Correlation between Pulp Stones and Gall Bladder Stones: A Radiographic Retrospective Case-Control Study

Calcifications can occur in the dental pulp as discrete bodies known as pulp stones. Their etiology remains obscure. They were believed to be formed as a result of local irritating factors within the pulp; however, a few authors now suggest that they may be a part of systemic biomineralization process that affects many body parts such as kidneys, gall bladder, joints, arteries as well as pulp leading to formation of stones.

This retrospective case-control study was taken up to (i) determine the prevalence of pulp stones as well as pulp chamber narrowing in patients with gallbladder stones as well as the controls (ii) whether any correlation exists between the prevalence of pulp stones and gallbladder stones so as to test the hypothesis that pulp stones and gallbladder stones may be a part of a common systemic calcification process.

This retrospective case-control study was conducted in the Department of Gastroenterology and Department of Radiodiagnosis, Sri Guru Ram Das Institute of Medical Sciences and Research, Amritsar. A total of 200 individuals were taken up for the study. Group I consisted of 100 patients (cases) with confirmed diagnosis of gallbladder stones. Group II included the control group in which individuals who were the close relatives of the patients with gall bladder stones were taken (n = 100), so as to eliminate the common confounding factors in these two groups such as diet, air, water, environment, genes, and age, which could affect the formation of pulp stones could not be the reason for the formation of pulp stones.

Standard bitewing radiographs were taken for all the patients in each group and presence or absence of pulp chamber narrowing and pulp stones were observed.

McNemar's statistical test was used to find the difference between the two groups, and the P value was determined. Coefficient of association using the Phi coefficient was used to determine if there was any association between the two groups.

In Group I, 37% of the patients with gallbladder stones showed the presence of pulp stones; whereas in the Group II which was the control, 57% of individuals showed the presence of pulp stones. McNemar's test of significance calculated with one-degree freedom (1-df) showed that P = 0.01, thereby showing that there was a significant difference between these two groups.

According to the study, a negative correlation between pulp stones and gallbladder stones was found and they are not related to each other.