A Diagnostic Insight of Dental Pulp Testing Methods in Pediatric Dentistry

Abstract

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.

Orthodontic management of traumatic dental injuries in Norway and orthodontists' perceptions of referral routines: A quality assurance survey

“…Sensibility testing is an important tool in cases of uncertain tooth vitality and recommended before orthodontic treatment, even in teeth with mild injuries 29 . However, sensibility testing of the obliterated and/or immature teeth may yield unreliable results, and this may contribute to the modest use of this technique 39,40 . A few studies have investigated whether or not orthodontic treatment of teeth with TDI is associated with an increased risk of development of pulpal necrosis 16–19 .…”

“…29 However, sensibility testing of the obliterated and/or immature teeth may yield unreliable results, and this may contribute to the modest use of this technique. 39,40 A few studies have investigated whether or not orthodontic treatment of teeth with TDI is associated with an increased risk of development of pulpal necrosis. [16][17][18][19] A follow-up with sensibility testing may not be an established routine among orthodontists.…”

Pruebas Térmicas de Sensibilidad Pulpar en Dientes Permanentes con Pulpitis: Valor Diagnóstico y Limitaciones

“…Con el calor puede aparecer una respuesta tardía, de modo que basta con esperar 10 segundos aproximadamente entre cada una para que puedan surgir tanto los síntomas precoces como los tardíos 17 . Debemos ser conscientes de que no todos los agentes para las pruebas pulpares y/o los métodos son adecuados para todas las situaciones clínicas 30 . En nuestra opinión, también los métodos para aplicar el calor sobre la corona dentaria son determinantes al momento de requerir emplear este estímulo (por ejemplo: gutapercha caliente o agua caliente.…”

“…La aplicación de hielo es el método más simple, el agente más económico y el más comúnmente utilizado para aplicar el frío. Sin embargo, la aplicación directa de una barra de hielo sobre un diente puede resultar incómoda y poco precisa, debido a que el área de contacto es grande y corremos el riesgo de estimular accidentalmente múltiples dientes o la encía, incluso al derretirse 30 . En ese caso es recomendable emplear la torunda impregnada con el tetrafluoroetano.…”

Determination of the Ideal Tooth Surface and Pain Threshold to Improve the Efficacy of an Electric Pulp Tester in the Diagnosis of Pulp Sensitivity and Vitality in Premolar and Molar Teeth: A Cross-Sectional Study

“…The clinician experiences a significant barrier in accurately diagnosing the pulpal state of posterior teeth affected by caries. The histologic examination, the sole reliable method for assessing the condition of the dental pulp, is not practically viable within the clinical environment [ 1 ]. Clinically, the status of the pulp must be determined through clinical examination, intra-oral radiographs, anamnesis, and a pulp sensibility test.…”