Teeth: malignant neoplasms in the dental pulp?

SummaryCommon pathologies of the dental pulp differentiate between acute and chronic inflammatory states caused by caries or dental trauma. Inflammations of the dental pulp as a result of neoplastic alterations are generally considered non-existent. In fact, using the search phrase “dental pulp” combined with “sarcoma”, “carcinoma”, or “neoplasms” in PubMed when using the MeSH search mode yielded no reports on primary malignant neoplasms. However, a hand search yields clinical reports on pulpal tumours that were published over a century ago. In this Essay, the results of a hand search in historic published work are presented. Furthermore, deductive reflections are done on general tumour pathogenesis with respect to specific anatomical prerequisites of the dental pulp. Because of the restricted space in a tooth, tumour expansion will probably lead to the formation of irritation dentine by secondary odontoblasts and, subsequently, to a haemorrhage infarct of the pulp. One hypothesis states that a purported neoplasm of the dental pulp leads to a chronic appositive pulpitis and–sooner or later–will be treated likewise by root-canal treatment or extraction. Further research, including stem-cell studies, is recommended.