Comparison of the Presence and Frequency of Pulp Stones in Mandibular Teeth with Panoramic Radiography and Cone Beam Computed Tomography Images: A Retrospective Study

Abstract

Background: This study aimed to evaluate and compare the diagnostic effectiveness of cone beam computed tomography (CBCT) and panoramic radiography in detecting pulp stones in mandibular teeth and investigate the relationship between pulp stone prevalence and demographic variables.

Methods: This retrospective study analyzed a total of 1947 mandibular teeth from 150 patients (80 males, 70 females) using both CBCT and panoramic radiography images. Teeth were categorized into 4 anatomical groups: incisors, canines, premolars, and molars. The presence of pulp stones was assessed by a calibrated observer for each imaging modality. Chi-square tests were employed to determine statistical significance (P < .05) in detection rates between imaging modalities and across demographic variables.

Results: Cone beam computed tomography demonstrated significantly greater sensitivity in the detection of pulp stones compared to panoramic radiography, particularly in molars (27.3% vs. 8.7%) and anterior teeth, where panoramic radiography frequently failed to detect pulp stones. A statistically significant difference in pulp stone prevalence was observed in the canine group, with higher detection rates in females than males (11.4% vs. 1.3%, P=.009). The CBCT demonstrated superior sensitivity (94.1%, 95% CI: 89.2%-97.3%) compared to panoramic radiography (31.7%, 95% CI: 24.8%-39.4%) for pulp stone detection, with specificity values of 100% for both modalities.

Conclusion: Cone beam computed tomography is significantly more effective than panoramic radiography for detecting pulp stones in mandibular dentition, offering enhanced diagnostic capability, particularly in complex anatomical regions. While sex may influence pulp stone prevalence in specific tooth groups, age does not appear to be a determining factor within the examined cohort.

Cite this article as: Eren İ, Şahin YN. Comparison of the presence and frequency of pulp stones in mandibular teeth with panoramic radiography and cone beam computed tomography images: A retrospective study. Essent Dent. 2025, 4, 0075, doi:10.5152/ EssentDent.2025.25075.