Pulp stones (also denticles or endoliths) are nodular, calcified masses appearing in either or both the coronal and root portion of the pulp organ in teeth. Pulp stones are not painful unless they impinge on nerves. They are classified:
A) On the basis of structure
1) True pulp stones: formed of dentin by odontoblasts
2) False pulp stones: formed by mineralization of degenerating pulp cells, often in a concentric patternB) On the basis of location
1) Free: entirely surrounded by pulp tissue
2) Adherent: partly fused with dentin
3) Embedded: entirely surrounded by dentin

Introduction
Pulp stones are discrete calcifications found in the pulp chamber of the tooth which may undergo changes to become diffuse pulp calcifications such as dystrophic calcification. They are usually noticed by radiographic examination and appeared as round or ovoid radiopaque lesions. Clinically, a tooth with a pulp stone has normal appearance like any other tooth. The number of pulp stones in a single tooth may vary from 1 to 12 or more, with varying sizes from minute particles to large masses which tend to occlude the pulpal space. It is reported that pulp stones are more commonly found in the coronal region of pulp, albeit also found in the radicular pulp.It is believed that pulp stones develop around a central nidus of pulp tissue, for instance collagen fibril, ground substance and necrotic cell remnants. Initial calcification occurs around the central nidus and extends outward with regular calcified material in a concentric or radial manner.
A pulmonary consolidation is a region of normally compressible lung tissue that has filled with liquid instead of air. The condition is marked by induration (swelling or hardening of normally soft tissue) of a normally aerated lung. It is considered a radiologic sign. Consolidation occurs through accumulation of inflammatory cellular exudate in the alveoli and adjoining ducts. The liquid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood (from bronchial tree or hemorrhage from a pulmonary artery). Consolidation must be present to diagnose pneumonia: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation. Signs
Signs that consolidation may have occurred include:

Expansion of the thorax on inspiration is reduced on the affected side
Vocal fremitus is increased on the affected side
Percussion is dull in the affected area
Breath sounds are bronchial
Possible medium, late, or pan-inspiratory crackles
Vocal resonance is increased. Here, the patients voice (or whisper, as in whispered pectoriloquy) can be heard more clearly when there is consolidation, as opposed to the healthy lung where speech sounds muffled. A pleural rub may be present. A lower PAO2 than calculated in the alveolar gas equation

Diagnosis
Radiology
Typically, an area of white lung is seen on a standard X-ray. Consolidated tissue is more radio-opaque than normally aerated lung parenchyma, so that it is clearly demonstrable in radiography and on CT scans. Consolidation is often a middle-to-late stage feature/complication in pulmonary infections. See also
Pulmonary infiltrate

References


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