Reduction of excessive electrical stimulus during electric pulp testing

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

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.

Quality of techniques used to assess clinical outcomes of regenerative endodontic treatment in necrotic mature teeth

Data sources A preliminary, randomised, prospective, controlled clinical trial of patients managed with two regenerative endodontic procedures, revitalisation and a platelet-rich fibrin (PRF)-based technique, in the treatment of mature permanent teeth with necrotic pulps.Study selection Twenty patients with mature necrotic anterior teeth with large periapical lesions treated with the blood clot and a PRF-based techniques for revitalisation. Periradicular healing and pulp sensibility was assessed at 6 and 12 months after treatment.Results Significant periradicular radiographic healing and sensibility was reported at 6 and 12 months.

Electric pulp test threshold responses in healthy incisors, canines, premolars and molars

The purpose of this study was to determine the range of threshold responses of healthy dental pulps and test the reproducibility of the electric pulp test (EPT). Forty-nine dental students participated in the study. Sound teeth in both arches, except third molars, were included. The teeth were isolated using cotton rolls and dried with compressed air, and the threshold responses were recorded. Participants stopped the stimulus increase by pressing the switch at the first sensation of discomfort. The measurements were repeated after 30 days. The obtained data were analysed using SPSS^® 16.0. The mean thresholds for the maxillary incisors, canines, premolars and molars were 10.77, 21.07, 21.88 and 34.07 μA, and for mandibular incisors, canines, premolars and molars 9.81, 18.7, 19.24 and 30.1 μA respectively. The differences between the two measurements were statistically significant for teeth 32, 31, 41 and 42. The EPT was shown to be reproducible for all the teeth tested except mandibular incisors.

Review of pulp sensibility tests. Part II: electric pulp tests and test cavities

The electric pulp test (EPT) is one type of pulp sensibility test that can be used as an aid in the diagnosis of the status of the dental pulp. However, like thermal pulp sensibility tests, it does not provide any direct information about the vitality (blood supply) of the pulp or whether the pulp is necrotic. The relevant literature on pulp sensibility tests in the context of endodontics up to January 2009 was reviewed using PubMed and MEDLINE database searches. This search identified articles published between November 1964 and January 2009 in all languages. The EPT is technique sensitive, and false responses may occur. Various factors can affect the test results, and therefore it is important that dental practitioners understand the nature of these tests and how to interpret them. Test cavities have been suggested as another method for assessing the pulp status; however, the use of this technique needs careful consideration because of its invasive and irreversible nature. In addition, it is unlikely to be useful in apprehensive patients and should not be required because it provides no further information beyond what thermal and electric pulp sensibility tests provide - that is, whether the pulp is able to respond to a stimulus. A review of the literature and a discussion of the important points regarding these two tests are presented.