1
|
Kasper RH, Coelho MR, Miguens-Jr SAQ, Grazziotin-Soares R, Barletta FB. Pulse oximetry as a dental pulp test: A scoping review to identify barriers hindering the use of oximeters in clinical practice. Saudi Dent J 2024; 36:262-269. [PMID: 38419999 PMCID: PMC10897589 DOI: 10.1016/j.sdentj.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/27/2023] [Accepted: 11/05/2023] [Indexed: 03/02/2024] Open
Abstract
Background and Objective Although medical pulse oximeters are considered effective for endodontic diagnoses, the method remains uncommon in current dental practice. The aim of the present scoping review was to investigate clinical factors that exert a negative impact on the use of pulse oximeters in dental practice. Methods This study followed the PRISMA-ScR guidelines and the protocol was prospectively registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/3GQCE). A comprehensive search of the MEDLINE (via PubMed), Cochrane Library, and Web of Science databases was performed in December 2022 for articles published in English or Spanish. All types of clinical studies were included, except comments, letters to the editor, and abstracts. Two independent investigators analyzed 45 full-text articles. Data extraction included general characteristics, oxygen saturation levels, and limiting factors/barriers to the use of oximeters as pulp testers. Results The search of the databases yielded 1,300 records and 38 were included (quantitative data extraction was performed for 35 and three articles were systematic reviews). Publications were highest in number between 2016 and 2017, with an evident reduction occurring after 2021. The oxygen saturation level for sound/vital maxillary anterior teeth was 84.99% (overall mean). The main limiting factors/barriers were i) the difficulty in maintaining the two light-emitting diodes parallel during pulp tests, ii) infrared light diffraction by enamel/dentin/gingiva, and iii) the diversity of patient ages in studies. Conclusion This scoping review encountered noteworthy findings associated with the impracticability of using medical pulse oximeters as dental pulp testers. The recent decrease in the frequency of published studies compared to approximately seven years ago may imply a negative trend in the use of the method.
Collapse
|
2
|
Krongbaramee T, Wongpattaraworakul W, Lanzel EA, Hellstein JW, Teixeira FB. Retrospective Evaluation of Periradicular Biopsies: An 18-Year Study. J Endod 2023; 49:1457-1463. [PMID: 37543187 DOI: 10.1016/j.joen.2023.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/21/2023] [Accepted: 07/24/2023] [Indexed: 08/07/2023]
Abstract
INTRODUCTION Radiographic findings in periradicular areas are repeatedly associated with infected root canal systems. Although non-odontogenic lesions in teeth are reported to be low, they often mimic periapical pathoses, and consequently, histopathologic examinations after surgical revisions are nurtured. METHODS Biopsies submitted to the College of Dentistry between 2003 and 2021 were reviewed. Clinicopathologic characteristics were collected, including age, sex, medical history, location, sensibility tests, and clinic impressions from each specimen. Histopathologic diagnosis and gross description were also part of our database. RESULTS A total of 72,055 pathology reports were reviewed, of which 10,031 lesions (13.9%) met the criterion of being intraosseous lesions at the periradicular area. Among those 10,031 lesions, 7.94% (n = 796) were of non-endodontic origin, 7153 were documented as non-vital, and 2.36% (n = 169) of these non-vital teeth were diagnosed with a non-endodontic origin. A total of 5707 lesions were obtained from surgeries within the periapical tissues, primarily performed by endodontists (94.02%). Non-endodontic lesions were reported in 1.09% of the cases. Odontogenic keratocyst was the most common non-endodontic diagnosis, followed by nasopalatine duct cyst and benign fibro-osseous lesion, respectively. CONCLUSIONS Pathologic findings of the periradicular tissues are not always from endodontic origin. The probability of encountering non-endodontic lesions is almost 8%. Even in clinically reported teeth with pulp necrosis, 1%-3% of biopsies were confirmed as non-endodontic lesions.
Collapse
Affiliation(s)
- Tadkamol Krongbaramee
- Division of Endodontics, Department of Restorative Dentistry & Periodontology, Chiang Mai University, Chiang Mai, Thailand; Department of Endodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Wattawan Wongpattaraworakul
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Emily A Lanzel
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - John W Hellstein
- Department of Oral Pathology, Radiology and Medicine, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa
| | - Fabricio B Teixeira
- Department of Endodontics, College of Dentistry and Dental Clinics, University of Iowa, Iowa City, Iowa.
| |
Collapse
|
3
|
Santana MLL, Ribeiro TE, Silva JA, de Alencar AHG, Novais VR, Estrela C, Decurcio DDA. Does irradiation of the tooth structure interfere with oxygen saturation measured by pulse oximetry?-An ex vivo laboratorial study. AUST ENDOD J 2023; 49 Suppl 1:419-425. [PMID: 37036185 DOI: 10.1111/aej.12758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 02/16/2023] [Accepted: 04/02/2023] [Indexed: 04/11/2023]
Abstract
The effect of tooth structure subjected to ionising radiation on oxygen saturation levels (SpO2 ) measured by pulse oximetry was investigated. Fifty-four extracted human third molars were sectioned mesiodistally. Pulse oximeter diodes were placed in prefabricated silicone moulds, secured on a vise with tooth surfaces placed between the diodes and the participant's finger, and SpO2 levels were measured. After that, the tooth surfaces were subjected to ionising radiation in fractionated doses of up to 70 Gy, and SpO2 was measured according to the protocol described. The Kolmogorov-Smirnov test was used for the analysis of normality of the quantitative variables, and Student's t-test compared mean SpO2 levels before and after irradiation. Mean SpO2 after irradiation was 94.6 ± 0.9%, without a statistically significant difference from SpO2 before irradiation, which was 94.7 ± 0.6%. Irradiation of the tooth structure did not interfere with SpO2 levels measured by pulse oximetry.
Collapse
Affiliation(s)
| | | | | | | | | | - Carlos Estrela
- Faculdade de Odontologia, Universidade Federal de Goiás, Goiânia, Brazil
| | | |
Collapse
|
4
|
Ribeiro TE, Novais VR, Estrela C, Santana MLL, Rossi-Fedele G, Decurcio DDA. Does radiotherapy treatment alter the pulp condition in patients with head and neck cancer? A systematic review. Braz Oral Res 2023; 37:e079. [PMID: 37531515 DOI: 10.1590/1807-3107bor-2023.vol37.0079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 02/06/2023] [Indexed: 08/04/2023] Open
Abstract
The main purpose of this study was to answer the question: "Can radiotherapy cause changes in the dental pulp condition of patients treated with irradiation in the head and neck region?" Clinical observational studies in adults with head and neck cancer undergoing treatment with ionizing radiation, longitudinal or cross-sectional follow-up to measure oxygen saturation (SpO2), and/or pulp sensitivity test to cold stimulation, were considered eligible. A systematic literature search was performed in six different databases, including the gray literature, and in article references. Two independent evaluators selected the studies, extracted the data, recorded the data on electronic spreadsheets, and then evaluated the methodological quality using the Checklist for Quasi-Experimental Studies tool devised by JBI. The data were assessed qualitatively using the Synthesis Without Metanalysis (SWiM) guidelines. After removing the duplicate articles, carefully analyzing the titles and abstracts, and reading the papers in full, seven studies were included. Four of the studies evaluated applied the cold sensitivity test, two associated pulse oximetry and cold sensitivity, and only one used just pulse oximetry. Evaluation using the cold sensitivity test and pulse oximetry in the initial periods before radiotherapy showed a decrease in the sensitive response and in SpO2 levels during a maximum period of 1 year. However, analyses thereafter indicated a normal response in both tests from 5 to 6 years after the end of radiotherapy treatment. Radiotherapy causes changes in pulp behavior patterns in the short term; however, recovery and return to average values occurs after long periods.
Collapse
Affiliation(s)
- Thalles Eduardo Ribeiro
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Stomatologic Science, Goiânia, GO, Brazil
| | - Veridiana Resende Novais
- Universidade Federal de Uberlândia - UFU, School of Dentistry, Department of Dentistry and Dental Materials, Uberlândia, MG, Brazil
| | - Carlos Estrela
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Stomatologic Science, Goiânia, GO, Brazil
| | - Maria Luiza Lima Santana
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Stomatologic Science, Goiânia, GO, Brazil
| | - Giampiero Rossi-Fedele
- University of Adelaide, Adelaide Dental School, Department of Endodontics, Adelaide, South Australia, Australia
| | - Daniel de Almeida Decurcio
- Universidade Federal de Goiás - UFG, School of Dentistry, Department of Stomatologic Science, Goiânia, GO, Brazil
| |
Collapse
|
5
|
Wali R, Sacco R, Singh G, Patel V. The clinical effect of radiotherapy on pulpal microvasculature: a systematic review. Br Dent J 2022:10.1038/s41415-022-5301-8. [PMID: 36473977 DOI: 10.1038/s41415-022-5301-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 07/29/2022] [Indexed: 12/12/2022]
Abstract
Introduction/objectives Radiotherapy (RT) has a detrimental effect on the histomorphology of oral tissues. Patients undergoing RT are at risk of developing macrovascular and microvascular changes, which can lead to significant clinical consequences. Despite advances in RT delivery systems, radiation injury remains a modern-day clinical problem. The aim of this systematic review is to investigate the available evidence regarding the impact of RT to the dental pulp and the clinical manifestations of these effects.Data and sources A multi-database search (PubMed, Medline, Embase and CINAHL) was performed to identify related papers published from inception until November 2021. An additional manual search was performed to identify further articles. The data extracted from relevant papers were analysed according to the outcomes selected in this review.Study selection The search generated seven articles eligible for analysis with a total of 2,709 teeth included. RT dose exposure ranged from 30-71.2 Gray with a common finding that RT decreases the number of teeth responding to pulp sensibility testing.Conclusions Knowledge related to the impact of RT on dental pulp is limited and based on weak evidence and a low-level quality of studies. Future studies should incorporate exact RT doses to the teeth and use replicable pulpal testing methods. Understanding the pulpal status post-RT remains an important consideration as dental extractions should be avoided in this cohort due to the risk of osteoradionecrosis.
Collapse
Affiliation(s)
- Rana Wali
- Oral Surgery Registrar, Oral Surgery Department, Guy´s and St Thomas´ Hospital, London, UK
| | - Roberto Sacco
- Clinical Lecturer, Division of Dentistry, School of Medical Sciences, Oral Surgery Department, University of Manchester, Manchester, UK; 3Clinical Teacher, Oral Surgery Department, King´s College Hospital, London, UK
| | - Gurpreet Singh
- Managed Clinical Network Chair, Restorative Dentistry, NHS England and NHS Improvement East of England, UK
| | - Vinod Patel
- Oral Surgery Consultant, Oral Surgery Department, Guy´s and St Thomas´ Hospital, London, UK.
| |
Collapse
|
6
|
Antic S, Markovic-Vasiljkovic B, Dzeletovic B, Jelovac DB, Kuzmanovic-Pficer J. Assesment of radiotherapy effects on the blood flow in gingiva and dental pulp - a laser Doppler flowmetry study. J Appl Oral Sci 2022; 30:e20220329. [PMID: 36477557 PMCID: PMC9724493 DOI: 10.1590/1678-7757-2022-0329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2022] [Accepted: 10/24/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE This study aims to determine and compare the dental pulp and gingival blood flow in patients referred for oropharyngeal radiotherapy (RT) at three different time points: before the start, immediately after, and six months following the completion of RT. The aim is also to evaluate the dependence of the pulp and gingival blood flow on the radiation dose. METHODOLOGY A prospective study included 10 patients referred for intensity-modulated RT (IMRT) in the oropharyngeal region, with at least one intact tooth surrounded by a healthy gingiva. The dose received by each selected tooth and adjacent gingiva was determined according to the map of treatment planning and computer systems. The blood flow measurements were performed using the laser Doppler flowmetry (LDF) method. RESULTS Comparing vascular flows at three different time points, the median blood flow in the dental pulp showed no statistically significant difference (p=0.325), contrary to gingiva (p=0.011). Immediately after RT completion, the gingival flow significantly increased compared to its starting point (p=0.012). The pulp flow correlated negatively with the radiation dose, whereas a strong correlation was noted 6 months following the RT completion. CONCLUSIONS RT caused a significant acute gingival blood flow increase, followed by a long-term (over six months) tendency to return to the starting levels. The dental pulp blood flow is differently affected by higher radiation doses (over 50Gy) in comparison to lower doses (below 50Gy). During RT planning, considering the possibility of protecting the teeth localized near the Gross Tumor Volume as a sensitive organ is recommended.
Collapse
Affiliation(s)
- Svetlana Antic
- University of BelgradeSchool of Dental MedicineCenter for Radiological DiagnosticsBelgradeSerbiaUniversity of Belgrade, School of Dental Medicine, Center for Radiological Diagnostics, Belgrade, Serbia.,Corresponding address: University of Belgrade - School of Dental Medicine - Center for Radiological diagnostics - Svetlana Antic - dr Subotica 8,11000 - Belgrade - Serbia. Phone: +381113440841/ tel:+381642175834, e-mail:
| | - Biljana Markovic-Vasiljkovic
- University of BelgradeSchool of Dental MedicineDepartment of Restorative Odontology and EndodonticsBelgradeSerbiaUniversity of Belgrade, School of Dental Medicine, Department of Restorative Odontology and Endodontics, DentalNet Research Group, Belgrade, Serbia.
| | - Bojan Dzeletovic
- University of BelgradeSchool of Dental MedicineClinic for Maxillofacial SurgeryBelgradeSerbiaUniversity of Belgrade, School of Dental Medicine, Clinic for Maxillofacial Surgery, Belgrade, Serbia.
| | - Drago B. Jelovac
- University of BelgradeSchool of Dental MedicineClinic for Maxillofacial SurgeryBelgradeSerbiaUniversity of Belgrade, School of Dental Medicine, Clinic for Maxillofacial Surgery, Belgrade, Serbia.
| | - Jovana Kuzmanovic-Pficer
- University of BelgradeSchool of Dental MedicineDepartment for Medical Statistics and InformaticsBelgradeSerbiaUniversity of Belgrade, School of Dental Medicine, Department for Medical Statistics and Informatics, Belgrade, Serbia.
| |
Collapse
|
7
|
Pedroso CM, Migliorati CA, Epstein JB, Ribeiro ACP, Brandão TB, Lopes MA, de Goes MF, Santos-Silva AR. Over 300 Radiation Caries Papers: Reflections From the Rearview Mirror. FRONTIERS IN ORAL HEALTH 2022; 3:961594. [PMID: 35911379 PMCID: PMC9330023 DOI: 10.3389/froh.2022.961594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Radiation caries (RC) is an aggressive oral toxicity in head and neck cancer survivors, which develops 6 to 12 months after head and neck radiotherapy. It initially affects the tooth cervical/incisal surfaces, and if not promptly diagnosed/managed, progresses to dental crown amputation and risk of osteoradionecrosis. It results from a multidimensional cluster of treatment-induced oral symptoms, including hyposalivation, dietary changes, and oral hygiene impairment. Although recognized as a frequent complication of radiotherapy and extensively assessed by a myriad of retrospective, in vitro, and in situ studies, RC patients are still orphans of clinically validated methods for risk prediction, prevention, and treatment of early lesions. This review provides a historical overview of science-based concepts regarding RC pathogenesis and treatment, emphasizing the growing demand for interventional clinical studies (randomized trials).
Collapse
Affiliation(s)
- Caique Mariano Pedroso
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Campinas, Brazil
| | | | - Joel B. Epstein
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, United States
- City of Hope Comprehensive Cancer Center, Duarte, CA, United States
| | | | - Thaís Bianca Brandão
- Cedars-Sinai Medical Center, Samuel Oschin Comprehensive Cancer Institute, Los Angeles, CA, United States
| | - Márcio Ajudarte Lopes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Campinas, Brazil
| | - Mário Fernando de Goes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Campinas, Brazil
| | - Alan Roger Santos-Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas (UNICAMP), Campinas, Brazil
- *Correspondence: Alan Roger Santos-Silva
| |
Collapse
|
8
|
Weissheimer T, Só BB, Pradebon MC, de Figueiredo JAP, Martins MD, Só MVR. Head and neck radiotherapy effects on the dental pulp vitality and response to sensitivity tests. A systematic review with meta-analysis. Int Endod J 2022; 55:563-578. [PMID: 35298027 DOI: 10.1111/iej.13726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 03/09/2022] [Accepted: 03/10/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND There is no consensus whether radiotherapy for head and neck cancer (HNC) could induce pulp necrosis. Therefore, a systematic review of clinical studies is necessary. OBJECTIVES To evaluate the evidences on radiotherapy for HNC and pulp status. METHODS A systematic search of articles published until November 2021 was performed in the MEDLINE/PubMed, Cochrane Library, Web of Science (All Databases), Scopus, EMBASE and Open Grey databases. The eligibility criteria were based on the PICOS strategy, as follows: (P) vital teeth of adult patients with intraoral and/or oropharyngeal cancer; (I) radiotherapy; (C) control group or values of the same tooth before radiotherapy (basal values); (O) pulpal status after radiotherapy; (S) clinical studies. The Cochrane Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tool was used to assess the quality of the included studies. Meta-analyses were performed using fixed and random effects. The overall quality of evidence was assessed through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool. RESULTS Six studies were included for qualitative analysis. Five were classified as serious risk of bias and one as moderate risk of bias. Four studies reported altered pulp responses to cold thermal test after radiotherapy initiation. Meta-analyses were performed using three included studies. From these, all were included in the meta-analysis for pulp response values to cold sensitivity test immediately after radiotherapy initiation (risk ratio: 0.00[CI:0.00, 0.02], P < 0.00001; I2 = 0%); and two in the meta-analysis for pulp response values to cold sensitivity test after 4-5 months of radiotherapy (risk ratio: 0.01[CI: 0.00. 0.06], P < 0.00001; I2 = 0%). Two reported progressively higher readings to pulp response in the electrical test after radiotherapy initiation (mean difference: -11.46[-13.09, -9.84], P < 0.00001; I2 = 68%) and at all periods evaluated. Two studies demonstrated a pulp oxygen saturation (SpO2 ) decrease at the end of radiotherapy; and increase after 4-6 months of radiotherapy beginning. And other demonstrated normal dental pulp SpO2 4 to 6 years after treatment. GRADE analysis presented a moderate certainty of evidence. DISCUSSION This review verified that radiotherapy for HNC causes significant alterations on the dental pulp responses, but does not seem to induce pulp necrosis. Significant limitations regarding controlling for confounding factors, classification of interventions and measurement of outcomes were verified, evidencing the need for well-designed studies. CONCLUSIONS This systematic review demonstrated that radiotherapy for HNC induced significant changes in the pulp response with moderate quality of evidence. Such altered responses cannot determine pulp status accurately.
Collapse
Affiliation(s)
- Theodoro Weissheimer
- Department of Endodontics, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Bruna Barcelos Só
- Department of Endodontics, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Marieli Chitolina Pradebon
- Department of Endodontics, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | | | - Manoela Domingues Martins
- Department of Endodontics, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| | - Marcus Vinicius Reis Só
- Department of Endodontics, School of Dentistry, Rio Grande do Sul Federal University (UFRGS), Porto Alegre, RS, Brazil
| |
Collapse
|
9
|
A Clinical Study Determining Pulp Vitality in Oropharyngeal Cancer Patients Undergoing Radiotherapy Using Diagnostic Tool-Pulse Oximetry. CURRENT HEALTH SCIENCES JOURNAL 2021; 47:5-9. [PMID: 34211740 PMCID: PMC8200620 DOI: 10.12865/chsj.47.01.01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 01/12/2021] [Indexed: 11/20/2022]
Abstract
Pulse oximetry is an equipment that evaluates pulp vitality for concrete endodontic diagnosis and treatment plan. One of the treatment methods of oropharyngeal cancer is radiotherapy. Radiotherapy has some harmful effects on dental pulp that affects pulp vitality. The objective of study was to assess pulp vitality before, at the end of radiotherapy and six months after radiotherapy (RT) in oropharyngeal cancer patients undergoing radiotherapy. 25 patients who were diagnosed with oropharyngeal cancer having asymptomatic intact crowns were selected for the study. Pulp vitality was checked before the commencement of radiotherapy (PV1), immediately after radiotherapy (PV 2) and six months post radiotherapy (PV 3). Pulp vitality of first posterior tooth was selected of each patient and was checked with pulse oximetry. Paired t-test was used as statistical analysis. Statistically significant difference was observed when PV 1 and PV 2, PV 1 and PV 3 and PV 2 and PV 3 were compared amongst each other. There was reduction noted in mean SpO2 value when groups PV 2 and PV1 were compared. This was statistically significant. Statistically significant increase in mean SpO2 value was observed six months post radiotherapy (PV 3). Thus, it can be concluded that statistically significant reduction in mean SpO2 level post radiotherapy recovers after six months.
Collapse
|
10
|
Pulse Oximetry as a Diagnostic Tool to Determine Pulp Vitality: A Systematic Review. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11062747] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Pulse oximetry (PO) can be used as a technique to assess vascularization. Although it is commonly used in the field of medicine, it still has limited use in dentistry. The aim of this study is to evaluate, by means of a systematic review, if pulse oximetry is a viable and effective system to determine pulp vitality and assess the clinical criteria for its use. A literature search was performed in Medline, Scopus, Embase, and Web of Science databases. Clinical studies using pulse oximetry as a tool to determine pulp vitality in permanent teeth were eligible. Quality assessment of the included studies was performed following the Quality Assessment for Diagnostic Accuracy Studies (QUADAS-2) guidelines. A total of 24 articles were included in the review. The subjective test most compared to PO was the cold test. PO has shown a good sensibility and specificity, and it has been used in different clinical situations. Pulse oximetry has a high potential as a tool for the diagnosis of pulp vitality. However, the absence of a specific pulse oximeter for a dental practice, among other limitations, added to the lack of evidence on how different systemic and oral pathologies may affect the pulp’s oxygen saturation levels, which hinders its clinical use.
Collapse
|
11
|
Lambert P, Miguens SAQ, Solda C, Sganzerla JT, Reichert LA, Estrela C, Barletta FB. Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis. Restor Dent Endod 2020; 45:e48. [PMID: 33294413 PMCID: PMC7691259 DOI: 10.5395/rde.2020.45.e48] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 11/11/2022] Open
Abstract
Objectives This systematic review aimed to identify mean oxygen saturation values (SpO2) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of “oximetry” AND “dental pulp test” were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%–85.04%) for the central incisors, 89.29% (95% CI, 89.22%–89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%–89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status. Trial Registration International Prospective Register of Systematic Reviews Identifier: CRD42018085598
Collapse
Affiliation(s)
- Paula Lambert
- Department of Endodontics, Graduate Program in Dentistry, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
| | | | - Caroline Solda
- Department of Endodontics, Faculdade Meridional (IMED) School of Dentistry, Passo Fundo, RS, Brazil
| | - Juliana Tomaz Sganzerla
- Department of Oral Diagnostic, Graduate Program in Dentistry, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
| | - Leandro Azambuja Reichert
- Department of Operative Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS) School of Dentistry, Porto Alegre, RS, Brazil
| | - Carlos Estrela
- Department of Endodontics, Graduate Program in Dentistry, Universidade Federal de Goiás (UFG), Goiania, GO, Brazil
| | - Fernando Branco Barletta
- Department of Endodontics, Graduate Program in Dentistry, Universidade Luterana do Brasil (ULBRA), Canoas, RS, Brazil
| |
Collapse
|
12
|
Radiation-related caries: current diagnostic, prognostic, and management paradigms. Oral Surg Oral Med Oral Pathol Oral Radiol 2020; 130:52-62. [DOI: 10.1016/j.oooo.2020.04.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/02/2020] [Accepted: 04/08/2020] [Indexed: 11/23/2022]
|
13
|
The impact of radiation caries in the quality of life of head and neck cancer patients. Support Care Cancer 2019; 28:2977-2984. [DOI: 10.1007/s00520-019-05171-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 11/05/2019] [Indexed: 12/16/2022]
|
14
|
Fonsêca JM, Palmier NR, Silva WG, Faria KM, Vargas PA, Lopes MA, Salvajoli JV, Brandão TB, Ribeiro ACP, Almeida JFA, De Goes MF, Santos-Silva AR. Dentin-pulp complex reactions in conventional and radiation-related caries: A comparative study. J Clin Exp Dent 2019; 11:e236-e243. [PMID: 31001393 PMCID: PMC6461726 DOI: 10.4317/jced.55370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 12/17/2018] [Indexed: 11/05/2022] Open
Abstract
Background Radiation-related caries (RRC) is one of the most significant oral toxicities of head and neck radiotherapy (HNRT); however, the potential of radiation to directly cause harmful dentin and pulpal effects and impair response to caries progression is controversial. Material and Methods Therefore, the aim of this study was to characterize the reactions of the dentin-pulp complex in teeth affected by RRC. Patients and methods: Twenty-two carious teeth extracted from 22 head and neck cancer (HNC) patients were divided into control (conventional caries; n=11) and irradiated (RRC; n=11) groups and paired matched by dental homology, clinical patterns of caries progression following the Post-Radiation Dental Index (PRDI) and microscopic depth of carious invasion. Histopathological characteristics based on morphological hierarchy, cell populations of dental pulp, blood vessels, neural elements, extracellular matrix components, inflammation, patterns of carious invasion and reactionary dentin presence were evaluated by optical light microscopy and histomorphometry. Results Mean PRDI scores were 3.2 for the control group and 3.8 for the irradiated group. Dentin demineralization patterns were also similar between the groups and the mean depths of demineralization were 1,158.58µm and 1,056.89µm for the control and irradiated groups, respectively. Conclusions Pulp histopathological changes and dentin reaction patterns were similar between groups and varied according to the PRDI scores and carious lesions depth. Dentin and pulp reactions are highly preserved in RRC teeth. Key words:Cancer, radiotherapy, radiation-related caries, teeth, pulp.
Collapse
Affiliation(s)
- Jéssica-Montenegro Fonsêca
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brasil
| | - Natália-Rangel Palmier
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brasil
| | - Wagner-Gomes Silva
- Serviços de Odontologia e Radioterapia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Karina-Morais Faria
- Serviços de Odontologia e Radioterapia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Pablo-Agustin Vargas
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brasil
| | - Marcio-Ajudarte Lopes
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brasil
| | - João-Victor Salvajoli
- Serviços de Odontologia e Radioterapia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Thais-Bianca Brandão
- Serviços de Odontologia e Radioterapia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - Ana-Carolina-Prado Ribeiro
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brasil.,Serviços de Odontologia e Radioterapia, Instituto do Câncer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brasil
| | - José-Flávio-Affonso Almeida
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brasil
| | - Mario-Fernando De Goes
- Departamento de Odontologia Restauradora, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brasil
| | - Alan-Roger Santos-Silva
- Departamento de Diagnóstico Oral, Faculdade de Odontologia de Piracicaba, Universidade Estadual de Campinas (UNICAMP), Piracicaba, São Paulo, Brasil
| |
Collapse
|
15
|
Healthy Dental Pulp Oxygen Saturation Rates in Subjects with Homozygous Sickle Cell Anemia: A Cross-Sectional Study Nested in a Cohort. J Endod 2017; 43:1997-2000. [DOI: 10.1016/j.joen.2017.07.011] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 07/11/2017] [Accepted: 07/16/2017] [Indexed: 11/23/2022]
|
16
|
Anusha B, Madhusudhana K, Chinni SK, Paramesh Y. Assessment of Pulp Oxygen Saturation Levels by Pulse Oximetry for Pulpal Diseases -A Diagnostic Study. J Clin Diagn Res 2017; 11:ZC36-ZC39. [PMID: 29207830 DOI: 10.7860/jcdr/2017/28322.10572] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 08/29/2017] [Indexed: 11/24/2022]
Abstract
Introduction Diagnosis of pulpal inflammation is a key to endodontics. Pulse oximetry is a true vitality testing device which relies on oxygen saturation levels of pulp and helps in diagnosis of different pulpal conditions. Aim The aim of the study was to analyse oxygen saturation levels of different pulpally inflamed teeth by using pulse oximetry. Materials and Methods Hundred patients were included in the study and categorized into five groups based on pulpal status of the test tooth by using heat test and cold test. Twenty patients were recruited in each of the experimental groups i.e., Reversible Pulpitis (RP), Irreversible Pulpitis (IP), Pulpal Necrosis (PN), Positive Control (PC, healthy teeth), and Negative Control (NC, endodontically treated teeth). Oxygen saturation levels of all the groups were measured along with each patient index finger oxygen saturation readings. Results were analysed by using ANOVA and Tukey HSD tests. Results The mean oxygen saturation levels of RP, IP, PN, PC and NC were 85.4%, 81.6%, 70.7%, 94.6% and 0 respectively. There was significant difference in the oxygen saturation levels between all the groups. Conclusion Pulse oximeter is an effective tool in diagnosing different pulpal pathologies especially PN which was interpreted inaccurately by thermal tests.
Collapse
Affiliation(s)
- Bander Anusha
- Postgraduate Student, Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Koppolu Madhusudhana
- Professor and Head, Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Suneel Kumar Chinni
- Professor, Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Yelloji Paramesh
- Postgraduate Student, Department of Conservative Dentistry and Endodontics, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| |
Collapse
|
17
|
Madani ZS, Azarakhsh S, Shakib PA, Karimi M. Histopathological changes in dental pulp of rats following radiotherapy. Dent Res J (Isfahan) 2017; 14:19-24. [PMID: 28348613 PMCID: PMC5356384 DOI: 10.4103/1735-3327.201139] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Radiotherapy is one of the oral and pharyngeal cancer treatment methods that can cause damage to the tissues in the radiation area; the purpose of this study is to evaluate the effects of radiotherapy on dental pulp tissue in rats. MATERIALS AND METHODS In this interventional, experimental double-blind study, 30 rats were studied in three groups (n = 10 each). The first group received 12 gray (Gy), the second group received 18 Gy in one session, and the third group was not exposed to radiation (control group). The 5 μm sections of mandibular molar tooth were prepared and stained with hematoxylin and eosin. Samples were studied under optical microscope to evaluate and score inflammation, necrosis, hyalinization, and vascular congestion. The data were coded and analyzed by statistical tests of χ2 and Fisher's exact tests. The significant level of P = 0.05. RESULTS In Group 1, necrosis in two cases, inflammation in one case, hyalinization in one case, and vascular congestion in four cases were observed. In Group 2, inflammation in four cases, hyalinization in two cases, and vascular congestion in five cases were observed. In Group 3, inflammation was observed only in one case. In comparison between the groups, no significant differences were observed in inflammation (P > 0.05), necrosis (P > 0.05), and hyalinization (P > 0.05). However, the difference was significant for vascular congestion (P < 0.05). CONCLUSION Radiotherapy with doses of 12 and 18 Gy had no significant effect on inflammation, necrosis, and hyalinization in all groups; however, the difference was significant for vascular congestion.
Collapse
Affiliation(s)
- Zahra Sadat Madani
- Department of Endodontics, Dental Faculty, Babol University of Medical Sciences, Babol, Iran
| | - Soheil Azarakhsh
- Department of Endodontics, Dental Faculty, Arak University of Medical Sciences, Arak, Iran
| | - Pouyan Amini Shakib
- Department of Oral Maxillofacial Pathology, School of Dentistry, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoomeh Karimi
- Department of Radiology and Radiotherapy, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran
| |
Collapse
|
18
|
Caldeira CL, Barletta FB, Ilha MC, Abrão CV, Gavini G. Pulse oximetry: a useful test for evaluating pulp vitality in traumatized teeth. Dent Traumatol 2016; 32:385-9. [DOI: 10.1111/edt.12279] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 12/01/2022]
Affiliation(s)
| | | | | | | | - Giulio Gavini
- School of Dentistry; University of São Paulo; Sao Paulo Brazil
| |
Collapse
|
19
|
Morais-Faria K, Neves-Silva R, Lopes MA, Ribeiro ACP, de Castro G, da Conceição-Vasconcelos KGM, Brandão TB, Santos-Silva AR. The wolf in sheep's clothing: Microtomographic aspects of clinically incipient radiation-related caries. Med Oral Patol Oral Cir Bucal 2016; 21:e299-304. [PMID: 26946198 PMCID: PMC4867202 DOI: 10.4317/medoral.20886] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 12/16/2015] [Indexed: 11/23/2022] Open
Abstract
Background Radiation-related caries (RRC) can cause rapid progression, with a high potential for dental destruction affecting mainly cervical and incisal areas. Unlike the injuries that occur in the conventional caries, incipient RRC present in unusual surfaces have difficult diagnosis and classification stages of cavitation. Material and Methods Evaluate the radiographic patterns of demineralization of RRC by using micro-CT. Ten teeth with incipient RRC and 10 teeth with incipient conventional caries (control group) matched by anatomic teeth group and caries affected surfaces were evaluated by X-ray microtomography (micro-CT) Skyscan 1174V2 (50Kv, 1.3 megapixel, Kontich, Belgium). Teeth were placed in a standard position for micro-CT (coronal, transaxial and sagittal sections) during images acquisition. Lesions were classified according to the depth of invasion and relationship with enamel, dentin and pulp. Results RRC samples presented deeper lesions with higher involvement of enamel and dentin. Control group presented focal and superficial lesions with lower involvement of enamel and dentin. Conclusions Incipient RRC present aggressive microtomographic patterns of demineralization when compared to conventional caries, as indicated by deep lesions, regardless of its clinically incipient aspects. Key words:Head and neck cancer, radiotherapy, microtomography, radiation caries.
Collapse
Affiliation(s)
- K Morais-Faria
- Oral Diagnosis Department, Semiology Area, Piracicaba Dental School, University of Campinas (UNICAMP), Piracicaba, Sao Paulo, Brazil, Av. Limeira, 901. P.O. Box 52, Areão, Piracicaba, SP, Brazil,
| | | | | | | | | | | | | | | |
Collapse
|
20
|
Late Effects of Head and Neck Radiotherapy on Pulp Vitality Assessed by Pulse Oximetry. J Endod 2016; 42:886-9. [PMID: 27071975 DOI: 10.1016/j.joen.2016.02.016] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Revised: 02/22/2016] [Accepted: 02/28/2016] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Radiation therapy (RT) of malignant tumors in the head and neck area may have damaging effects on surrounding tissues. The aim of this investigation was to evaluate the long-term effects of ionizing radiation on pulp vitality by measuring pulp oxygenation levels (%SpO2) in patients with history of RT of intraoral and oropharyngeal tumors 4-6 years after treatment. METHODS In an experimental group RT (n = 90, history of RT) and a control group CON (n = 90, no history of RT), pulp vitality was assessed by measuring %SpO2 by using pulse oximetry and pulp sensitivity by cold thermal testing. All anterior teeth without history of endodontic therapy of the participants in group RT were measured (n = 693), regardless of the quadrant and the irradiated area. An equal number of anterior teeth were tested in group CON. RESULTS There was no significant difference between the %SpO2 levels in group RT (92.7%; standard deviation, ± 1.83) and group CON (92.6%; standard deviation, ± 1.80). All teeth in RT and CON groups showed a positive response to the thermal test. All tested teeth were considered vital. CONCLUSIONS Pulp %SpO2 was found to be within normal limits 4-6 years after RT. This suggests that RT may not have a long-term influence on pulp vitality, and reported short-term changes in pulpal microcirculation because of RT may be temporary.
Collapse
|
21
|
Dental Pulp Status of Posterior Teeth in Patients with Oral and Oropharyngeal Cancer Treated with Concurrent Chemoradiotherapy. J Endod 2015; 41:1830-3. [DOI: 10.1016/j.joen.2015.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Revised: 08/06/2015] [Accepted: 08/09/2015] [Indexed: 11/19/2022]
|
22
|
Stella JPF, Barletta FB, Giovanella LB, Grazziotin-Soares R, Tovo MF, Felippe WT, Estrela C. Oxygen Saturation in Dental Pulp of Permanent Teeth: Difference between Children/Adolescents and Adults. J Endod 2015; 41:1445-9. [PMID: 26093471 DOI: 10.1016/j.joen.2015.04.024] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2014] [Revised: 04/28/2015] [Accepted: 04/30/2015] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The objective of this study was to use pulse oximetry to measure oxygen saturation in permanent maxillary central incisors with normal pulp in 2 different age groups: children/adolescents and adults. METHODS Blood oxygen saturation levels were measured using a pulse oximeter in 110 maxillary central incisors of 57 individuals, in 1 of 2 possible age bands, as follows: 28 children/adolescents (7-13 years old) and 29 adults (22-36 years old). The following factors were also analyzed: (1) heart rate (beats/min); (2) oxygen saturation rate measured at the patient's index finger, also using a pulse oximeter; (3) tooth crown dimensions; and (4) the time taken by the oximeter to provide a reading. RESULTS The mean oxygen saturation level in normal central incisors was higher among children/adolescents (84.35%) than adults (77.88%, P = .003). Oxygen saturation rates measured at the patients' fingers were not correlated with saturation obtained at the teeth (r = 0.10). There was no correlation between oxygen saturation readings and tooth dimensions (buccal surface area), heart rate, or oximeter reading time (P > .05). CONCLUSIONS Oxygen saturation values measured in maxillary central incisors using a pulse oximeter revealed differences between children/adolescents and adults, showing that children/adolescents have higher oxygen saturation levels. There was no correlation between oxygen saturation levels in patients' fingers and values from their teeth or between oxygen saturation readings from central incisors and tooth dimensions (buccal surface), heart rate, or oximeter reading time.
Collapse
Affiliation(s)
| | | | | | - Renata Grazziotin-Soares
- School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | | | | | - Carlos Estrela
- School of Dentistry, Federal University of Goiás, Goiânia, Goias, Brazil.
| |
Collapse
|
23
|
Giovanella LB, Barletta FB, Felippe WT, Bruno KF, de Alencar AHG, Estrela C. Assessment of oxygen saturation in dental pulp of permanent teeth with periodontal disease. J Endod 2014; 40:1927-31. [PMID: 25282376 DOI: 10.1016/j.joen.2014.08.009] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2014] [Revised: 07/09/2014] [Accepted: 08/14/2014] [Indexed: 10/24/2022]
Abstract
INTRODUCTION In individuals with periodontal disease, dental pulp status should be determined before a treatment plan is made. Pulse oximeters are promising diagnostic tools to evaluate pulp vascularization. This study used pulse oximetry to determine the level of oxygen saturation in dental pulp of intact permanent teeth with periodontal attachment loss (PAL) and gingival recession (GR) and to evaluate the correlation between periodontal disease and level of oxygen saturation in the pulp. METHODS This study included 67 anterior teeth of 35 patients; all teeth showed intact crowns, PAL, a periodontal pocket (PP), and GR. The teeth underwent periodontal examination, cold and electric pulp testing, and pulse oximetry measurements. The Pearson correlation coefficient and a linear regression coefficient were calculated to evaluate the degree of correlation between periodontal disease markers (PAL, PP, and GR) and the level of oxygen saturation in dental pulp. These tests also evaluated possible associations between oxygen saturation and cold and electric pulp testing. RESULTS PAL, PP, and GR had negative correlations with oxygen saturation in dental pulp. Conversely, no statistically significant association was found between oxygen saturation in dental pulp and the response to electric sensibility testing. CONCLUSIONS Oxygen saturation was lower in the pulp of permanent teeth with PAL, PP, and GR, indicating that periodontal disease correlates with the level of oxygen saturation in the pulp.
Collapse
Affiliation(s)
- Larissa Bergesch Giovanella
- Department of Endodontics, School of Dentistry, Universidade Luterana do Brasil, Canoas, Rio Grande do Sul, Brazil
| | - Fernando Branco Barletta
- Department of Endodontics, School of Dentistry, Universidade Luterana do Brasil, Canoas, Rio Grande do Sul, Brazil.
| | - Wilson Tadeu Felippe
- Department of Endodontics, School of Dentistry, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Kely Firmino Bruno
- Department of Endodontics, School of Dentistry, Universidade Paulista, Goiânia, Goiás, Brazil
| | | | - Carlos Estrela
- Department of Stomatologic Sciences, School of Dentistry, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| |
Collapse
|
24
|
Micromorphology of the Dental Pulp Is Highly Preserved in Cancer Patients Who Underwent Head and Neck Radiotherapy. J Endod 2014; 40:1553-9. [DOI: 10.1016/j.joen.2014.07.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2014] [Revised: 06/12/2014] [Accepted: 07/07/2014] [Indexed: 11/19/2022]
|
25
|
Bruno KF, Barletta FB, Felippe WT, Silva JA, Gonçalves de Alencar AH, Estrela C. Oxygen Saturation in the Dental Pulp of Permanent Teeth: A Critical Review. J Endod 2014; 40:1054-7. [DOI: 10.1016/j.joen.2014.04.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2013] [Revised: 03/17/2014] [Accepted: 04/25/2014] [Indexed: 11/16/2022]
|
26
|
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; 38:1182-6. [DOI: 10.1016/j.joen.2012.06.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2012] [Revised: 06/09/2012] [Accepted: 06/11/2012] [Indexed: 10/28/2022]
|
27
|
Setzer FC, Kataoka SHH, Natrielli F, Gondim-Junior E, Caldeira CL. Clinical diagnosis of pulp inflammation based on pulp oxygenation rates measured by pulse oximetry. J Endod 2012; 38:880-3. [PMID: 22703647 DOI: 10.1016/j.joen.2012.03.027] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 03/27/2012] [Accepted: 03/27/2012] [Indexed: 10/28/2022]
Abstract
INTRODUCTION The objective of this study was to investigate correlations between pulp oxygenation rates (%SpO(2)) and clinical diagnoses of reversible pulpitis (RP), irreversible pulpitis (IP), or pulp necrosis (PN). METHODS Sixty patients who presented with a tooth with endodontic pathology were grouped according to a clinical diagnosis of either RP (n = 20), IP (n = 20), or PN (n = 20). The clinical diagnosis was based on the patient's dental history, periapical radiographs, clinical inspection, and percussion and thermal sensitivity testing. Pulse oximetry (PO) was used to determine pulp oxygenation rates. For every patient, one additional endodontically treated tooth (negative control [NC], n = 60) and one additional healthy tooth with healthy pulp status (positive control [PC], n = 60) were evaluated. Analysis of variance, the Tukey HSD test, and the Student's t test were used for statistical analysis. RESULTS The mean %SpO(2) levels were as follows: RP: 87.4% (standard deviation [SD] ±2.46), IP: 83.1% (SD ±2.29), PN: 74.6% (SD ±1.96), PC: 92.2% (SD ±1.84), and NC: 0% (SD ±0.0). There were statistically significant differences between RP, IP, and PN compared with NC and PC and between RP, IP, and PN (all P ≤ .01). CONCLUSIONS The evaluation of pulp oxygenation rates by PO may be a useful tool to determine the different inflammatory stages of the pulp to aid in endodontic diagnosis.
Collapse
Affiliation(s)
- Frank C Setzer
- Department of Endodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
| | | | | | | | | |
Collapse
|
28
|
Kataoka SH, Setzer FC, Fregnani ER, Pessoa OF, Gondim E, Caldeira CL. Effects of 3-Dimensional Conformal or Intensity-modulated Radiotherapy on Dental Pulp Sensitivity during and after the Treatment of Oral or Oropharyngeal Malignancies. J Endod 2012; 38:148-52. [DOI: 10.1016/j.joen.2011.09.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Revised: 09/25/2011] [Accepted: 09/30/2011] [Indexed: 02/07/2023]
|