Efficacy of laser Doppler flowmetry for the diagnosis of revascularization of reimplanted immature dog teeth

Abstract

LDF readings correctly predicted the pulp status (vital vs. non-vital) in 83.7% of the readings. 73.9% (17 of 23) were correct for the vital teeth and 95% (19 of 20) were correct for the non-vital teeth. Fisher's exact test (2-tail) indicated that there was no significant association between the efficacy of LDF and tooth type (P = 0.166), although P2 was the least accurate tooth tested. Wilcoxon's matched-pair signed rank test demonstrated that in the revascularized (vital) teeth, the flux value between the baseline and week 2 dropped significantly (P = 0.0001), increased significantly from week 2 to week 4 (P = 0.0001) and then decreased steadily until week 12. However, at week 12 the flux was still significantly higher than at week 2 (P = 0.010). In the teeth that failed to revascularize, the flux value dropped significantly by weeks 1 and 2 (P = 0.004 and P = 0.0001, respectively). Flux values did not increase from week 2. A Fast Fourier Transform (FFT) analysis confirmed a pulse of dominant frequency of 2 Hz in the teeth that returned to vitality and the lack thereof in those that stayed non-vital. One tooth in which the flux value evaluation indicated a non-vital tooth but the radiographic/histologic findings showed vital (false negative) possessed a pulse of dominant frequency and proved by this method to have successfully revascularized.

Laser Doppler Flowmetry Evaluation of the Microcirculation in Dentistry

“…It has been shown that the light from a LDF probe placed at 2 mm above the buccal cement-enamel junction is transmitted apically towards the radicular pulp [41]. There are several studies that have reported the placement of the LDF probe at 1-1.5 [43], 2 [44], 2-3 [45,46], ~3 [47] and 4-5 mm [48] coronal to the gingival margin. In our studies, the probe was placed on the cervical third of the tooth, at 3 mm away from the gingival margin (Figure 1).…”

“…Yanpiset et al [43] found LDF measurements to be extremely accurate in differentiating a revascularized (vital) tooth from a necrotic tooth pulp. An exciting finding of their study was that an accurate LDF reading of pulpal revascularization could be established at the fourth week after treatment, which is much earlier than it would be expected from standard sensitivity tests.…”

Diagnosis Dilemmas in Vital Pulp Therapy: Treatment for the Toothache Is Changing, Especially in Young, Immature Teeth

“…In a very detailed histologic and radiographic study of revitalization of dogs' teeth after reimplantation, Yanpiset et al (36) were able to make a correct diagnosis 84% of the time. In nonvital pulps, the histologic study proved to be accurate in 95% of cases, whereas in vital ones the data were correct 74% of the time.…”

“…Laser Doppler flowmetry has been reported to be very reliable for diagnosing pulpal vitality (13,36,37). In a very detailed histologic and radiographic study of revitalization of dogs' teeth after reimplantation, Yanpiset et al (36) were able to make a correct diagnosis 84% of the time.…”

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

“…Previous studies have investigated methods such as pulse oximetry, Laser Doppler flowmetry (LDF), and crown surface temperature change as ways of measuring pulpal blood flow, and each are described below in detail. However, none of these methods have been established as a standard of care in clinical dentistry 63, 64…”