Evaluation of the Two Commonly Used Pulp Tests for Assessing Pulp Vitality and Sensitivity (original) (raw)
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Dental pulp testing is a useful and essential diagnostic aid in endodontics. Pulp sensibility tests include thermal and electric tests, which extrapolate pulp health from sensory response. Whilst pulp sensibility tests are the most commonly used in clinical practice, they are not without limitations and shortcomings. Pulp vitality tests attempt to examine the presence of pulp blood flow, as this is viewed as a better measure of true health than sensibility. Laser Doppler flowmetry and pulse oximetry are examples of vitality tests. Whilst the prospect is promising, there are still many practical issues that need to be addressed before vitality tests can replace sensibility tests as the standard clinical pulp diagnostic test. With all pulp tests, the results need to be carefully interpreted and closely scrutinised as false results can lead to misdiagnosis which can then lead to incorrect, inappropriate, or unnecessary treatment.
Pakistan BioMedical Journal, 2022
Hard tissue boundaries are limited to pulp tissue and cannot be inspected directly for health evaluation so most of its evaluations are based on sensitivity testing. It is believed that electric pulp test (EPT) has some limitations in determining the vitality of the pulp. Therefore the objective in the current study was to see how well the electric pulp test and the cold test agreed in evaluating pulp vitality and sensitivity. Study Design, Place and Duration: This Observational/Retrospective study was carried from 1st March, 2021 to 31st December, 2021 at the Department of Dental Materials, Sardar Begum Dental College, Gandhara University, Peshawar. Methods: Total one hundred and eighteen patients of both genders had pulpits because of dental caries were included in this study. A range of ages were represented from 18 to 50 years old. As part of the informed written consent process, each patient was asked to provide demographic information such as their age, gender, and the type of...
Agreement between Two Commonly Used Pulp Tests in Determining Pulp Vitality
Agreement between Two Commonly Used Pulp Tests in Determining Pulp Vitality, 2020
Background: The pulp tissue is confined within hard tissue boundaries and cannot be examined directly for health evaluation. Hence, its assessment is usually based on sensibility tests. Accurate diagnosis of the pulpal status requires evaluation with combination of sensibility tests. The objective of this study was to assess the mutual agreement between the electric pulp test and cold test in determining pulp vitality. Methods: Total 106 patients, aged 18 to 30 years, attending the dental OPD of Operative Dentistry/Endodontics department; Dr. Ishrat-ul-Ibad Institute of Oral Health Sciences, Karachi were selected for the study. The cold and electric pulp tests were used to determine the presence or absence of tingling sensation. Teeth were marked as vital in presence and non-vital in absence of any tingling or painful response. Agreement between these two tests was calculated using SPSS-18. To calculate the mean and standard deviation, descriptive statistics were applied for quantitative variables. For qualitative variables, frequencies and percentages were calculated. Kappa statistics was applied for agreement between electric pulp and cold test. Results: The cold test showed that 70.8% of the teeth were vital and 29.2% were necrotic. The electrical pulp test showed that 74.5% were vital and 25.5% were necrotic. The outcome showed 83.0% agreement between the tests; with kappa value of 0.574 which provided sufficient agreement with p-value=0.000. Conclusion: There was a high agreement found between the cold test and electric pulp test. Assessment of pulp vitality would be more accurate when EPT and Endo frost are used in combination.
Comparison of Electric Pulp Testing with Thermal Testing to Register Pulp Vitality in Anterior Teeth
2019
For this reason, indirect methods must be used to determine pulp vitality.2 Dental pulp tests are investigations that provide a dental clinician with diagnostic and treatment planning information. These tests are considered to be relatively non-invasive, easy to use and cost-effective.3 Electric pulp tester excites A-delta fibers in the pulp. If a sensation is felt by the patient, the pulp is assumed to be responsive or at least partially vital, when a gradually increasing level of electric current is transmitted through the tooth.4 Apart from being easy to use, Green Endo-Ice also shows rapid results. A bright A-delta sensation or cold response felt by the patient indicates that part or all of the pulpal tissue is responsive.5 With each INTRODUCTION
Journal of conservative dentistry : JCD
Pulp sensitivity testing, even with its limitations and shortcomings, has been and still remains a very helpful aid in endodontic diagnosis. Pulp sensitivity tests extrapolate pulpal health from the sensory response. The aim of the present study was to identify the sensitivity, specificity, positive and negative predictive values (NPVs) of thermal and electrical tests of pulp sensitivity. Pulp tests studied were two cold and heat tests respectively and electrical test. A total of 330 teeth were tested: 198 teeth with vital pulp and 132 teeth with necrotic pulps (disease prevalence of 40%). The ideal standard was established by observing bleeding within the pulp chamber. Sensitivity values of the diagnostic tests were 0.89 and 0.94 for cold test, 0.84 and 0.87 for the heat tests, and 0.75 for electrical pulp test and the specificity values of the diagnostic tests were 0.91 and 0.93 for the cold tests, 0.86 and 0.84 for the heat tests, and 0.90 for electrical pulp test. The NPVs were ...
Evaluation of the ability of thermal and electrical tests to register pulp vitality
of the ability of thermal and electrical tests to register pulp vitality. Endod Dent Traumatol 1999; 15: 127-1 3 1. 0 Munksgaard, 1999. Abstract -The aim of the present study was to evaluate the ability of thermal and electrical tests to register pulp vitality. Sensitivity, specificity, negative predictive value and positive predictive value were calculated by comparing the test results with a "gold standard". The thermal tests studied were a cold test (ethyl chloride) and a heat test (hot gutta-percha). For the electrical test, the Analytic Technology Pulp Tester@ was used. The examined teeth were 59 teeth with unknown pulpal status in need of endodontic treatment and 16 intact teeth, all with radiographically normal periapical bone structures. In total 46 teeth with vital pulps and 29 teeth with necrotic pulps were tested. This gave a disease prevalence of 39%. The gold standard was established by direct pulp inspection of the 59 teeth in need of endodontic treatment. In the 16 intact teeth the pulp was judged as vital. The number of true positive (TP), false positive (FP), true negative (TN) and false negative (FN) test results was calculated for each method as compared to the gold standard. Based on this, the sensitivity, specificity, positive predictive value and negative predictive value were calculated for each method. The sensitivity was 0.83 for the cold test, 0.86 for the heat test and 0.72 for the electrical test. The specificity was 0.93 for the cold test, 0.41 for the heat test and 0.93 for the electrical test. The positive predictive value was 0.89 for the cold test, 0.48 for the heat test and 0.88 for the electrical test, and the negative predictive value was 0.90 for the cold test, 0.83 for the heat test and 0.84 for the electrical test. This indicated that the probability of a nonsensitive reaction representing a necrotic pulp was 89% with the cold test, 48% with the heat test and 88% with the electrical test. It also indicated that the probability of a sensitive reaction representing a vital pulp was 90% with the cold test, 83% with the heat test and 84% with the electrical test.