Comparative evaluation of dental pulp tests in pulpal status diagnostics.

  • Roberto E. Campos Department of Operative Dentistry, School of Dentistry, Federal University of Uberlândia. – Uberlândia, MG, Brazil.
  • Paulo César Freitas Santos Filho Department of Operative Dentistry, School of Dentistry, Federal University of Uberlândia. – Uberlândia, MG, Brazil. http://orcid.org/0000-0003-3739-9003
  • Érice França Resende School of Dentistry, Federal University of Uberlândia.
  • Lílian Vieira Oliveira School of Dentistry, Federal University of Uberlândia.
  • Gláucia Maria Bovi Ambrosano Piracicaba School of Dentistry. Campinas State University, São Paulo, SP, Brazil.

Abstract

Introduction: The purpose of this study was to evaluate the effectiveness and compare the accuracy of pulp tests in the diagnosis of teeth pulpal health.
Material and Methods: Traumatized (n=71) and non-traumatized (n=71) teeth from 42 patients were evaluated. Each tooth underwent cold, heat, electric and oximetry tests, followed by radiographic examination and calculation of the sensitivity, specificity, PPV, NPV and accuracy.
Results: Clinical and radiographic examination showed no alteration for the 71 teeth from the intact contralateral group. From the traumatized group, 29 teeth presented complete endodontic treatment, 17 presented periapical alterations that required endodontic treatment and 25 teeth did not present conclusive radiographic alteration. The cold test showed a significantly higher proportion of correct results, while the electric test showed a significantly lower proportion. The data showed higher accuracy for the cold, followed by oximeter and heat tests, while the electric test presented the lowest accuracy. Cold and oximeter tests proved superior over the electric and heat tests, while the electric test showed better parameters when diagnosing diseased pulp.
Conclusion: Combining two pulp tests seems reasonable for improving the pulp diagnoses using both oximeter and cold or oximeter and heat tests to detect healthy pulp; or cold and electric tests to define diseased pulp.

References

[1]. Andreasen FM, Pedersen BV. Prognosis of luxated permanent teeth--the development of pulp necrosis. Endod Dent Traumatol. 1985;1(6):207-20. doi: 10.1111/j.1600-9657.1985.tb00583.x. PMID: 3867505.

[2]. Gazelius B, Olgart L, Edwall B. Restored vitality in luxated teeth assessed by laser Doppler flowmeter. Endod Dent Traumatol. 1988;4(6):265-8. doi: 10.1111/j.1600-9657.1988.tb00645.x. PMID: 3078296.

[3]. Gopikrishna V, Tinagupta K, Kandaswamy D. Comparison of electrical, thermal, and pulse oximetry methods for assessing pulp vitality in recently traumatized teeth. J Endod. 2007;33(5):531-5. doi: 10.1016/j.joen.2007.01.014. PMID: 17437866.

[4]. Gopikrishna V, Pradeep G, Venkateshbabu N. Assessment of pulp vitality: a review. Int J Paediatr Dent. 2009;19(1):3-15. doi: 10.1111/j.1365-263X.2008.00955.x. PMID: 19120505.

[5]. Jafarzadeh H, Abbott PV. Review of pulp sensibility tests. Part I: general information and thermal tests. Int Endod J. 2010;43(9):738-62. doi: 10.1111/j.1365-2591.2010.01754.x. PMID: 20609022.

[6]. Cohen S, Hargreaves KM. Instruments, Materials, and Devices. In: Pathways of the pulp, 9th Ed. Saint Louis, Mosby, 2006.,

[7]. Weisleder R, Yamauchi S, Caplan DJ, Trope M, Teixeira FB. The validity of pulp testing: a clinical study. J Am Dent Assoc. 2009;140(8):1013-7. doi: 10.14219/jada.archive.2009.0312. PMID: 19654254.

[8]. Dastmalchi N, Jafarzadeh H, Moradi S. Comparison of the efficacy of a custom-made pulse oximeter probe with digital electric pulp tester, cold spray, and rubber cup for assessing pulp vitality. J Endod. 2012;38(9):1182-6. doi: 10.1016/j.joen.2012.06.012. PMID: 22892732.

[9]. Farid H, Khan FR, Pasha L, Shinwari MS. ARE PULP SENSIBILITY TESTS STILL SENSIBLE? J Ayub Med Coll Abbottabad. 2015;27(4):874-7. PMID: 27004343.

[10]. Levin LG. Pulp and periradicular testing. J Endod. 2013;39(3 Suppl):S13-9. doi: 10.1016/j.joen.2012.11.047. PMID: 23439039.

[11]. Newton CW, Hoen MM, Goodis HE, Johnson BR, McClanahan SB. Identify and determine the metrics, hierarchy, and predictive value of all the parameters and/or methods used during endodontic diagnosis. J Endod. 2009;35(12):1635-44. doi: 10.1016/j.joen.2009.09.033. PMID: 19932338.

[12]. Bhaskar SN, Rappaport HM. Dental vitality tests and pulp status. J Am Dent Assoc. 1973;86(2):409-11. doi: 10.14219/jada.archive.1973.0081. PMID: 4404999.

[13]. Alghaithy RA, Qualtrough AJ. Pulp sensibility and vitality tests for diagnosing pulpal health in permanent teeth: a critical review. Int Endod J. 2017;50(2):135-142. doi: 10.1111/iej.12611. PMID: 26789282.

[14]. Alghaithy RA, Qualtrough AJ. Pulp sensibility and vitality tests for diagnosing pulpal health in permanent teeth: a critical review. Int Endod J. 2017;50(2):135-142. doi: 10.1111/iej.12611. PMID: 26789282.

[15]. Alghaithy RA, Qualtrough AJ. Pulp sensibility and vitality tests for diagnosing pulpal health in permanent teeth: a critical review. Int Endod J. 2017;50(2):135-142. doi: 10.1111/iej.12611. PMID: 26789282.

[16]. Baumgardner KR, Walton RE, Osborne JW, Born JL. Induced hypoxia in rat pulp and periapex demonstrated by 3H-misonidazole retention. J Dent Res. 1996;75(10):1753-60. doi: 10.1177/00220345960750100801. PMID: 8955670.

[17]. Zadik D, Chosack A, Eidelman E. The prognosis of traumatized permanent anterior teeth with fracture of the enamel and dentin. Oral Surg Oral Med Oral Pathol. 1979;47(2):173-5. doi: 10.1016/0030-4220(79)90175-0. PMID: 284282.

[18]. Mullaney TP, Howell RM, Petrich JD. Resistance of nerve fibers to pulpal necrosis. Oral Surg Oral Med Oral Pathol. 1970;30(5):690-3. doi: 10.1016/0030-4220(70)90395-6. PMID: 5273849.

[19]. Fuss Z, Trowbridge H, Bender IB, Rickoff B, Sorin S. Assessment of reliability of electrical and thermal pulp testing agents. J Endod. 1986;12(7):301-5. doi: 10.1016/S0099-2399(86)80112-1. PMID: 3461119.

[20]. Šimundi? AM. Measures of Diagnostic Accuracy: Basic Definitions. EJIFCC. 2009;19(4):203-11. PMID: 27683318; PMCID: PMC4975285.

[21]. Trevethan R. Sensitivity, Specificity, and Predictive Values: Foundations, Pliabilities, and Pitfalls in Research and Practice. Front Public Health. 2017;5:307. doi: 10.3389/fpubh.2017.00307. PMID: 29209603; PMCID: PMC5701930.

[22]. Baratloo A, Hosseini M, Negida A, El Ashal G. Part 1: Simple Definition and Calculation of Accuracy, Sensitivity and Specificity. Emerg (Tehran). 2015;3(2):48-9. PMID: 26495380; PMCID: PMC4614595.

[23]. Mainkar A, Kim SG. Diagnostic Accuracy of 5 Dental Pulp Tests: A Systematic Review and Meta-analysis. J Endod. 2018;44(5):694-702. doi: 10.1016/j.joen.2018.01.021. PMID: 29571914.

[24]. Balevi B. Cold pulp testing is the simplest and most accurate of all dental pulp sensibility tests. Evid Based Dent. 2019;20(1):22-23. doi: 10.1038/s41432-019-0004-y. PMID: 30903124.

[25]. Petersson K, Söderström C, Kiani-Anaraki M, Lévy G. Evaluation of the ability of thermal and electrical tests to register pulp vitality. Endod Dent Traumatol. 1999;15(3):127-31. doi: 10.1111/j.1600-9657.1999.tb00769.x. PMID: 10530156.

[26]. Chen E, Abbott PV. Evaluation of accuracy, reliability, and repeatability of five dental pulp tests. J Endod. 2011;37(12):1619-23. doi: 10.1016/j.joen.2011.07.004. PMID: 22099893.

[27]. Peters DD, Baumgartner JC, Lorton L. Adult pulpal diagnosis. I. Evaluation of the positive and negative responses to cold and electrical pulp tests. J Endod. 1994 Oct;20(10):506-11. doi: 10.1016/S0099-2399(06)80048-8. PMID: 7714424.

[28]. Villa-Chávez CE, Patiño-Marín N, Loyola-Rodríguez JP, Zavala-Alonso NV, Martínez-Castañón GA, Medina-Solís CE. Predictive values of thermal and electrical dental pulp tests: a clinical study. J Endod. 2013;39(8):965-9. doi: 10.1016/j.joen.2013.04.019. PMID: 23880259.

[29]. Ingle JI, Bakland LK. Endodontics, 5th ed. London: BC Decker Inc, 2002.
Published
2022-04-30
How to Cite
CAMPOS, Roberto E. et al. Comparative evaluation of dental pulp tests in pulpal status diagnostics.. Journal of Oral Research, [S.l.], v. 11, n. 2, p. 1-11, apr. 2022. ISSN 0719-2479. Available at: <https://www.joralres.com/index.php/JOralRes/article/view/joralres.2022.014>. Date accessed: 28 mar. 2024. doi: https://doi.org/10.17126/joralres.2022.014.
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Articles