Associations Between Imaging-Detected Pulp Calcification and Systemic Diseases: A Systematic Review, Thematic...

Area of Science:

• Oral Radiology
• Systemic Health
• Evidence Synthesis

Background:

• Pulp calcification (PC) is a common dental finding, traditionally linked to local factors or aging.
• Emerging evidence suggests PC may be associated with broader systemic biological disturbances.
• Understanding this link could enhance the interpretation of dental findings in systemic health contexts.

Purpose of the Study:

• To systematically evaluate the association between imaging-detected PC and various systemic conditions.
• To synthesize evidence across diverse disorders and identify recurring biological and methodological patterns.

Main Methods:

• Conducted comprehensive literature searches across multiple databases up to November 2025.
• Included observational studies assessing PC and systemic conditions; assessed study quality using established tools.
• Employed a mixed-methods synthesis combining thematic analysis with random-effects meta-analysis.

Main Results:

• Included 33 studies (19,057 patients); meta-analysis revealed a significant association between systemic conditions and PC (OR=2.69).
• Consistent association found for diabetes mellitus (OR=2.30, I²=0.0%) and atherosclerosis (OR=4.70, I²=0.0%).
• Evidence for renal and genetic conditions was exploratory and of very low certainty; thematic analysis suggested metabolic and vascular triggers.

Conclusions:

• A statistically significant association exists between imaging-detected PC and systemic metabolic/vascular conditions, especially diabetes and atherosclerosis.
• The evidence is primarily observational, limiting conclusions on causality, temporality, or diagnostic utility.
• PC may indicate systemic dysregulation, but its biological significance requires cautious, context-dependent interpretation.