Blood Gas Tension and Acidity Level of Caries Exposed Vital Pulps in Primary Molars

Abstract

Objective: The purpose of this study was to determine if gas tension and acidity levels could serve as biomarkers of pulp inflammatory status in primary dentition. Study design: The present study evaluated acidity level and blood partial pressures of O2 and CO2 collected from vital pulp chambers of 84 primary molars with deep carious lesions encroaching the pulp. Teeth were treated with pulpotomy or pulpectomy based on clinical judgement. Pulpectomy was performed when symptoms of spontaneous pain, difficulty in obtaining hemostasis and/or dark purple blood were present. Using a glass capillary, pulp chamber bleeding was collected and within ten minutes a neonate Astrup test was performed to determine blood gas module pH, pCO2, and pO2. Results: Eighty-four children with one affected tooth participated in the study (37 girls and 47 boys). Age ranged between 3.5 to 9-years (average: 5.3 years). Seventy-one (84%) were treated with the aid of inhalation analgesia, conscious sedation or general anesthesia. Pulpotomy was performed on 58 teeth (69%). Teeth undergoing pulpectomy revealed significant higher level of CO2 partial pressure (P= 0.002). Acidity level values (pH) were also lower but none significantly in teeth with pulpectomy (P= 0.137). Conclusions: Higher pCO2 levels was found in pulps needing pulpectomy.

Blood pH Changes in Dental Pulp of Patients with Pulpitis

“…The sample size was calculated using the minimum number of teeth to state the difference between the mean values of the studied variables. Based on Shmueli et al (2020), the mean value for inflamed pulpal blood pH was 7.52, and for healthy blood, it was 7.40 [ 21 , 22 ]. By considering an alpha error = 0.05 and power of 80%, and based on the following formula, the sample size was estimated to be 14 teeth in total.…”

“…The information about the blood pH changes in human pulp is very limited. In a study of Shmueli et al (2020), the acidity levels of the exposed pulp were estimated in the primary molars with deep caries lesions, with no clinical symptoms of the pulp inflammation using the color of the exposed blood and the time to achieve hemostasis as the determining factor for the following treatment strategy [ 21 ]. The estimated blood pH values of the dental pulps subjected to pulpotomy and pulpectomy were similar and did not provide an answer about the acidity levels in the pulp of teeth.…”