The anesthetic test: a diagnostic aid for referred pain.
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A modern electronic pulp tester is evaluated in both the laboratory and clinical situations. Different electrode media are tested and compared to results obtained without any electrode media. Contact pads are also evaluated and found to add another variable to electric pulp testing. Several technique variables were introduced and found to have a significant effect on transmission of the stimulus to the tooth.
The relationships between endodontics and periodontics are explored. Diagnosis, prognosis, and treatment planning are discussed for the primary endodontic lesion and the primary endodontic lesion with secondary periodontal involvement. These endodontic lesions are compared with primary periodontal lesions and primary periodontal lesions with secondary endodontic participation. The "true" combined lesion is also reviewed. Clinical photographs and radiographs are used to illustrate specific aspects.
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Different methods of assessing functional impairment of the inferior alveolar nerve after sagittal split osteotomy were compared with subjective reports. Thirty patients were tested preoperatively as well as after four days, three weeks, three months, six months, and one year of follow up. All the patients underwent bilateral mandibular ramus sagittal split osteotomy. The sensation of the mandibular teeth was assessed by an electric vitality scanner. Other neurosensory assessments included light touch, two-point discrimination, tactile discrimination, and thermal discrimination. It was shown that electric sensibility-testing of mandibular teeth is a useful method for evaluating neurosensory disturbance after sagittal split osteotomy, and it correlated even better with the patient's subjective evaluation than the other tests used in this study.
The purpose of this in vitro study was to evaluate the sensibility of frozen human pulp cells, in order to examine the cytotoxicity of dental products. The cell cultures and the biological assessments, using still incomplete human premolars and pulp germs, were achieved according to a standardized method. The sensibility of frozen cells was assessed by comparison of cell reactions before and after 1, 3 and 6 months of congelation, for two dental products called Aquacem and Pulpdent, the cytotoxicity and biocompatibility of which were further confirmed. The behaviour of cells with and without congelation was microscopically evaluated, the growth and morphology of cells were assessed after 7, 14, 21 and 28 days. The comparison of the results showed a similar behaviour between cells with and without congelation, except for few cell alterations in the form of granula which occurred during a short period, probably due to the congelation process. This cell liability offers the opportunity to elaborate a bank of cells available on demand for preliminary cytotoxicity assessments.
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Failure to achieve complete anaesthesia of teeth with acutely inflamed pulps is a well-known clinical symptom. In this study, we compared the quality of anaesthesia in intact and inflamed mandibular teeth by using an electric pulp tester. Thirty patients with inflamed lower teeth, which had spontaneous or night pain, were selected; two healthy teeth in the same quadrant were used as control teeth. Electric pulp testing and thermal tests were made on each inflamed and control tooth. Teeth were then anaesthetised by inferior alveolar nerve block and electric pulp tests were repeated on inflamed and control teeth. Significant differences were found between electrical stimulation of inflamed and intact pulp (p approximately 0). There was no significant difference between the responses of inflamed teeth to electric pulp testing before and after anaesthesia (p = 0.327), which showed that the teeth could become resistant to anaesthesia due to the inflammation.
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In this preliminary study, we explored the feasibility of employing photoplethysmography and pulse oximetry to assess the status of the blood circulation in the dental pulp. A simple photometer that measures diffuse light transmission at 575 nm was built to record tooth plethysmograms, and the ability to distinguish vital from surgically devitalized teeth of a dog using plethysmography was demonstrated. As an extension of the photoplethysmographic technique, red-infrared pulse oximetry applied to the measurement of the oxygen saturation (SO2) of blood in the pulp was also examined using an in vitro test setup. Results suggest that the measurement of relative SO2 changes is feasible, but standard dual-wavelength pulse oximetry does not enable determination of SO2 independent of tooth geometry and sensor placement.
The diagnosis and therapeutic approach to periapical cysts is an extremely controversial concern for dentists. Furthermore, as this complaint represents the most frequent cystic lesion of the maxilla, together with the fact that its differential diagnosis with chronic apical periodontitis presents special difficulty, the question takes on even greater importance. The purpose of this article is to assess the validity of the various diagnostic techniques used to differentiate between both pathologies and make a critical analysis of the controversy surrounding the therapeutic approach to suspected periapical cysts through non-surgical and follow-up treatment, or surgical enucleation and histopathological analysis.
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The aim of this study was to assess the reliability of children's responses to pulp testing of deciduous teeth. The maxillary canine was chosen as the test tooth. One hundred children aged 7-10 years were selected who had at least one non-carious maxillary canine with an intact root showing only early radiographic signs of resorption. Using a minimization sampling technique, the children were allocated to one of two groups, for pulp testing with ethyl chloride (EC) or with an electric pulp tester (EPT). True and sham tests for both pulp testing methods were applied. The tests were repeated following an application of 5% lignocaine paste to the gingival margin around the tooth to prevent gingival detection of the stimulus. Children were asked to record their responses to each of the four tests on a visual analogue scale (VAS) of 1-10. Significantly higher mean scores were obtained with true tests than with sham tests, for both EC and EPT. The application of lignocaine to the gingival margin did not significantly affect the responses to either EC or EPT. It was concluded that pulp testing of intact maxillary deciduous canines with no or only early signs of radiographic root resorption, using EC or EPT, results in reliable responses in 7-10-year-olds, suggesting that pulp testing is valid in the deciduous dentition. The VAS was a useful tool for the evaluation of the children's responses.