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Gürhan C, Yiğit H, Yılmaz S, Çetinkaya C. A novel deep learning-based pipeline architecture for pulp stone detection on panoramic radiographs. Oral Radiol 2025:10.1007/s11282-025-00804-7. [PMID: 39806222 DOI: 10.1007/s11282-025-00804-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 01/06/2025] [Indexed: 01/16/2025]
Abstract
OBJECTIVES Pulp stones are ectopic calcifications located in pulp tissue. The aim of this study is to introduce a novel method for detecting pulp stones on panoramic radiography images using a deep learning-based two-stage pipeline architecture. MATERIALS AND METHODS The first stage involved tooth localization with the YOLOv8 model, followed by pulp stone classification using ResNeXt. 375 panoramic images were included in this study, and a comprehensive set of evaluation metrics, including precision, recall, false-negative rate, false-positive rate, accuracy, and F1 score was employed to rigorously assess the performance of the proposed architecture. RESULTS Despite the limited annotated training data, the proposed method achieved impressive results: an accuracy of 95.4%, precision of 97.1%, recall of 96.1%, false-negative rate of 3.9%, false-positive rate of 6.1%, and a F1 score of 96.6%, outperforming existing approaches in pulp stone detection. CONCLUSIONS Unlike current studies, this approach adopted a more realistic scenario by utilizing a small dataset with few annotated samples, acknowledging the time-consuming and error-prone nature of expert labeling. The proposed system is particularly beneficial for dental students and newly graduated dentists who lack sufficient clinical experience, as it aids in the automatic detection of pulpal calcifications. To the best of our knowledge, this is the first study in the literature that propose a pipeline architecture to address the PS detection tasks on panoramic images.
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Affiliation(s)
- Ceyda Gürhan
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Muğla Sıtkı Koçman University, Muğla, 4800, Turkey.
| | - Hasan Yiğit
- Department of Software Engineering, Faculty of Engineering, Muğla Sıtkı Koçman University, Muğla, 4800, Turkey
| | - Selim Yılmaz
- Department of Software Engineering, Faculty of Engineering, Muğla Sıtkı Koçman University, Muğla, 4800, Turkey
| | - Cihat Çetinkaya
- Department of Software Engineering, Faculty of Engineering, Muğla Sıtkı Koçman University, Muğla, 4800, Turkey
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Ye L, Li S, Li C, Wang C, Wei X, Zhou W, Du Y. Pulp calcification identification on cone beam computed tomography: an artificial intelligence pilot study. BMC Oral Health 2024; 24:1132. [PMID: 39333975 PMCID: PMC11438316 DOI: 10.1186/s12903-024-04922-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 09/16/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND This study aims to verify the effectiveness of a deep neural network (DNN) in automatically identifying pulp calcification on cone beam computed tomography (CBCT) images. METHODS This study retrospectively analysed 150 CBCT images. Pulp calcification was identified and manually annotated by three endodontists with 10 years of experience. A DNN model based on the U-Net architecture was constructed to identify pulp calcification, and ten rounds of fourfold cross-validation were conducted. The model performance was evaluated using sensitivity, specificity, accuracy, and the area under the receiver operating characteristic curve (AUC). RESULTS The model achieved a sensitivity of 75.91 ± 2.84% in automatically identifying pulp calcification, with a specificity of 68.88 ± 2.35%, an accuracy of 72.78 ± 2.13%, and an AUC of 73.68 ± 3.09%. According to the ranking for diagnostic tests, the proposed method achieved a "good" grade for sensitivity, accuracy, and AUC and a "fair" grade for specificity. CONCLUSIONS The results indicate that the proposed method shows promise for identifying pulp calcification on CBCT images. Future research aims to expand the dataset and refine the model, thereby enhancing its clinical applicability. The integration of artificial intelligence into diagnostic and treatment systems is anticipated to increase the efficiency of diagnosing pulp calcification and assist dentists in assessing the difficulty of root canal treatment cases preoperatively. CLINICAL REGISTRATION Registration was performed on the Chinese Clinical Trial Registry ( https://www.chictr.org.cn/ ) (Registration number: ChiCTR2300077078, 27/10/2023) and National Medical Research Registry Information System ( https://www.medicalresearch.org.cn/ , 30/10/2023) (Number: MR-44-23-039664).
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Affiliation(s)
- Li Ye
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | | | | | | | - Xi Wei
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China
| | - Wu Zhou
- School of Medical Information Engineering, Guangzhou University of Chinese Medicine, Guangzhou, China.
| | - Yu Du
- Hospital of Stomatology, Guanghua School of Stomatology, Sun Yat-Sen University, Guangzhou, China.
- Guangdong Provincial Key Laboratory of Stomatology, Guangzhou, China.
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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; 24:947. [PMID: 39148066 PMCID: PMC11325625 DOI: 10.1186/s12903-024-04727-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 08/08/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Pulp stones are a type of pulp calcification, the presence of which tends to hinder endodontic treatment. Thus, this retrospective study aimed to analyze the distribution of pulp stones in the population in southwest China and identify the influencing factors. MATERIALS Cone-beam computed tomography (CBCT) scans of 5066 teeth of 200 patients (91 males and 109 females) aged 16-45 years were evaluated. Pulp stones were marked as either present or absent when distinct radiopaque masses were found in the pulp cavity, then evaluated the occurrence of pulp stones with regard to tooth type, sex, age group, and contact it with tooth status. The Pearson chi-square test and nonparametric test were used for statistical analysis. RESULTS Pulp stones were detected in 49.0% of patients and 7.4% of teeth, respectively. The incidence in females was 1.9 times higher than in males (OR = 1.9, 95% CI = 1.1-3.3, p = 0.001). Pulp stones were most prevalent in patients 36-45 years of age. Furthermore, in the age range of 16-45 years, the likelihood of finding pulp stones increased 1.1 times per year with age (OR = 1.1, 95% CI = 1.0-1.1, p = 0.032). A higher incidence of pulp stones was observed in the maxilla and molars. Of the 5066 teeth studied, pulp stones were more common in non-intact teeth. CONCLUSION Nearly half of the population in southwest China had pulp stones. Pulp stones were found significantly more often in females, maxilla, and non-intact teeth, and their frequency increased with age. For dentists, understanding the distribution of pulp stones is crucial for the proper design of root canal treatment (RCT). TRIAL REGISTRATION This study was approved by the Ethics Committee of the Affiliated Hospital of Stomatology, Southwest Medical University (certificate number: 20220818001).
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Affiliation(s)
- Wantong Zhang
- Department of Preventive Dentistry, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China
| | - Yao Wang
- Department of Preventive Dentistry, The Affiliated Stomatological Hospital, Southwest Medical University, Luzhou, 646000, China.
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China.
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China.
| | - Lin Ye
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China
| | - Yan Zhou
- Luzhou Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Luzhou, 646000, China
- Institute of Stomatology, Southwest Medical University, Luzhou, 646000, China
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Lv Y, Zhu J, Fu CT, Liu L, Wang J, Li YF. Multiple pulp stones emerge across all teeth during mixed dentition: A case report. World J Clin Cases 2024; 12:5189-5195. [DOI: 10.12998/wjcc.v12.i22.5189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 05/11/2024] [Accepted: 05/30/2024] [Indexed: 06/30/2024] Open
Abstract
BACKGROUND This paper reports a rare presentation of multiple pulp stones (PSs) emerging in all teeth during mixed dentition. It offers valuable insights into the clinical diagnosis, treatment, and prognosis of multiple PSs, shedding light on their occurrence during the mixed dentition period.
CASE SUMMARY A 10-year-old girl presented with repeated pain in the mandibular right posterior teeth. Intraoral examination revealed carious lesions, abnormal tooth shapes, and anomalies in tooth number. Radiographic examinations showed multiple PSs with diverse shapes, sizes, and quantities in all teeth, alongside anomalies in tooth shape and number. Root canal therapy was initiated, but the patient initially lacked timely follow-up. Upon return for treatment completion, an extracted tooth revealed irregular calculus within the pulp cavity.
CONCLUSION This case underscores the importance of considering multiple PSs in mixed dentition, necessitating comprehensive evaluation and management strategies.
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Affiliation(s)
- Yuan Lv
- Department of Stomatology, China Aerospace Science & Industry Corporation 731 Hospital, Beijing 100074, China
| | - Jie Zhu
- Department of Stomatology, China Aerospace Science & Industry Corporation 731 Hospital, Beijing 100074, China
| | - Cheng-Tao Fu
- School of Medicine, Huzhou University, Huzhou 313204, Zhejiang Province, China
| | - Le Liu
- Department of Stomatology, The Fourth Medical Centre, Chinese People's Liberation Army General Hospital, Beijing 100048, China
| | - Jing Wang
- Department of Stomatology, The Fourth Medical Centre, Chinese People's Liberation Army General Hospital, Beijing 100048, China
| | - Yan-Feng Li
- Department of Stomatology, The Fourth Medical Centre, Chinese People's Liberation Army General Hospital, Beijing 100048, China
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Kaabi HH, Riyahi AM, Bakrman AK, Almutaw YA, Alrumayyan SF, Al-Maflehi NS. Pulp stones in unerupted teeth: a retrospective analysis using cone-beam computed tomography. BMC Oral Health 2024; 24:714. [PMID: 38907221 PMCID: PMC11191153 DOI: 10.1186/s12903-024-04503-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 06/18/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND A pulp stone is a calcified mass that develops in the dental pulp of any tooth. Despite many studies examining the relationship between pulp stone formation and non-oral factors, the methods used in these studies have been unable to explain the exact role of these factors alone as distinct from probable effects within the oral cavity environment. Considering that totally unerupted (impacted or developing) teeth are unexposed to the oral cavity's environmental and functional conditions, they provide a more suitable material for studying the effects of these non-oral factors on pulp stone formation. This research study aimed to investigate pulp stones in unerupted teeth and the associated factors in a Saudi subpopulation. METHODS The study included 644 cone-beam computed tomography images, with 496 (50.9%) maxillary and 479 (49.1%) mandibular teeth. Of the investigated patients, 293 (45.5%) were men, and 351 (54.5%) were women. The age range was 15-76 years. A chi-square test was used to investigate the associations between pulp stones and age, gender, and history of systemic disease and chronic medication use. RESULTS Pulp stones in unerupted teeth were present in 24.2% of the examined dental jaws and 18.6% of the examined teeth. There was no statistically significant relationship between pulp stones and gender (p > 0.05). A significantly greater percentage of pulp stones were found with increasing age (p = 0.000). Additionally, a significantly increased number of pulp stones was observed in patients with systemic diseases and chronic medications (p < 0.05). CONCLUSIONS The results support the idea that pulp stones can be present in any type of unerupted tooth. This study provides additional evidence of the increased incidence of pulp stones with age, systemic disease, and chronic medications.
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Affiliation(s)
- Hassan Hamed Kaabi
- Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh, 11545, Saudi Arabia.
| | - Abdullah Mahmoud Riyahi
- Division of Endodontic Dentistry, Department of Restorative Dental Sciences, College of Dentistry, King Saud University, P.O. Box 60169, Riyadh, 11545, Saudi Arabia
| | | | - Yazeed Ali Almutaw
- College of Dentistry, King Saud University, P.O Box 60169, Riyadh, 11545, Saudi Arabia
| | | | - Nassr Saleh Al-Maflehi
- Division of Community Dentistry, Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University, P.O Box 60169, Riyadh, 11545, Saudi Arabia
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Rusu Olaru A, Popescu MR, Pleşea IE, Şerbănescu MS, Pleşea RM, Cojocaru MO, Coculescu EC. Abrasion and dental pulp morphological changes in occlusal dysfunction. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2024; 65:279-290. [PMID: 39020543 PMCID: PMC11384036 DOI: 10.47162/rjme.65.2.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2024]
Abstract
AIM The authors set out to assess if the presence and the degree of severity of the abrasion, as a consequence of the occlusal dysfunction, determine further morphological changes in the dental pulp. MATERIALS AND METHODS Study group included teeth dental pulp from 45 cases with occlusal dysfunction, subsequently divided into two subgroups: 24 cases with abrasion (AB) and 21 cases without abrasion (NONAB). The set of morphological parameters of dental pulp were thicknesses of the outer layer, inner layer and entire peripheral pulp zone, the presence of pulpal calcifications and their extent within the dental pulp, the presence of interstitial fibrosis and its extent within the dental pulp and the vascular density (VD) of pulpal capillary network. Tissue samples were fixed in 10% buffered formalin, embedded in paraffin, and sectioned off at 4 μm. Serial slides were stained with Hematoxylin-Eosin (HE), Masson's trichrome (MT) and anti-cluster of differentiation 34 (CD34) antibodies labeled with 3,3'-Diaminobenzidine (DAB) and transformed into virtual slides on which the above-mentioned parameters were studied comparatively with the help of a dedicated in-house software, realized in MATLAB (MathWorks, USA). The numerical values of the assessed parameters were also stratified in classes, thus obtaining score scales for each parameter. Statistical tools used were Lilliefors test, t-test (two-sample assuming equal variances), Mann-Whitney test, Pearson's correlation test, one-way analysis of variance (ANOVA) test and χ² (chi-squared) test. RESULTS AND DISCUSSIONS Both peripheral zone (PZ) and its layers individually tended to be thicker in the teeth with abrasion than in those without abrasion. Also, teeth with abrasion tended to develop larger amounts of calcium deposits in their dental pulp than teeth without abrasion. On the other hand, fibrotic tissue in dental pulp had no relationship with the presence or absence of abrasion. PZ as a whole and its layers evolved together in the same way, with a stronger correlation in the group of teeth without abrasion. Deposits of calcium evolved in the opposite direction to both the amount of fibrous tissue and the capillaries density of the dental pulp. Consequently, the amount of fibrous tissue and VD evolved together in the same way, more pronounced in the teeth without abrasion. CONCLUSIONS Our preliminary study pointed out that different components of the dental pulp showed slight to moderate changes depending on the degree of abrasion in teeth with occlusal dysfunction.
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Affiliation(s)
- Adi Rusu Olaru
- Department of Occlusology and Fixed Prosthetics, University of Medicine and Pharmacy of Craiova, Romania;
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Khan MI, Khare A, Arif K, Khan SS, Nasir A, Lari S. Dental pulp stones and their correlation with metabolic diseases. J Oral Maxillofac Pathol 2024; 28:192-199. [PMID: 39157846 PMCID: PMC11329071 DOI: 10.4103/jomfp.jomfp_536_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 04/17/2024] [Accepted: 05/07/2024] [Indexed: 08/20/2024] Open
Abstract
Background Dental pulp calcifications or pulp stones are calcified structures found in dental pulp, mostly around or enclosing a blood vessel. The formation of these calcifications begins with concentric layers of calcified tissue within which remnants of necrotic and calcified cells may be present. The calcifications of thrombi in blood vessels, called phleboliths, may also serve as nidi for denticles. In metabolic diseases such as diabetes, hypertension or poor periodontal health, there are obvious changes in blood vessels and vascularization. In our study, we observed histopathological sections of dental pulp and correlated systemic diseases such as diabetes and hypertension with poor periodontal health and dental pulp stones. Aim The aim of our study was to evaluate the histopathology of dental pulp stones, their distribution among various age groups and sexes and to identify any correlations between pulp stone formation and systemic diseases such as type II diabetes and hypertension. Materials and Methods Samples from 100 patients with metabolic diseases such as type II diabetes and hypertension were collected. The pulp was extirpated from the teeth that were undergoing root canal treatment, and the teeth were extracted. The collected pulp sample was fixed in 10% formaline neutral buffer, subjected to routine histopathological procedures and stained with haematoxylin and eosin. The pulp of teeth extracted for orthodontic treatment was considered a control for patients with no metabolic disease. Results There was a definite relationship between increased pulp stones and metabolic diseases such as type II diabetes and hypertension; likewise, poor periodontal health was significantly related to pulp stones.
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Affiliation(s)
- Mohammad Imran Khan
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Career Post Graduate Institute of Dental Sciences and Hospital, Ghaila, IIM Road Lucknow, Uttar Pradesh, India
| | - Abhisheik Khare
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Career Post Graduate Institute of Dental Sciences and Hospital, Ghaila, IIM Road Lucknow, Uttar Pradesh, India
| | - Khushboo Arif
- Department of Public Health Dentistry, Faculty of Dental Sciences, King George’s Medical University, Lucknow, Uttar Pradesh, India
| | - Sameera Shamim Khan
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Career Post Graduate Institute of Dental Sciences and Hospital, Ghaila, IIM Road Lucknow, Uttar Pradesh, India
| | - Abdullah Nasir
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Career Post Graduate Institute of Dental Sciences and Hospital, Ghaila, IIM Road Lucknow, Uttar Pradesh, India
| | - Shafik Lari
- Department of Oral and Maxillofacial Pathology and Oral Microbiology, Chandra Dental College and Hospital, Safedabad, Lucknow, Uttar Pradesh, India
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Kaabi HH, Riyahi AM, Al-Maflehi NS, Alrumayyan SF, Bakrman AK, Almutaw YA. Three-dimensional analysis for detection of pulp stones in a Saudi population using cone beam computed tomography. J Oral Sci 2023; 65:257-260. [PMID: 37612065 DOI: 10.2334/josnusd.23-0091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/25/2023]
Abstract
PURPOSE To assess the prevalence and distribution of pulp stones in a Saudi population. METHODS A cone beam computed tomography (CBCT) analysis of 150 upper and 150 lower dental arches was performed. The relationships between pulp stones and age, sex, tooth type, dental arch, orthodontic treatment, caries, and restoration were statistically examined (P < 0.05). RESULTS A total of 295 dental arches (98.3%) had at least one pulp stone, and the prevalence was higher in the maxillary teeth (56.2%) than in the mandibular teeth (48.1%) (P = 0.0003). Men were more likely to have pulp stones than women (P = 0.011 for the maxilla, P < 0.0001 for the mandible). Furthermore, age and orthodontic treatment had no significant effects on the incidence of pulp stones (P > 0.05). A higher occurrence of pulp stones was observed in the first molars (>91%), and in carious and restored teeth when compared to intact teeth (P < 0.05). CONCLUSION Pulp stones were more prevalent in the upper dental arches, first molars, and carious and restored teeth, as well as in the male population, and were not associated with age or orthodontic treatment.
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Affiliation(s)
- Hassan H Kaabi
- Division of Oral Biology, Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University
| | - Abdullah M Riyahi
- Division of Endodontic Dentistry, Department of Restorative Dental Sciences, College of Dentistry, King Saud University
| | - Nassr S Al-Maflehi
- Division of Community Dentistry, Department of Periodontics and Community Dentistry, College of Dentistry, King Saud University
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Alamoudi RA, Alzayer FM, Alotaibi RA, Alghamdi F, Zahran S. Assessment of the Correlation Between Systemic Conditions and Pulp Canal Calcification: A Case-Control Study. Cureus 2023; 15:e45484. [PMID: 37859878 PMCID: PMC10583123 DOI: 10.7759/cureus.45484] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
OBJECTIVE Pulp canal calcification is a dental condition that is characterized by the deposition of mineralized tissue within the dental pulp space. While it is primarily a local phenomenon, recent studies have suggested a potential link between pulp calcification and systemic diseases. This study aimed to determine the correlation between certain systemic diseases, medications, and the presence of pulp canal calcification. Second, it aimed to estimate the prevalence of pulp calcification in the smoker population. METHODS A pair-matched case-control observational study was conducted from June 2022 to June 2023 at the Faculty of Dentistry, King Abdulaziz University. Digital periapical and bitewing radiographs were used for case-based sampling. Patients were categorized into two study groups: the cases group (n=100), consisting of patients with pulp canal calcification including either pulp stone, pulp canal obliteration, or both. Whereas the control group (n=100), consisted of patients without pulp canal calcification. Detailed medical histories were obtained to identify the presence of systemic diseases. Additionally, systemic medications and smoking status were documented. RESULT The participants were divided into two groups; cases (n=100), diagnosed with teeth calcifications and confirmed by radiographic examination, and controls (n=100), showing no evidence of teeth calcifications. Among the patients in the calcification group, 26% had a history of systemic disease compared to 17% in the control non-calcification group with no significant difference between both groups. No correlation between certain medications and pulp canal calcification. Smoking did not demonstrate a statistically significant association with teeth calcifications (p > 0.05). CONCLUSION Pulp calcification on routine radiographic examination could indicate an underlying unnoticed systemic disorder that demands accurate referral and subsequent therapy.
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Affiliation(s)
- Ruaa A Alamoudi
- Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Fatimah M Alzayer
- General Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Rawabi A Alotaibi
- General Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Faisal Alghamdi
- Oral Biology, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
| | - Shatha Zahran
- Endodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, SAU
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Mehdizadeh M, Tavakoli Tafti K, Soltani P. Evaluation of histogram equalization and contrast limited adaptive histogram equalization effect on image quality and fractal dimensions of digital periapical radiographs. Oral Radiol 2023; 39:418-424. [PMID: 36076131 DOI: 10.1007/s11282-022-00654-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 08/31/2022] [Indexed: 11/29/2022]
Abstract
OBJECTIVES This study aims to evaluate the effects of histogram equalization (HE) and contrast limited adaptive histogram equalization (CLAHE) on periapical images and fractal dimensions in the periapical region. METHODS In this cross-sectional study, digital periapical images were selected from the archive of Dentistry School of Isfahan University of Medical Sciences. The radiographs were taken from mandibular and maxillary anterior single root teeth with healthy root and periodontium. After applying HE and CLAHE algorithms to images, two radiologists evaluated the quality of apex detection from using a 5-point Likert scale (from 5 for very good image quality to 1 for very bad image quality). Afterward, all the images were imported to the ImageJ application, and the region of interest (ROI) was specified as the region between the two central incisors. The fractal box-counting method was used to determine fractal dimensions (FD) values. Nonparametric Wilcoxon-Friedman test, Intraclass Correlation Coefficient test, T-test, and Pair T-test were performed as statistical analysis (α = 0.05). RESULTS Fifty-three radiographs were analyzed and the image quality assessments were significantly different between raw images and images after performing HE, CLAHE (p value < 0.001), and using CLAHE algorithm significantly increases image quality assessments more than HE (p value = 0.009). There was a significant difference in FD values for images after applying CLAHE and HE compared to raw images (p value < 0.001), and HE decreased the FD value significantly more than CLAHE (p value = 0.019). CONCLUSIONS Employing CLAHE and HE algorithm via OpenCV python library improves the periapical image quality, which is more significant using the CLAHE algorithm. Moreover, applying CLAHE and HE reduces trabecular bone structure detection and FD values in periapical images, especially in HE.
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Affiliation(s)
- Mojdeh Mehdizadeh
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Kioumars Tavakoli Tafti
- Dental Students' Research Committee, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran.
| | - Parisa Soltani
- Department of Oral and Maxillofacial Radiology, Dental Implants Research Center, Dental Research Institute, School of Dentistry, Isfahan University of Medical Sciences, Isfahan, Iran
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Vieira WA, Paranhos LR, Meneses-Santos D, Floriano LO, Borges GH, Sponchiado-Junior EC, de-Jesus-Soares A. Association between the prevalence of pulp stones and calcified atherosclerotic plaques: a systematic review and meta-analysis. Dentomaxillofac Radiol 2023; 52:20230004. [PMID: 37052394 PMCID: PMC10170168 DOI: 10.1259/dmfr.20230004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 04/14/2023] Open
Abstract
OBJECTIVE To evaluate the association between the prevalence of pulp stones (PS) in permanent teeth and calcified atherosclerotic plaques (CAP). METHODS An electronic search was performed in 10 databases to locate observational studies that investigated the association between PS in permanent teeth and CAP, published until March 2022. Two reviewers performed the search, selection and extraction of data from eligible studies. The individual risk of bias of eligible studies was assessed using the JBI Critical Appraisal Tools. The meta-analysis was conducted using fixed and random effects and odds ratio (OR) as an effect measure with a 95% confidence interval (CI). The heterogeneity between the studies was quantified using the I² test. The certainty of evidence was evaluated using the GRADE approach. RESULTS The electronic search resulted in 2968 records, of which only 7 studies were considered eligible. The total sample consisted of 3770 participants from 5 countries. All studies showed biases of confounding factors and exposure assessment. Based on six studies and with very low certainty of evidence, the meta-analysis showed that patients with PS were more likely to also have CAP in carotid or coronary arteries (OR: 1.70; 95% CI: 1.21; 2.38, I² = 0%). CONCLUSIONS Limited evidence suggests that there is a positive association between the prevalence of PS in permanent teeth detected using panoramic radiography and CAP in the coronary or carotid arteries.
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Affiliation(s)
- Walbert A. Vieira
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, UniversidadeEstadual de Campinas, Piracicaba, Brazil
| | - Luiz Renato Paranhos
- Division of Preventive and Community Dentistry, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, Brazil
| | - Daniela Meneses-Santos
- Department of Morphology, Center of Biological Sciences and Health, Universidade Federal de Sergipe, São Cristóvão, SE, Brazil
| | - Luiz Otávio Floriano
- Undergraduate student in dentistry, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | - Guilherme Henrique Borges
- Postgraduate Program in Dentistry, School of Dentistry, Universidade Federal de Uberlândia, Uberlândia, MG, Brazil
| | | | - Adriana de-Jesus-Soares
- Department of Restorative Dentistry, Endodontics Division, School of Dentistry of Piracicaba, UniversidadeEstadual de Campinas, Piracicaba, Brazil
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Wang N, Gao Y, Ren H, He L, Zhao Y. Histological analysis for pulp mineralisation after severe intrusive luxation of immature molars in rats. Dent Traumatol 2023. [PMID: 36807827 DOI: 10.1111/edt.12831] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Revised: 02/10/2023] [Accepted: 02/12/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND/AIM Pulp mineralisation is a survival process that may occur in the pulp of immature teeth following trauma. However, the mechanism of this process remains unclear. The aim of this study was to evaluate the histological manifestations of pulp mineralisation after intrusion in immature molars of rats. MATERIALS AND METHODS Three-week-old male Sprague-Dawley rats were subjected to intrusive luxation of the right maxillary second molar by an impact force from a striking instrument through a metal force transfer rod. The left maxillary second molar of each rat was used as a control. The control and injured maxillae were collected at 3, 7, 10, 14, and 30 days after trauma (n = 15 per time group) and evaluated using haematoxylin and eosin staining and immunohistochemistry. Independent two-tailed Student's t-test was used for statistical comparison of the immunoreactive area. RESULTS Pulp atrophy and mineralisation were observed in 30%-40% of the animals, and no pulp necrosis occurred. Ten days after trauma, pulp mineralisation, with osteoid tissue rather than reparative dentin, formed around the newly vascularised areas in the coronal pulp. CD90-immunoreactive cells were observed in the sub-odontoblastic multicellular layer in control molars, whereas the number of these cells was decreased in the traumatised teeth. CD105 localised in cells around the pulp osteoid tissue of the traumatised teeth, whereas in control teeth, it was only expressed in the vascular endothelial cells of capillaries in the odontoblastic or sub-odontoblastic layers. In specimens with pulp atrophy at 3-10 days after trauma, hypoxia inducible factor expression and CD11b-immunoreactive inflammatory cells increased. CONCLUSIONS Following intrusive luxation of immature teeth without crown fractures in rats, no pulp necrosis occurred. Instead, pulp atrophy and osteogenesis around neovascularisation with activated CD105-immunoreactive cells were observed in the coronal pulp microenvironment characterised by hypoxia and inflammation.
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Affiliation(s)
- Nan Wang
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University, Beijing, China
| | - Yike Gao
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University, Beijing, China
| | - Huihui Ren
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University, Beijing, China
| | - Linhai He
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology, Beijing, China.,First Clinical Division, Peking University School and Hospital of Stomatology, Beijing, China
| | - Yuming Zhao
- Department of Pediatric Dentistry, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology, Peking University, Beijing, China
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Diéguez-Pérez M, Ticona-Flores JM. Three-Dimensional Analysis of the Pulp Chamber and Coronal Tooth of Primary Molars: An In Vitro Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159279. [PMID: 35954635 PMCID: PMC9368266 DOI: 10.3390/ijerph19159279] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 02/04/2023]
Abstract
The anatomical variability of primary molars promotes research to improve clinical restorative activity, forensic identification, and industrial development. The objective was to study the morphology of the pulp chamber and its three-dimensional relationship with the external morphology of the tooth. A total of 151 deciduous molars were collected and subjected to three-dimensional imaging analysis in order to determine dental crown (CV) and pulp chamber (PV) volumes, their ratio (VR), pulp chamber roof (PCR) and pulp chamber floor (PCF) area, the furcation length (FD), and morphological peculiarities. The data were compared using the Kruskal–Wallis test in SPSS 26 software. The statistical analysis determined statistically significant differences between the four groups of molars for all variables. Great anatomical variability was observed, especially in the maxillary first molar, the volumes were higher in the maxillary second molar and the highest risk of furcal perforation was seen in the mandibular first molar. Additionally, mandibular second molars with six pulp horns, and some different density images compatible with accessory canals and pulp stones were found. Based on the findings of this investigation, we confirm the great anatomical variability that exists between the maxillary and mandibular molars.
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Affiliation(s)
- Montserrat Diéguez-Pérez
- Preclinical Dentistry Department, Faculty of Biomedicine and Health Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain
- Correspondence:
| | - Jesús Miguel Ticona-Flores
- Faculty of Biomedicine and Health Sciences, European University of Madrid, Villaviciosa de Odón, 28670 Madrid, Spain;
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