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Results for “DENTAL PULP TEST”

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At least 253 records · Page 14Linked to original sources

PubMed1995

Pulpal response in electrothermal debonding.

An alternative method to conventional bracket removal that minimizes the potential for ceramic bracket failure as well as trauma to the enamel surface is electrothermal debonding (ETD). However, the potential for pulpal damage using ETD on ceramic brackets still needs assessment. The purpose of this research is to investigate and assess any pulpal damage caused by ETD. Ten patients requiring four premolar extractions each were randomly selected (5 boys and 5 girls). Ceramic brackets were bonded to experimental and control teeth. A total of 30 teeth were used to provide histologic material of the human pulp. Fifteen teeth were extracted 24 hours after ETD, seven were extracted 28 to 32 days after ETD, and eight were the control teeth and debonded by a conventional method, with pliers. The pulp was normal in most cases in the control group. There was significant hyperemia seen 24 hours after debonding in teeth debonded by ETD. Teeth extracted 30 days afer ETD showed varied responses, ranging from complete recovery in some cases to persistence of inflammation and pulpal fibrosis. Teeth subjected to the conventional debonding were normal histologically. The teeth in our research were healthy teeth with a rich blood supply and were from a younger age group. Patients with compromised teeth that have large restorations or a questionable pulpal status could behave more adversely to this significant amount of heat applied. In compromised cases and on older patients, performing pulp vitality tests before ETD may inform the operator about the status of the pulp and thereby prevent the potential for pulpal damage.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1993

Influence of wearing latex gloves on electric pulp tester readings in children.

Electric pulp testers operated by completing an electric circuit. Latex examination gloves have been claimed to interrupt this circuit and lead to false-negative results. This study was conducted to evaluate the influence of wearing latex gloves on electric pulp tester (EPT) readings. The pulps of 80 maxillary permanent incisors of 22 children 10-13 1/2 years old were tested using the Pelton & Crane 'Vitapulp' instrument. Each tooth was tested twice: with gloves and with bare hands. Teeth failing to respond to the EPT without gloves were excluded from the study. All EPT readings ranged between 1 and 9.5. Five teeth gave the same responses with gloved and ungloved hands. Only five teeth did not respond when gloves were worn, and all of these gave readings near the top of the EPT scale when tested without gloves. The other 70 teeth presented significantly higher readings with gloves than without gloves. It is concluded that removal of examination gloves during the operation of the EPT is necessary only if no response is obtained.

Adolescent↗

PubMed1998

Change in pain threshold by meperidine, naproxen sodium, and acetaminophen as determined by electric pulp testing.

The purpose of this study was to compare changes in pain threshold caused by meperidine, naproxen sodium, acetaminophen, and placebo. The change in pain threshold was measured by electric pulp testing. Acetaminophen elevated the pain threshold statistically significantly. Clinically, however, the superiority of acetaminophen is questionable. No elevation of the pain threshold occurred with narcotic drugs or with nonsteroidal anti-inflammatory drugs: our research shows that the electric pulp tests of patients who have taken these drugs preoperatively will have results similar to those of patients who have taken no drugs. We question the philosophy of administering these drugs for change in pain threshold at the levels used here preoperatively.

Acetaminophen↗

PubMed1982

The stressed pulp condition: an endodontic-restorative diagnostic concept.

The stressed pulp condition is a clinical concept that describes pulps that have received repeated previous injury and survived with diminished responses and lessened repair potentials. Before performing restorative dentistry the dentist should conduct a comprehensive pulpal health evaluation on teeth to be restored. This evaluation should include (1) traditional pulp-testing methods and (2) a review of the past, present, and planned future treatment of the tooth. This analysis will usually identify teeth with stressed pulp conditions. Teeth with stressed pulps should be treated before complex restorative dentistry.

Crowns↗

PubMed2000

Comparison of methods for measuring root and mucogingival sensitivity.

OBJECTIVE: The aim of this study was to compare the variability of measurements of root and mucogingival sensitivity over a 24-hour period. STUDY DESIGN: Sixteen individuals (46.8 +/- 3.2 years old) were randomly tested for pain thresholds with calibrated electrical stimulation of the root and adjacent mucosa (electric pulp tester), pressure on mucosa (pressure-sensitive probe), and cold on the root (experimental thermocoupler probe) at baseline and after 4, 8, and 24 hours. Variability between and within subjects was estimated by using analysis of variance for random effects. RESULTS: Intrasubject variability was highest for electric testing of the root and lowest for cold testing of the root across time. Of all subjects, 93% fell within 5 degrees C at all periods for the cold stimulation/moderate pain threshold. CONCLUSIONS: Calibrated cold stimulation of root areas appears to provide the most sensitive measure to assess therapeutic interventions to control cervical dental pain because of low intrasubject variability in untreated patients.

Analysis of Variance↗

PubMed1994

Endodontic treatment of mandibular molars with concrescence.

Endodontic treatment of a permanent mandibular first molar and a second molar presumably joined by cementum is presented. This case illustrates the difficulty in interpreting the vitality testing in such a situation. It also suggests possible irreversible pulp injury of a vital healthy tooth caused by extension of the inflammatory periapical pathosis of the adjacent tooth.

Adolescent↗

PubMed1990

A dentist's dilemma: nonsurgical endodontic therapy or periapical surgery for teeth with apparent pulpal pathosis and an associated periapical radiolucent lesion.

First presented is a brief review of nonsurgical versus surgical treatment of radicular cysts. This is followed by a consideration of the use of radiographs for differential diagnosis of periapical radiolucent lesions. Some of the nonendodontic local and systemic lesions that can occur periapically are then presented. Next examined are the fallibilities of pulp vitality testing methods. The need for histopathologic examination of periapical lesions is the subject of the next discussion. The dentist's dilemma is then examined: should teeth with apparent pulpal pathosis and an associated periapical radiolucent lesion have routine surgical treatment including biopsy or should they be treated nonsurgically and have periodic follow-ups? A possible resolution of this dilemma is the final consideration.

Dental Pulp Diseases↗

PubMed2004

Endodontic diagnosis. Mystery or mastery?

UNLABELLED: Review of 6 clinical distinctions: (1) Symptom: "anything under the sun." DIAGNOSIS: pulp exposure. Duplicate: clinical or radiographic pulp exposure evidence. TREATMENT: endodontics or pulp cap under strict protocol conditions. (2) Symptom: "cold." DIAGNOSIS: hyperemia. Duplicate: ice. TREATMENT: pulp protection or endodontics. (3) Symptom: "heat." DIAGNOSIS: pulpitis. Duplicate: heat. TREATMENT: pulpotomy for multirooted teeth or pulpectomy for single-rooted teeth. Schedule endodontic completion. (4) Symptom: "I recently had a toothache and now it is gone." DIAGNOSIS: necrosis. Duplicate: Electric Pulp Test and ice are negative. TREATMENT: endodontics. (5) Symptom: "I had a toothache awhile back and now it is gone." DIAGNOSIS: LEO. Duplicate: Electric Pulp Test, ice, and test cavity are negative. TREATMENT: endodontics. (6) Symptom: "It really hurts to touch my tooth." DIAGNOSIS: percussion. Duplicate: may or may not have a LEO and may or may not have cellulitis. TREATMENT: reduce occlusion, access cavity, water chew, and schedule to finish endodontics. If these tests are carefully performed, then they are objective and the doctor does not have to be in a subjective situation. A newfound sense of endodontic diagnostic mastery is experienced. Perhaps the best way to summarize the simplicity of this clinical diagnostic scheme is to quote Sherlock Holmes: "Nothing is more deceptive than the obvious."

Dental Pulp Diseases↗

PubMed1991

[Temperature profile in the enamel during cold tests].

The temperatures on the surface of human teeth during pulp vitality tests with frigen and carbon dioxide snow were recorded in an in vitro study. Frigen spray caused particularly rapid changes in temperature. The lowest temperature (-52 degrees C) was measured with CO2-snow (with a pressure of 9.81 N against the tooth surface). To obtain higher temperatures at lower rates of change, the use of a thin latex fingerstall proved to be effective.

Body Temperature↗

PubMed1998

Subjective sensation and objective neural discharges recorded from clinically nonvital and intact teeth.

The aim of this study was to compare subjective sensation with objective neural discharges recorded by microneurography. We examined human teeth that did not respond to pulp vitality testing, but that responded to cavity preparation for endodontic treatment (pathophysiological). Intact teeth and endodontically obturated teeth were used as controls. Pulpal blood flow in the clinical crown and histological examination were also used. Most teeth, both in normal and pathophysiological conditions, did not respond to all pulp vitality tests. Even when teeth in the pathophysiological group showed spike discharges evoked by pulp vitality tests or from spontaneous activity no sensation was elicited. These results confirmed the usefulness of microneurography for research on pulpal sensation and the significance of summation in the perception of sensation in chronically inflamed tooth pulp.

Action Potentials↗

PubMed1996

Randomized clinical trial of the efficacy and safety of a home bleaching procedure.

The safety and efficacy of a home-use carbamide peroxide tooth-whitening procedure were evaluated in a double-blind experimental design. Fifty-two adults were randomly assigned to experimental and control (placebo gel) groups. The products were applied in a custom-fitted tray and used for 5 consecutive nights in accordance with the manufacturer's recommendations. Tooth color changes from baseline were measured with a small-area colorimeter. Concurrently, electric pulp test and periodontal indices were measured. At the end of 6 months, the teeth in the active group had a statistically significant greater mean color change that did the placebo controls. The mean color change differed significantly by tooth type. No statistically significant changes in vitality, sulcus depth, or Gingival Index were found in the treatment group.

Adult↗

PubMed1995

Laser Doppler flowmetry in the assessment of tooth vitality after Le Fort I osteotomy.

The aim of the present study was to evaluate pulp vitality in 15 patients, 11 to 29 months after a Le Fort I osteotomy. Assessment of pulpal blood flow was obtained by means of laser Doppler flowmetry, and it was measured bilaterally from the first maxillary premolar to the central incisor. The results were compared with those obtained by electric pulp testing in the same teeth. In addition, periodontal ligament perception was evaluated by applying axial loads to the central incisors. Radiographs were also studied. Fourteen subjects served as a control group. There was no significant difference between the level of pulpal blood flow in the teeth of the operated group compared with the control group. Twenty-one per cent of the teeth in the group operated on were insensitive to electric pulp testing, and in the remaining 79% the mean threshold was significantly higher than in the corresponding teeth in the control subjects. Similarly, the axial load threshold for the incisors for the control subjects was below 5 g, but in the group operated on 66% had a threshold above 5 g. These experiments clearly demonstrate that teeth without normal innervation can have an intact blood supply and be vital.

Adult↗

PubMed1980

Neutrophil chemotaxis induced by anaerobic bacteria isolated from necrotic dental pulps.

Anaerobic bacteria belonging to the species Bacteroides melaninogenicus, Bacteroides asaccharolyticus, Fusobacterium nucleatum, Peptostreptococcus anaerobius and Eubacterium alactolyticum, isolated from necrotic dental pulps, were tested for their capacity to induce neutrophil leukocyte chemotaxis. Generation of chemotactic factors in serum by whole bacterial cells and chemotaxis induced by bacterial extracts were studied in vitro by the Boyden technique. Subcutaneously implanted wound chambers in guinea pigs were used for testing leukocyte migration in vivo. All bacterial strains had a similar high capacity to induce neutrophil chemotaxis. The heavy accumulation of polymorhponuclear neutrophil leukocytes associated with clinical and experimental infections by B. melaninogenicus or B. asaccharolyticus cannot be ascribed to any extreme ability of these organisms to generate chemotactic factors.

Adult↗

PubMed1996

Effect of wavelength and bandwidth on the clinical reliability of laser Doppler recordings.

The aim of this study was to investigate the effect of wavelength and bandwidth on laser Doppler flowmeter signals from vital and root-filled teeth, and to establish their sensitivity and specificity. Twenty human subjects were recruited, each with a vital tooth and the contralateral tooth root filled but not restored apart from the palatal access cavity. Readings were taken from these teeth for 3 min at 20 Hz for each of 3.1 kHz, 14.9 kHz and 22.1 kHz bandwidths using a modified laser Doppler blood flow monitor which permitted simultaneous recording using 810 nm and 633 nm light sources with a probe of four optical fibres with 0.25 mm separation. Ten traces from each combination of variables was examined by 10 trained observers who indicated if the traces came from vital or root-filled teeth judged by the amplitude and regularity of pulsatility of the trace. From the accuracy of their replies, sensitivity and specificity were calculated. Median flux values were higher for vital teeth than for root-filled teeth and for the 810 nm wavelength than for the 633 nm wavelength. Flux values increased with wider bandwidth using the 810 nm light source. With the 633 nm light source, the highest flux values were recorded using the 3.1 kHz bandwidth. Using the Mann-Whitney U test, there was a highly significant difference between readings from vital and root-filled teeth for the 3.1 kHz/810 nm wave length combination (p<0.003) and a significant difference for the 3.1 kHz/633 nm wavelength group (p<0.02). Comparison of other groups showed no significant difference (p>0.05). The 810 nm wavelength showed good sensitivity but poor specificity at 14.9 and 22.1 kHz bandwidths. The 633 nm wavelength showed good specificity, but poor sensitivity, at 14.9 and 22.1 kHz bandwidths. The 3.1 kHz bandwidth showed the best sensitivity and specificity for both wavelengths. Sensitivity and specificity were increased if the results of fast Fourier analysis were considered in addition to observations of flux values and pulsatility of traces. The 810 nm/3.1 kHz combination offered the greatest sensitivity and specificity as a test to distinguish between root-filled and vital teeth. This combination was best when the results of Fourier analysis were considered in addition to visual observations.

Artifacts↗

PubMed1976

Influence of maturation status and tooth type of permanent teeth upon electrometric and thermal pulp testing.

The threshold values of developing teeth were determined for two commonly used electrometric pulp testers (Siemens Sirotest and Bofors Pulp Tester) and a new thermal test based on carbon dioxide snow (Odontotest). The teeth examined were divided into 7 stages according to maturation status. This study showed that teeth in Stages 3-5, i.e. until completion of root formation, show an increased electrometric threshold value. The Siemens tester appeared to be equal to the Bofors tester with regard to reliability. The Odontotest was the most reliable method examined, giving a consistent positive response in all examined teeth.

Adolescent↗

PubMed2004

Evaluation of pulpal blood flow after tooth splinting of luxated permanent maxillary incisors.

Laser Doppler flowmetry (LDF) is a non-invasive method to assess pulpal blood flow (PBF). Dental injury has been associated with losses of pulpal sensibility. The purpose of this study was to assess whether LDF could be used to detect short- and long-term changes of PBF values of luxated permanent maxillary central incisors after repositioning and splinting. In 18 trauma patients, a single maxillary incisor treated by repositioning and splinting, and the respective contralateral homologous tooth were investigated by LDF to assess local PBF values. Perfusion units (PU) were taken in four sessions: on the day of splint removal, and 12, 24, and 36 weeks after splint removal. Analysis of the luxation type-related PBF measurements revealed intrusion type-related PBF values to be associated with a significant decrease in PBF values (P < 0.05), while lateral luxation and extrusion type-related PBF values showed no significant difference between the session-related values (P > 0.05). PBF measurements did not change over time for the contralateral incisors (P > 0.05). Teeth affected by an intrusion-type luxation injury remained unresponsive to sensitivity testing at follow up, while 3 (60%) developed grey discoloration of the crown. LDF may become useful in the detection of ischemic episodes of luxated maxillary central incisors after repositioning and splinting. Further studies are warranted to assess the validity of post-traumatic 'ischemic episodes' by comparing it to histological tooth pulp changes.

Adolescent↗

PubMed1994

Pulpal anesthesia efficacy of four lidocaine solutions injected with an intraligamentary syringe.

Four lidocaine solutions that differed in concentration or vasoconstrictor composition were compared for efficacy of pulpal anesthesia. These drugs were injected in a double-blind manner with the use of an intraligamentary syringe to the periodontal ligament of maxillary lateral incisors. These teeth were subjected to electric pulp test stimulation that yielded absolute sensation threshold values. It was found that there was no dose response relationship between the local anesthetic concentration and the efficacy of pulpal anesthesia. Lidocaine 2% with vasopressin 25 IU% and noradrenaline bitartrate produced a noticeably shorter duration of pulpal anesthesia in comparison with the other three drugs. The results indicated that the nature of vasoconstrictors when added to the local anesthetic can affect the efficacy of pulpal anesthesia using the intraligamentary model.

Adolescent↗

PubMed2000

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.

Adult↗