 2500 radiographs (OPG) were retrieved from the outpatient department and were assessed for pulp stones within age group of 12–72 years. Statistical Analysis was carried out using chi square test; Minitab (version 17.1.0.0). Results: Overall prevalence of pulp stones in both the gender was 28.9% (723/2500). Out of 723 cases, 411 females& 312 males had pulp stones. Pulp stones were significantly higher in maxilla than mandible (Max. = 67.3%, Mand. = 32.6%).More number of pulp stones were observed in females(56.8%) than males(43.1%).The prevalence of pulp stones in age group from 32–42 years showed higher pulp stones as compared to other groups (29.3%).The prevalence of pulp stones in dental conditions include (Caries -25.5%, Periodontitis- 28.8%, Restored 16.5%, Orthodontically treated teeth -18.9%).The prevalence of pulp stones in hyperlipaedimicpatients was 24.7& renal stones were 21.7%. Conclusion: Even though the aetiological factors involved in their formation are still not fully understood, it would appear that pulp stones are primarily a physiological manifestation and may increase in number and/or size due to local or systemic pathology. The radiographic assessment of pulp stones helps in early diagnosis of many systemic conditions which eventually helps for a better treatment plan.