{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T10:43:57Z","timestamp":1790419437602,"version":"4.1.0"},"reference-count":34,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2020,12,11]],"date-time":"2020-12-11T00:00:00Z","timestamp":1607644800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>The detection of pulp stone in a patient suffering from undiagnosed systemic diseases can be an early diagnostic indicator. Thus, the aim of the study was to assess the prevalence of pulp stones in the Saudi Arabian population with cardiovascular diseases and diabetes mellitus. In a retrospective study, we included cone-beam computed tomography (CBCT) scans of 73 patients with cardiovascular disease and 76 patients with diabetes mellitus as group I and II, respectively. Group III comprised of CBCT scan of 80 healthy controls. From a total of 229 scans, 4807 teeth were screened for pulp stones throughout the arches. A chi-square test was used for comparing the prevalence of pulp stones among the groups. Univariable and multivariable analysis was done to evaluate the independent risk indicators for pulp stones. The tooth-wise prevalence of pulp stones in group I, II, and III was found to be 16.65%, 9.01%, and 3.86%, respectively. Patient-wise (p &lt; 0.01) and tooth-wise (p &lt; 0.01) prevalence was recorded significantly highest in the cardiovascular group followed by the diabetic group. The control group had the least prevalence. Significantly (p &lt; 0.01) higher number of pulp stones were found in cardiovascular patients with age &gt; 50 years compared to other groups. Similarly, a significantly increased number of pulp stones were seen in the 1st molar (p &lt; 0.05) and the maxillary jaw (p &lt; 0.05) of patients with cardiovascular diseases. Subjects with cardiovascular disease and diabetes were found to have 2.94 times (p &lt; 0.001; CI 1.54\u20133.10) and 1.81 times (p &lt; 0.01; CI 0.48\u20132.06) higher risk of having pulp stones in comparison to healthy subjects. The first molar has 2.20 times (p &lt; 0.001; CI 0.84\u20132.45) increased the risk of having pulp stones compared to other tooth types. Systemic disease such as cardiovascular disease and diabetes mellitus poses a higher risk for the development of pulp stones. Among the systemic disease group, patients in the cardiovascular group showed a higher risk for pulp stones and also reported the maximum number of pulp stones compared to the diabetic and healthy subjects.<\/jats:p>","DOI":"10.3390\/ijerph17249293","type":"journal-article","created":{"date-parts":[[2020,12,13]],"date-time":"2020-12-13T23:39:36Z","timestamp":1607902776000},"page":"9293","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":43,"title":["Assessing the Prevalence and Association of Pulp Stones with Cardiovascular Diseases and Diabetes Mellitus in the Saudi Arabian Population\u2014A CBCT Based Study"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5969-6810","authenticated-orcid":false,"given":"Kumar Chandan","family":"Srivastava","sequence":"first","affiliation":[{"name":"Oral Medicine &amp; Radiology, Department of Oral and Maxillofacial Surgery &amp; Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1073-9920","authenticated-orcid":false,"given":"Deepti","family":"Shrivastava","sequence":"additional","affiliation":[{"name":"Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0251-1253","authenticated-orcid":false,"given":"Anil Kumar","family":"Nagarajappa","sequence":"additional","affiliation":[{"name":"Oral Medicine &amp; Radiology, Department of Oral and Maxillofacial Surgery &amp; Diagnostic Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8593-3659","authenticated-orcid":false,"given":"Zafar Ali","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Oral and Maxillofacial Surgery &amp; Diagnostic Sciences, Division of Oral Surgery, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim A.","family":"Alzoubi","sequence":"additional","affiliation":[{"name":"Periodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6268-6824","authenticated-orcid":false,"given":"Mohammed Assayed","family":"Mousa","sequence":"additional","affiliation":[{"name":"Prosthodontics, Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"},{"name":"Research Fellow, Prosthodontic Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota bharu 16150, Kelantan, Malaysia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"May","family":"Hamza","sequence":"additional","affiliation":[{"name":"Prosthodontics, Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anju P.","family":"David","sequence":"additional","affiliation":[{"name":"Registrar at Al-Jouf Specialist Dental Centre, Ministry of Health, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid","family":"Al-Johani","sequence":"additional","affiliation":[{"name":"Department of Oral Diagnostic Sciences, Faculty of Dentistry, King Abdulaziz University, Jeddah 80200, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Ghazi","family":"Sghaireen","sequence":"additional","affiliation":[{"name":"Prosthodontics, Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7131-1752","authenticated-orcid":false,"given":"Mohammad Khursheed","family":"Alam","sequence":"additional","affiliation":[{"name":"Orthodontics, Department of Preventive Dentistry, College of Dentistry, Jouf University, Sakakah 72345, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,12,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/jebm.12331","article-title":"Prevalence of pulp stones: A systematic review and meta-analysis","volume":"12","author":"Jannati","year":"2018","journal-title":"J. Evid. Based Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1111\/j.1365-2591.2008.01374.x","article-title":"Pulp stones: A review","volume":"41","author":"Goga","year":"2008","journal-title":"Int. Endod. J."},{"key":"ref_3","first-page":"9","article-title":"Prevalence and Analysis of Factors Related to Ooccurrence of Pulp Stone in Adult Restorative Patients","volume":"1","author":"Udoye","year":"2011","journal-title":"Ann. Med Health Sci. Res."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.jds.2016.05.001","article-title":"A histological and radiographic study of pulpal calcification in periodontally involved teeth in a Taiwanese population","volume":"11","author":"Huang","year":"2016","journal-title":"J. Dent. Sci."},{"key":"ref_5","first-page":"863","article-title":"Cytokine genotype distribution in patients with periodontal disease and rheumatoid arthritis or diabetes mellitus","volume":"30","author":"Crincoli","year":"2016","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/j.mehy.2015.02.013","article-title":"Periodontitis as a risk factor for systemic disease: Are microparticles the missing link?","volume":"84","author":"Badran","year":"2015","journal-title":"Med. Hypotheses"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"748","DOI":"10.5005\/jp-journals-10024-2838","article-title":"Assessment of Oral\u2013Systemic Disease Association amongst Dental Patients: A Retrospective Panoramic Radiographic Study","volume":"21","author":"Srivastava","year":"2020","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Bourgeois, D., Inquimbert, C., Ottolenghi, L., and Carrouel, F. (2019). Periodontal Pathogens as Risk Factors of Cardiovascular Diseases, Diabetes, Rheumatoid Arthritis, Cancer, and Chronic Obstructive Pulmonary Disease\u2014Is There Cause for Consideration?. Microorganisms, 7.","DOI":"10.3390\/microorganisms7100424"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1099","DOI":"10.1016\/j.joen.2019.06.006","article-title":"Association between Pulp Stones and Kidney Stones: A Systematic Review and Meta-analysis","volume":"45","author":"Gabardo","year":"2019","journal-title":"J. Endod."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"50","DOI":"10.4103\/0972-0707.105299","article-title":"Idiopathic dental pulp calcifications in a tertiary care setting in South India","volume":"16","author":"Satheeshkumar","year":"2013","journal-title":"J. Conserv. Dent."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Alsweed, A., Farah, R.I., Ps, S., and Farah, R.I. (2019). The Prevalence and Correlation of Carotid Artery Calcifications and Dental Pulp Stones in a Saudi Arabian Population. Diseases, 7.","DOI":"10.3390\/diseases7030050"},{"key":"ref_12","first-page":"509","article-title":"Pulp Stones as Risk Predictors for Coronary Artery Disease (CAD)","volume":"9","author":"Sridevi","year":"2019","journal-title":"Ann. Med Health Sci. Res."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"336","DOI":"10.4236\/health.2015.73038","article-title":"Diagnostic Value of Dental Pulp Stones in the Early Diagnosis of Ischemic Heart Diseases","volume":"7","author":"Nemayandeh","year":"2015","journal-title":"Health"},{"key":"ref_14","first-page":"61","article-title":"Pulp Stones and Hypertension-A Missing Link-A Clinical Study","volume":"4","author":"Narang","year":"2018","journal-title":"Int. J. Res. Health Allied Sci. Clin. Study"},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Inchingolo, F., Martelli, F.S., Isacco, C.G., Borsani, E., Cantore, S., Corcioli, F., Boddi, A., Nguy\u1ec5n, K.C., De Vito, D., and Aityan, S.K. (2020). Chronic Periodontitis and Immunity, Towards the Implementation of a Personalized Medicine: A Translational Research on Gene Single Nucleotide Polymorphisms (SNPs) Linked to Chronic Oral Dysbiosis in 96 Caucasian Patients. Biomedicine, 8.","DOI":"10.3390\/biomedicines8050115"},{"key":"ref_16","first-page":"273","article-title":"Periodontal Disease and Bone Pathogenesis: The Crosstalk between Cytokines and Porphyromonas Gingivalis","volume":"29","author":"Ballini","year":"2015","journal-title":"J. Biol. Regul. Homeost. Agents"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Shrivastava, D., Srivastava, K.C., Dayakara, J.K., Sghaireen, M.G., Gudipaneni, R.K., Al-Johani, K., Baig, M.N., and Khurshid, Z. (2020). BactericidalActivity of Crevicular Polymorphonuclear Neutrophils in Chronic Periodontitis Patients and Healthy Subjects under the Influence of Areca Nut Extract: An In Vitro Study. Appl. Sci., 10.","DOI":"10.3390\/app10145008"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1111\/j.1834-7819.2002.tb00301.x","article-title":"A Radiographic Assessment of the Prevalence of Pulp Stones in Australians","volume":"47","author":"Ranjitkar","year":"2008","journal-title":"Aust. Dent. J."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1111\/iej.13115","article-title":"Cone beam computed tomography in Endodontics\u2014A review of the literature","volume":"52","author":"Patel","year":"2019","journal-title":"Int. Endod. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1016\/j.ajoms.2019.09.009","article-title":"Method to control tongue position and open source image segmentation for cone-beam computed tomography of patients with large palatal defect to facilitate digital obturator design","volume":"32","author":"Farook","year":"2020","journal-title":"J. Oral Maxillofac. Surg. Med. Pathol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Sghaireen, M.G., Alduraywish, A.A., Srivastava, K.C., Shrivastava, D., Patil, S., Al Habib, S., Hamza, M., Ab Rahman, S., Lynch, E., and Alam, M.K. (2020). Comparative Evaluation of Dental Implant Failure among Healthy and Well-Controlled Diabetic Patients\u2014A 3-Year Retrospective Study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17145253"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Sghaireen, M.G., Srivastava, K.C., Shrivastava, D., Ganji, K.K., Patil, S.R., Abuonq, A., Mousa, M., Odeh, N.D.D., Sghaireen, G.M., and Kamal, M.A. (2020). A CBCT Based Three-Dimensional Assessment of Mandibular Posterior Region for Evaluating the Possibility of Bypassing the Inferior Alveolar Nerve While Placing Dental Implants. Diagnosis, 10.","DOI":"10.3390\/diagnostics10060406"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"377","DOI":"10.21474\/IJAR01\/2405","article-title":"Journey towards the 3d Dental Imaging-the Milestones in the Advancement of Dental Imaging","volume":"4","author":"Srivastava","year":"2016","journal-title":"Int. J. Adv. Res."},{"key":"ref_24","first-page":"804278","article-title":"Assessment of the Prevalence of Pulp Stones in a Sample of Turkish Central Anatolian Population","volume":"2012","author":"Hamidi","year":"2012","journal-title":"Sci. World J."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"109","DOI":"10.2147\/IJN.S13267","article-title":"Association between dental pulp stones and calcifying nanoparticles","volume":"6","author":"Yang","year":"2011","journal-title":"Int. J. Nanomed."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"369","DOI":"10.4103\/0970-9290.70806","article-title":"A radiographic correlation between systemic disorders and pulp stones","volume":"21","author":"Nayak","year":"2010","journal-title":"Indian J. Dent. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1097\/01.don.0000168890.42903.2b","article-title":"Pilot study of correlation of pulp stones with cardiovascular disease","volume":"31","author":"Edds","year":"2005","journal-title":"J. Endod."},{"key":"ref_28","first-page":"456","article-title":"Can Dental Pulp Calcification Predict the Risk of Ischemic Cardiovascular Disease?","volume":"10","author":"Khojastepour","year":"2013","journal-title":"J. Dent."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1016\/S0099-2399(75)80024-0","article-title":"Effect of aging on the human pulp","volume":"1","author":"Bernick","year":"1975","journal-title":"J. Endod."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"755","DOI":"10.4103\/1319-2442.265449","article-title":"The Relationship between carotid artery calcification and pulp stone among hemodialysis patients: A retrospective study","volume":"30","author":"Yilmaz","year":"2019","journal-title":"Saudi J. Kidney Dis. Transplant."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2019\/5907195","article-title":"Diabetes: Oral Health Related Quality of Life and Oral Alterations","volume":"4","author":"Cervino","year":"2019","journal-title":"BioMed Res. Int."},{"key":"ref_32","first-page":"617590","article-title":"Prevalence of Coronal Pulp Stones and Its Relation with Systemic Disorders in Northern Indian Central Punjabi Population","volume":"2014","author":"Bains","year":"2014","journal-title":"ISRN Dent."},{"key":"ref_33","first-page":"2327","article-title":"Assessing pulp stones by cone-beam computed tomography","volume":"21","author":"Prado","year":"2016","journal-title":"Clin. Oral Investig."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jds.2017.06.005","article-title":"The prevalence and distribution of radiopaque, calcified pulp stones: A cone-beam computed tomography study in a northern Taiwanese population","volume":"13","author":"Hsieh","year":"2018","journal-title":"J. Dent. Sci."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/24\/9293\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T10:44:07Z","timestamp":1760179447000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/24\/9293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,12,11]]},"references-count":34,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2020,12]]}},"alternative-id":["ijerph17249293"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17249293","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,11]]}}}