Original Article

Comparison of Abundance of Premolar and Molar Pulp Stones Before and After Orthodontic Treatment Using Panoramic Radiography

Comparison of Pulp Stones After Orthodontics


Objectives: Pulp stone is a focal calcification in dental pulp, which is often detected on conventional dental radiographs. Pulp stones can complicate easy access to the root canal and pulp chamber in root canal treatment. Orthodontic treatment may be associated with the formation of pulp stones. Therefore, this study examined the number of pulp stones pre- and post-orthodontic treatment.
Materials and Methods: In this retrospective cross-sectional comparative study, 222 digital panoramic radiographs collected from private orthodontic offices in Rasht, were divided into two groups: radiographs of patients undergoing orthodontic and non-orthodontic treatment according to the inclusion criteria. The obtained data were analyzed by SPSS via the Wilcoxon and Mann-Whitney tests (P<0.05).
Results: The difference in the number of pulp stones pre- and post-orthodontic treatment was significant (P<0.0001). The maximum number of pulp stones after orthodontic treatment was observed in second molars (P=0.016). The change in the number of pulp stones in the mandible (P=0.001) was significantly higher than that in the maxilla (P=0.002). This change was also greater in the left side (P<0.0001) than in the right side (P=0.002). The changes in the number of pulp stones was significant in females (P=0.02). Age had an insignificant effect on pulp stone formation (P>0.05).
Conclusion: This study showed the effect of orthodontic treatment on the number of pulp stones. Further studies are required to clarify the underlying mechanisms for this increase and come up with strategies to prevent it.

1. Johal A, Alyaqoobi I, Patel R, Cox S. The impact of orthodontic treatment on quality of life and self-esteem in adult patients. Eur J Orthod. 2014 Jun;37(3):233-7.
2. Kiefner P, Connert T, ElAyouti A, Weiger R. Treatment of calcified root canals in elderly people: a clinical study about the accessibility, the time needed and the outcome with a three‐year follow‐up. Gerodontology. 2017 Jun;34(2):164-70.
3. Turkal M, Tan E, Uzgur R, Hamidi M, Çolak H, Uzgur Z. Incidence and distribution of pulp stones found in radiographic dental examination of adult Turkish dental patients. Ann Med Health Sci Res. 2013;3(4):572-6.
4. Ertas ET, Veli I, Akin M, Ertas H, Atici MY. Dental pulp stone formation during orthodontic treatment: A retrospective clinical follow-up study. Niger J Clin Pract. 2017;20(1):37-42.
5. Han G, Hu M, Zhang Y, Jiang H. Pulp vitality and histologic changes in human dental pulp after the application of moserate and severe instrusive orthodontic forces. Am J Orthod Dentofacial Orthop. 2013 Oct;144(4):518-540.
6. Kansu O, Ozbek M, Avcu N, Aslan U, Kansu H, Gençtoy G. Can dental pulp calcification in patients with renal diseases? Dentomaxillofac Radiol 2009 Dec;38(8):542-5.
7. Domínguez Á, Ballesteros RE, Viáfara JH, Tamayo OM. Effect of low level laser therapy on dental pulp during orthodontic movement. World J Methodol. 2013 Jun;3(2):19.
8. Lazzaretti DN, Bortoluzzi GS, Fernandes LFT, Rodriguez R, Grehs RA, Hartmann MSM. Histologic evaluation of human pulp tissue after orthodontic intrusion. J Endod. 2014 Oct;40(10):1537-40.
9. Donta C, Kavvadia K, Panopoulos P, Douzgou S. Generalized pulp stones: report of a case with 6‐year follow‐up. Int Endod J. 2011 Oct;44(10):976-82.
10. Ravanshad S, Khayat S, Freidonpour N. The prevalence of pulp stones in adult patients of Shiraz Dental School, a radiographic assessment. J Dent. 2015 Dec;16(4):356.
11. Ramazanzadeh BA, Sahhafian AA, Mohtasham N, Hassanzadeh N, Jahanbin A, Shakeri MT. Histological changes in human dental pulp following application of intrusive and extrusive orthodontic forces. J Oral Sci. 2009 Mar;51(1):109-15.
12. Gaddalay S, Pathan M, Kale A, Ahhirao Y. Prevalence of pulp stones in urban and rural population of Latur Maharashtra and the challenges encountered: an endodontic perspectives. J Dent Med Sci. 2015;9:5-8.
13. Dalili Z, Nemati S, Dolatabadi N, Javadzadeh AS, Mohtavipoor ST. Prevalence of developmental and acquired dental anomalies on digital panoramic radiography in patients attending the dental faculty of Rasht, Iran. J Dentomaxillofac Radiol Pathol Surg. 2012 Dec;1(2):24-32.
14. Kuzekanani M, Haghani J, Walsh LJ, Estabragh M. Pulp stones, prevalence and distribution in an Iranian population. J Contemp Dent Pract. 2018 Jan;19(1):60-5.
IssueVol 18 (Continuously Published Article-Based) QRcode
SectionOriginal Article
DOI https://doi.org/10.18502/fid.v18i22.6932
Dental Pulp Calcification Radiography Panoramic Dental Digital Orthodontics Corrective

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Niksolat E, Afsari E, Ostovar rad F, Karimi S. Comparison of Abundance of Premolar and Molar Pulp Stones Before and After Orthodontic Treatment Using Panoramic Radiography. Front Dent. 2021;18.