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PubMed1977

[Experimental studies with radionuclides on the functional behavior of the blood circulation system in the dental pulp].

Using a special semiconductor detector probe and the radiopharmacon DF32P, the author measured the blood supply in the dental pulp. To test the sensitivity of the measuring system, adrenaline was injected for the purpose of vasoconstriction. The resulting change in blood volume is demonstrated by measuring the decrease of the pulse rates during a given period of time.

Animals↗
PubMed2002

A two-probe laser Doppler flowmetry assessment as an exclusive diagnostic device in a long-term follow-up of traumatised teeth: a case report.

The reliability of laser Doppler flowmetry in a two-probe assessment of pulpal blood flow is well known. The purpose of this case report was to determine its use as an exclusive and reliable tool for tooth vitality diagnosis in a long-term follow-up. As a result of a traumatic injury to a 24-year-old Caucasian female, tooth pulp vitality was studied in six maxillary front teeth over 30 weeks using two-probe laser Doppler flowmetry and current sensitivity tests. A similar assessment was repeated after 228 weeks. Confronted with an alveolar bone fracture with a tooth in the fracture line, one intrusion and several luxated teeth, current sensitivity tests are found not to be as reliable indicators of revascularisation, as significant results are obtained later (7 weeks) than using laser Doppler flowmetry tests (1 week). A pathway with ischaemia (3 weeks), hyperaemia (7 weeks) and restored blood supply in the pulp measured by laser Doppler flowmetry tests was found and avoided endodontic treatment. Teeth vascularisation evolved normally (228 weeks). Despite a strong indication in all sensitivity tests for endodontic treatment, the use of laser Doppler flowmetry tests was clear, more reliable than sensitivity tests and exclusive, as denervation was postponed and pulp vascularisation evident.

Adult↗
PubMed2004

Proliferation of dental pulp fibroblasts in response to thrombin involves mitogen-activated protein kinase signalling.

AIM: To examine the involvement of mitogen-activated protein kinases (MAPK) signalling on thrombin-stimulated human dental pulp fibroblasts (DPF). METHODOLOGY: Dental pulp fibroblasts were isolated from dental pulp connective tissue of third molars and expanded in vitro. Expression of thrombin receptors was analysed by RT-PCR, and cell proliferation was measured by 3[H]-thymidine incorporation assay. Phosphorylation levels of MAPK were determined by Western blot analysis, and alkaline phosphatase activity was measured to serve as a marker for odontogenic differentiation. Statistical analysis was performed by Student's t-test. RESULTS: Dental pulp fibroblasts express the thrombin receptors protease-activated receptor-1 (PAR-1), PAR-3 and PAR-4. Measurement of 3[H]-thymidine incorporation revealed a dose-dependent increase of DNA synthesis in response to thrombin treatment. The thrombin-induced mitogenic activity was decreased by the extracellular signal-regulated protein kinase (ERK) signalling inhibitor PD98059 (P < 0.05), and by SB203580 (P < 0.05), a p38 MAPK inhibitor. Western blot analysis demonstrated increased phosphorylation of ERK in DPF following stimulation with thrombin, while p38 MAPK and c-Jun NH2-terminal kinase (JNK) were not activated. Alkaline phosphatase activity of DPF remained unchanged upon incubation with thrombin. CONCLUSIONS: These results suggest that signalling via MAPK mediates the mitogenic activity of thrombin on DPF and may thus play a role during the early stages of pulp repair.

Adult↗
PubMed2004

Cold testing through full-coverage restorations.

Endodontic diagnosis often requires thermal testing through porcelain fused-to-metal (PFM) and all-ceramic restorations. The purpose of this study was to measure and compare the temperature change during thermal testing by three commonly used methods occurring at the pulp-dentin junction (PDJ) of nonrestored teeth and teeth restored with full coverage restorations made of PFM, all-porcelain, or gold. The methods used to produce a thermal change were (a) an ice stick, (b) 1,1,1,2-tetrafluoroethane (TFE), and (c) carbon dioxide snow. A thermocouple measured temperature changes occurring at the PDJ in 10 extracted premolars when thermal tested by each method over a period of 30 seconds. Temperature reduction was also measured for the same samples restored with full gold crowns, PFM, and Empress crowns. Results showed intact premolars and those restored with PFM or all-ceramic restorations to respond similarly to thermal testing. In these teeth, TFE produced a significantly greater temperature decrease than carbon dioxide snow between 10 and 25 seconds (p < 0.05). In conclusion, application of TFE on a saturated #2 cotton pellet was the most effective method for producing a temperature reduction at the PDJ of intact teeth and those restored with gold, PFM, and all-porcelain when testing for less than 15 seconds.

Bicuspid↗
PubMed1991

The presence of nerve fibres in the coronal odontoblast layer of teeth at various stages of root development.

Many studies have investigated the presence of nerve fibres in the coronal odontoblast layer of mature teeth. However, little information is available on the presence of these structures in immature human teeth. The pulps of 18 human maxillary and mandibular third molars at various stages of development were collected, sectioned, and stained by the immunoperoxidase technique. The results showed the presence of numerous myelinated nerve fibres in the coronal odontoblast layer of teeth with fully formed roots. Similar observations were made in teeth with half formed roots, and in those without roots. On the basis of these results, it appears that a lack of response to vitality tests in teeth with incompletely formed roots is not wholly due to the absence of nerve fibres in the coronal odontoblast layer.

Dental Pulp↗
PubMed2002

Pulse oximetry: a diagnostic instrument in pulpal vitality testing.

One hundred children with normal maxillary central and lateral incisors were subjected to vitality tests each by electrical and pulse oximetry. As a control population to confirm the readings, 10 known nonvital anterior teeth with complete endodontic fillings were tested. The systemic oxygen saturation values measured on the index finger of the patient served as the control for the comparison of the oxygen saturation values measure on the teeth. The SaO2 values obtained on the teeth were correlated with the electrical test readings. The correlation between the SaO2 readings and electrical testing readings were found to be negative i.e. as the values of the electrical pulp testing reading increased, the SaO2 values decreased. Since a reproducible SaO2 level is obtainable on the vital teeth, pulse oximetry has immediate clinical value in providing base line vitality data for the traumatised teeth.

Case-Control Studies↗
PubMed2001

Reperfusion of autotransplanted teeth--comparison of clinical measurements by means of dental magnetic resonance imaging.

OBJECTIVE: Dental magnetic resonance imaging (dMRI) with administration of contrast material is one method of assessing pulpal perfusion. The purpose of this study was to evaluate the level of contrast enhancement displayed by means of dMRI after transplantation of teeth and to compare these findings with the results of tooth mobility, pocket depth, cold, and electrical tests. STUDY DESIGN: Twenty-three teeth with either complete root formation or incomplete root formation (IRF) were investigated by using dMRI and were clinically examined at intervals of 2, 4, 8, and 12 weeks, as well as 6 months and 12 months after transplantation. RESULTS: An analysis of the enhancement in the dental images revealed a significant difference between teeth with IRF and teeth with complete root formation. In addition, the time to occurrence of a positive reaction to the cold test was significantly longer for teeth with IRF. CONCLUSIONS: The findings of this study indicate that transplanted IRF teeth are associated with reperfusion seen by means of dMRI as well as with delayed occurrence of a positive cold test.

Adolescent↗
PubMed2006

[Tooth and molar pains].

A patient's pain history is the primary source of information in case of toothache (dentoalveolar pain); revealing its location, its main characteristics and its course, both from the onset and during the day. Clinical diagnostic tests that provoke (such as pulp testing or percussion) or eliminate (such as local anaesthesia) pain are most useful. Several mechanisms may underlie dentoalveolar pain. Pain caused by pulpitis shows characteristics of visceral types of pain, whereas pain originating from the periodontal ligament is characterized by musculoskeletal features. It also happens fairly often that the pain is found to originate from a different tooth than the one in which it is perceived, or from an even more distant source (referred pain). These mechanisms emphasize the importance of differential diagnostics.

Anesthetics, Local↗
PubMed2006

Electric pulp tester conductance through various interface media.

A conducting media is necessary when using an electric pulp tester (EPT). The objective of this study was to observe differences in conductance through various media. We hypothesized that variations in current conductance through different media exist. The pulp chamber of a freshly extracted premolar was exposed, and the cathode of a voltmeter was inserted into the pulpal tissue. The anode was coupled to the EPT handpiece. The measurement taken during dry (no interface media) EPT tip-to-tooth contact was 0 V, which served as negative control. EPT tip directly touching the cathode measured 3.9V and served as positive control. A number of media readily available in the dental office were tested. Data was analyzed using single factor ANOVA. Listerine (3.3) conducted the most voltage (p<0.5). Of nonliquids, K-Y Brand UltraGel and Crest Baking Soda & Peroxide Whitening Tartar Control toothpaste recorded significantly (p<0.05) higher voltage readings (1.4 V).

Bicuspid↗
PubMed1990

A long-term study of 370 autotransplanted premolars. Part I. Surgical procedures and standardized techniques for monitoring healing.

Tooth autotransplantation has recently become a method of treating certain orthodontic problems. Over a 13-year period 370 premolar transplants were monitored by electrometric pulp sensibility testing and radiographic examination for pulp and periodontal ligament healing as well as root growth. This article describes the surgical technique as well as the precision of sensibility testing and radiographic examination for evaluating transplant healing. The sensibility response was found markedly related to the stage of tooth development but not to the type of premolar. The precision of sensibility testing (i.e. deviation of two consecutive measurements at a few weeks' interval) was found to range from 15-36 per cent for the different stages. Film holders were used to standardize the intraoral radiographic exposures. The precision percentage for the measuring technique of tooth length and crown width based on a single radiograph read twice (reading error) ranged from 1.1 to 1.8 with only small variations among the different types of premolar. The precision percentage of the radiographic exposure technique evaluated from two consecutive radiographs (measuring plus exposure error) was found to range from 1.2 to 4.2, again with small variations among the different premolars. The accuracy of the radiographic technique (i.e. deviation of radiographically determined tooth dimensions from the true values) was found to range from 2.0 to 2.9 with only small variation between the various types of premolar. In conclusion the evaluation of electrometric sensibility testing should take into account the stage of root formation of premolars.

Adolescent↗
PubMed1989

[Biological testing and clinical assessment of composite restorations].

The vital-microscopic acute pulp test in rat incisors did not show any toxic effects of the light-curing composite material Lux-a-fill, independent of the remaining dentin thickness. The clinically controlled 2-year study of restorations of cavity class I, III, IV and V have yielded good results in the front teeth region. In addition to the clinical study a micromorphological follow-up study of the surface morphology was performed in cavity class I, and small restorations have been found clinically acceptable after 2 years. Despite of the good results further medium term studies are needed for extended restorations in posterior teeth. The combination of biological application tests in an adequate animal experiment and highly standardized clinical studies is a important prerequisite for the introduction of new filling materials.

Animals↗
PubMed2005

[Endodontic diagnosis].

In this article endodontic diagnosis is discussed following the clinical diagnostic process. A description is given about pain from endodontic origin and a comprehensive overview of the clinical diagnostic tests is discussed. In the chapter clinical classification of pulpal and periapical disorders all the possible endodontic diagnoses are extensively discussed.

Dental Pulp Diseases↗
PubMed1996

Anesthetic efficacy of the periodontal ligament injection after an inferior alveolar nerve block.

The purpose of this study was to determine the contribution of the periodontal ligament injection (PDL) to the inferior aveolar nerve (IAN) block in human first molars. Using a repeated-measures design, 40 subjects randomly received a combination IAN block and PDL injections of the first molar using 2% lidocaine with 1:100,000 epinephrine and a combination IAN block and mock PDL injections (needle penetration only) at two successive appointments. The first molar and adjacent teeth, and contralateral canine (positive and negative controls) were blindly tested with an Analytic Technology pulp tester at 2-min cycles for 60 min. Profound anesthesia was defined as no subject response at an 80 reading. One hundred percent of the subjects had lip numbness with the IAN block. When the combination IAN/PDL injections were compared with the IAN block, the incidence of successful pulpal anesthesia (80 reading) was significantly greater for the combination injections through the first 23 min of pulp testing. However, after 23 min, there was no increase in anesthetic success by adding the PDL to the IAN injection. We concluded that adding the PDL injection to an IAN block increased the incidence of pulpal anesthesia for the first 23 min in the first molar.

Adult↗
PubMed2002

Comparison of carbon dioxide versus refrigerant spray to determine pulpal responsiveness.

There is little evidence for which cold delivery method is most accurate in determining pulp responsiveness. This study compared carbon dioxide dry ice sticks (CO2) versus refrigerant spray (RS) to generate a patient response from different types of teeth restored to varying degrees. Fifteen human patients were selected. In each quadrant, three teeth were identified and the restoration type recorded. Blindfolded patients were randomly tested with either CO2 or RS in a crossover design at two different sessions. Responsiveness was recorded as yes/no and the interval (in seconds) from application to response was determined. Results showed that (a) CO2 and RS were equivalent in producing a pulpal response regardless of tooth and presence of restoration, and (b) CO2 took significantly (p < 0.05) longer to evoke a response than RS using paired t tests. In conclusion, RS and CO2 were equivalent in determining pulpal responsiveness, but the elicited response from RS was faster.

Adult↗