Annals of Tropical Medicine and Public Health
Home About us Ahead Of Print Instructions Submission Subscribe Advertise Contact e-Alerts Editorial Board Login 
Users Online:937
  Print this page  Email this page Small font sizeDefault font sizeIncrease font size
 


 
Table of Contents   
LETTER TO THE EDITOR  
Year : 2015  |  Volume : 8  |  Issue : 1  |  Page : 19-20
Pulp stones' association with renal stones: "A minute one can help detect a large one"


1 Department of Periodontics, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India
2 Department of Oral Medicine and Radiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab, India

Click here for correspondence address and email

Date of Web Publication8-May-2015
 

How to cite this article:
Bains AB, Bains SK. Pulp stones' association with renal stones: "A minute one can help detect a large one". Ann Trop Med Public Health 2015;8:19-20

How to cite this URL:
Bains AB, Bains SK. Pulp stones' association with renal stones: "A minute one can help detect a large one". Ann Trop Med Public Health [serial online] 2015 [cited 2019 Oct 21];8:19-20. Available from: http://www.atmph.org/text.asp?2015/8/1/19/156725
Dear Sir,

The following annotations are an effort to explore the association of pulp stones with renal stones, and subsequently with cardiovascular diseases (CVDs). Early recognition of pulp stones may be useful in the identification of renal stones and also in the prevention of developing CVDs.

Pulp stones are the foci of calcification in the dental pulp. These may be free, attached to, or embedded to the dentine. Histologically, they are classified into "true" and "false" pulp stones, the former containing irregular dentine and the latter being degenerative pulp calcifications. [1] Pulp stones may impinge the nerve to which they are closely attached and hence, some pain of an idiopathic nature may be caused by these. There could be release of pain, causing substances like 5-hydroxytryptamine and potassium ion from blood platelets and red blood cells. [2]

Urolithiasis is a problem that has confronted clinicians since the time of Hippocrates, and many family physicians have extensive experience in its clinical management. [3]

The prevalence of urolithiasis is approximately 2-3% in the general population, and the estimated lifetime risk of developing a kidney stone is about 12% for white males. The overall probability of forming stones differ in various parts of the world and is estimated to be 1-5% in Asia, 5-9% in Europe, and 13% in North America (Robertson 1993); the recurrence rate of renal stones is about 75% in a 20-year span (Sutherland et al. 1985). Approximately, 50% of the patients with previous urinary calculi have recurrence within 10 years. [3] Kidney stone disease is a multifactorial disorder resulting from the combined influence of epidemiological, biochemical, and genetic risk factors. [4] It occurs in both men and women, but the risk is generally high in men and is becoming more common in young women (Selvem 2002).

The formation of pulp stones resembles the formation of kidney stones. A recent immunohistochemical study by Ninomiya et al. investigated the organic matrix component of human pulp stones, using specific antibodies to type I collagen and noncollagenous proteins (osteopontin, osteonectin, and osteocalcin). It was found that type I collagen was evenly located throughout the pulp stones, showing that it is a major matrix component of the free pulp stones, whereas osteopontin was found in the peripheral area of the pulp stones, suggesting that it plays an integral part in the calcification front and that it has come from less differentiated pulp cells. [5] In a study by Couble et al. it was shown that osteopontin produced cells from third molar germs that have odontoblastic features, which include the formation of type I collagen and the subsequent hydroxyapatitic mineralization of the same. [6] In their immunohistochemical study on atherosclerotic plaques and urinary stones, Hirota et al. and Kohri et al. found similar occurrence of osteopontin in these calcifications. [7]

Nephrolithiasis is gradually being recognized as a systemic disease, indicative of an adverse metabolic environment. [8] Previous studies have documented an increased prevalence and incidence of hypertension in stone formers and a higher incidence of nephrolithiasis in hypertensive patients. [8]

Patients having pulp stones should be screened for the possible presence of renal stones, as the formation of both carries similar pathogenesis. Authors suggest that routine dental radiographs could possibly have prognostic significance or even theoretically be used as a rapid screening method for early identification of potential pulp stones and renal stones. Dental radiographs require minimal radiation, especially the newer digital imaging techniques available. Such a screening method could easily be employed on a large scale as a public health measure, perhaps many years before renal diseases and cardiovascular symptoms occur. [9] There is a need for prospective long-term studies to assess the risk for CVDs, and it is recommended that a careful assessment of cardiovascular risk factors be undertaken in patients with pulp stone formation.

 
   References Top

1.
Goga R, Chandler NP, Oginni AO. Pulp stones: A review. Int Endod J 2008;41:457-68.   Back to cited text no. 1
    
2.
Mukhtar H. Abdel Wahab Pulp stones and dental pain. SDJ 1989;1:65-6.  Back to cited text no. 2
    
3.
Portis AJ, Sundaram CP. Diagnosis and initial management of kidney stones. Am Fam Physician 2001;63:1329-38.  Back to cited text no. 3
    
4.
Abbagani S, Gundimeda SD, Varre S, Ponnala D, Mundluru HP. Kidney stone disease: Etiology and evaluation. Int J App Bio and Pharma Tech 2010;1:175-82.  Back to cited text no. 4
    
5.
Ninomiya M, Ohishi M, Kido J, Ohsaki Y, Nagata T. Immunohistochemical localization of osteopontin in human pulp stones. J Endod 2001;27:269-72.  Back to cited text no. 5
    
6.
Couble ML, Farges JC, Bleicher F, Perrat-Mabillon B, Boudeulle M, Magloire H. Odontoblast differentiation of human dental pulp cells in explant cultures. Calcif Tiss Int 2000;66:129-38.   Back to cited text no. 6
    
7.
Hirota S, Imakita M, Kohri K, Ito A, Morii E, Adachi S, et al. Expression of osteopontin messenger RNA by macrophages in atherosclerotic plaques. A possible association with calcification. Am J Pathol 1993;143:1003-8.  Back to cited text no. 7
    
8.
Domingos F, Serra A. Nephrolithiasis is associated with an increased prevalence of cardiovascular disease. Nephrol Dial Transplant 2011;26:864-8.  Back to cited text no. 8
    
9.
Ezoddini Ardekani F, Mohammadi Z, Hashemian Z, SadrBafghi M, Hedayati A, Rahmani Baghemalek MJ. Exploring the relationship between dental pulp stones and ischemic cardiovascular diseases. JDM 2009;22:74-80.  Back to cited text no. 9
    

Top
Correspondence Address:
Dr. Sandeep Kumar Bains
Department of Oral Medicine and Radiology, Dasmesh Institute of Research and Dental Sciences, Faridkot, Punjab
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.156725

Rights and Permissions




 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
    Email Alert *
    Add to My List *


    References

 Article Access Statistics
    Viewed1359    
    Printed29    
    Emailed0    
    PDF Downloaded14    
    Comments [Add]    

Recommend this journal