Comparison of two laser Doppler systems on the measurement of blood flow of premolar teeth under different pulpal conditions

The Decisive Role of Laser Doppler Flowmetry for Pulp Preservation in Discolored Traumatized Teeth

Objective: It has been stated that blood pigments within discolored teeth may interfere with Laser Doppler Flowmetry (LDF) measurements. The aim of this study was to assess pulp vitality with LDF in a cohort of discolored traumatized teeth referred for endodontic treatment or where the referring dentist had doubts regarding maintained tooth vitality. Background: Discoloration of teeth is a common sequel of dental trauma. Still today, it is taken as an indicator for root canal treatment. Transient apical breakdown (TAB) is confused with apical periodontitis, although it is a sequel of dental trauma in young mature teeth and will result in revascularization and dissolution of the apical radiolucency. Methods: A total of 26 patients with 28 discolored teeth, belonging to a cohort of referred patients with traumatized teeth referred for root canal treatment and/or pulp vitality assessment were screened on color with photographs by three investigators, with traditional sensibility tests and with a Moor VMS II LDF meter. Results: The color of the intrinsically discolored teeth was grayish in 58% of teeth, blue 20%, pink/crimson 12%, and yellow 4%. Eighty-five percent were central maxillary incisors, 11% were mandibulary incisors. Thanks to LDF, 43% of the trauma cases in this small cohort with discoloration underwent root canal treatment instead of 70% with traditional sensibility tests as indicator. TAB was found in 11%. Conclusions: LDF was decisive in diagnosing vitality of discolored teeth and there was no negative impact of tooth discoloration on LDF measurements.

Laser Doppler Blood-Flow Signals from Human Teeth during an Alignment and Leveling Movement Using a Superelastic Archwire

Objective. The purpose of this study was to examine alterations in blood-flow signals (BFS) from human teeth during an alignment and leveling phase (superelastic wire 0.014′′) in a clinical orthodontic treatment using laser doppler flowmetry (LDF). Materials and Methods. Recordings were made in 12 maxillary left central incisors. The basal value of the BFS from each tooth (without orthodontic forces) was compared with the corresponding values of BFS during four periods of observation: 20 minutes, 48 hours, 72 hours, and one month after the activation of the orthodontic appliance. Results. Statistically significant decrease of BFS was observed at 20 minutes, 48 hours, and 72 hours (P < 0.05). No differences were found comparing BFS on day 30 and the corresponding basal values. Conclusion. Under real clinical conditions, a significant decrease in BFS was verified during the initial phase of the treatment, followed by a recovery on day 30.

Doppler flowmetry as a tool of predictive, preventive and personalised dentistry

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.

Diagnostic Aids in Pediatric Dentistry

Diagnosis involves development of a comprehensive and concise database of pertinent information, sufficient to understand the patient’s problem as well as answer questions arising in the treating clinicians’ mind. It is an accomplished art to develop a communication with the child and elicit relevant information from him. Thus, the signs and symptoms elicited on the basis of patient’s experiences and clinician’s knowledge forms the elementary framework of a good prognosis. This article aims to unveil the “must know” fundamentals of a sound diagnosis for a sound treatment plan.