Pulp Stones as Risk Predictors for Coronary artery disease (CAD)

Context and Aim: Coronary artery disease (CAD) has been recorded as the leading cause of morbidity and mortality worldwide. Studies indicate that subjects with CAD show higher degree of pulp calcifications. Localized pulp calcifications are microscopically apparent in more than half of the teeth in young adolescents. However, pulp stones extending to the entire dentition are infrequent and need further evaluation to predict the risk of other probabilities of associated diseases. The present study was planned to estimate the prevalence of pulp stones in subjects diagnosed with or, undergoing treatment for CAD. Materials and Methods: The present study consisted of 300 subjects within an age range of 20-55 years who were divided into the study group consisting of 150 subjects including 108 males and 42 females and 150 age and sex-matched controls. Pulp stones were imaged using bitewing radiographs using paralleling technique under standard conditions. The radiographs were interpreted separately by two experienced radiologists. Statistical Analysis Used: The statistical analysis was performed using IBM SPSS statistics 20 Core system software (SPSS Inc., Chicago, IL, USA) while statistical tests used were unpaired t-test and Z test. Chi-square test was used to check the prevalence of pulp stones in CAD subjects in addition to their arch wise and region wise distribution while p-value less than 0.05 was considered statistically significant. Results: CAD subjects exhibited 100% prevalence of pulp stones while posterior teeth were predominantly affected (p<0.05). Furthermore, pulp stones were significantly higher in the maxilla than in the mandible in both the groups (p<0.05). No significant difference was found in gender predilection in the study group, although, the control group showed a definite preponderance for the males for development of pulp stones (p<0.05). Conclusion: CAD subjects have high chance of being affected with pulp stones. Higher prevalence of this entity in multiple teeth may warrant such an individual, in the presence of other compounding risk factors, as a candidate for CAD to be ruled-out.