Multiple pulp stones and shortened roots of unknown etiology

An unusual case of generalised pulpal calcifications (pulp stones) with normal clinical crowns is reported in a 13-year-old boy. Radiographic examination revealed pulp stones in the single rooted and premolar teeth, situated at the midroot level, with the roots bulging around them. The apical portion of the roots, periodontal ligament space, and surrounding bone had a normal radiographic appearance, apart from the upper premolars, and no periapical pathology was discernible. The upper premolars exhibited considerably shortened roots. No medical, dental, or family history was found to be contributory. Reviewing the literature revealed similar cases, but with differing diagnoses including dentine dysplasia (DD) or idiopathic cases. This report suggests either a variation of DD or possibly a new nonsyndromic dentine defect, and highlights the difficulties in establishing a definitive diagnosis by traditional methods. The recent discovery that mutation of the bicistronic dentine sialophosphoprotein gene (DSPP) is involved in DD may provide solutions to this problem.