Oximetría de pulso y su eficacia para diagnosticar vitalidad pulpar / Pulse oximetry and its use in diagnosing pulp vitality

Objetivo: Identificar y analizar en la literatura científica reciente el uso de la oximetría de pulso como método diagnóstico de vitalidad pulpar. Metodología: En este trabajo se llevó a cabo una revisión de la literatura en las plataformas de PubMed y Google Académico, en la cual se analizó el uso de la oximetría de pulso en el diagnóstico y monitoreo odontológico del estado pulpar. Resultados: Después de una exhaustiva revisión, y de acuerdo con los criterios de inclusión y exclusión, se analizaron 21 artículos. La mayoría de los trabajos consideran la oximetría de pulso un método alternativo de diagnóstico indoloro, seguro y eficaz; sin embargo, la adaptación de un instrumento de uso exclusivo odontológico es necesaria para una medición exacta de la saturación de oxígeno en la pulpa dental. Los avances tecnológicos en el campo clínico de la odontología nos han llevado a la búsqueda de nuevas técnicas diagnósticas clínicas para mejorar la atención y los tratamientos de los pacientes que acuden día con día a recibir una consulta odontológica. Conclusiones: En los últimos años la oximetría de pulso ha demostrado ser una herramienta de diagnóstico eficaz para el diagnóstico de la vitalidad pulpar. El análisis de los artículos incluidos en esta revisión concluye que la oximetría de pulso es una técnica innovadora que puede ser utilizada como una herramienta diagnóstica adyuvante en el diagnóstico de la vitalidad pulpar (AU)

Objective: To identify and analyze in the recent scientific literature the use of pulse oximetry as a diagnostic method for pulp vitality. Methodology: In this work, a literature review was carried out on the PubMed and Google Scholar platforms in which the use of pulse oximetry in the dental diagnosis and monitoring of pulp status was analyzed. Results: After an exhaustive review and in accordance with the inclusion and exclusion criteria, 21 articles were analyzed. Most of the studies consider pulse oximetry an alternative method of painless, safe and effective diagnosis, however, the adaptation of an instrument for exclusive dental use is necessary for an exact measurement of the oxygen saturation in the dental pulp. Technological advances in the clinical field of dentistry have led us to search for new clinical diagnostic techniques to improve the care and treatment of patients who come every day to receive a dental consultation. Conclusions: In recent years, pulse oximetry has proven to be an effective diagnostic tool for the diagnosis of pulp vitality. The analysis of the articles included in this review concludes that pulse oximetry is an innovative technique that can be used as an adjunct diagnostic tool in the diagnosis of pulp vitality (AU)

Electric pulp testing: a review.

Electric pulp testing (EPT) has been available for more than a century and used in dental practices worldwide. This article provides an overview of this diagnostic aid. The PubMed database from 1953 was used initially; the reference list for pulp testing featured 1071 articles, and for EPT identified 121 papers. A forward search was undertaken on these articles and using selected author names. Potentially relevant material was also sought in contemporary endodontic texts, while older textbooks on endodontics, operative dentistry and pain revealed historic information and primary research not found electronically. A short account of the innervation of the pulp is followed by an historic overview. Clinical considerations discussed include tooth isolation, glove wearing and tester electrode placement. Orthodontic treatment, pacemaker wearing and patient medications are considered. Research applications are also discussed. While EPT is valuable, no single pulp testing technique can reliably diagnose all pulp conditions. Careful collection of patient history regarding the problem tooth and prudent use of appropriate radiographs are also helpful. The shortcomings of electric tests, especially in the case of immature and concussed teeth, must be understood. The demeanour of the patient and the responses given by control teeth also require careful consideration.

Effect of transcutaneous electrical nerve stimulation on pain perception threshold of human teeth: a double-blind, placebo-controlled study.

In this double-blind, placebo-controlled study, we studied the effect of three different transcutaneous electrical nerve stimulation (TENS) devices with extra- and intraoral electrodes on the pain perception thresholds of 234 unrestored, caries-free human teeth of 66 healthy individuals subjected to stimulation with an electric pulp tester. A placebo control collective of 64 healthy subjects received no electrical stimulation, since an inactive TENS device was used. In all tooth types tested (maxillary and mandibular incisors and premolars), the use of the active TENS devices resulted in an increase of 16.3-32.5% versus baseline in the pain perception threshold. The differences between active TENS and baseline were statistically significant for both TENS devices using extraoral electrodes (P < 0.05). No statistically significant differences were found between the different devices tested (P > 0.05). In the placebo collective, the increase in the pain perception threshold ranged between 6.4% and 10.3% versus baseline. There were no significant differences between placebo TENS and baseline on the one hand and between placebo TENS and the active TENS devices on the other hand (P > 0.05). The findings suggest that, as an alternative to local anesthetics, TENS seems not to be useful in the case of painful dental interventions, since it offered only minor advantages over a placebo.

Adrenaline in local anaesthesia: the effect of concentration on dental pulpal circulation and anaesthesia.

This study investigated the effects of inferior alveolar nerve block anaesthesia using 2% lignocaine with 1:100,000 or 1:80,000 adrenaline on pulpal blood flow in mandibular molar and canine teeth in 10 human subjects by laser Doppler flowmetry. The duration of pulpal anaesthesia in the teeth using electric pulp testing was also investigated. The injection of 2 ml of 2% lignocaine with 1:100,000 adrenaline caused a decrease in pulpal blood flow in both teeth in every subject. The mean pulpal blood flow in the canine tooth at 15 min was 58% of the baseline value whilst that in the molar was 76%. These values were not significantly different from the reduction in pulpal blood flow produced by 2% lignocaine with 1:80,000 adrenaline. Both solutions produced a reduction in blood flow that was of shorter duration than pulpal and soft tissue anaesthesia, and of shorter duration in the molar tooth compared with the canine. When 2% lignocaine with 1:100,000 adrenaline was injected, the mean reduction of blood flow was of shorter duration (canine, 60 min; molar, 42 min) than following 2% lignocaine with 1:80,000 adrenaline (canine, 93 min; molar, 72 min); these differences in reductions were statistically significant (P < 0.05). Using 2% lignocaine with 1:100,000 adrenaline, the mean duration of pulpal anaesthesia was 76 min in the canine tooth compared with 58 min in the molar tooth. Full soft tissue anaesthesia lasted for 117 min. These values were reduced significantly when compared with the lignocaine solution containing 1:80,000 adrenaline (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Endodontic anesthesia in mandibular molars: a clinical study.

Sixty-one mandibular molar teeth with clinically manifest pulpitis, which required endodontic therapy, were studied. Twenty-seven subjects received standard inferior alveolar nerve block (IANB) with 2% lidocaine HCI with 1:100,000 epinephrine and 34 subjects received IANB with 3% mepivacaine with no vasoconstrictor. Pulpal anesthesia was assessed with dichlorodifluormethane (DDM). Subjects who gave a positive response to DDM were given a periodontal ligament injection with 2% lidocaine with 1:100,000 epinephrine. This study showed that 3% mepivacaine HCI is as effective as 2% lidocaine HCI in achieving pulpal anesthesia in mandibular molars with IANB. Of a total 61 IANB with lip anesthesia, 23 subjects required periodontal ligament injection to achieve a negative response to DDM. It was concluded that lip anesthesia is not a reliable indicator of pulpal anesthesia. The use of DDM is a reliable method of determining true pulpal anesthesia.