3 Research Laboratory LR12ES11
AbstractÂ
Pulpal calcifications or also called pulpal calcium degeneration are
small masses of calcified tissue that obliterates part or almost all of
the endodontic network, the presence of these masses can further
complicate endodontic treatment and requires an adaptation of the
therapeutic approach. The objective of this article is to illustrate the
difficulties and the keys to success of endodontic treatment in the
presence of pulpal calcifications. Three patients with three levels of
difficulty; a free coronary pulp stone, an adherent coronary pulp stone
and diffuse root canal calcification required well-adapted treatment in
order to eradicate these calcified masses. The discovery of pulpal
calcifications during daily practice is particularly frequent. These
calcifications can present different clinical forms and pose problems of
diagnosis and management. The indication for endodontic treatment cannot
be based solely on the presence of pulp stone but on a diagnosis
confirmed by a clinical and radiological examination showing the pulp
status of the tooth.
Keywords
Pulp-Stone, obliteration, dental microscope, catheterization
Introduction
Pulpal calcifications or also called pulpal calcium degenerations are
small masses of calcified tissue that obliterates part or almost all of
the endodontic network [1]. the exact cause of their formation
remains unknown. Therefore, it is currently unclear whether their
presence reflects a pathological manifestation or a normal physiological
development of the dental pulp [2]. Thus, many factors predisposing
to the development of pulpal calcification have been suggested, such as
aging, caries, periodontal disease and orthodontic movements. On the
other hand, some studies have tried to establish a relationship with
other general diseases such as cardiovascular and renal diseases
[3]. These masses of calcified tissue can be found at the level of
the pulp chamber and/or at the level of the root canals, but the
accessibility to the canal orifices which is an essential element for
the success of any endodontic treatment can become more complicated by
the presence of these pulpolites [4].
The objective of this article is to illustrate, through three clinical
cases, the difficulties and the keys to the success of endodontic
treatment in the presence of pulpal calcifications.
Materials and Methods
Clinical case N°1
A 22-year-old patient in good general condition consulted following
spontaneous pain related to the first left mandibular molar (36). The
clinical examination reveals a Sista 1.3 carious lesion. The
radiological examination shows the presence of calcification which
obliterates almost all of the pulp chamber with a cleavage plane (clear
X-ray line) between the calcified tissue and the healthy dental tissue
(Fig.1).