Associations Between Imaging-Detected Pulp Calcification and Systemic Diseases: A Systematic Review, Thematic Analysis, and Meta-Analysis.
José Evando da Silva-Filho, Paula Maria da Costa Torres, Eduardo Diogo Gurgel-Filho
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In 30 seconds
This systematic review, thematic analysis and random-effects meta-analysis examined observational studies of imaging-detected pulp calcification (PC) and systemic conditions. Across 33 studies comprising 19 057 patients, the primary meta-analysis of 22 studies found higher odds of PC among people with systemic conditions (OR = 2.69; 95% CI: 2.04-3.54), with substantial heterogeneity. Associations were consistent for diabetes mellitus and strongest in atherosclerosis-focused analyses, while broader cardiovascular disease findings were not statistically significant. Evidence certainty ranged from low to very low; the review does not establish causality, prediction or diagnostic utility.
Key findings
- The primary meta-analysis found an association between systemic conditions and PC (OR = 2.69; 95% CI: 2.04-3.54), with substantial heterogeneity.
- Diabetes mellitus was associated with PC (OR = 2.30; I 2 = 0.0%), with no statistical heterogeneity.
- Atherosclerosis-focused analyses showed the largest association (OR = 4.70; I 2 = 0.0%); broader cardiovascular disease conditions were not statistically significant (p = 0.155).
- Evidence for renal and specialised genetic conditions was exploratory, based on two studies, and rated very low certainty.
Why it matters
The findings suggest that dental pulp calcification may co-occur with systemic metabolic and vascular conditions, so it could be relevant context when interpreting dental imaging. However, the evidence is observational and low to very low certainty. It does not show that PC precedes or predicts systemic disease, nor that it can diagnose it; its biological significance remains uncertain.
What to keep in mind
The evidence is predominantly observational, with substantial heterogeneity in the primary analysis and low to very low certainty across outcomes. The review does not establish causality, temporality, prediction or diagnostic utility.