Análise clínica, morfológica, topográfica e química de mineralizações pulpares

Abstract

Introduction: pulp mineralizations are structures formed by hard tissue, located within the pulp tissue, and derived from a tissue alteration process that predisposes to the deposition of calcium phosphate salts. The literature suggests that long-duration, low-intensity pathological stimuli are the main etiological factors of mineralizations in the pulp tissue. Objective: to analyze the clinical aspects, morphological, topographic, and chemical patterns of pulp mineralizations. Material and methods: the research used 44 pulp mineralizations from teeth requiring endodontic treatment in a Polish population. Clinical data from the patients were collected, and the pulp mineralizations were removed after access surgery to the pulp chamber. Computational microtomography was used for morphological and topographic evaluation of the structures, and Raman spectroscopy was used to analyze and characterize the chemical composition of the sample, in terms of mineral-to-matrix ratio and carbonate content. Results: Clinical data revealed that pulp mineralizations, in the studied sample, occurred more frequently in women, in the maxilla, on the left side of the face, and in molars, especially the first molars, consistent with the literature. The most affected age group comprised patients between 19 and 59 years old. The location in the pulp cavity correlated with the morphology of the mineralizations, but not with the topography. The most prevalent morphological aspect was irregular, while the predominant topography was mixed. There was no statistical difference in the mineral/matrix ratio between the morphological types; however, irregular nodules presented a higher carbonate content, with a statistically significant difference compared to the other morphological types. In terms of topography, smooth and compact nodules presented a higher mineral-to-matrix ratio, indicating a more mineralized structure, with a statistically significant difference compared to the other types; however, the carbonate content did not differ between the topographic types. Conclusion: in the studied sample, pulp mineralizations occurred predominantly in the first left upper molars of adult women. Irregular nodules were the most prevalent morphological types, especially in the pulp chamber, while cylindrical morphology was predominant in the root canal. Irregular mineralizations had a higher carbonate content, indicating a less developed mineralization process. Smooth and compact mineralizations were more mineralized than the other topographic types.