Endodontic Management of Unusual Large Pulp Stone in Mandibular Canine- A Case Report

Abstract

A 25-year-old male reported to the Department of Conservative Dentistry and Endodontics with a chief complaint of pain and swelling in the lower right canine region since three days. Patient reported history of trauma due to self-fall one year back. The tooth was associated with pain and tenderness when chewing food and increased on thermal changes. Intraoral examination revealed an obliteration of vestibule on the right mandibular canine region and tenderness on percussion. Pulp vitality with electric and thermal test elicited no response. Intraoral periapical radiograph revealed diffuse periapical radiolucency and in the pulp chamber space a radiopacity was evident, indicating calcification. Pulp stones are calcification formed in pulp chamber and sometimes extending to the root canal part. Radiographically, they are easily identified and they appear as radiopaque mass in the pulp space. Normally, pulp stones are found in isolated tooth and rarely all or many teeth are associated with the presence of pulp stones. The present case describes the removal of an 8 mm long pulp stone in a single mass from a mandibular canine in a patient with generalised occurrence of pulp stones. Pulp stones are discrete calcifications formed in the pulp chamber or the root canals and may exist freely within pulp tissue or may be attached to or embedded in dentin. 1 They are also called denticles and vary in size. The presence of pulp stones is frequently noticed on a routine bitewing or periapical radiograph. Pulp stones are a common occurrence. A study on Australian population found the prevalence of 46.1% in young adults. Occurrences were rare in premolars (0.4%), but significantly higher in molars (19.7%). 2