The Pulp Stones: Morphological Analysis in Scanning Electron Microscopy and Spectroscopic Chemical Quantification

Abstract

Background and objectives: Pulp stones are hard tissue structures formed in the pulp of permanent and deciduous teeth. Few studies have evaluated their morphology and chemical composition. However, their formation, composition, configuration and role played in overall health status are still unclear. Clinically, they may be symptomatic; technically, they impede access during endodontic therapy, increasing the risk of treatment errors. Thus, this study aimed to morphologically analyze pulp stones and present their chemical quantification, identifying their main chemical elements. It also correlates the results with their possible induction mechanisms. Materials and Methods: Seven pulp nodules were collected from molar teeth needing endodontic treatment. The morphology of the stones was analyzed by scanning electron microscopy (SEM), and their chemical composition was determined by X-ray dispersive energy spectroscopy (EDX). Results: These structures varied considerably in shape, size and topography. The site of the stones in the pulp cavity was the factor that most affected the morphology. The majority of the stones found in the pulp chambers presented nodular morphology, while those in the root canals presented a diffuse shape, resembling root canal anatomy. The topography of the nodules showed heterogeneous relief, revealing smooth and compact areas contrasting with the rugged and porous ones. The chemical composition varied depending on the location of the nodule in the pulp cavity and the relief of the analyzed area. Radicular stones presented considerably lower calcium and phosphorus content than coronary nodules. Conclusions: The high cellularity rate of the coronal pulp predisposes this region to nodular mineralizations around injured cells. The presence of larger caliber vascular bundles and higher collagen fiber content in radicular pulp determines a diffuse morphological pattern in this region. Understanding the morphology and chemical composition of the pulp stones allows future translational pathways towards the prevention or treatment of such conditions.

Three-Dimensional Analysis of the Pulp Chamber and Coronal Tooth of Primary Molars: An In Vitro Study

“…However, scanning electron microscopy (SEM) is the correct technique to determine the presence and morphology of these pulp stones. It is the high cell growth rate of the coronal pulp that is the cause of this nodular mineralisation [ 14 ].…”

“…The three-dimensional analysis allows more efficient detection and localization of mineralised tissues within the connective tissue of the pulp chamber, which generally has a nodular appearance [ 14 ]. Furthermore, the primary teeth anatomy study has a legal and forensic application since knowledge of the length of the pulp and coronal cavity in mandibular primary molars could be a simple and non-invasive analysis that allows for an estimate of children’s dental and chronological age [ 15 ].…”

Denticles: study diagnostic and perspectives of treatment (a review, part II)

“…Физико-химические свойства дентиклей изучаются лабораторными методами: с помощью сканирующей электронной микроскопии с вторичными и обратно рассеянными электронами, энергодисперсионной спектроскопии, микрорамановской спектроскопии, микродифракции рентгеновских лучей, атомно-эмиссионной спектроскопии с индуктивно связанной плазмой, рентгеноструктурного анализа, рентгеновской флуоресценции [ 3,25 ] . Понимание морфологии и химического состава камней в пульпе позволяет в будущем найти пути для профилактики или лечения таких состояний [ 25 ] .…”

Histological analysis for pulp mineralisation after severe intrusive luxation of immature molars in rats

“…2,3 The histological manifestations of normal and aging dental pulp mineralisation are pulp stones or diffuse calcifications exhibiting smooth and compact surface structures, respectively. 4,5 However, the morphology of mineralisation in the traumatised dental pulp of immature teeth has been rarely reported. Andreasen proposed that pulp mineralisation may present as reparative dentin, osteoid dentin, or even as bone (tissue metaplasia).…”