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Accurate assessment of the state of the health of the dental pulp, which is a key step for a successful diagnosis of oral diseases, is the outcome of detailed patient history, thorough clinical and radiographic examination, and careful use of special diagnostic tests. The diagnosis and treatment of diseases at their early stages is one of the challenges facing dental healthcare systems. This is attributed to the failure of disease identification by clinicians because they lack better testing methods. This study investigates the reliability of two testing methods (Pulp Testing and Thermal testing methods with the relatively newly introduced Laser Doppler Flowmetry (LDF) and Pulse Oximetry (PO) test methods) to ascertain which is reliable in the determination of pulpal status.
Dental pulp testing refers to the process of investigating the dental pulp that provides reliable diagnostic, as well as treatment information useful in the dentistry. In the presence of pathosis, pulp tests, along with historical information, are used in the diagnosis of the concerned patient (Alomari, Al-Habahbeh & Alsakarna, 2011). Since the early nineties, pulp testing has been used in several areas of clinical dentistry.
Research has shown that there is a need to realize the ideal diagnostic test. Presently, the available pulp tests have a lot of challenges, as far as reproducibility, reliability and accuracy are concerned for any particular diagnosis (Chen & Abbott, 2011). Furthermore, it is important to apply the right pulp test for any particular clinical scenario. For this reason, carrying out an assessment of the dental pulp state is a significant step if any oral disease diagnosis is to be successful. This can only be achieved by analyzing the patient’s history by carrying out both radiographic and clinical examination.
Often, some diseases are not treated for a long period because clinicians fail to identify the diseases at early stages. Diseases that affect the dental pulp of human beings can be infectious or inflammatory (Alomari et al., 2011). The body’s microcirculation has the capacity to respond to the effects of the infectious and inflammatory disease that affects the dental pulp. Chen and Abbott (2011) pointed out that assessing the supply and circulation of blood in the dental pulp is the only best way to learn the health condition of an individual’s dental pulp.
For many years, the determination of pulpal health of an individual’s teeth has been done through electric and thermal pulp tests. Such tests usually include responses that are either false negative or false positive in an event whereby the teeth under examination are not mature, or the sensory nerves are disabled as a result of traumatic injuries (Villa et al., 2013). Nevertheless, it is likely that normalcy exists within the dental pulp’s microcirculatory constituents despite such a temporary disability. Such a scenario proves that the tests are bound to inaccuracies.
Nowadays, pulp vitality testers are in use. Examples of such tests include the Pulse Oximetry (PO) and Laser Doppler Flowmetry (LDF). Setzer, Kataoka, Natrielli, Gondim and Caldeira (2012) pointed out that the LDF and PO have the capability of assessing the movement of blood in one’s dental pulp. In addition, these tests can overcome issues related to sensitivity testing (Hori, Poureslami, Parirokh, Mirzazadeh & Abbott, 2011). This paper thus reviews extant literature to assess, as well as compare the diagnostic accuracy between pulp vitality testers and pulp sensitivity testers.
Aims and objectives
The objectives of the study included:
- To find out any published clinical trials on pulp testing methods.
- To establish the advantages and disadvantages of each method in the assessment of pulp vitality and sensitivity.
- To assess the reliability of the LDF and PO testing methods.
The study was based on two hypotheses:
Null hypothesis: There is no significant difference in reliability when determining pulpal status using the Electrical Pulp Testing and Thermal testing methods with the relatively newly introduced Laser Doppler Flowmetry (LDF) and Pulse Oximetry (PO) test methods.
Alternate Hypothesis: There is a significant difference in the reliability between the determination of pulpal status using Electrical Pulp Testing and Thermal testing methods with the relatively newly introduced Laser Doppler Flowmetry (LDF) and Pulse Oximetry (PO) test methods.
This study was based on one research question: Is there a significant difference in reliability between the determination of pulpal status using the Electrical Pulp Testing and Thermal testing methods with the relatively newly introduced Laser Doppler Flowmetry (LDF), Pulse Oximetry (PO) test methods?
Significance of the study
The diagnosis and treatment of diseases at their early stages is one of the challenges facing dental healthcare systems. This is attributed to the failure of disease identification by clinicians because they lack better testing methods. For this reason, the results from this study would be significant in advancing the diagnosis and treatment of diseases affecting the dental pulp.
Alomari, F., Al-Habahbeh, R., & Alsakarna, B. (2011). Responses of pulp sensibility tests during orthodontic treatment and retention. International Endodontics Journal, 44 (7), 635-643. Web.
Chen, E., & Abbott, P. (2011). Evaluation of Accuracy, Reliability, and Repeatability of Five Dental Pulp Tests. Journal of Endodontics, 37 (12), 1619-1623. Web.
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Hori, A., Poureslami, H., Parirokh, M., Mirzazadeh, A., & Abbott, P. (2011). The ability of pulp sensibility tests to evaluate the pulp status in primary teeth. International Journal of Pediatric Dentistry, 21 (6), 441-445. Web.
Setzer, F., Kataoka, S., Natrielli, F., Gondim, E., & Caldeira, C. (2012). Clinical Diagnosis of Pulp Inflammation Based on Pulp Oxygenation Rates Measured by Pulse Oximetry. Journal of Endodontics, 38 (7), 880-883. Web.
Villa, C., Patino, N., Loyola, J., Zavala, N., Marti, G., & Medina, C. (2013). Predictive Values of Thermal and Electrical Dental Pulp Tests: A Clinical Study. Journal of Endodontics, 39 (8), 965-969. Web.