Denticles. A literature review

Denticles are pulp degenerations in the form of calcified deposits of mineral salts, usually found in molars and lower incisors, as well as in impacted teeth and deciduous molars. Denticles may come in various sizes, from microscopic particles to larger mass that almost obliterate the pulp chamber and are visible only on X-ray images. Denticles form as a result of chronic inflammatory lesions, but may also be caused by injuries and conservative treatment. They are most frequently found in necrotic foci. Denticles may cause problems for root canal treatment, as their presence might make it difficult to obtain proper access to the pulp chamber bottom and the canal orifices. There is also the increased risk of bending or breaking the endodontic instruments. Sometimes, denticles fill the entire space of the tooth chamber and pushing the pulp to the edges of the chamber. Denticles can cause pain due to the pressure on the nerves and blood vessels supplying the internal tissue of the tooth. The presence of large denticles might eventually lead to necrosis of the pulp. Denticles accompany certain diseases, such as dentin dysplasia, odontodysplasia or Albright hereditary dystrophy.