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Imtiaz T, Gurunathan D, Saikiran KV. Determination of the Ideal Tooth Surface and Pain Threshold to Improve the Efficacy of an Electric Pulp Tester in the Diagnosis of Pulp Sensitivity and Vitality in Premolar and Molar Teeth: A Cross-Sectional Study. Cureus 2023; 15:e50754. [PMID: 38239553 PMCID: PMC10794787 DOI: 10.7759/cureus.50754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 12/18/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction The electric pulp tester (EPT) is an extensively used diagnostic tool in endodontics. However, several factors, especially the location and thickness of the tooth structures, such as enamel and dentine, can affect the result of an electric pulp test. Further, these factors also alter the pain threshold, which may lead to an inaccurate diagnosis. Hence, it is crucial to ascertain the optimal tooth surface that requires minimal time to elicit a response and pain threshold to enhance the effectiveness of the electric pulp tester for diagnosing the status of the pulp. Methods Fifty volunteers (36 males and 14 females) aged 18 to 32 years without any prior experience with the EPT were recruited. The EPT was placed on the seven premolar sites, and molar teeth with an appropriate electrolyte as a conducting medium were tested. The pain threshold values were recorded using the stopwatch, whereas pain assessment was carried out using the Memojis pain scale. An independent sample t-test and descriptive statistics were used to analyze the data statistically. Results The buccal occlusal third in males (27.3±8.6 seconds) and the buccal middle third in females (28.5±8.2 seconds) showed lower response times than other sites in premolar teeth. The mesiobuccal cusp showed a lower response time for males (21.3±6.6 seconds) and females (21.5±6.2 seconds) in molar teeth. Of all the various sites tested, the majority of the individuals chose pain scores of 0 (36 in premolars, 84 in molars), two (138 in premolars, 180 in molars), and four (96 in premolars, 42 in molars) in both the premolars and molars. Conclusion The ideal sites for placing the EPT in premolars for males and females are the buccal occlusal third and the buccal middle third. At the same time, the mesiobuccal cusp is the ideal site for molars in both males and females, as it is responded to the quickest by the electric current. Most individuals have experienced a score of two (hurts a little bit) for the perceived pain using EPT for both the molars and premolars.
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Affiliation(s)
- Taanya Imtiaz
- Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Deepa Gurunathan
- Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University, Chennai, IND
| | - Kanamarlapudi Venkata Saikiran
- Paediatric and Preventive Dentistry, Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences, Saveetha University,, Chennai, IND
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Ajcharanukul O, Santikulluk P, Sasingha P, Sabpawat S, Sukyanan K. Iontophoresis effects of two-step self-etch and total-etch systems on dentin permeability and sealing of composite restoration under simulated pulpal pressure. BMC Oral Health 2022; 22:574. [PMID: 36482395 PMCID: PMC9730621 DOI: 10.1186/s12903-022-02632-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/29/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Studies demonstrated the bond strength enhancement and the decrease in degradation of the adhesive interface after applying either self-etch adhesives or two-step, etch-and-rinse adhesives under an electric field. However, the presence of dentinal fluid driven by the pulpal pressure in vivo is a profounding factor affecting both the sealing ability and bond strength of adhesives. This study aimed to evaluate the effect of three-step etch-and-rinse and two-step self-etch adhesives when applied with iontophoresis under simulated pulpal pressure on the permeability of dentin, resin infiltration, and the sealing ability of resin composite. METHODS The experiments were done on 32 recently extracted premolars, randomly assigned into four groups (n = 8) according to two adhesive systems (SBMP and SE), applied following the manufacturer's instructions (control) for two groups or with iontophoresis for the others (SBMPi and SEi). For the iontophoresis, the anodal current was applied at 75 μA for 20 s through the cavity electrode during the bond. The fluid flow rate of dentin was recorded after cavity preparation (smear-layer-covered dentin; T1), bonding (T2), and composite restoration (T3) during the maintained pulpal pressure of 20 mm Hg. The flow rates were expressed as a percentage relative to the initial smear-layer-covered value for each specimen. Results were analyzed using repeated measures ANOVA. Scanning electron microscopy (SEM) was performed to observe the resin/dentin interface. RESULTS There were no significant increases in the mean flow rates from T1 to T3 in the SBMP (P = 0.355), while these changes in the SE were significant between T1 (100%) and T2 (166.77%) and T1 and T3 (221.16%) (P = 0.002; one-way RM ANOVA; Holm-Sidak test). For the iontophoresis groups, the mean flow rates decreased significantly from T1 to T2 and T1 to T3 of both SBMPi (T2 = 86.43, and T3 = 79.53; P < 0.001) and SEi groups (T2 = 87.96, and T3 = 81.48; P = 0.004). The iontophoresis of both adhesives produced the optimal resin infiltration with improved quality of the hybrid layer and resin tags. CONCLUSIONS SBMP bonded with or without iontophoresis performed better sealing ability than SE under the same condition. Both adhesives applied with anodal iontophoresis significantly decreased the dentin permeability, contributing to the improved resin infiltration.
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Affiliation(s)
- Orapin Ajcharanukul
- grid.412739.a0000 0000 9006 7188Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Asokemontri Road, Wattana, Bangkok, 10110 Thailand
| | - Peeraya Santikulluk
- grid.412739.a0000 0000 9006 7188Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Asokemontri Road, Wattana, Bangkok, 10110 Thailand
| | - Palat Sasingha
- grid.412739.a0000 0000 9006 7188Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Asokemontri Road, Wattana, Bangkok, 10110 Thailand
| | - Sirithorn Sabpawat
- grid.412739.a0000 0000 9006 7188Department of Stomatology, Faculty of Dentistry, Srinakharinwirot University, Asokemontri Road, Wattana, Bangkok, 10110 Thailand
| | - Kanokporn Sukyanan
- grid.412739.a0000 0000 9006 7188The Dean Office, Faculty of Dentistry, Srinakharinwirot University, Bangkok, Thailand
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Turedi I, Ulusoy AT. Evaluation of electric pulp test thresholds and correct probe tip placement site in developing incisors: a clinical study in 1200 teeth. Eur Arch Paediatr Dent 2022; 23:449-454. [PMID: 35320833 DOI: 10.1007/s40368-022-00703-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 03/09/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE Although electric pulp tests (EPT) may play a valuable diagnostic role in traumatized immature permanent teeth, the EPT threshold values which can be used as reference are not known. The aim of this study was to determine the average range of EPT threshold values in healthy permanent incisors according to their stage of root development. METHODS A total of 1200 permanent incisors were examined in 273 children (142 girls, 131 boys) aged 6-12 years. Panoramic radiographs were used to group teeth according to the stage of root development. A digitest II pulp vitality tester (Parkell, Inc, Edgewood, NY) was used along with toothpaste as the conducting medium to determine sensibility on three different sites (incisal, middle and cervical third). RESULTS In all teeth, mean EPT values showed a tendency to decrease along with advanced root development. Irrespective of the stage of root development, the lowest EPT values were obtained when measurements were made on the incisal third of the crown (p < 0.001). Mandibular incisors had lower mean response thresholds than their maxillary counterparts. CONCLUSION The present findings provide reference EPT threshold values according to stage of tooth development to monitor the post traumatic pulp status of permanent incisors.
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Affiliation(s)
- I Turedi
- Department of Paediatric Dentistry, Faculty of Dentistry, Ondokuz Mayis University, Kurupelit, 55139, Samsun, Turkey
| | - A T Ulusoy
- Department of Paediatric Dentistry, Faculty of Dentistry, Ondokuz Mayis University, Kurupelit, 55139, Samsun, Turkey.
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Aravind A, R R, Sharma R, Rana A, Sharma S, Kumar V, Chawla A, Logani A. Response to Pulp Sensibility Tests after Full Pulpotomy in Permanent Mandibular Teeth with Symptomatic Irreversible Pulpitis: A Retrospective Data Analysis. J Endod 2021; 48:80-86. [PMID: 34715134 DOI: 10.1016/j.joen.2021.10.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 10/14/2021] [Accepted: 10/18/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION This retrospective study analyzed the 12-month pulp sensibility (cold and electric) test response after mineral trioxide aggregate (MTA) full pulpotomy in mature permanent teeth with symptomatic irreversible pulpitis. METHODS The records of 120 subjects from 3 completed and 1 ongoing clinical study on MTA full pulpotomy were retrieved. Ninety-six first and second mandibular molar teeth with a diagnosis of symptomatic irreversible pulpitis that underwent a single-visit MTA full pulpotomy and had completed a 12-month clinical, radiographic, and pulp sensibility (cold and electric) test follow-up were included. The data were analyzed using the Fisher exact test, the Pearson chi-square test, and the McNemar test. The significance level was predetermined at P < .05. RESULTS A higher percentage of teeth (94.7%) responded to the electric pulp test in comparison with the cold test (13.5%) (P < .05). Sex-based responses to the electric pulp test (P > .05) and the cold test were similar (P > .05). The age-based response was similar for the electric pulp test (P > .05) but was significant for the cold test (P < .05). The tooth quadrant (left and right), the tooth (mandibular first and second molar), and the location of restoration (proximal or occlusal) did not influence the response of either the electric pulp test (P > .05) or the cold test (P > .05). At the 1-year follow-up, all the teeth that were classified as clinically and radiographically successful responded to the electric pulp test; however, only 13 teeth responded to the cold test (P = .00). CONCLUSIONS The majority (94.7%) of the teeth that underwent MTA full pulpotomy responded to the electric pulp test at a 1-year time interval.
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Affiliation(s)
- Archana Aravind
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Rechithra R
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Radha Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amal Rana
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Sidhartha Sharma
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Vijay Kumar
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Amrita Chawla
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Logani
- Division of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, All India Institute of Medical Sciences, New Delhi, India.
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Owlia F, Mahmoudzade N, Modaresi J, Zarchi MA. Evaluation of the response to electric pulp testing in multiple sclerosis patients without a history of trigeminal neuralgia: a case-control study. BMC Neurol 2021; 21:403. [PMID: 34670504 PMCID: PMC8527635 DOI: 10.1186/s12883-021-02416-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/30/2021] [Indexed: 12/18/2022] Open
Abstract
Background The importance of evaluating the pulpal threshold to electrical stimulation, as a side effect of probable neuropathy in Multiple Sclerosis (MS) patients is a novel issue. This study aimed to investigate electrical pulp test thresholds in MS patients without a history of trigeminal neuralgia compared to healthy individuals. Methods Sixty-nine maxillary central incisors, belonging to 34 relapsing-remitting MS patients, and 35 healthy individuals were included in this survey. The MS patients matched for intended variables, were 22–50 years old, had a more than 1-year history of MS, no history of trigeminal neuralgia and/or other neuropathy. The electric pulp sensibility test was performed on all samples. Electric pulp testing (EPT) results were recorded based on the pulp tester’s grade that evoked a response. Data were analyzed with paired T-test, Mann-Whitney test, and Spearman correlation (P < 0.05). Results According to the results of this study, the mean values of response to EPT were 1.2 ± 0.5 and 1.8 ± 0.5 in MS patients and healthy individuals, respectively. The pulpal response to EPT between the two groups was significantly different (P < 0.0001). Conclusions MS patients showed a significantly reduced response to the electric pulp test in their maxillary central incisors in comparison to matched healthy persons.
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Affiliation(s)
- Fatemeh Owlia
- Department of Oral and Maxillofacial Medicine, Social Determinants of Oral Health Research Center, School of Dentistry, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Islamic Republic of Iran.
| | - Nazanin Mahmoudzade
- School of Dentistry, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Islamic Republic of Iran
| | - Jalil Modaresi
- Department of Endodontics, School of Dentistry, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Islamic Republic of Iran
| | - Marzieh Abutorabi Zarchi
- Department of Neurology, Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Islamic Republic of Iran
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Sui H, Lv Y, Xiao M, Zhou L, Qiao F, Zheng J, Sun C, Fu J, Chen Y, Liu Y, Zhou J, Wu L. Relationship between the difference in electric pulp test values and the diagnostic type of pulpitis. BMC Oral Health 2021; 21:339. [PMID: 34246278 PMCID: PMC8272274 DOI: 10.1186/s12903-021-01696-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Accepted: 06/25/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND According to the diagnosis criteria of the American Association of Endodontists (AAE), sensitive responses to cold and/or heat tests of suspected teeth compared with those of control teeth can be used for the diagnosis of pulpitis, but the role of electric pulp test (EPT) is not mentioned. It is believed that EPT has some limitations in determining the vitality of the pulp. The aim of this study was to explore the association between the difference in EPT values and the differential diagnoses of reversible pulpitis (RP) and symptomatic irreversible pulpitis (SIRP) caused by dental caries. METHODS A total of 203 cases with pulpitis caused by dental caries were included. A diagnosis of pulpitis was made on the basis of the diagnostic criteria of AAE. Patient demographic and clinical examination data were collected. The EPT values of the suspected teeth and control teeth were measured, and the differences between them were calculated. The correlation between the difference in the EPT values and diagnosis of pulpitis was analyzed using univariate and multivariate logistic regression. RESULTS In the 203 cases (78 males and 125 females; 115 cases of RP, 88 cases of SIRP; 9 anterior teeth, 59 premolars, and 135 molars), the mean patient age was 34.04 ± 13.02 (standard deviation) years. The unadjusted (crude) model, model 1 (adjusted for age), model 2 (adjusted for age and sex), and model 3 (adjusted for age, sex, and tooth type) were established for the statistical analyses. In model 3 [odds ratio (OR) = 1.025; 95% confidence interval (CI) 1.002-1.050; P = 0.035], the difference in EPT values between RP and SIRP was statistically significant. However, the areas under the curve of predictive probability of the crude model, model 1, model 2, and model 3 were 0.565, 0.570, 0.585, and 0.617, respectively, showing that the model accuracy was low. The P-value for the trend in differences between the EPT values as a categorical variable showed that the differences in the EPT values, comparing RP and SIRP, were not statistically significant. CONCLUSIONS Based on the present data, the difference in EPT values was not sufficient to differentiate RP from SIRP.
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Affiliation(s)
- Huachao Sui
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Yangyang Lv
- Department of Endodontics, Wuxi Stomatology Hospital, Jiangsu, China
| | - Mo Xiao
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Liwen Zhou
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Feng Qiao
- Department of Oral and Maxillofacial Surgery, School of Stomatology, Tianjin Medical University, Tianjin, China
| | - Jinxin Zheng
- Department of Endodontics, Tianjin Stomatological Hospital, School of Medicine, Nankai University, Tianjin, China
| | - Cuicui Sun
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Jieni Fu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Yufan Chen
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Yimeng Liu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China
| | - Jie Zhou
- Department of Stomatology, Wuqing People Hospital, Tianjin, China
| | - Ligeng Wu
- Department of Endodontics, School of Stomatology, Tianjin Medical University, #12 Qi Xiang Tai Road, He Ping District, Tianjin, 300070, China.
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Time-course of the effect of potassium oxalate in the treatment of hypersensitive dentine in man. Arch Oral Biol 2021; 126:105109. [PMID: 33813358 DOI: 10.1016/j.archoralbio.2021.105109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/18/2021] [Accepted: 03/18/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Investigate the cause of hypersensitive dentine (HD) by recording the time course of changes in dentine sensitivity, sensory threshold to electrical stimulation (ET) and pulpal blood flow (PBF) following tubular occlusion using in vitro and clinical experiments. DESIGN Nineteen teeth with HD and 13 with normal dentine from 8 participants were evaluated, and the intensity of any pain produced by various stimuli was recorded at different times after oxalate treatment. The participants used a visual-analogue scale (VAS) to indicate the intensity of any pain. The ET and PBF were recorded at the same times. RESULTS Preliminary in vitro experiments showed that oxalate treatment had no effect on the method used to record PBF, and blocked the treated tubules immediately after application. Considering teeth with HD, a decrease in the median VAS evoked by all forms of stimulation was observed at all post-treatment times, except immediately after treatment (p < 0.05), while the treatment produced no significant effect in teeth with normal dentine. No significant changes in ET or PBF was observed in any of the groups. CONCLUSIONS The effect of oxalate in relieving the symptoms of HD is not only due to a reduction in the intensity of stimulation of sensory receptors sensitive to fluid flow in the dentinal tubules, but also to a reduce in the sensitivity of the receptors that respond to dentine stimulation. There was no evidence that acute pulpitis or central sensitization to pain, which would be associated with changes in PBF or ET, contributes to HD.
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Bulut M, Ulusoy AT. The variability of electric pulp response thresholds in primary molars: a clinical study. Eur Arch Paediatr Dent 2021; 22:693-697. [PMID: 33616886 DOI: 10.1007/s40368-021-00608-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2020] [Accepted: 02/09/2021] [Indexed: 10/22/2022]
Abstract
PURPOSE The variability of the EPT response threshold is the most important part of accurate diagnosis of pulp status of caries-affected resorbing primary teeth. This study evaluated the mean EPT threshold values and appropriate electrode placement sites for primary molar teeth based on their physiological root resorption levels. METHODS This study was conducted with 100 primary second molars in 100 children ages 3-12 (mean age: 7.88 years). Teeth were divided into 2 groups according to physiological root resorption levels. EPT response thresholds were recorded at the mesiobuccal cusp, occlusal third, middle third and cervical third of the crown. Data were analyzed according to resorption level using one-way analysis of variance and Duncan tests, with the level of significance set at 0.05. RESULTS Mean threshold values at all placement sites were higher in the group with the higher level of physiological root resorption. In terms of placement, the lowest mean EPT threshold values were obtained at the mesiobuccal cusp regardless of resorption level. CONCLUSIONS According to the study results, higher resorption levels were associated with higher physiologocial threshold values for EPT of primary second molars, with the mesiobuccal site identified as the most appropriate electrode placement site, regardless of resorption level.
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Affiliation(s)
- M Bulut
- Department of Pediatric Dentistry, Faculty of Dentistry, Istanbul Okan University, Istanbul, Turkey.
| | - A T Ulusoy
- Department of Pediatric Dentistry, Faculty of Dentistry, Ondokuz Mayis Univesity, Samsun, Turkey
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Idon PI, Nwamba PN, Udoye CI, Jafarzadeh H. Does dental fluorosis affect electric pulp test response and/or optimum probe placement site? AUST ENDOD J 2021; 47:307-313. [PMID: 33438314 DOI: 10.1111/aej.12479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/24/2020] [Accepted: 11/27/2020] [Indexed: 12/01/2022]
Abstract
The placement site of electric pulp tester (EPT) probe on the tooth affects the threshold values obtained. The aim of this study was to determine and compare threshold levels and appropriate placement sites for EPT probe on fluorotic and normal teeth. Equal numbers of fluorotic and non-fluorotic maxillary central incisors of 40 subjects were assessed. The mean of three threshold readings from an EPT was taken from the labial surface at the incisal edge, incisal third, middle third and cervical third. Kruskal-Wallis and Friedman ANOVA followed by post hoc tests were used to compare threshold scores. Significantly higher thresholds were recorded for fluorotic teeth at the incisal edge and incisal third. The lowest thresholds were obtained for the incisal edge in both fluorotic and non-fluorotic teeth when compared to the cervical third. There was no statistically significant difference among corresponding test sites between the genders and age groups.
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Affiliation(s)
- Paul I Idon
- Department of Dental Surgery, University of Maiduguri Teaching Hospital, Borno State, Maiduguri, Nigeria
| | - Patricia N Nwamba
- Department of Restorative Dentistry, University of Nigeria Teaching Hospital, Enugu, Nigeria
| | - Christopher I Udoye
- Department of Restorative Dentistry, College of Medicine, University of Nigeria, Nsukka, Enugu State, Nigeria
| | - Hamid Jafarzadeh
- Dental Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Castillo-Silva BE, Martínez-Jiménez V, Martínez-Castañón GA, Medina-Solís CE, Aguirre-López EC, Castillo-Hernández JR, Niño-Martínez N, Patiño-Marín N. Expression of calcitonin gene-related peptide and pulp sensitivity tests in irreversible pulpitis. Braz Oral Res 2019; 33:e077. [PMID: 31531564 DOI: 10.1590/1807-3107bor-2019.vol33.0077] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Accepted: 06/11/2019] [Indexed: 11/22/2022] Open
Abstract
The aim of the present study was to identify the relationship between the expression of calcitonin gene-related peptide (CGRP) and the responses of pulp sensitivity tests in healthy pulps and irreversible pulps by performing a cross-sectional study on patients. Two hundred subjects were evaluated. A total of 75 subjects complied with the criteria. The participants were divided into two groups: a) Healthy pulp (subjects [n = 35] having posterior teeth with clinically normal pulp tissue), and b) Irreversible pulpitis (subjects [n = 40] having posterior teeth with irreversible pulpitis). All participants were evaluated using the following variables: a) medical and dental history, b) pulp sensitivity tests, c) expression of CGRP by the enzyme-linked immunosorbent assay (ELISA), and d) expression levels of mRNA CGRP and mRNA CGRP receptor genes. We determined that the responses of the cold test between 4 and ≥12 s presented a higher average of the expression of CGRP in the group having irreversible pulpitis (p = 0.0001). When we compared the groups with the value of the electrical impulse, we found statistically significant differences (p = 0.0001), observing positive responses to the test with electrical impulses of 7 to 10, with an average of 72.15 ng/mL of CGRP in the irreversible pulpitis group. High values of CGRP expression were observed in that group in the responses of pulp sensitivity.
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Affiliation(s)
- Brenda Eréndida Castillo-Silva
- University of San Luis Potosí, Program of Doctorate in Dental Sciences, Department of Clinical Research, San Luis Potosí, SLP, Mexico
| | - Verónica Martínez-Jiménez
- University of San Luis Potosí, Program of Doctorate in Dental Sciences, Department of Clinical Research, San Luis Potosí, SLP, Mexico
| | | | - Carlo Eduardo Medina-Solís
- Autonomous University of The State of Hidalgo, Institute of Health Sciences, Department of Dentistry, Pachuca, Hidalgo, Mexico
| | - Eva Concepción Aguirre-López
- University of San Luis Potosí, Program of Doctorate in Dental Sciences, Department of Clinical Research, San Luis Potosí, SLP, Mexico
| | | | - Nereyda Niño-Martínez
- University of San Luis Potosí, Program of Doctorate in Dental Sciences, San Luis Potosí, SLP, Mexico
| | - Nuria Patiño-Marín
- University of San Luis Potosí, Program of Doctorate in Dental Sciences, Department of Clinical Research, San Luis Potosí, SLP, Mexico
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Castillo-Silva BE, Alegría-Torres JA, Martínez-Castañón GA, Medina-Solís CE, Zavala-Alonso NV, Niño-Martínez N, Aguirre-López EC, Patiño-Marín N. Diagnostic accuracy of three placement sites for the cold test in subjects amongst different age groups. BMC Oral Health 2019; 19:189. [PMID: 31426774 PMCID: PMC6700768 DOI: 10.1186/s12903-019-0878-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 08/06/2019] [Indexed: 11/24/2022] Open
Abstract
Background The cold test is a specific test of pulp sensitivity and is part of the endodontic diagnosis. The aim of this study was to identify the diagnostic accuracy including sensitivity, specificity, accuracy, positive predictive value and negative predictive value in three sites for the cold test in teeth with a need for endodontic treatment within different age groups from both genders. Methods A cross-sectional study was performed, evaluating 425 subjects. Two hundred and fifty-eight subjects from both genders from the ages of 17–27, 28–39, 40–50, and 51–65 years-old participated in the study. The cold test studied was 1, 1, 1, 2-tetrafluoroethane, and the gold standard was established through direct pulp inspection. The sites evaluated in the study were: The sites evaluated in the study were: a) the middle third of the buccal surface; b) the cervical third of the buccal surface, and c) the middle third of the lingual surface. Results The highest diagnosted accuracy was observed on the middle third buccal surface with an accuracy of = 0.97, a sensitivity of = 1.00, a specificity of 0.95, a predictive value of = 0.95 and a negative predictive value of = 1.00. This was in the female group aged from 40 to 50 years old. Conclusion The tables of this study can be used as an auxiliary for pulp sensitivity tests.
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Affiliation(s)
- Brenda Eréndida Castillo-Silva
- Clinical Research Laboratory, Program of Doctorate in Dental Sciences, Faculty of Dentistry, San Luis Potosí University, Manuel Nava # 2. Zona Universitaria, PC 78290, San Luis Potosí, Mexico
| | | | | | - Carlo Eduardo Medina-Solís
- Area of Dentistry of the Institute of Health's Sciences, Autonomous University of The State of Hidalgo, Pachuca, Hidalgo, Mexico
| | - Norma Verónica Zavala-Alonso
- Program of Doctorate in Dental Sciences, Faculty of Dentistry, San Luis Potosí University, San Luis Potosí, Mexico
| | - Nereyda Niño-Martínez
- Program of Doctorate in Dental Sciences, Faculty of Dentistry, San Luis Potosí University, San Luis Potosí, Mexico
| | - Eva Concepción Aguirre-López
- Clinical Research Laboratory, Program of Doctorate in Dental Sciences, Faculty of Dentistry, San Luis Potosí University, Manuel Nava # 2. Zona Universitaria, PC 78290, San Luis Potosí, Mexico
| | - Nuria Patiño-Marín
- Clinical Research Laboratory, Program of Doctorate in Dental Sciences, Faculty of Dentistry, San Luis Potosí University, Manuel Nava # 2. Zona Universitaria, PC 78290, San Luis Potosí, Mexico.
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12
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Barczak K, Palczewska-Komsa M, Wilk A, Nowicka A, Buczkowska-Radlińska J, Wiszniewska B, Kotwas A. Pulp sensibility to electric stimuli in the Caucasian population. AUST ENDOD J 2019; 46:26-32. [PMID: 31116503 DOI: 10.1111/aej.12341] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2019] [Indexed: 11/29/2022]
Abstract
The aim of the study was to determine electric sensibility of the pulp in the Caucasian population depending on tooth morphotype, age and sex. Dental pulp sensibility was determined in 279 patients (2640 teeth). The study group consisted of 226 patients (1296 teeth), 110 men and 116 women aged 55-101. The control group consisted of 53 patients (1344 teeth), 23 men and 30 women aged 20-30. A statistically significant lower sensory threshold and increased pulp sensibility in the study group were noted. These affected the lower incisors, the second upper premolars and the first and second upper molar. The differences in the pulp sensibility were found in the region of maxillary central incisors, maxillary premolars, mandibular lateral incisors and mandibular premolars. The pulp sensibility threshold was lower for the aforementioned groups of teeth in the study group. The correlation between sensibility of the pulp and sex was not confirmed.
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Affiliation(s)
- Katarzyna Barczak
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Mirona Palczewska-Komsa
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Szczecin, Poland
| | - Aleksandra Wilk
- Department of Histology and Embryology, Pomeranian Medical University, Szczecin, Poland
| | - Alicja Nowicka
- Department of Conservative Dentistry and Endodontics, Pomeranian Medical University, Szczecin, Poland
| | | | - Barbara Wiszniewska
- Department of Histology and Embryology, Pomeranian Medical University, Szczecin, Poland
| | - Artur Kotwas
- Department of Social Medicine and Public Health, Pomeranian Medical University, Szczecin, Poland
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13
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Mladenovic I, Krunic J, Supic G, Kozomara R, Bokonjic D, Stojanovic N, Magic Z. Pulp Sensitivity: Influence of Sex, Psychosocial Variables, COMT Gene, and Chronic Facial Pain. J Endod 2018; 44:717-721.e1. [DOI: 10.1016/j.joen.2018.02.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/27/2018] [Accepted: 02/01/2018] [Indexed: 01/28/2023]
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14
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Vaez SC, Faria-E-Silva AL, Loguércio AD, Fernandes MTG, Nahsan FPS. Preemptive use of etodolac on tooth sensitivity after in-office bleaching: a randomized clinical trial. J Appl Oral Sci 2018; 26:e20160473. [PMID: 29412363 PMCID: PMC5777424 DOI: 10.1590/1678-7757-2016-0473] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Accepted: 07/16/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose This study determined the effectiveness of the preemptive administration of etodolac on risk and intensity of tooth sensitivity and the bleaching effect caused by in-office bleaching using 35% hydrogen peroxide. Material and methods Fifty patients were selected for this tripleblind, randomized, crossover, and placebo-controlled clinical trial. Etodolac (400 mg) or placebo was administrated in a single-dose 1 hour prior to the bleaching procedure. The whitening treatment with 35% hydrogen peroxide was carried out in two sessions with a 7-day interval. Tooth sensitivity was assessed before, during, and 24 hours after the procedure using the analog visual scale and the verbal rating scale. Color alteration was assessed by a bleach guide scale, 7 days after each session. Relative risk of sensitivity was calculated and adjusted by session, while overall risk was compared by the McNemar's test. Data on the sensitivity level of both scales and color shade were subjected to Friedman, Wilcoxon, and Mann-Whitney tests, respectively (α=0.05). Results The preemptive administration of etodolac did not affect the risk of tooth sensitivity and the level of sensitivity reported, regardless of the time of evaluation and scale used. The sequence of treatment allocation did not affect bleaching effectiveness, while the second session resulted in additional color modification. The preemptive administration of etodolac in a single dose 1 hour prior to in-office tooth bleaching did not alter tooth color, and the risk and intensity of tooth sensitivity reported by patients. Conclusion A single-dose preemptive administration of 400 mg of etodolac did not affect either risk of tooth sensitivity or level of sensitivity reported by patients, during or after the in-office tooth bleaching procedure.
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Affiliation(s)
| | | | - Alessandro Dourado Loguércio
- Universidade Estadual de Ponta Grossa, Faculdade de Odontologia, Departamento de Odontologia Restauradora, Ponta Grossa, PR, Brasil
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15
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Fernandes MT, Vaez SC, Lima CM, Nahsan FP, Loguércio AD, Faria-e-Silva AL. Preemptive Use of Naproxen on Tooth Sensitivity Caused by In-Office Bleaching: A Triple-Blind, Crossover, Randomized Clinical Trial. Oper Dent 2017; 42:486-496. [DOI: 10.2341/16-100-c] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
SUMMARY
Objectives:
A triple-blind, randomized, crossover clinical trial evaluated prior use of nonsteroidal anti-inflammatory naproxen on sensitivity reported by patients undergoing in-office tooth bleaching.
Methods and Materials:
Fifty patients were subjected to two sessions of in-office tooth bleaching with 35% hydrogen peroxide in a single application of 40 minutes for two sessions, with an interval of seven days between applications. One hour prior to the procedure, each patient randomly received a single dose of naproxen (500 mg) or placebo. The patient's sensitivity level was evaluated during and immediately after the bleaching using two scales (verbal and visual analog); the verbal scale only was repeated after 24 hours. The effectiveness of the bleaching procedures was evaluated with the Bleachedguide scale. Relative risk to sensitivity was calculated and adjusted by session, while comparison of overall risk was performed by the McNemar test. Data on the sensitivity level for both scales and shade were subjected to the Friedman, Wilcoxon, and Mann-Whitney tests (α=0.05).
Results:
The use of naproxen only decreased the absolute risk and intensity of tooth sensitivity reported immediately after the second session. On the other hand, no measurable effect was observed during or 24 hours after either session. The sequence of drug administration did not affect the bleaching effectiveness.
Conclusions:
Preemptive use of naproxen only reduced tooth sensitivity reported by patients immediately after the second session of bleaching.
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Affiliation(s)
- MT Fernandes
- Micaelle T Fernandes, MSc, graduate student, Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - SC Vaez
- Savil C Vaez, MSc, graduate student, Graduate Program in Dentistry, Federal University of Sergipe, Aracaju, Brazil
| | - CM Lima
- Cláudio M Lima, professor, Department of Pharmacy, Federal University of Sergipe, Lagarto, Brazil
| | - FP Nahsan
- Flavia P Nahsan, DDS, PhD, professor, Department of Dentistry, Federal University of Sergipe, Lagarto, Brazil
| | | | - AL Faria-e-Silva
- Andre L Faria-e-Silva, DDS, MSc, PhD, Department of Dentistry, Federal University of Sergipe, Aracaju, Brazil
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