A Diagnostic Insight of Dental Pulp Testing Methods in Pediatric Dentistry.

The accurate diagnosis of pulpal pathology in pediatric dentistry is essential for the success of vital pulp therapy. Pulp testing is often a challenging task due to understanding and cooperation issues of pediatric patients, as well as the particularities of pulpal physiology encountered in primary and immature permanent teeth. Sensibility tests, although still widely used by dental practitioners, are no longer recommended by pediatric specialists mainly due to their subjective nature. Vitality pulp tests have gained popularity in the last decade in light of some encouraging results of clinical studies. However, their use is not a routine practice yet. This paper is a literature review aimed to guide dental practitioners towards selecting the appropriate pulp testing method for their pediatric cases. It provides an overview on a multitude of pulp testing methods and an update in recommendations for primary and immature permanent teeth.

Pulp Vitality Testing with a Developed Universal Pulse Oximeter Probe Holder.

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.

Diagnostic accuracy of dental pulse oximeter with customized sensor holder, thermal test and electric pulp test for the evaluation of pulp vitality: an in vivo study / Precisão diagnóstica do oxímetro de pulso odontológico com suporte de sensor personalizado, teste térmico e teste elétrico da polpa para avaliação da vitalidade pulpar: um estudo in vivo

Background: the efficiency of the diagnostic aids plays an important role in the treatment plan. This study aims to assess the diagnostic accuracy of dental pulse oximeter with a customized sensor holder, thermal test and electric pulp tester in assessing the actual pulp status and to evaluate the oxygen saturation level in control healthy teeth, non-vital and teeth with irreversible pulpitis. Material and methods: thirty-seven single canal teeth requiring endodontic therapy were included in the study. The selected teeth were tested with dental pulse oximeter, electric pulp test, cold spray, and heated gutta percha stick. Between each test a time lag of 2 minutes was allowed for the central sensitization to occur. Three blinded operators were involved in the study. The actual status of the pulp was evaluated after the initiation of endodontic treatment, by direct visual examination of the accessed cavity. The data was statistically analysed using (ANOVA) Analysis of Variance and Post-hoc Tukey test. Results: sensitivity of pulse oximeter, heat test, cold and electric pulp test, was 100, 25, 50, and 12, respectively. The specificity of these tests was 100, 72 81, and 77, respectively. The ANOVA showed that there was statistical difference between all the groups (p=0.0005). Post-Hoc Tukey revealed that there was statistical difference among all the groups, nonvital group (p=0.0005), control group (p=0.01) and for irreversible pulpitis (p=0.01). The overall diagnostic accuracy of pulse oximeter was 100% followed by cold test 66%, heat test to be 49% and electric pulp test to be 45%. Conclusion: the custom-made holder used in the present study aided in providing accurate response for pulp vitality testing. In this study the diagnostic accuracy was high with dental pulse oximeter followed by cold, heat and the least was electric pulp tester in different pulpal conditions. (AU)

Fundamentação: a eficiência dos meios de diagnóstico desempenha um papel importante no plano de tratamento. Este estudo tem como objetivo avaliar a precisão diagnóstica do oxímetro de pulso odontológico com um suporte de sensor personalizado, teste térmico e testador de polpa elétrico na avaliação da condição pulpar e na avaliação do nível de saturação de oxigênio em dentes controle saudáveis, não vitais e dentes com pulpite irreversível. Material e métodos: trinta e sete dentes de canal único que necessitavam de terapia endodôntica foram incluídos no estudo. Os dentes selecionados foram testados com oxímetro de pulso, teste pulpar elétrico, spray frio e bastão de guta-percha aquecido. Entre cada teste, foi permitido um intervalo de tempo de 2 minutos para a sensibilização central ocorrer. Três operadores cegos foram envolvidos no estudo. A condição real da polpa foi avaliada após o início do tratamento endodôntico, por meio de exame visual direto da cavidade de acesso. Os dados foram analisados estatisticamente pelo teste de Análise de Variância (ANOVA) e pelo teste Post-hoc de Tukey. Resultados: a sensibilidade do oxímetro de pulso, teste de calor, de frio e teste pulpar elétrico foi de 100, 25, 50 e 12, respectivamente. A especificidade desses testes foi de 100, 72 81 e 77, respectivamente. O teste de ANOVA mostrou que houve diferença estatística entre todos os grupos (p = 0,0005). O teste Post-Hoc de Tukey revelou que houve diferença estatística entre todos os grupos, grupo não-vital (p = 0,0005), grupo controle (p = 0,01) e pulpite irreversível (p = 0,01). A precisão diagnóstica geral do oxímetro de pulso foi de 100%, seguida pelo teste a frio de 66%, o teste de calor a 49% e o teste pulpar elétrico a 45%. Conclusão: o suporte personalizado utilizado no presente estudo ajudou a fornecer uma resposta precisa para o teste de vitalidade pulpar. Neste estudo, a precisão diagnóstica foi alta com o oxímetro de pulso dental, seguido do teste com frio e calor, sendo o teste elétrico o menos eficaz nas diferentes condições pulpares testadas.(AU)

Evaluation of efficacy of a pulse oximeter to assess pulp vitality.

BACKGROUND: To evaluate the efficacy of pulse oximeter as a pulp vitality tester. MATERIALS AND METHODS: The sample group consisted of 60 patients of age 15 to 30 years with normal maxillary anterior teeth. Thirty nonvital teeth with complete endodontic fillings were tested as control group. Systemic oxygen saturation values from the patient's fingers served as the control sample for comparison of pulp oxygen saturation values. Readings were recorded on index fingers first; teeth were then evaluated by placing sensor onto the tooth. RESULTS: Nonvital teeth recorded oxygen saturation values of 0%. The mean value for central incisor was 85.11 (SD ± 2.07), for lateral incisors 80.21 (SD ± 2.03) and for canines 89.55 (SD ± 1.09). Their control values (patient's index fingers) averaged 95.88% (SD ± 0.66). Pearson's correlation analysis showed a correlation of 0.11 for central incisors, 0.19 for lateral incisors and 0.12 for canines. CONCLUSION: This study confirms that pulse oximeter is effective equipment for pulp vitality testing. Pulse oximeter evidences the actual method of evaluating the pulp vitality compared to contemporary methods. How to cite the article: Sadique M, Ravi SV, Thomas K, Dhanapal P, Simon EP, Shaheen M. Evaluation of efficacy of a pulse oximeter to assess pulp vitality. J Int Oral Health 2014;6(3):70-2.