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| 2010-22 |
| 22-1 |
ISSN (Print) 1013-9052
EISSN 1658-3558
P.O. Box 52500,
Riyadh 11563,
Kingdom of Saudi Arabia
| Tel. |
966-1-467-7328 |
| Fax. |
933-1-467-7308 / 966-1-467-7534 |
| Email |
saudidj@ksu.edu.sa |
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Pulp Stones and Dental Pain
Mukhtar H. Abdel Wahab, BDS, PhD
Riyadh Dental Center, P.O.Box 1584, Riyadh 11441, Saudi Arabia.
A case is
reported of a 42 year-old female who presented with the painful upper left
first molar. Comprehensive clinical examination did not reveal the cause of the
pain which got progressively worse. The tooth was extracted on the insistence
of the patient. Microscopic examination of multiple sections of the decalcified
tooth showed a large freestone which occupied most of the pulp chamber and was
closely related to a nerve bundle. The finding tended to support the view that
pulp stones in an apparently healthy tooth may cause toothache.
Pulp stones are aggregations of calcium phosphate, calcium carbonate, and magnesium phosphate formed in the pulp chamber or the root canals and may be attached to the dentinal wail or lie freely within the pulp.1-24 Shafer's" classified pulp stones into true denticles, which resemble dentine because of their tubular structure, and false denti cles, which are composed of localized masses of calcified material and do not show dentinal tubules.
According to Cook2, pulp stones
can be found in normal teeth with healthy pulps as well as in cari ous teeth
and periodontally involved teeth. Bergman,' however, stated that stones occur Case History
A female
patient, aged 42 years, complained of a painful upper left first molar. The
tooth had a
Clinical examination of
the tooth revealed no abnormality other than mild tenderness to precision. The
tooth responded to cold and electrical stimulation at the same level as the
control tooth. The tooth was electively extracted according to the patient's
wish and microscopic examination of multiple sections of the tooth, showed no
inflam matory process in the pulp. However, a large free pulp stone occupying
most of the pulp chamber was present (Fig. 1) and in some sections was shown to
be closely related to a nerve bundle (Fig. 2).
It is evident that the precise cause of pain incases such as this may not be clear. Nevertheless, this finding supports the view that teeth with pulp stones could be painful and because the stone may compress the nerve bundle to which it is closely opposed. The patient stated that the pain increased in intensity, conceivably as the pulp stone enlarged, causing greater compression on the nerve bundle.
Some authors consider
pulp stones to be a form of dystrophic or pathological calcification1
In conclusion, this case
tended to support the view that pulp stones can cause toothache.
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