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Afkhami F, Wright PP, Chien PYH, Xu C, Walsh LJ, Peters OA. Exploring approaches to pulp vitality assessment: A scoping review of nontraditional methods. Int Endod J 2024. [PMID: 38661046 DOI: 10.1111/iej.14073] [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: 11/24/2023] [Revised: 04/03/2024] [Accepted: 04/04/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Diagnostic procedures for pulp vitality assessment are a crucial aspect of routine dental practice. This review aims to provide a comprehensive overview of nontraditional techniques and methodologies for assessing pulp vitality, specifically exploring promising approaches that are currently not used in dental practice. METHODS The study protocol was registered a priori (https://osf.io/3m97z/). An extensive electronic search was conducted across multiple databases, including MEDLINE via PubMed, Scopus, Web of Science, and Embase. Inclusion criteria were guided by the research question based on the PCC model as follows: "What are the potential nontraditional techniques (Concept) for assessing pulp vitality (Population) in the field of endodontics or clinical practice (Context)?" Studies were included that explored possible approaches to pulp vitality assessment, utilizing a range of techniques, whilst any studies using traditional pulp tests (cold, heat, and electric stimulation) or well-known methods (pulse oximetry and laser Doppler flowmetry) were excluded. Reviewers independently screened articles and extracted data. A patent search was also performed. RESULTS Of 3062 studies, 65 were included that described nontraditional approaches for assessing pulp vitality. These included a range of optical diagnostic methods, ultrasound Doppler flowmetry (UDF), magnetic resonance imaging (MRI), terahertz imaging, tooth temperature measurements, as well as invasive methodologies, including 133xenon washout, radioisotope-labelled tracers, hydrogen gas desaturation, intravital microscopy and fluorescent microspheres isotope clearance. The patent search included artificial intelligence and biomarkers methods. CONCLUSIONS This review provides details for potential innovative tests that may directly describe pulp vitality. Importantly, these methods range from clinically impractical through to promising methods that may transform clinical practice. Several nontraditional techniques have the potential to enhance diagnostic accuracy and could provide valuable insights into the assessment of pulp vitality in challenging clinical scenarios.
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Affiliation(s)
- Farzaneh Afkhami
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | | | - Philip Yuan-Ho Chien
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Chun Xu
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Laurence James Walsh
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
| | - Ove Andreas Peters
- School of Dentistry, The University of Queensland, Herston, Queensland, Australia
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Rodriguez Betancourt A, Samal A, Chan HL, Kripfgans OD. Overview of Ultrasound in Dentistry for Advancing Research Methodology and Patient Care Quality with Emphasis on Periodontal/Peri-implant Applications. Z Med Phys 2023; 33:336-386. [PMID: 36922293 PMCID: PMC10517409 DOI: 10.1016/j.zemedi.2023.01.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/20/2022] [Accepted: 01/11/2023] [Indexed: 03/14/2023]
Abstract
BACKGROUND Ultrasound is a non-invasive, cross-sectional imaging technique emerging in dentistry. It is an adjunct tool for diagnosing pathologies in the oral cavity that overcomes some limitations of current methodologies, including direct clinical examination, 2D radiographs, and cone beam computerized tomography. Increasing demand for soft tissue imaging has led to continuous improvements on transducer miniaturization and spatial resolution. The aims of this study are (1) to create a comprehensive overview of the current literature of ultrasonic imaging relating to dentistry, and (2) to provide a view onto investigations with immediate, intermediate, and long-term impact in periodontology and implantology. METHODS A rapid literature review was performed using two broad searches conducted in the PubMed database, yielding 576 and 757 citations, respectively. A rating was established within a citation software (EndNote) using a 5-star classification. The broad search with 757 citations allowed for high sensitivity whereas the subsequent rating added specificity. RESULTS A critical review of the clinical applications of ultrasound in dentistry was provided with a focus on applications in periodontology and implantology. The role of ultrasound as a developing dental diagnostic tool was reviewed. Specific uses such as soft and hard tissue imaging, longitudinal monitoring, as well as anatomic and physiological evaluation were discussed. CONCLUSIONS Future efforts should be directed towards the transition of ultrasonography from a research tool to a clinical tool. Moreover, a dedicated effort is needed to introduce ultrasonic imaging to dental education and the dental community to ultimately improve the quality of patient care.
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Affiliation(s)
| | - Ankita Samal
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
| | - Hsun-Liang Chan
- Department of Periodontology and Oral Medicine, Dental School, University of Michigan, Ann Arbor, MI, USA
| | - Oliver D Kripfgans
- Department of Radiology, Medical School, University of Michigan, Ann Arbor, MI, USA
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Kim D, Ko HS, Park SY, Ryu SY, Park SH. The effects of gingival blood flow on pulpal blood flow detection using ultrasound Doppler flowmetry: animal study. Restor Dent Endod 2023; 48:e9. [PMID: 36875807 PMCID: PMC9982237 DOI: 10.5395/rde.2023.48.e9] [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: 10/04/2022] [Revised: 10/27/2022] [Accepted: 10/27/2022] [Indexed: 02/10/2023] Open
Abstract
Objectives This study evaluated the effect of adjacent gingival blood flow on detection of pulpal blood flow (PBF) using ultrasound Doppler flowmetry (UDF) through animal study. Materials and Methods The study included 36 right and left maxillary the third incisors and canines in 9 experimental dogs. The study included 2 main steps: In the first step, the pulse sound level (PSL) was recorded on the cervical part of each tooth without flap elevation (Group 1), with flap elevation (Group 2), and after it was repositioned in place (Group 3). In the second step, the PSL was recorded on the cervical part of each tooth (Group 4), after pulpotomy (Group 5), after partial pulp extirpation (Group 6), after complete extirpation (Group 7), and after canal filling (Group 8). In Groups 5-8, the study was performed with and without flap elevation in the left and right teeth, respectively. The PSL was graded as follows: 0, inaudible; 1, heard faintly; and 2, heard well. The difference between each group was analyzed using Friedman's test with Wilcoxon signed-rank tests (α = 0.05). Results In step 1, the PSL results were Group 1 > 2 and 3. In step 2, there was no significant difference between the groups when the flap was not elevated, while PSL results were Group 4 > 5 ≥ 6 and 7 ≥ 8 when the flap was elevated. Conclusions PBF is affected by gingival blood flow when measured with UDF. UDF measurements require isolation of gingiva from the tooth.
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Affiliation(s)
- Dohyun Kim
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Hyoung-Seok Ko
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Soo-Yeon Park
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Seung-Yeon Ryu
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - Sung-Ho Park
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
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Lee HN, Chen PH, Huang CY, Chen CM, Jeng JH, Chen YK, Chuang FH. Efficacy assessment of laser Doppler imager in diagnosing the pulp vitality after dental trauma. J Dent Sci 2022; 18:618-625. [PMID: 37021222 PMCID: PMC10068390 DOI: 10.1016/j.jds.2022.07.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 07/29/2022] [Indexed: 11/17/2022] Open
Abstract
Background/purpose This is the first paper evaluating the efficacy of laser Doppler imager in diagnosis of pulpal vitality. The purpose of this study was to evaluate and compare the diagnostic benefits of laser Doppler imaging and electric pulp test (EPT) in dental trauma. Materials and methods Seven patients were selected for pulp vitality evaluation in Kaohsiung Medical University Hospital between 2018 and 2019. EPT and laser Doppler imager evaluation were performed for patients with traumatic injury to teeth. Statistical methods included the Kappa consistency test and the chi-square test. In addition, the receiver operating characteristic (ROC) curve, and the area under the curve (AUC) were used. Results There was a significant difference in Doppler flow values between the severe trauma group and the mild trauma group, regardless of patient self-reported symptoms (P = 0.043) or physicians' diagnostic classification (P = 0.018). For an EPT instrument, the Kappa coefficient was 0.67 and 1-year pulpal status findings were highly consistent (P < 0.001). Using a Doppler instrument, the Kappa coefficient was 0.85. According to the ROC curve, the AUC for EPT was 0.94, the AUC for Doppler was 1, and the optimal cut-off value was 31.55, indicating that both were superior diagnostic tools. Conclusion Both laser Doppler imager and EPT can be used as tools for diagnosing traumatic pulp necrosis. Doppler imaging instruments allow for a more timely and accurate assessment of pulp vitality in dental trauma. In the future, ongoing research and related training are necessary for interpretation of Doppler data.
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Affiliation(s)
- Hui-Na Lee
- Division of Endodontics and Operative Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Ping-Ho Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chun-Yin Huang
- Department of Nuclear Medicine, E-DA Hospital, Kaohsiung, Taiwan
| | - Chun-Ming Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Department of Oral and Maxillofacial Surgery, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Jiiang-Huei Jeng
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- School of Dentistry, National Taiwan University Medical College, Taipei, Taiwan
- Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
| | - Yuk-Kwan Chen
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Division of Oral Pathology & Maxillofacial Radiology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Oral & Maxillofacial Imaging Center, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Fu-Hsiung Chuang
- Division of Endodontics and Operative Dentistry, Department of Dentistry, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Dentistry, College of Dental Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- Corresponding author. No. 100, Shih-Chuan 1st Road, Kaohsiung 807378, Taiwan.
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Carreira-Míguez M, Belinchón-deMiguel PP, Clemente-Suárez VJ. Behavioural, odontological and physical activity patterns of hypertense and control population. Physiol Behav 2022; 252:113841. [PMID: 35561809 DOI: 10.1016/j.physbeh.2022.113841] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/04/2022] [Accepted: 05/09/2022] [Indexed: 01/04/2023]
Abstract
Behavioural and multifactorial factors such as odontological and physical activity habits are controlling factors in hypertension. The aim of the present study was to analyze differences in behavioral, odontological and physical activity patterns of hypertense and control population. Fifty participants with hypertension (57.5±13.6 years) and 100 participants as control group with no hypertension disease (48.9±7.9 years) were interviewed via online questionnaire. Multifactorial items in oral behavioral, health habits and physical activity profile were analyzed by a compendium of questionnaires. Result showed how control group showed significantly lower age, weight, body mass index, TV hours per day, gastritis or heartburn, dental sensibility, and sick days last year, and significantly higher level of academic education, quality of sleep and daily toothbrushing than hypertension group. In conclusion our results showed that hypertense patients presented higher levels of overweight, poor sleep quality and sedentary behaviors than control participants. In addition, hypertense patients also presented poor odontological health, showing higher indices of gastritis, dental sensibility, and sick days per year. Both groups presented a low physical activity pattern. This information allows to better understand of a multifactorial disease, as well to the creation of protocols for intervention and prevention of this disease at the behavioral level and lifestyle.
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Affiliation(s)
- María Carreira-Míguez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, Madrid 28670 , Spain.
| | | | - Vicente Javier Clemente-Suárez
- Faculty of Sports Sciences, Universidad Europea de Madrid, Tajo Street, s/n, Madrid 28670 , Spain; Grupo de Investigación en Cultura, Educación y Sociedad, Universidad de la Costa, Barranquilla 080002, Colombia.
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Antibiofilm and immunomodulatory resorbable nanofibrous filing for dental pulp regenerative procedures. Bioact Mater 2022; 16:173-186. [PMID: 35386316 PMCID: PMC8965695 DOI: 10.1016/j.bioactmat.2022.01.027] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/05/2022] [Accepted: 01/17/2022] [Indexed: 12/22/2022] Open
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Laser Doppler for Accurate Diagnosis of Oehler’s Type III Dens Invaginatus: A Case Report. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11093848] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
In vital pulp therapy, pulp testing aids in the differential diagnosis and influences the treatment plan. Different from previous doppler flowmetry studies that only recorded waves and data, we report the first time, the use of a laser doppler blood flow monitor and imager with a colored image to present pulp vitality information in the dental field. We report here a case of Oehlers type IIIa dens invaginatus of the right upper lateral incisor in a 31-year-old girl, with the opening of the invagination near CDJ and a peri-invagination lesion sized 8 × 9 mm2. Cone beam computed tomography was used to verify specific spatial and stereoscopic data. After removing the source of infection, mineral trioxide aggregate was selected to fill the invagination. Laser doppler was scheduled for further assessment. After three years of regular follow-up, the patient’s clinical condition improved, the peri-invagination lesion healed, and the laser doppler and electric pulp test both showed a positive reaction. Laser doppler has successfully improved the diagnostic accuracy Thus, unnecessary interventions can be avoided while reducing the treatment time by preserving the vitality. However, further work is needed to resolve the limitations of laser doppler.
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Yoon MJ, Kim DH, Jung IY, Park SH. A laboratory study to detect simulated pulpal blood flow in extracted human teeth using ultrasound Doppler flowmetry. Int Endod J 2020; 54:231-240. [PMID: 32931061 DOI: 10.1111/iej.13410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 09/08/2020] [Indexed: 11/30/2022]
Abstract
AIM To develop a laboratory-based tooth model of simulated blood flow in teeth and evaluate it using ultrasound Doppler flowmetry (UDF). METHODOLOGY A laboratory-based tooth model for UDF was created based on a microfluidic experimental model proposed by Kim & Park (2016 a,b). Twenty-one maxillary or mandibular anterior human teeth within 1 month of extraction were used. Four holes were made in each tooth to fit 1.6-mm diameter polytetrafluoroethylene (PTFE) tubes: at the apical foramen, palatal surface in the centre of the crown, palatal surface apical to the cementoenamel junction (CEJ) and the root centre. Fluid mimicking pulsating blood was pumped (pressure range: 0-200 mbar, flow rate range: 0-80 μL min-1 ) into the apical foramen via the PTFE tubes, which exited the tooth through the palatal surface in the centre of the crown (control group), palatal surface below the CEJ (group 1) and the palatal surface at the mid-root level (group 2). An UDF transducer of 20 MHz was placed at a 60° angle to the labial surface of tooth and was used to measure the fluid flow velocity (Vs, Vas, Vm, Vam, Vd, Vad and Vakd). The flow velocity of the different groups was compared using the Wilcoxon signed-rank test, with a 95% confidence level. RESULTS UDF facilitated the detection of the simulated pulpal blood flow in the control group and group 1, but not in group 2. The mean and standard deviations of Vas, Vam and Vakd were 0.921 ± 0.394, 0.479 ± 0.208 and 0.396 ± 0.220 cm s-1 , respectively, in the control group, and 0.865 ± 0.368, 0.424 ± 0.215 and 0.487 ± 0.279 cm s-1 , respectively, in group 1. The pulpal blood flow values of the control group and group 1 were not significantly different (p > 0.05). CONCLUSIONS This laboratory study revealed that ultrasound Doppler flowmetry enabled the detection of simulated blood flow below the level of the CEJ but not at the mid-root level.
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Affiliation(s)
- M J Yoon
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - D H Kim
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - I Y Jung
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
| | - S H Park
- Department of Conservative Dentistry, Oral Science Research Center, College of Dentistry, Yonsei University, Seoul, Korea
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Farias Gomes A, Sousa Melo SL, Nejaim Y, Groppo FC, Teixeira FB, Freitas DQ. Variations in pulp volume between normotensive and hypertensive individuals on CBCT imaging. Clin Oral Investig 2020; 24:4069-4076. [PMID: 32333179 DOI: 10.1007/s00784-020-03279-4] [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: 11/13/2019] [Accepted: 04/08/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To compare the pulp volume of individuals with altered and normal systemic blood pressure (BP) in order to verify if high BP promotes dimensional modifications in the pulp space. MATERIALS AND METHODS Cone beam computed tomography scans of 91 patients (49 females and 42 males, mean age 31.7 ± 6.38 years) who had a healthy maxillary canine were selected. Values of arterial BP measured at two dental visits were used to classify the sample as normal BP (< 130 × 80 mmHg) and altered BP (≥ 130 × 80 mmHg); 49 patients had normal BP and 42 had altered BP. One oral radiologist evaluated each patient's pulp and tooth volumes, using semi-automatic segmentation, and the tooth length. Data were submitted to Student's t test and logistic regression, with a significance level of 5% (p < 0.05). RESULTS Pulp volume (p = 0.0027), pulp volume/tooth volume (p = 0.0013), and pulp volume/tooth length (p = 0.0007) ratios were greater in the altered BP group. Conversely, there was no difference in tooth volume between the groups (p = 0.0697). A logistic regression model (p = 0.0002) using pulp volume and age enabled the development of a formula for predicting altered BP, with 68% accuracy. CONCLUSIONS Individuals with altered systemic BP have greater pulp volumes than those with normal BP. The formula developed in this study may indicate the presence of altered BP. CLINICAL RELEVANCE As arterial hypertension is a silent disease that produces no warning signs or symptoms, identification of modifications in the pulp volume in cone beam computed tomography scans may be an adjuvant sign of the diagnosis of this disease.
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Affiliation(s)
- Amanda Farias Gomes
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil.
| | - Saulo L Sousa Melo
- Department of Integrative Biomedical and Diagnostic Sciences, Oregon Health and Science University, Portland, OR, USA
| | - Yuri Nejaim
- Oral Radiology Area, Dental School, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Francisco Carlos Groppo
- Department of Physiological Sciences, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
| | - Fabrício B Teixeira
- Department of Endodontics, College of Dentistry and Dental Clinics, The University of Iowa, Iowa City, IA, USA
| | - Deborah Queiroz Freitas
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, Piracicaba, SP, Brazil
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Ertugrul IF, Orhan EO, Yazkan B. Effect of different dry-polishing regimens on the intrapulpal temperature assessed with pulpal blood microcirculation model. J ESTHET RESTOR DENT 2018; 31:268-274. [PMID: 30450655 DOI: 10.1111/jerd.12442] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/21/2018] [Accepted: 10/23/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate the effect of different dry-polishing regimens on the intrapulpal temperature assessed using a pulpal blood microcirculation model. MATERIALS AND METHODS Eighty extracted human mandibular premolar teeth were used. Standardized class V cavity preparations were performed and were then restored. Teeth were divided into four main groups (n = 20): Fine polishing disc (SSF; 3M Sof-Lex, 3M ESPE, Minnesota); Super-fine polishing disc (SSS; 3M Sof-Lex); Spiral finishing wheel (SSW; 3M Sof-Lex); Enhance PoGo-One step diamond micro-polisher cup (EPO; Dentsply Sirona, Inc, Delaware). The main groups were divided: the low-load pressure (0.4N) and the high-load pressure (0.8N). The average change in intrachamber temperatures (Δt), from initial to highest, were measured. RESULTS The highest temperature increase was recorded in SSF08 (9.55°C). The lowest value was recorded in EPO04 (1.9°C). SSS08, SSW08, and EPO08 demonstrated significantly higher Δt values than the low-load mode in SSS04, SSW04, and EPO04, respectively (P < .0001). CONCLUSIONS Temperature was the least affected by the diamond cup in both pressure modes, and it was also less affected by the spiral finishing wheel in the low-load mode than in the high-load mode. Fine and super-fine discs had the greatest effect on intrachamber temperatures. CLINICAL SIGNIFICANCE The present study suggests intrachamber temperature can rise among different dry-polishing regimes. Dental practitioners should pay attention to dry-polishing regimens and pressures for reducing heat-related dental problems.
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Affiliation(s)
- Ihsan Furkan Ertugrul
- Department of Endodontics, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
| | - Ekim Onur Orhan
- Department of Endodontics, Faculty of Dentistry, Eskişehir Osmangazi University, Eskisehir, Turkey
| | - Basak Yazkan
- Department of Restorative Dentistry, Faculty of Dentistry, Pamukkale University, Denizli, Turkey
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Lee CH, Kim E, Kim D. Detection of atrial fibrillation during pulpal blood flow assessment using Doppler ultrasound: a case report. Dentomaxillofac Radiol 2018; 47:20170354. [PMID: 29583037 DOI: 10.1259/dmfr.20170354] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
This report describes the case of a 52-year-old male patient who exhibited suspicious pulsation patterns during pulpal blood flow assessment using Doppler ultrasound. Initially, he was not aware of his cardiovascular problem; however, after referral to a medical clinic, he was diagnosed with atrial fibrillation. The patient was injured in a motor vehicle accident and referred to our clinic for management of multiple traumatized teeth. On clinical examination, several teeth exhibited negative responses to cold and electrical sensibility tests. For accurate diagnosis, pulpal blood flow assessment using a Doppler ultrasound device was performed. During the tests, irregular pulsation patterns were detected, indicating the possibility of a cardiovascular problem. As he denied any history of cardiovascular problems, he was recommended to visit a medical doctor for further evaluation. The following day, he visited a medical clinic, and a 12-lead electrocardiogram was performed. He was ultimately diagnosed with atrial fibrillation with idioventricular rhythm, and was started on anticoagulant medication for prevention of thrombogenesis, which is a possible complication of atrial fibrillation. As presented in this case, Doppler ultrasound can provide useful information, not only about blood flow in the dental pulp, but also about an individual's pulsation rhythm. When a patient presents with irregular pulsation patterns in certain situations, the possibility of cardiovascular problems should be considered.
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Affiliation(s)
- Chan-Hyun Lee
- 1 Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry , Seodaemun-gu, Seoul , South Korea.,2 The Armed Forces Capital Hospital , Bundang-gu, Seongnam-si, Gyeonggi-do , South Korea
| | - Euiseong Kim
- 3 Department of Conservative Dentistry and Oral Science Research Center, Yonsei University College of Dentistry , Seoul , South Korea.,4 Department of Electrical and Electronic Engineering, Yonsei University College of Engineering , Seoul , South Korea
| | - Dohyun Kim
- 1 Department of Conservative Dentistry and Oral Science Research Center, Microscope Center, Yonsei University College of Dentistry , Seodaemun-gu, Seoul , South Korea
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Efficacy of Ultrasound Doppler Flowmetry in Assessing Pulp Vitality of Traumatized Teeth: A Propensity Score Matching Analysis. J Endod 2018; 44:379-383. [DOI: 10.1016/j.joen.2017.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 08/30/2017] [Accepted: 10/03/2017] [Indexed: 11/22/2022]
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Ahn SY, Kim D, Park SH. Long-term Prognosis of Pulpal Status of Traumatized Teeth Exhibiting Contradictory Results between Pulp Sensibility Test and Ultrasound Doppler Flowmetry: A Retrospective Study. J Endod 2018; 44:395-404. [DOI: 10.1016/j.joen.2017.12.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/22/2017] [Accepted: 12/01/2017] [Indexed: 10/18/2022]
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