Evaluation of pulp stone between a sub-group of Iraqi population using CBCT radiographs: a retrospective observational study.

BACKGROUND

Pulp stones (PS) or denticles are a type of calcification foci that are found in the coronal pulp or, less frequently, radicular pulp cavity. The appearance of PS might hinder endodontic treatments in some cases.

OBJECTIVE

To examine the distribution of PS in a subgroup of the Iraqi population and to detect the factors that induce this condition among patients.

METHODS

This cross-sectional study was conducted retrospectively at the FOTON Maxillofacial Imaging Centre, Sulaimaniyah, Iraq, from January 2020 to December 2025, using participants' data from the imaging centre's database. Cone-beam computed tomography (CBCT) images of 6147 teeth of 250 participants (125 males and 125 females) aged 15 to 56 years and older were evaluated. PS were considered when separate radiopaque masses were found in the pulp cavity; the association of PS with patients' age, gender, and dental factors was then estimated.

RESULTS

PS were identified in 33.6% of participants and 2.9% of teeth. After adjustment for age and gender, female was identified as a significant independent predictor of PS occurrence at the tooth level only (p = 0.004). In contrast, age group was not significantly associated with PS prevalence at either the patient or tooth level. More PS was found in molars and the maxilla, specifically in restored and carious teeth.

CONCLUSIONS

Nearly one-third of the Iraqi subgroup had PS, frequently in the molars, maxilla, and non-intact teeth. Female sex was identified as an independent predictor of PS occurrence. These findings suggest that dental factors and gender are more important factors for developing PS than chronological aging.