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Yang K, Guo F, Zhou Z, Hui Z, Wang Z, Wang J, Chen Y, Ge X, Huang R, Wang X. Laser doppler flowmetry to detect pulp vitality, clinical reference range and coincidence rate for pulpal blood flow in permanent maxillary incisors in Chinese children: a clinical study. BMC Oral Health 2023; 23:283. [PMID: 37173683 PMCID: PMC10182670 DOI: 10.1186/s12903-023-02747-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 01/16/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND A laser doppler flowmetry (LDF) test can reflect the pulp vitality caused by the change in pulp blood flow (PBF). This study aimed to investigate the PBF of the permanent maxillary incisors using LDF and to calculate the clinical reference range and coincidence rate for pulp vitality using PBF as an indicator. METHODS School-age children (7-12 years) were recruited randomly. A total of 455 children (216 female and 239 male) were included in this study. An additional 395 children (7-12 years) who attended the department due to anterior tooth trauma from October 2015 to February 2018 were included to assess the clinical occurrence rate. The PBF was measured using LDF equipment and an LDF probe. RESULTS The clinical reference range of PBF values for the permanent maxillary incisors (teeth 11, 12, 21, and 22) in children were from 7 to 14 perfusion units (PU), 11 (6.016; 11.900 PU), 12 (6.677; 14.129 PU), 21 (6.043;11.899 PU), and 22 (6.668; 14.174 PU). There was a statistically significant correlation between PBF and children's age (p < 0.000) without any significant gender discrimination (p = 0.395). For all incisors, for any age group, the PBF detection value of the lateral incisors was significantly higher than that of the central incisors (p < 0.05). The clinical coincidence rate of detecting PBF in the traumatic teeth was 90.42% and the sensitivity and specificity were 36.99% and 99.88%, respectively. CONCLUSIONS The determination of the PBF clinical reference range and clinical coincidence rate for the permanent maxillary incisors in children using LDF provided a promising theoretical basis for clinical applications.
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Affiliation(s)
- Kuan Yang
- Department of Orthodontics, College of Stomatology, Xi'an Jiaotong University, Xi'an, China
- Department of Orthodontics, Affiliated Hospital of Qingdao University, School of Stomatology, Qingdao University, Qingdao, China
| | - Feifei Guo
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shanxi Key Laboratory of Stomatology, Department of Pediatric Dentistry, Fourth Military Medical University, Xi'an, 710032, China
| | - Zhifei Zhou
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shanxi Key Laboratory of Stomatology, Department of Pediatric Dentistry, Fourth Military Medical University, Xi'an, 710032, China
| | - Zeming Hui
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shanxi Key Laboratory of Stomatology, Department of Pediatric Dentistry, Fourth Military Medical University, Xi'an, 710032, China
| | - Zirui Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shanxi Key Laboratory of Stomatology, Department of Pediatric Dentistry, Fourth Military Medical University, Xi'an, 710032, China
| | - Junhui Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shanxi Key Laboratory of Stomatology, Department of Pediatric Dentistry, Fourth Military Medical University, Xi'an, 710032, China
| | - Yujiang Chen
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shanxi Key Laboratory of Stomatology, Department of Pediatric Dentistry, Fourth Military Medical University, Xi'an, 710032, China
| | - Xin Ge
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shanxi Key Laboratory of Stomatology, Department of Pediatric Dentistry, Fourth Military Medical University, Xi'an, 710032, China
| | - Ruizhe Huang
- Key laboratory of Shaanxi Province for Craniofacial Precision Medicine Research,College of Stomatology, Xi'an Jiaotong University, Xi'an, China.
| | - Xiaojing Wang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shanxi Key Laboratory of Stomatology, Department of Pediatric Dentistry, Fourth Military Medical University, Xi'an, 710032, China.
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Richert R, Ducret M, Alliot-Licht B, Bekhouche M, Gobert S, Farges JC. A critical analysis of research methods and experimental models to study pulpitis. Int Endod J 2022; 55 Suppl 1:14-36. [PMID: 35034368 DOI: 10.1111/iej.13683] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/29/2022]
Abstract
Pulpitis is the inflammatory response of the dental pulp to a tooth insult, whether it is microbial, chemical, or physical in origin. It is traditionally referred to as reversible or irreversible, a classification for therapeutic purposes that determines the capability of the pulp to heal. Recently, new knowledge about dental pulp physiopathology led to orientate therapeutics towards more frequent preservation of pulp vitality. However, full adoption of these vital pulp therapies by dental practitioners will be achieved only following better understanding of cell and tissue mechanisms involved in pulpitis. The current narrative review aimed to discuss the contribution of the most significant experimental models developed to study pulpitis. Traditionally, in vitro two(2D)- or three(3D)-dimensional cell cultures or in vivo animal models were used to analyse the pulp response to pulpitis inducers at cell, tissue or organ level. In vitro 2D cell cultures were mainly used to decipher the specific roles of key actors of pulp inflammation such as bacterial by-products, pro-inflammatory cytokines, odontoblasts or pulp stem cells. However, these simple models did not reproduce the 3D organisation of the pulp tissue and, with rare exceptions, did not consider interactions between resident cell types. In vitro tissue/organ-based models were developed to better reflect the complexity of the pulp structure. Their major disadvantage is that they did not allow the analysis of blood supply and innervation participation. On the contrary, in vivo models have allowed researchers to identify key immune, vascular and nervous actors of pulpitis and to understand their function and interplay in the inflamed pulp. However, inflammation was mainly induced by iatrogenic dentine drilling associated with simple pulp exposure to the oral environment or stimulation by individual bacterial by-products for short periods. Clearly, these models did not reflect the long and progressive development of dental caries. Lastly, the substantial diversity of the existing models makes experimental data extrapolation to the clinical situation complicated. Therefore, improvement in the design and standardization of future models, for example by using novel molecular biomarkers, databased models and artificial intelligence, will be an essential step in building an incremental knowledge of pulpitis in the future.
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Affiliation(s)
- Raphaël Richert
- Hospices Civils de Lyon, Service d'Odontologie, Lyon, France.,Université de Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Laboratoire de Mécanique des Contacts et Structures, UMR 5259, Villeurbanne, France
| | - Maxime Ducret
- Hospices Civils de Lyon, Service d'Odontologie, Lyon, France.,Université de Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305, CNRS, Université, UMS, Claude Bernard Lyon 1, 3444 BioSciences Gerland-Lyon Sud, Lyon, France
| | - Brigitte Alliot-Licht
- Université de Nantes, Faculté d'Odontologie, Nantes, France.,CHU de Nantes, Odontologie Conservatrice et Pédiatrique, Service d, Nantes, France
| | - Mourad Bekhouche
- Université de Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305, CNRS, Université, UMS, Claude Bernard Lyon 1, 3444 BioSciences Gerland-Lyon Sud, Lyon, France
| | - Stéphanie Gobert
- Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305, CNRS, Université, UMS, Claude Bernard Lyon 1, 3444 BioSciences Gerland-Lyon Sud, Lyon, France
| | - Jean-Christophe Farges
- Hospices Civils de Lyon, Service d'Odontologie, Lyon, France.,Université de Lyon, Université Claude Bernard Lyon 1, Faculté d'Odontologie, Lyon, France.,Laboratoire de Biologie Tissulaire et Ingénierie thérapeutique, UMR 5305, CNRS, Université, UMS, Claude Bernard Lyon 1, 3444 BioSciences Gerland-Lyon Sud, Lyon, France
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Laser Doppler for Accurate Diagnosis of Oehler’s Type III Dens Invaginatus: A Case Report. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11093848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In vital pulp therapy, pulp testing aids in the differential diagnosis and influences the treatment plan. Different from previous doppler flowmetry studies that only recorded waves and data, we report the first time, the use of a laser doppler blood flow monitor and imager with a colored image to present pulp vitality information in the dental field. We report here a case of Oehlers type IIIa dens invaginatus of the right upper lateral incisor in a 31-year-old girl, with the opening of the invagination near CDJ and a peri-invagination lesion sized 8 × 9 mm2. Cone beam computed tomography was used to verify specific spatial and stereoscopic data. After removing the source of infection, mineral trioxide aggregate was selected to fill the invagination. Laser doppler was scheduled for further assessment. After three years of regular follow-up, the patient’s clinical condition improved, the peri-invagination lesion healed, and the laser doppler and electric pulp test both showed a positive reaction. Laser doppler has successfully improved the diagnostic accuracy Thus, unnecessary interventions can be avoided while reducing the treatment time by preserving the vitality. However, further work is needed to resolve the limitations of laser doppler.
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Farughi A, Rouhani A, Shahmohammadi R, Jafarzadeh H. Clinical comparison of sensitivity and specificity between sensibility and vitality tests in determining the pulp vitality of mandibular premolars. AUST ENDOD J 2021; 47:474-479. [PMID: 33829611 DOI: 10.1111/aej.12506] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Revised: 02/19/2021] [Accepted: 03/02/2021] [Indexed: 11/30/2022]
Abstract
This clinical study was designed to compare cold pulp testing (CPT), heat pulp testing (HPT) and electric pulp test (EPT) with pulse oximetry (PO), flowmetry (FM) and thermometry (TM) in terms of sensitivity and specificity. Twenty premolar teeth in need of root canal treatment were included in the study. Pulp sensibility tests (CPT, HPT and EPT) along with vitality tests (PO, FM and TM) were performed. As the gold standard, the teeth were endodontically treated and pulp vitality was determined by direct visual observation. Sensitivity, specificity and accuracy values for each test were as follows: HPT 1, 1, 100%; CPT 1, 0.818, 90%; EPT 1, 0.909, 95%; PO 1, 0.545, 75%; TM 0.111, 0.272, 20%; and FM 0.444, 0.272, 35%, respectively. The most accurate test among all was HPT. PO was the most accurate vitality test.
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Affiliation(s)
- Aidin Farughi
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Armita Rouhani
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Reza Shahmohammadi
- Department of Endodontics, Faculty of Dentistry, Birjand University of Medical Sciences, Birjand, Iran
| | - Hamid Jafarzadeh
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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GÜLER D, ŞEN TUNÇ E. Lazer Doppler Flovmetre. MUSTAFA KEMAL ÜNIVERSITESI TIP DERGISI 2019. [DOI: 10.17944/mkutfd.538803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
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Ghouth N, Duggal MS, Kang J, Nazzal H. A Diagnostic Accuracy Study of Laser Doppler Flowmetry for the Assessment of Pulpal Status in Children’s Permanent Incisor Teeth. J Endod 2019; 45:543-548. [DOI: 10.1016/j.joen.2019.01.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 01/15/2019] [Accepted: 01/25/2019] [Indexed: 11/16/2022]
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Vitality Tests for Pulp Diagnosis of Traumatized Teeth: A Systematic Review. J Endod 2019; 45:490-499. [DOI: 10.1016/j.joen.2019.01.014] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Revised: 01/21/2019] [Accepted: 01/21/2019] [Indexed: 11/21/2022]
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Self-repaired Process of a Traumatized Maxillary Central Incisor with Pulp Infarct after Horizontal Root Fracture Monitored by Laser Doppler Flowmetry Combined with Tissue Oxygen Monitor. J Endod 2017; 43:1218-1222. [DOI: 10.1016/j.joen.2017.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Revised: 02/25/2017] [Accepted: 03/01/2017] [Indexed: 01/25/2023]
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CARTAGENA AF, PARREIRAS SO, LOGUERCIO AD, REIS A, CAMPANHA NH. In-office bleaching effects on the pulp flow and tooth sensitivity – case series. Braz Oral Res 2015; 29:S1806-83242015000100223. [DOI: 10.1590/1807-3107bor-2015.vol29.0026] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 08/29/2014] [Indexed: 11/22/2022] Open
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Cho YW, Park SH. Measurement of pulp blood flow rates in maxillary anterior teeth using ultrasound Doppler flowmetry. Int Endod J 2014; 48:1175-80. [DOI: 10.1111/iej.12422] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Accepted: 12/03/2014] [Indexed: 11/26/2022]
Affiliation(s)
- Y.-W. Cho
- Department of Conservative Dentistry; College of Dentistry; Yonsei University; Seodaemun-Gu Seoul South Korea
| | - S.-H. Park
- Department of Conservative Dentistry; Oral Science Research Center; College of Dentistry; Yonsei University; Seodaemun-Gu Seoul, South Korea
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Improvement of the detection of human pulpal blood flow using a laser Doppler flowmeter modified for low flow velocity. Arch Oral Biol 2013; 59:199-206. [PMID: 24370192 DOI: 10.1016/j.archoralbio.2013.11.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 11/14/2013] [Accepted: 11/16/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Human pulpal blood flow (PBF) signals as measured by laser Doppler flowmeter (LDF) decrease with age. Although this decrease is considered to be due in part to slow blood flow, information regarding this velocity in humans has been lacking. The aims of the present study were to estimate the blood flow velocity in human dental pulp and to evaluate the validity of LDF modified for the measurement of slow blood flow. DESIGN Mean blood flow velocities at the upper central incisor, gingiva, fingertip and forearm of 28 volunteers (mean age: 38.6 years old) were estimated using LDF with a frequency analyser. Blood flow signals at these measurement areas were recorded using two different LDFs: (a) one with a standard blood flow range; and (b) one modified for low blood flow velocity. RESULTS The frequency range of the Doppler shift measured at the teeth with an opaque rubber dam was the narrowest (median: 4.3kHz) among all of the measurement areas. The estimated mean blood flow velocity was the slowest at the teeth with a dam (median: 0.18mm/s). LDF for low blood flow velocity detected larger and clearer pulsatile blood flow signals from the teeth with dams than did standard LDF. CONCLUSIONS The present results indicate that the velocity of PBF in humans is very low and that LDF modified for the measurement of slow blood flow is appropriate for PBF measurement in humans.
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Orekhova LY, Barmasheva AA. Doppler flowmetry as a tool of predictive, preventive and personalised dentistry. EPMA J 2013; 4:21. [PMID: 23981527 PMCID: PMC3846663 DOI: 10.1186/1878-5085-4-21] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2013] [Accepted: 08/20/2013] [Indexed: 12/19/2022]
Abstract
Periodontal lesions are considered a major problem in the global burden of oral diseases due to their high frequency and negative impact on quality of life. Periodontal inflammation is accomplished by a breakdown of microcirculatory function. Early detection of gingival microvessel dysfunction helps diagnose and prevent the progression of initial periodontal pathology. Doppler flowmetry is a useful tool in the diagnosis, monitoring, prognosis and management of periodontal patients which allows access not only of gingival blood flow but also of pulpal microcirculation. Doppler flowmeters might help to realise the ultimate target of predictive, preventive and personalised periodontology tailored with respect to the particular patient. This article highlights the main working principles of laser Doppler flowmeters and the ultrasonic Doppler flowmeters. The advances in blood flow measurement by ultrasonic flowmetry are discussed.
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Affiliation(s)
- Liudmila Yu Orekhova
- Therapeutic Dentistry Department, I,P, Pavlov Saint-Petersburg State Medical University, 6/8 Lev Tolstoy Street, Saint Petersburg 197022, Russia.
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Au M, Rattigan S. Barriers to the management of Diabetes Mellitus - is there a future role for Laser Doppler Flowmetry? Australas Med J 2012; 5:627-32. [PMID: 23382766 DOI: 10.4066/amj.2012.1526] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Diabetes Mellitus (DM) is a chronic disease that carries a significant disease burden in Australia and worldwide. The aim of this paper is to identify current barriers in the management of diabetes, ascertain whether there is a benefit from early detection and determine whether LDF has the potential to reduce the disease burden of DM by reviewing the literature relating to its current uses and development. In this literature review search terms included; laser Doppler flowmetry, diabetes mellitus, barriers to management, uses, future, applications, vasomotion, subcutaneous, cost. Databases used included Google Scholar, Scopus, Science Direct and Medline. Publications from the Australian government and textbooks were also utilised. Articles reviewed had access to the full text and were in English.
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Affiliation(s)
- Minnie Au
- Menzies Research Institute, University of Tasmania, Australia ; School of Medicine, University of Tasmania, Australia
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Mejàre IA, Axelsson S, Davidson T, Frisk F, Hakeberg M, Kvist T, Norlund A, Petersson A, Portenier I, Sandberg H, Tranaeus S, Bergenholtz G. Diagnosis of the condition of the dental pulp: a systematic review. Int Endod J 2012; 45:597-613. [DOI: 10.1111/j.1365-2591.2012.02016.x] [Citation(s) in RCA: 146] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Ferreira MM, Botelho MF, Abrantes M, Oliveiros B, Carrilho EV. Quantitative scintigraphic analysis of pulp revascularization in autotransplanted teeth in dogs. Arch Oral Biol 2010; 55:825-9. [DOI: 10.1016/j.archoralbio.2010.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2010] [Revised: 07/14/2010] [Accepted: 07/27/2010] [Indexed: 11/25/2022]
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