Changes in the dentin-pulp complex of teeth through the prism of CBCT-studies: A retrospective analysis
https://doi.org/10.36377/ET-0108
Abstract
INTRODUCTION. Calcifying metamorphosis and obliteration of the pulp chamber often complicate endodontic treatment, requiring the use of modern visualization and monitoring techniques during therapy.
The application of CBCT diagnostics allows for a better assessment of the condition of the dentin-pulp complex, which helps reduce risks and increase the effectiveness of complex endodontic treatment.
AIM. To conduct a statistical assessment of the prevalence of degenerative changes in the dentin-pulp complex of teeth based on data obtained from CBCT studies, as well as to identify possible correlational relationships between potential factors contributing to the development of calcifying metamorphosis in the pulp space of vital teeth.
MATERIALS AND METHODS. For the retrospective analysis, 187 archival CBCT study data were selected. The obtained images were examined in all planes for the presence of discrete radiopaque masses in the radiolucent pulp space of the teeth, while the obliteration of the root pulp was determined based on the narrowing or complete closure of the root canal space visible on the radiograph. Statistical analysis was performed using SPSS software with a significance level set at p < 0.05.
RESULTS. During the statistical analysis, the prevalence of pulp calcifications was identified in 56.7% of cases, and pulp space obliteration was observed in 24%. Teeth with pulp stones were 1.8 times more likely to exhibit radiographic and clinical signs of caries compared to teeth with root canal obliteration. Among all examined teeth, nearly half in each calcification group had restorations. According to the obtained results, a positive correlation was found between pulp calcification and the dental status of the teeth.
CONCLUSIONS. According to the obtained data, a higher frequency of calcifications is associated with pulp inflammation caused by local prolonged irritants, such as the presence of deep restorations, carious processes, previously performed biological treatments, prior orthodontic treatment, trauma, and wear, as well as other systemic aspects.
About the Authors
A. V. MitroninRussian Federation
Alexander V. Mitronin – Dr. Sci. (Med.), Professor, Deputy Director of the A.I. Evdokimov Institute of Dentistry, Head of the Department of Therapeutic Dentistry and Endodontics, Honored Doctor of the Russian Federation
4 Dolgorukovskaya St., Moscow 127006
D. A. Ostanina
Russian Federation
Diana A. Ostanina – Cand. Sci (Med.), Associate Professor of the Department of Therapeutic Dentistry and Endodontics
4 Dolgorukovskaya St., Moscow 127006
S. Sh. Alimukhamedova
Russian Federation
Sabina Sh. Alimukhamedova – Senior Laboratory Assistant, Postgraduate Student of the Department of Therapeutic Dentistry and Endodontics
4 Dolgorukovskaya St., Moscow 127006
A. M. Fulova
Russian Federation
Angelina M. Fulova – Assistant, Postgraduate Student of the Department of Therapeutic Dentistry and Endodontics
4 Dolgorukovskaya St., Moscow 127006
References
1. Ben Yahya I. Global oral health initiative: World Health Organization strategic action plan. J Dent Educ. 2024;88(Suppl. 1):699–702. https://doi.org/10.1002/jdd.13504
2. Mitronin A.V., Ostanina D.A., Apresian N.A. Postoperative pain after endodontic treatment. a systematic review. Medicine Science and Education. 2022;33:113–116. (In Russ.)
3. Ostanina D.A., Mitronin Yu.A., Anisimova D.V., Mitronin A.V. Optimization of difficult endodontic treatment with nickel-titanium files in martensitic and austenitic phase. Endodontics Today. 2024;22(1):4–10. (In Russ.) https://doi.org/10.36377/ET-0004
4. Essam O., Boyle E.L., Whitworth J.M., Jarad F.D. The Endodontic Complexity Assessment Tool (E-CAT): A digital form for assessing root canal treatment case difficulty. Int Endod J. 2021;54(7):1189–1199. https://doi.org/10.1111/iej.13506
5. Huang D., Wang X., Liang J., Ling J., Bian Z., Yu Q. et al. Expert consensus on difficulty assessment of endodontic therapy. Int J Oral Sci. 2024;16(1):22. https://doi.org/10.1038/s41368-024-00285-0
6. Almohaimede A.A., AlShehri B.M., Alaiban A.A., AlDakhil R.A. Significance of endodontic case difficulty assessment: A retrospective study. Int Dent J. 2022;72(5):648–653. https://doi.org/10.1016/j.identj.2022.01.001
7. Kornetova I.V., Mitronin A.V., Rabinovich I.M. Current opportunities of primary endodontic treatment of chronic apical periodontitis with endo-perio origin. Endodontics Today. 2021;19(4):338–342. (In Russ.) https://doi.org/10.36377/1683-2981-2021-19-4-338-342
8. Fayad M.I., Nair M., Levin M.D., Benavides E., Rubinstein R.A., Barghan S. et al. AAE and aaomr joint position statement: use of cone beam computed tomography in endodontics 2015 update. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;120(4):508–512. https://doi.org/10.1016/j.oooo.2015.07.033
9. Xiang L., Wang B., Zhang Y., Wang J., Wu P., Zhang J. et al. Cone beam computed tomography assessment of the prevalence and association of pulp calcification with periodontitis. Odontology. 2023;111(1):248–254. https:// doi.org/10.1007/s10266-022-00733-5
10. Sanz J.L., Callado L., Mantale S., Nicolás J., Ghilotti J., Llena C. Cone-beam computed tomography assessment of the prevalence and association of pulp calcification with dental and periodontal pathology: A descriptive study. J Clin Med. 2025;14(4):1373. https://doi.org/10.3390/jcm14041373
11. Chen G., Huang L.G., Yeh P.C. Detecting calcified pulp stones in patients with periodontal diseases using digital panoramic and periapical radiographies. J Dent Sci. 2022;17(2):965–972. https://doi.org/10.1016/j.jds.2021.12.010
12. Zahran S.S., Alamoudi R.A. Radiographic evaluation of teeth with pulp stones and pulp canal obliteration: characteristics, and associations with dental parameters. Libyan J Med. 2024;19(1):2306768. https://doi.org/10.1080/19932820.2024.2306768
13. Ostanina D.A., Mitronin Y.A., Khizrieva T.V., Mitronin A.V. Comparative evaluation of the efficiency of smear layer removal and root canal disinfection using new generation irrigants. Cathedra. Dental Education. 2023;(85):40–43. (In Russ.)
14. Ivanauskaitė D., Kubiliūtė D., Janavičienė D., Brukienė V. Prevalence of pulp stones in molars based on bitewing and periapical radiographs. Stomatologija. 2021;23(1):9–15.
15. Alaajam W.H., Saleh A.A., Alghamdi N.S., Ain T.S., Algarni Y.A., Abubaker M. Incidence and distribution of pulp stones among Southern Saudi Arabian sub-population. SAGE Open Med. 2021;9:20503121211062796. https://doi.org/10.1177/20503121211062796
16. Sanz J.L., Callado L., Mantale S., Nicolás J., Ghilotti J., Llena C. Cone-beam computed tomography assessment of the prevalence and association of pulp calcification with dental and periodontal pathology: A descriptive study. J Clin Med. 2025;14(4):1373. https://doi.org/10.3390/jcm14041373
17. Zhang W., Wang Y., Ye L., Zhou Y. Distribution and influencing factors of pulp stones based on CBCT: a retrospective observational study from southwest China. BMC Oral Health. 2024;24(1):947. https://doi.org/10.1186/s12903-024-04727-3
18. Palatyńska-Ulatowska A., Fernandes M.C., Pietrzycka K., Koprowicz A., Klimek L., Souza R.A. et al. The pulp stones: Morphological analysis in scanning electron microscopy and spectroscopic chemical quantification. Medicina. 2021 Dec 21;58(1):5. https://doi.org/10.3390/medicina58010005
19. Kaabi H.H., Riyahi A.M., Al-Maflehi N.S., Alrumayyan S.F., Bakrman A.K., Almutaw Y.A. Three-dimensional analysis for detection of pulp stones in a Saudi population using cone beam computed tomography. J Oral Sci. 2023;65(4):257–260. https://doi.org/10.2334/josnusd.23-0091
20. Vera J., Thepris-Charaf J., Hernández-Ramírez A., García J.G., Romero M., Vazquez-Carcaño M., Arias A. Prevalence of pulp canal obliteration and periapical pathology in human anterior teeth: A three-dimensional analysis based on CBCT scans. Aust Endod J. 2023;49(2):351–357. https://doi.org/10.1111/aej.12669
Review
For citations:
Mitronin A.V., Ostanina D.A., Alimukhamedova S.Sh., Fulova A.M. Changes in the dentin-pulp complex of teeth through the prism of CBCT-studies: A retrospective analysis. Endodontics Today. (In Russ.) https://doi.org/10.36377/ET-0108