Changes in the dentin-pulp complex of teeth through the prism of CBCT-studies: A retrospective analysis

INTRODUCTION. Calcifying metamorphosis and obliteration of the pulp chamber often complicate endodontic treatment, requiring the use of modern visualization and monitoring techniques during therapy. The application of CBCT diagnostics allows for a better assessment of the condition of the dentin-pulp complex, which helps reduce risks and increase the effectiveness of complex endodontic treatment. AIM. To conduct a statistical assessment of the prevalence of degenerative changes in the dentin-pulp complex of teeth based on data obtained from CBCT studies, as well as to identify possible correlational relationships between potential factors contributing to the development of calcifying metamorphosis in the pulp space of vital teeth. MATERIALS AND METHODS. For the retrospective analysis, 187 archival CBCT study data were selected. The obtained images were examined in all planes for the presence of discrete radiopaque masses in the radiolucent pulp space of the teeth, while the obliteration of the root pulp was determined based on the narrowing or complete closure of the root canal space visible on the radiograph. Statistical analysis was performed using SPSS software with a significance level set at p < 0.05. RESULTS. During the statistical analysis, the prevalence of pulp calcifications was identified in 56.7% of cases, and pulp space obliteration was observed in 24%. Teeth with pulp stones were 1.8 times more likely to exhibit radiographic and clinical signs of caries compared to teeth with root canal obliteration. Among all examined teeth, nearly half in each calcification group had restorations. According to the obtained results, a positive correlation was found between pulp calcification and the dental status of the teeth. CONCLUSIONS. According to the obtained data, a higher frequency of calcifications is associated with pulp inflammation caused by local prolonged irritants, such as the presence of deep restorations, carious processes, previously performed biological treatments, prior orthodontic treatment, trauma, and wear, as well as other systemic aspects.