Prevalence of Coronary Mineralised Pulp Nodules in Molars Using Cone Beam Computerised Tomography in a Brazilian Subpopulation
Ana Maria Veiga Vasques
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Ana Laura Ribeiro Ruiz
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Gabriele Oliveira Amaral
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Ana Cláudia Rodrigues da Silva
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Gustavo Sivieri-Araújo
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Rogério de Castilho Jacinto
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
João Eduardo Gomes-Filho
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Luciano Tavares Angelo Cintra
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Eloi Dezan Júnior
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
Carlos Roberto Emerenciano Bueno
Department of Restorative Dentistry, Endodontics Section, Araçatuba School of Dentistry, São Paulo State University (FOA/UNESP), São Paulo, Brazil.
*Author to whom correspondence should be addressed.
Abstract
Background: Pulp nodules, also known as Pulp stones, are a complex biological phenomenon characterised by the abnormal accumulation of mineralised tissue within the dental pulp. Only nodules larger than 200 μm in diameter are radiographically visible. Due to the variation in previous results and the limitations of earlier studies based on conventional radiographs, there is a need for more accurate diagnostic tools.
Aims: The aim of the study is to evaluate the prevalence of mineralised coronary pulp nodules by cone beam computerised tomography (CBCT) and explore any potential correlation between the occurrence of pulp nodules with gender, age, tooth, arches, and condition of the dental crown.
Methodology: CBCT scans of 300 patients, totalling 631 molars, were assessed. CBCT scans were collected from a private radiology clinic in Brazil between August 2017 and July 2018. All maxillary and mandibular molars were analysed in the sagittal, axial and coronal planes, and, when present, pulp nodules were identified as a round or oval hyperdense mass. Statistical analysis was conducted using chi-square tests, with a significance level set at 5% through Sigma Plot software (version 12.0).
Results: Of a total of 300 patients, pulp nodules were identified in 35% of subjects and in 25.5% of molars. The presence of pulp nodules was most frequently found in females (41.1%) than in males (27.7%) and in individuals aged over 60 years. The first upper molars showed the highest incidence of pulp nodules. No significant difference was observed when maxillary and mandibular arches were compared, either side. The presence of pulp nodules was higher in restored molars when compared to intact teeth (P<0.05). Within the observed teeth with pulp stones, 70 molars had a round-shaped nodule, while 91 were oval-shaped.
Conclusion: CBCT is an efficient resource for the diagnosis and location of pulp nodules and may be used to assist clinicians in planning the safest endodontic approach. Understanding the prevalence and distribution of pulp nodules regarding gender and type of teeth is paramount for the proper design of root canal treatment. The main limitation of the study is its single-centre data evaluation, highlighting the need for future multicenter studies from different regions of the country, with larger sample sizes and greater population diversity.
Keywords: CBCT, dental pulp calcifications, endodontics