Fixed Orthodontic Treatment Linked to Increased Pulp Stone Formation: Study
Researchers have discovered in a new study that fixed orthodontic treatment is associated with a higher incidence of pulp stone formation, irrespective of tooth extraction status. These findings may assist clinicians in early detection and monitoring of teeth at risk during orthodontic care. The study was published in the journal of Clinical and Experimental Research by Kosar G. and colleagues.
This research sought to compare pulp stone development in patients undergoing orthodontic treatment with extractions and those treated without extractions. Authors examined panoramic dental radiographs of 80 orthodontic patients treated from 2014 to 2020. The sample consisted of 40 patients in the extraction group and 40 in the non-extraction group, all of whom possessed a complete set of permanent molars. 640 molars were assessed for pulp stones, both pre- and post-treatment.
Analysis of data was performed using McNemar test and Chi-square, with the statistical significance level at p < 0.05. Data analysis was carried out using SPSS software.
Results
• The research found high and significant pulp stone formation after orthodontic treatment in both groups.
• In the extraction group, the rise was significantly higher (p < 0.001), whereas in the non-extraction group, the rise was also significant but less severe (p = 0.02).
• Although the increase in each group was evident, there was no statistically significant difference found between the extraction and non-extraction groups concerning the overall incidence of pulp stone formation (p = 0.09), as it means that extractions do not significantly affect the risk of having pulp stones during orthodontic treatment.
• Gender did not play a role in either group since no difference between males and females was observed for pulp stone frequency (p = 0.392 for extraction; p = 0.451 for non-extraction).
• In the extraction group, first molars were more affected compared to second molars (p = 0.001), whereas in the non-extraction group, the difference was not significant (p = 0.108).
• Also, there was no association detected between the formation of pulp stone and the jaw affected (mandible vs. maxilla) (p > 0.05).
Orthodontic treatment, with or without extractions, greatly enhances the occurrence of pulp stone formation in molar teeth. Such calcifications can complicate endodontic treatment and should be followed closely via radiographic examination during and after orthodontic treatment. The study advises clinicians to be cautious and include pulp health examination as part of routine orthodontic treatment protocols to reduce long-term complications.
Reference:
Gholinezhad, K., Ghorbani, H., Seyedmajidi, S., Sheikhzadeh, S., & Rahmati Kamel, M. (2025). Pulp stone formation following fixed orthodontic treatment: A panoramic radiographic comparison of extraction and non‐extraction approaches. Clinical and Experimental Dental Research, 11(4). https://doi.org/10.1002/cre2.70181
