Edds A C, Walden J E, Scheetz J P, Goldsmith L J, Drisko C L, Eleazer P D
University of Louisville, Louisville, KY, USA.
J Endod. 2005 Jul;31(7):504-6. doi: 10.1097/01.don.0000168890.42903.2b.
We propose that calcification of dental pulp may have a similar pathogenesis as calcified atheromas and could lead to use of routine dental radiographs as a rapid screening method for early identification of potential cardiovascular disease (CVD). Fifty-five dental patients ages 20 to 55 were chosen because pulp stones in pulpally noninflamed teeth were not expected in this age group. They completed a questionnaire regarding their CVD status and that of their parents and siblings. Entry criteria included at least one asymptomatic, minimally restored, noncarious molar and no history of gout, renal disease, or renal lithiasis. Patients' periapical radiographs of record were viewed to determine the presence of pulp stones. There was a significant relationship between pre-existing CVD and pulp stones (odds ratio of 4.4 with a 95% confidence interval of 1.1, 18.7), but no relationship was found for family history of CVD and pulp stones (odds ratio of 1.7 with a 95% confidence interval of 0.5, 5.5). Seventy-four percent (14/19) of patients with reported CVD had detectable pulp stones while only 39% (14/36) of patients without a history of CVD had pulp stones. This pilot study demonstrates that patients with CVD have an increased incidence of pulp stones in teeth with noninflamed pulps compared to patients with no history of CVD. No relationship was found between presence of pulp stones and family history of CVD. The findings suggest that dental radiographic determination of the presence or absence of pulp stones may have possibilities for use in CVD screening.
我们认为,牙髓钙化可能与动脉粥样硬化斑块钙化有着相似的发病机制,并且这可能会使得常规牙科X光片成为早期识别潜在心血管疾病(CVD)的一种快速筛查方法。选取了55名年龄在20至55岁之间的牙科患者,因为预计在这个年龄组中牙髓未发炎的牙齿不会出现髓石。他们填写了一份关于自身及父母和兄弟姐妹心血管疾病状况的问卷。纳入标准包括至少一颗无症状、修复最少、无龋的磨牙,且无痛风、肾病或肾结石病史。查看患者已有的根尖片以确定髓石的存在情况。已患心血管疾病与髓石之间存在显著关联(优势比为4.4,95%置信区间为1.1至18.7),但未发现心血管疾病家族史与髓石之间存在关联(优势比为1.7,95%置信区间为0.5至5.5)。报告患有心血管疾病的患者中有74%(14/19)可检测到髓石,而无心血管疾病史的患者中只有39%(14/36)有髓石。这项初步研究表明,与无心血管疾病史的患者相比,患有心血管疾病的患者牙髓未发炎的牙齿中髓石的发生率更高。未发现髓石的存在与心血管疾病家族史之间存在关联。这些发现表明,通过牙科X光片确定髓石的有无可能用于心血管疾病筛查。