Pulp Testing Research Paper
IS THERE A RELIABLE METHOD FOR TESTING THE VITALITY OF TEETH IN MAN?
Introduction
Vitality assessment of teeth is a critical diagnostic procedure, but is complicated by the fact that pulp tissue is encased within calcified tissue and cannot directly be accessed without invasive procedures. Pulp condition cannot be determined from a single test; diagnosis involves a fusion of history, radiological examination, clinical examination and special tests.
Pulp testing may be indicated prior to operative procedures. It should be remembered that pulpal deterioration can occur without supplementary symptoms (Kramer, 1954). The origin of most oral pain is pulpal (Ehrmann, 1977). Pulp testing is valuable in the diagnosis of pain in the trigeminal area …show more content…
The tester should be placed on the tooth surface adjacent to a pulp horn (highest density of nerve fibres). According to Lin and co-workers (2007), the optimum site of tester placement on molars is the mesiobuccal cusp tip. An ionic shift in dentinal tubule fluid causes local depolarisation and action potential generation from intact Aδ nerves, giving a positive result where the patient feels warmth or a tingling sensation. Reproducibility may be compromised due to lack of intrinsic accuracy of electric pulp …show more content…
False positive results may be obtained from supporting tissues, so caution is advised. The clinician must keep in mind that blood pigments within a discoloured tooth crown can interfere with laser light transmission (Gopikrishna et al, 2009).
Transmitted light photoplethysmography
This non-invasive technique monitors pulpal blood flow and incurs less signal contamination from periodontal blood flow than for LDF.
Pulse oximetry
It utilises the pulsatile changes in blood volume to determine the saturation of arterial blood. It is crucial that the sensor conforms to the size, shape and anatomical contours of the teeth. The test’s accuracy is dependent on a normal arterial blood flow. Measurements may be unobtainable during hypovolemia, hypothermia or intense peripheral vasoconstriction (Wilson and Shapiro, 2001). Specificity may be lowered when the pulp is undergoing calcific changes; a radicular vital pulp with coronal calcification may cause a false negative response (Gopikrishna et al, 2009).
Fibre-based laser speckle imaging
It can detect the presence of pulsatile flow. This recently developed technique is based on the observation that dentine tubules act as light-guiding conduits (Regan et al, 2015).
Introduction
Vitality assessment of teeth is a critical diagnostic procedure, but is complicated by the fact that pulp tissue is encased within calcified tissue and cannot directly be accessed without invasive procedures. Pulp condition cannot be determined from a single test; diagnosis involves a fusion of history, radiological examination, clinical examination and special tests.
Pulp testing may be indicated prior to operative procedures. It should be remembered that pulpal deterioration can occur without supplementary symptoms (Kramer, 1954). The origin of most oral pain is pulpal (Ehrmann, 1977). Pulp testing is valuable in the diagnosis of pain in the trigeminal area …show more content…
The tester should be placed on the tooth surface adjacent to a pulp horn (highest density of nerve fibres). According to Lin and co-workers (2007), the optimum site of tester placement on molars is the mesiobuccal cusp tip. An ionic shift in dentinal tubule fluid causes local depolarisation and action potential generation from intact Aδ nerves, giving a positive result where the patient feels warmth or a tingling sensation. Reproducibility may be compromised due to lack of intrinsic accuracy of electric pulp …show more content…
False positive results may be obtained from supporting tissues, so caution is advised. The clinician must keep in mind that blood pigments within a discoloured tooth crown can interfere with laser light transmission (Gopikrishna et al, 2009).
Transmitted light photoplethysmography
This non-invasive technique monitors pulpal blood flow and incurs less signal contamination from periodontal blood flow than for LDF.
Pulse oximetry
It utilises the pulsatile changes in blood volume to determine the saturation of arterial blood. It is crucial that the sensor conforms to the size, shape and anatomical contours of the teeth. The test’s accuracy is dependent on a normal arterial blood flow. Measurements may be unobtainable during hypovolemia, hypothermia or intense peripheral vasoconstriction (Wilson and Shapiro, 2001). Specificity may be lowered when the pulp is undergoing calcific changes; a radicular vital pulp with coronal calcification may cause a false negative response (Gopikrishna et al, 2009).
Fibre-based laser speckle imaging
It can detect the presence of pulsatile flow. This recently developed technique is based on the observation that dentine tubules act as light-guiding conduits (Regan et al, 2015).