Pulp Cavity Calcification in SLE Patient Associated with Long-term Use of Glucocorticoids: A Case Study with Endodontic Approaches

Abstract

Background Calcification in the tooth pulp cavity occurs in response to various factors, including dental trauma and chronic irritation. Systemic lupus erythematosus (SLE) is the most common type of lupus, causing widespread inflammation and tissue damage in the affected organs. The SLE condition is generally managed by long-term use of drugs, including glucocorticoids (GCs). Objective This study aimed to assess the association of pulp cavity calcification in SLE patients with long-term use of GCs and to present endodontic perspectives on the issue. Case Presentation A female SLE patient with a history of long-term use of GCs visited our hospital for an oral surgery examination due to an accident. The crown of tooth 11 was visibly fractured. The tooth was sensitive to cold stimulus, while tooth 21 was mobile. Various examinations (including electric pulp test and panoramic radiography) pointed to the diagnosis of chronic pulpitis in the affected teeth (11 and 21), and cone beam computed tomography (CBCT) revealed that the pulp cavities in all teeth were almost completely calcified. Thus, the root canal treatment (RCT) was attempted and followed by crown restoration for the affected teeth. The involvement of GCs in the pulp cavity calcification was assessed. Conclusion According to this case and a series of related studies, long-term use of glucocorticoids is associated with the incidence of pulp cavity obliteration (PCO). More frequent dental examinations and appropriate adjustments in medication use (dose and duration) should be considered and implemented.