Assessment of pulp vitality: a review

Gopikrishna, Velayutham; Pradeep, Gali; Nagendrababu, Venkateshbabu

doi:10.1111/j.1365-263x.2008.00955.x

Cited by 137 publications

(148 citation statements)

References 89 publications

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“…Moreover, age-related changes to the morphophysiological characteristics of the dental pulp may induce false-negative responses to thermal and electric pulp sensibility tests, as a result of increased dentin thickness, presence of pulp calcifications and other biological changes (2,3).…”

Section: Introductionmentioning

confidence: 99%

“…In fact, it have been shown that sensibility tests do not accurately determine pulpal condition, irrespective of age, as they are based on vasoconstriction or vasodilation and sensitization of nerve fibers and are therefore incapable of providing precise information on pulpal blood flow (2)(3)(4). Moreover, age-related changes to the morphophysiological characteristics of the dental pulp may induce false-negative responses to thermal and electric pulp sensibility tests, as a result of increased dentin thickness, presence of pulp calcifications and other biological changes (2,3).…”

Section: Introductionmentioning

confidence: 99%

“…Among these new options, pulse oximetry has been incorporated to endodontic practice, constituting a method noninvasive, painless and reliable (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Introductionmentioning

confidence: 99%

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Oxygen Saturation in the Dental Pulp of Maxillary Premolars in Different Age Groups - Part 1

et al. 2017

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The aim of this study was to determine oxygen saturation levels in the dental pulp of maxillary premolars in different age groups. A total of 120 human maxillary premolars with normal dental pulps were selected covering the following age groups: 20-24, 25-29, 30-34, 35-39 and 40-44 years (n=24 each group). Oxygen saturation was assessed using pulse oximetry. Analysis of variance was used to assess differences in oxygen saturation levels and Tukey's test was used to identify the age groups that differed from each other. Significance was set at 0.05. Mean oxygen saturation of 120 premolars was 86.20% considering all age groups. Significantly reduced levels were found in the oldest group compared to the other groups: 40 to 44 years -80.00% vs. 89.71, 87.67, 88.71, and 84.80% for age groups 20-24, 25-29, 30-34, 35-39 years, respectively. The mean oxygen saturation levels were similar between 20 and 39 years of age (86.20%) in the whole sample, but reduced significantly in the 40-44-year age group, suggesting that older patients present lower oxygen saturation results even in the absence of pulp tissue injury.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Oxygen Saturation in the Dental Pulp of Maxillary Premolars in Different Age Groups - Part 1

et al. 2017

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“…Functional pulp regeneration, however, additionally requires evidence of thermal or electric pulp testing results, which assess whether there is response to a stimulus mainly by functional Ad-fiber innervation, in addition to using pulse oximetry or laser Doppler flowmetry evaluating the pulp's vascular supply both with high sensitivity and specificity. 30 Apart from a significant correlation recorded in case of an absence of vitality response and complete pulpal necrosis, the pulpal histological status generally poorly correlates with vitality testing results, 30 posing a limitation in relying solely on histological methods and requiring the combination with additional functional innervation and vascularization tests to comprehensively assess functional pulp-dentin complex regeneration.…”

Section: Discussionmentioning

confidence: 99%

Stem Cell Transplantation for Pulpal Regeneration: A Systematic Review

El‐Sayed

Jakusz

Jochens³

et al. 2015

Tissue Engineering Part B: Reviews

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For treating pulpal pathological conditions, pulpal regeneration through transplanted stem/progenitor cells might be an alternative to conventional root canal treatment. A number of animal studies demonstrated beneficial effects of stem/progenitor cell transplantation for pulp-dentin complex regeneration, that is, pulpal tissue, neural, vascular, and dentinal regeneration. We systematically reviewed animal studies investigating stem/progenitor cell-mediated pulp-dentin complex regeneration. Studies quantitatively comparing pulp-dentin complex regeneration after transplantation of stem/progenitor cells versus no stem/progenitor cell transplantation controls in intraoral in vivo teeth animal models were analyzed. The following outcomes were investigated: regenerated pulp area per root canal total area, capillaries per total surface, regenerated dentinal area per total defect area, and nerves per total surface. PubMed and EMBASE were screened for studies published until July 2014. Crossreferencing and hand searching were used to identify further articles. Standardized mean differences (SMD) and 95% confidence intervals (95% CI) were calculated using random-effects meta-analysis. To assess possible bias, SYRCLE's risk of bias tool for animal studies was used. From 1364 screened articles, five studies (representing 64 animals) were included in the quantitative analysis. Risk of bias of all studies was high. Stem/progenitor celltransplanted pulps showed significantly larger regenerated pulp area per root canal total area (SMD [95% CI]: 2.28 [0.35-4.21]) and regenerated dentin area per root canal total area ]) compared with no stem/progenitor cell transplantation controls. Only one study reported on capillaries per or nerves per total surface and found both significantly increased in stem/progenitor cell-transplanted pulps compared with controls. Stem/progenitor cell transplantation seems to enhance pulp-dentin complex regeneration in animal models. Due to limited data quantity and quality, current evidence levels are insufficient for further conclusions.

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“…Overall, reports of pain sensations without lingering pain indicate healthy pulp, with lingering pain suggest inflamed pulp, and finally reports of no sensation may indicate necrotic pulp. According to the Brännström Hydrodynamic Theory, temperature changes cause dentinal fluids to rapidly move within the dentinal tubules which in turn induce activation of nociceptive A‐delta fibers within the pulp‐dentin complex 70. Application of heat, however, must be used with caution as it produces lingering pain through activation of C‐fibers pain and may increase pulp inflammation 101, 102.…”

Section: Qst In Orofacial Pain and Dentistrymentioning

confidence: 99%

Applications of sensory and physiological measurement in oral‐facial dental pain

Dabiri

Harper

Kapila

et al. 2018

Special Care in Dentistry

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Dentists regularly employ a variety of self‐report and sensory techniques to aid in the diagnosis and treatment of tooth‐related disease. Many of these techniques leverage principles borrowed from psychophysics, the quantitative measurement of the relationship between stimuli and evoked sensations, which falls under the larger umbrella of quantitative sensory testing (QST). However, most clinicians fail to meet the bar for what could be considered quantitative sensory testing, and instead focus on qualitative and dichotomous “yes/no” aspects of sensory experience. With our current subjective measurements for pain assessments, diagnosis and treatment of dental pain in young children and individuals (any age) with severe cognitive impairment rely extensively on third‐party observations. Consequently, the limitation of inadequate pain diagnosis can lead to poor pain management. In this review, it discusses mechanisms that underlie acute and chronic dental pain. It details the measurement of somatosensory responses and pulpal blood flow as objective measures of tooth health and pain. It proposes that bridging these varied methodologies will significantly improve diagnosis and treatment of orofacial pain and pathology. It concludes that improving the precision of sensory measurements could yield important improvements in diagnostic challenges in pulpal pathology for noncommunicative and cognitively impaired individuals.

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Assessment of pulp vitality: a review

Cited by 137 publications

References 89 publications

Oxygen Saturation in the Dental Pulp of Maxillary Premolars in Different Age Groups - Part 1

Oxygen Saturation in the Dental Pulp of Maxillary Premolars in Different Age Groups - Part 1

Stem Cell Transplantation for Pulpal Regeneration: A Systematic Review

Applications of sensory and physiological measurement in oral‐facial dental pain

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