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LEON-RODRIGUEZ JA, ESPINOZA-SALCEDO M, GUTIERREZ-POLANCO YM, LEON-RODRIGUEZ JD, LOPEZ-TISNADO AA, RIVERA-CRUZ OS. Iron deficiency anemia as a risk factor for pulp disease in children from the central Peruvian jungle: a case‒control study. J Appl Oral Sci 2024; 32:e20240014. [PMID: 38896640 PMCID: PMC11182638 DOI: 10.1590/1678-7757-2024-0014] [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: 01/13/2024] [Revised: 04/13/2024] [Accepted: 04/23/2024] [Indexed: 06/21/2024] Open
Abstract
AIM To investigate iron-deficiency anemia as a risk factor for dental pulp disease in children from the central Peruvian jungle. METHODOLOGY A case-control study was carried out with 270 children, of which 90 referred to cases and 180, to controls. Patients with pulp disease were diagnosed according to the criteria of the Association of Endodontists and the American Board of Endodontics. A specific questionnaire was used to assess ferrous sulfate consumption, maternal education level, maternal age, occupation, and household income. Data were analyzed using Pearson's correlation coefficient and a binary logistic regression. RESULTS Iron deficiency anemia offers a risk factor for pulp disease in children (OR 7.44, IC 95% 4.0-13.8). According to multivariate analysis using binary logistic regression, ferrous sulfate consumption (OR 13.8, IC 95% 5.6.33.9), maternal education level (OR 2.4, IC 95% 1.1-5.3), maternal age (OR 7.5, IC 95% 2.9-19.4), household income (OR 4.0, IC 95% 1.6-9.6), and caries (OR 10.7, IC 95% 4.5-25.7) configured independent factors that were statistically associated with pulp disease. CONCLUSION Iron deficiency anemia, ferrous sulfate consumption, maternal education level, maternal age, household income, and dental caries were positively associated with pulp disease in children.
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Affiliation(s)
- Jhair Alexander LEON-RODRIGUEZ
- Antenor Orrego Private UniversityPostgraduate SchoolTrujilloPeruAntenor Orrego Private University, Postgraduate School, Trujillo, Peru.
| | - María ESPINOZA-SALCEDO
- Antenor Orrego Private UniversityPostgraduate SchoolTrujilloPeruAntenor Orrego Private University, Postgraduate School, Trujillo, Peru.
| | - Yovana Melisza GUTIERREZ-POLANCO
- San Martin National UniversityPostgraduate SchoolTarapotoPeruSan Martin National University, Postgraduate School, Tarapoto, Peru.
| | - Jherson David LEON-RODRIGUEZ
- Los Angeles Catholic University of ChimboteDental SchoolTrujilloPeruLos Angeles Catholic University of Chimbote, Dental School, Trujillo, Peru.
| | - Araceli Antonella LOPEZ-TISNADO
- Los Angeles Catholic University of ChimboteDental SchoolTrujilloPeruLos Angeles Catholic University of Chimbote, Dental School, Trujillo, Peru.
| | - Omaly Sulay RIVERA-CRUZ
- National university of TrujilloPostgraduate SchoolTrujilloPeruNational university of Trujillo, Postgraduate School, Trujillo, Peru.
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Betal SK, Singh S, Dasgupta B. Analysis of the Pulp Oxygenation Rate by Pulse Oximeter in Children with Pulpal Diseases. Int J Clin Pediatr Dent 2024; 17:576-579. [PMID: 39355188 PMCID: PMC11440666 DOI: 10.5005/jp-journals-10005-2847] [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] [Indexed: 10/03/2024] Open
Abstract
Background and objective Deciduous teeth portray less pain sensitivity in comparison to permanent teeth. Conventional vitality tests depend on the stimulation of nerve fibers. Loss of sensory function due to trauma can result in negative responses. Unpleasant painful stimuli may lead to apprehensiveness and require behavior management in children. This study is a genuine attempt to compare pulp oxygen saturation levels of deciduous posterior teeth clinically or radiographically diagnosed as reversible pulpitis (RP), irreversible pulpitis (IRP), and pulpal necrosis (PN) with healthy teeth using a pulse oximeter with probes in preoperative and postoperative conditions. Methods A total of 120 deciduous posterior teeth from participants aged 4-9 years were evaluated using random stratified sampling, divided into four groups with 30 teeth each based on clinical and radiological interpretation-group I: noncarious (NC) (control group); group II: RP; group III: IRP; group IV: PN. Teeth from children meeting the inclusion criteria were recorded and examined. The data obtained were sent for statistical analysis. Results A significant difference in pulp oxygenation rates was observed between teeth with pulpal pathologies and healthy teeth in both preoperative and postoperative conditions. Interpretation and conclusion Pulpal diseases cause a reduction in oxygen saturation of the pulp vasculature, thereby affecting the vitality of the tooth. The pulse oximeter used in the neonatal intensive care unit (ICU) was suitable for determining SpO2% in children. Clinical significance Pedodontists face challenges in making diagnoses because children may provide false-positive or false-negative responses to stimuli or questions. Pulse oximetry is a boon as it is highly efficient, can be used chairside, is completely atraumatic, and eco-friendly. How to cite this article Betal SK, Singh S, Dasgupta B. Analysis of the Pulp Oxygenation Rate by Pulse Oximeter in Children with Pulpal Diseases. Int J Clin Pediatr Dent 2024;17(5):576-579.
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Affiliation(s)
- Sumit Kumar Betal
- Department of Pedodontics and Preventive Dentistry, Hazaribag College of Dental Sciences & Hospital, Hazaribagh, Jharkhand, India
| | - Swati Singh
- Department of Pedodontics and Preventive Dentistry, Hazaribag College of Dental Sciences & Hospital, Hazaribagh, Jharkhand, India
| | - Barun Dasgupta
- Department of Pedodontics and Preventive Dentistry, Hazaribag College of Dental Sciences & Hospital, Hazaribagh, Jharkhand, India
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Patil A, Garg N, Pathivada L, Choudhary R, Kaur H, Yeluri R. Evaluation of Oxygen Saturation Levels Using a Custom-modified Finger Pulse Oximeter for Assessment of Pulp Vitality in Various Clinical Situations in Pediatric Dental Practice: An In Vivo Study. Int J Clin Pediatr Dent 2024; 17:S30-S36. [PMID: 39185260 PMCID: PMC11343983 DOI: 10.5005/jp-journals-10005-2744] [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] [Indexed: 08/27/2024] Open
Abstract
Background A major drawback of traditional pulp testing procedures is that they depend on neural responses rather than vascular circulation. Hence, this study aimed to develop a custom-modified dental sensor using a finger pulse oximeter (PO) that is applicable to any type of tooth so as to test its ability and accuracy in evaluating the oxygen saturation (SaO2) values of teeth at different developmental stages as a measure of pulp vitality. Materials and methods A customized finger PO was employed to determine the systemic and pulp SaO2 levels in 300 children. A total of 600 teeth (primary and permanent) were divided into group I (100 primary molars), group II (200 permanent molars), group III (200 permanent incisors), and 100 endodontically treated (primary and permanent) teeth were included in group IV. The mean SaO2 values thus obtained in various groups were compared. Results Intragroup comparison of mean SaO2% of the patient's finger (systemic), test teeth, and control teeth showed significant differences (p ≤ 0.001). Intergroup comparisons also revealed significant differences in most of the groups. Conclusions The modified PO probe can be applied to any type of tooth. It was found to be accurate and sensitive enough to detect changes in SaO2 levels in various clinical situations irrespective of developmental stage. It proved to be a direct method of evaluation of pulp vitality by objective means. How to cite this article Patil A, Garg N, Pathivada L, et al. Evaluation of Oxygen Saturation Levels Using a Custom-modified Finger Pulse Oximeter for Assessment of Pulp Vitality in Various Clinical Situations in Pediatric Dental Practice: An In Vivo Study. Int J Clin Pediatr Dent 2024;17(S-1):S30-S36.
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Affiliation(s)
- Abhijeet Patil
- Department of Pedodontics & Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Nishita Garg
- Department of Pedodontics and Preventive Dentistry, Dental Institute, Rajendra Institute of Medical Sciences (RIMS), Ranchi, Jharkhand, India
| | - Lumbini Pathivada
- Department of Paediatrics & Preventive Dentistry, Rungta College of Dental Sciences & Research, Bhilai, Chattisgarh, India
| | - Rishika Choudhary
- Department of Pedodontics & Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Harsimran Kaur
- Department of Pedodontics & Preventive Dentistry, Teerthanker Mahaveer Dental College and Research Centre, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - Ramakrishna Yeluri
- Department of Pediatric & Preventive Dentistry, Sharad Pawar Dental College & Hospital, Datta Meghe Institute of Higher Education & Research, Wardha, Maharashtra, India
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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.
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de Almeida e Bueno L, Kwong MT, Bergmann JHM. Performance of Oral Cavity Sensors: A Systematic Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:588. [PMID: 36679385 PMCID: PMC9862524 DOI: 10.3390/s23020588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/21/2022] [Accepted: 12/28/2022] [Indexed: 05/31/2023]
Abstract
Technological advancements are enabling new applications within biomedical engineering. As a connection point between the outer environment and the human system, the oral cavity offers unique opportunities for sensing technologies. This paper systematically reviews the performance of measurement systems tested in the human oral cavity. Performance was defined by metrics related to accuracy and agreement estimation. A comprehensive search identifying human studies that reported on the accuracy or agreement of intraoral sensors found 85 research papers. Most of the literature (62%) was in dentistry, followed by neurology (21%), and physical medicine and rehabilitation (12%). The remaining papers were on internal medicine, obstetrics, and aerospace medicine. Most of the studies applied force or pressure sensors (32%), while optical and image sensors were applied most widely across fields. The main challenges for future adoption include the lack of large human trials, the maturity of emerging technologies (e.g., biochemical sensors), and the absence of standardization of evaluation in specific fields. New research should aim to employ robust performance metrics to evaluate their systems and incorporate real-world evidence as part of the evaluation process. Oral cavity sensors offer the potential for applications in healthcare and wellbeing, but for many technologies, more research is needed.
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Affiliation(s)
| | - Man Ting Kwong
- Guy’s and St. Thomas’ NHS Foundation Trust, St. Thomas’ Hospital, Westminster Bridge Rd., London SE1 7EH, UK
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Age-Related Variation of Pulpal Oxygen Saturation in Healthy Primary and Permanent Teeth in Children: A Clinical Study. J Clin Med 2022; 12:jcm12010170. [PMID: 36614971 PMCID: PMC9821562 DOI: 10.3390/jcm12010170] [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: 11/15/2022] [Revised: 12/13/2022] [Accepted: 12/23/2022] [Indexed: 12/28/2022] Open
Abstract
(1) Background: Pulse oximetry (PO) is an effective method of dental pulp status monitorization but still lacks practical implementation in dentistry, as well as clear reference values for different tooth types. The study’s aim was to investigate the age-related variation of blood oxygen saturation (SpO2) from the dental pulp during different stages of tooth development in all types of primary and permanent teeth of children. (2) Methods: The pulps of 600 healthy primary and permanent teeth (incisors, canines, premolars, and molars) of patients aged 2−15 years were tested with an adapted PO device, and the results were statistically analyzed; (3) Results: Statistically significant differences (p < 0.05) were found between open-apex and closed-apex teeth and between the canines and other tooth types in both primary and permanent dentitions. (4) Conclusions: Values of SpO2 tended to decrease with age progression in both primary and permanent dentitions. Enamel and dentine thickness and their optical properties and the shape and volume of coronal pulp, which differed among tooth types, seemed to have some influence on the reading as well. The study indicates that factors such as the root development and the tooth type must be taken into account when establishing reference SpO2 values for the dental pulp.
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Henriques DHN, Alves AMH, Kuntze MM, Garcia LDFR, Bortoluzzi EA, Teixeira CDS. Effect of dental tissue thickness on the measurement of oxygen saturation by two different pulse oximeters. Braz Dent J 2022; 33:26-34. [DOI: 10.1590/0103-6440202204903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Accepted: 07/18/2022] [Indexed: 11/06/2022] Open
Abstract
Abstract This study aimed to evaluate the influence of different dental tissue thickness on the measurement of oxygen saturation (SpO2) levels in high (HP) and low (LP) blood perfusion by comparing the values obtained from two different pulse oximeters (POs) - BCI and Sense 10. Thirty freshly extracted human teeth had their crowns interposed between the POs and an optical simulator, which emulated the SpO2 and heart beats per minute (bpm) at HP (100% SpO2/75 bpm) and LP (86% SpO2/75 bpm) modes. Afterwards, the palatine/lingual surfaces of the dental crowns were worn with diamond drills. The reading of SpO2 was performed again using the POs alternately through the buccal surface of each dental crown. Data were analyzed by the Wilcoxon, Mann-Whitney and Kendall Tau-b tests (α=5%). The results showed significant difference at the HP and LP modes in the SpO2 readouts through the different dental thicknesses with the use of BCI, and at the LP mode with the use of Sense 10, which had a significant linear correlation (p<0.0001) and lower SpO2 readout values in relation to the increase of the dental thickness. Irrespective of tooth thickness, Sense 10 had significantly higher readout values (p<0.0001) than BCI at both perfusion modes. The interposition of different thicknesses of enamel and dentin influenced the POs measurement of SpO2, specially at the low perfusion mode. The POs were more accurate in SpO2 measurement when simulated perfusion levels were higher.
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Wilson EM, Minja IK, Machibya FM, Jonathan A, Makani J, Ruggajo P, Balandya E. Oxygen Saturation in Primary Teeth of Individuals With Sickle Cell Disease and Sickle Cell Trait. J Blood Med 2022; 13:407-412. [PMID: 35909799 PMCID: PMC9326034 DOI: 10.2147/jbm.s365040] [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: 03/05/2022] [Accepted: 05/23/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine oxygen saturation in the pulp of primary teeth in children with sickle cell disease (SCD) and sickle cell trait (SCT) for establishing the usefulness of pulse oximetry in screening and monitoring of SCD or therapy. Materials and Methods A cross-sectional study among 30-60 months children with sickle cell disease (SCD) and sickle cell trait (SCT) compared with healthy children (HbAA). A pulse oximeter (BCI 3301) recorded oxygen saturation on six anterior primary maxillary teeth and on index fingers. Data were analyzed using SPSS version 20.0. Mean oxygen saturation for teeth and fingers was calculated. Comparison of Mean across groups was done using post hoc analysis in one-way ANOVA (Bonferroni test). Pearson correlation coefficient was calculated for mean oxygen saturation on fingers and teeth. Level of significance was set at 0.05. Results Altogether 360, 102, and 96 teeth were examined from children with SCD, SCT, and HbAA respectively. 53% of participants were girls. The mean age of participants was 46.3 months ± 9.4 SD. Low mean oxygen saturation (77.5%) was recorded from teeth of children with SCD relative to those with SCT and HbAA (>86%; P = 0.00). There was no statistically significant difference in oxygen saturation on teeth between children with SCT and HbAA. The mean oxygen saturation on fingers was found to be above 97.2% regardless of sickle cell status. There was no correlation between oxygen saturation on teeth and fingers. Conclusion Pulse oximeter detected a lower oxygen saturation in dental pulp of primary teeth of participants with SCD (HbSS) relative to those with SCT (HbAS) and HbAA. Oxygen saturation on fingers remained unaffected regardless of sickle cell disease status. Although more studies are needed, our study shows that when other conditions affecting peripheral tissue oxygen delivery are ruled out, the low pulse oximetry in primary teeth may be indicative of SCD. The oximeter may also be useful in monitoring response to SCD therapy targeted at improving oxygen carrying capacity and delivery.
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Affiliation(s)
- Evarist Mulyahela Wilson
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Irene Kida Minja
- Department of Restorative Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.,Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam, Tanzania
| | - Ferdinand Mabula Machibya
- Department of Orthodontics, Pedodontics and Community Dentistry, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Agnes Jonathan
- Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Julie Makani
- Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam, Tanzania.,Department of Hematology and Blood Transfusion, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Paschal Ruggajo
- Department of Internal Medicine, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Emmanuel Balandya
- Sickle Pan-African Research Consortium (SPARCO), Dar es Salaam, Tanzania.,Department of Physiology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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Evaluation of the Pulp Oxygen Saturation Reading after Tooth Bleaching: A Randomized Clinical Trial. Int J Dent 2022; 2022:1598145. [PMID: 35531572 PMCID: PMC9072050 DOI: 10.1155/2022/1598145] [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: 12/15/2021] [Revised: 04/06/2022] [Accepted: 04/13/2022] [Indexed: 11/17/2022] Open
Abstract
Objectives The purpose of this clinical trial was to evaluate the influence of in-office dental bleaching on the pulp oxygen saturation (SpO2p) reading. Material and Methods. SpO2p was measured using a pulse oximeter in 112 upper and lower anterior teeth (canines and incisors) of patients submitted to bleaching. Whitegold Office 35% (WGO) (upper and lower left hemiarch) and Whiteness HP Auto Mixx 35% (WHP) (upper and lower right hemiarch) bleaching agents were used. SpO2 measurements (teeth and index finger) were taken before and after each of the three application sessions of the agents. In the 4th session, in which no bleaching gel was used, only SpO2 was measured. Before and after the bleaching sessions, a colorimetric device performed the teeth color reading. The waiting time between sessions was 7 days. Data were analyzed by the Friedman, Kruskal–Wallis, and Mann–Whitney U tests (α = 0.05). Color change (ΔE) data were correlated (Spearman's Rho test) with the SpO2p levels. Results Neither of the two bleaching agents showed significant differences between the readings when evaluated individually (WGO, P=0.780, and WHP, P=0.494). When taken together, the results showed significant difference between the readings performed, with higher median values after bleaching sessions: before (97.3) and after (98.6) 1st session; before (98.3) and after (98.3) 2nd session; before (98.3) and after (99.0) 3rd session; and after 1 week (98.3). The dental groups formed by maxillary lateral incisors (P=0.012) and mandibular incisors (P < 0.001) showed a significant difference. Spearman's Rho test showed a nonsignificant and weak correlation between ΔE and SpO2p in most comparisons. Conclusions The in-office dental bleaching influenced the SpO2p reading, regardless of the dental group evaluated or the bleaching agent used. Clinical Relevance. This study provides information about the influence of in-office tooth whitening on the pulp SpO2p levels. The observation of pulp vitality during and after the use of bleaching agents is important for the follow-up of patients undergoing tooth whitening. The use of a pulse oximeter may be a viable and painless alternative to perform this monitoring. The clinical trial was registered with the Brazilian Registry of Clinical Trials (ReBEC; registration number: https://clinicaltrials.gov/ct2/show/RBR-68xbth).
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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.
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Grabliauskienė Ž, Zamaliauskienė R, Lodienė G. Pulp Vitality Testing with a Developed Universal Pulse Oximeter Probe Holder. ACTA ACUST UNITED AC 2021; 57:medicina57020101. [PMID: 33498652 PMCID: PMC7912332 DOI: 10.3390/medicina57020101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 01/19/2021] [Accepted: 01/20/2021] [Indexed: 11/16/2022]
Abstract
Background and Objectives An accurate determination of the pulp status is relevant for a proper endodontic diagnosis. Objectives: The aim was to develop a universal pulse oximeter probe holder for measuring the oxygen saturation and to evaluate the use of pulse oximetry as a test for pulp vitality, by comparing the levels of oxygen saturation in the index finger and in the healthy dental pulp. Materials and Methods The universal holder was designed with software and printed with a 3D printer. The study was carried out on 128 healthy teeth. They were divided into eight groups according to tooth type. Ten root canal treated teeth served as a negative control group. For each patient, a pulse oximeter was first applied on the tooth followed by the index finger. The significance level (α) was set at 0.05. Results: The developed and manufactured universal pulse oximeter probe holder was suitable to measure the pulp vitality of all types of teeth. The handle allowed for holding the pulse oximeter on the tooth in parallel, firmly and securely. Significantly higher oxygen saturation was observed in the index finger (97.22%) compared to the dental pulp (93.17%) (p < 0.001). No correlation was observed between the maxillary teeth and index finger oxygen saturation values (r = 0.05, p = 0.72), whereas, between the mandibular teeth and index finger, a positive correlation was detected (r = 0.29, p = 0.02). There were no significant differences in the pulp oxygen saturation values between different teeth groups. Conclusion: The newly developed universal pulse oximeter probe holder is an effective device for pulp vitality testing.
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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
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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
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Janani K, Ajitha P, Sandhya R, Subbaiyan H, Jose J. Efficiency of new custom-made pulse oximeter sensor holder in assessment of actual pulp status. J Family Med Prim Care 2020; 9:3333-3337. [PMID: 33102292 PMCID: PMC7567235 DOI: 10.4103/jfmpc.jfmpc_73_20] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/12/2020] [Accepted: 03/26/2020] [Indexed: 11/04/2022] Open
Abstract
Aim This study aims to assess the diagnostic accuracy of new custom-made pulse oximeter sensor holder in assessment of actual pulp status with three pulp sensibility tests. Materials and Methods Seventy-nine single canal teeth requiring endodontic therapy was included in the study. The tooth that was requiring root canal treatment was tested with heat test, cold test, electric pulp test, and pulse oximeter. Between each test, a time period of 2 min was allowed. The response from three pulp sensibility tests and the reading from pulse oximeter were recorded. Following which root canal treatment was performed. The result obtained from four pulp tests were correlated with the clinical finding after access cavity preparation. The data obtained was statistically assessed. Receiver operator characteristic (ROC) curve analysis was performed to assess the efficacy of the pulp tests. In the above statistical tools, the probability value. 05 is considered as significant level. Results The overall diagnostic accuracy was found to be significantly higher with pulse oximeter when compared with other three pulp sensibility tests. The ROC curve demonstrates the results obtained from pulse oximeter was found to be more reliable than other pulp tests. Conclusion Within the limitation of the study, diagnostic accuracy of pulse oximeter with custom made sensor holder was reliable and accurate in assessment of actual pulp status.
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Affiliation(s)
- Krishnamachari Janani
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - P Ajitha
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Raghu Sandhya
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Haripriya Subbaiyan
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
| | - Jerry Jose
- Department of Conservative Dentistry and Endodontics, Saveetha Dental College, Saveetha Institute of Medical and Technical Sciences, Chennai, India
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McTigue DJ. Managing Traumatic Injuries in the Young Permanent Dentition. Pediatr Dent 2019. [DOI: 10.1016/b978-0-323-60826-8.00035-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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15
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Estrela C, Serpa GC, Alencar AHG, Bruno KF, Barletta FB, Felippe WT, Estrela CRA, Souza JB. Oxygen Saturation in the Dental Pulp of Maxillary Premolars in Different Age Groups - Part 1. Braz Dent J 2018; 28:573-577. [PMID: 29215681 DOI: 10.1590/0103-6440201701660] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 05/08/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to determine oxygen saturation levels in the dental pulp of maxillary premolars in different age groups. A total of 120 human maxillary premolars with normal dental pulps were selected covering the following age groups: 20-24, 25-29, 30-34, 35-39 and 40-44 years (n=24 each group). Oxygen saturation was assessed using pulse oximetry. Analysis of variance was used to assess differences in oxygen saturation levels and Tukey's test was used to identify the age groups that differed from each other. Significance was set at 0.05. Mean oxygen saturation of 120 premolars was 86.20% considering all age groups. Significantly reduced levels were found in the oldest group compared to the other groups: 40 to 44 years - 80.00% vs. 89.71, 87.67, 88.71, and 84.80% for age groups 20-24, 25-29, 30-34, 35-39 years, respectively. The mean oxygen saturation levels were similar between 20 and 39 years of age (86.20%) in the whole sample, but reduced significantly in the 40-44-year age group, suggesting that older patients present lower oxygen saturation results even in the absence of pulp tissue injury.
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Affiliation(s)
- Carlos Estrela
- Dental School, UFGO - Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Giuliano C Serpa
- Dental School, UFGO - Universidade Federal de Goiás, Goiânia, GO, Brazil
| | | | - Kely F Bruno
- Dental School, UFGO - Universidade Federal de Goiás, Goiânia, GO, Brazil
| | | | - Wilson T Felippe
- Dental School, UFSC - Universidade Federal de Santa Catarina, Florianópolis, SC, Brazil
| | | | - João B Souza
- Dental School, UFGO - Universidade Federal de Goiás, Goiânia, GO, Brazil
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16
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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]
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17
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Riehl J, Hetzel SJ, Snyder CJ, Soukup JW. Detection of Pulpal Blood Flow In Vivo with Pulse Oximetry in Dogs. Front Vet Sci 2016; 3:36. [PMID: 27243024 PMCID: PMC4873511 DOI: 10.3389/fvets.2016.00036] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2016] [Accepted: 04/20/2016] [Indexed: 11/23/2022] Open
Abstract
Objective The aim of the present study was to investigate the ability of pulse oximetry to detect blood flow within the canine tooth of dogs. Materials and methods Dogs aged 18–138 months presenting for oral treatment and meeting the inclusion criteria underwent pulse oximetry evaluation of at least one canine tooth. Oxygen saturation (SpO2) and pulse rate values were acquired from vital canine teeth of 38 clinical patients (representing 40 total teeth) with a handheld pulse oximeter and compared to a control area. SpO2 values from the tooth and control area were recorded every 5 s for three 60-s intervals. The sensors were repositioned after each 60-s interval. Results The vital teeth consistently recorded SpO2 values significantly lower than the control area. The mean vital tooth SpO2 was 85.9% (median = 87%; SD = 8.6), and the mean control area SpO2 was 97.7% (median = 98%; SD = 1.8). An age-related significant difference was noted in vital tooth SpO2 values. Conclusion In conclusion, the present data support the possible use of pulse oximetry to detect blood flow in canine teeth. However, there was no significant correlation between SpO2 values in the vital tooth and in the control areas. Additionally, the results were not definitive, and validation of the modality with additional studies of non-vital canine teeth is needed before clinical use can be recommended.
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Affiliation(s)
- Jessica Riehl
- Dentistry and Oral Surgery Section, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison , Madison, WI , USA
| | - Scott J Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison , Madison, WI , USA
| | - Christopher J Snyder
- Dentistry and Oral Surgery Section, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison , Madison, WI , USA
| | - Jason W Soukup
- Dentistry and Oral Surgery Section, Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison , Madison, WI , USA
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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
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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.
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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.
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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.
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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
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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]
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Abstract
The applicability of arterial pulse oximetry to dental pulp was demonstrated using in vitro and in vivo measurements. First, porcine blood of known oxygen saturation (SO2) was circulated through extracted human upper incisors, while transmitted-light plethysmography was performed using three different visible wavelengths. From the light intensity waveforms measured in vitro, a parameter that is statistically correlated to SO2 was calculated using the pulsatile/nonpulsatile component ratios of two wavelengths for different SO2. Then, values were measured in vivo for living incisors, and the corresponding SO2 values were calculated using the results of in vitro measurements. The estimated SO2 values of the upper central incisors measured in vivo were from 71.0 to 92.7%. This study showed the potential to measure the oxygen saturation changes to identify the sign of pulpal inflammation.
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Hall MW, Jensen AM. The role of pulse oximetry in chiropractic practice: a rationale for its use. J Chiropr Med 2012. [PMID: 23204957 DOI: 10.1016/j.jcm.2011.10.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Pulse oximetry is used regularly to assess oxygen saturation levels. The objective of this commentary is to discuss a rationale for using pulse oximetry in chiropractic practice. DISCUSSION Pulse oximetry may offer doctors of chiropractic a way to monitor patients' oxygen saturation levels. Quantification of saturation values with heart rate may give clinical aid to the management of chiropractic patients. Markedly reduced saturation levels may necessitate medical referral, whereas mildly reduced levels could lead to changes in chiropractic management. CONCLUSIONS Pulse oximetry has the potential to be an integral part of chiropractic practice.
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