Evaluation of variability of electric pulp response threshold in molars: an in vivo study

Abstract

<p><strong>Background:</strong> Electric pulp testers are widely used diagnostic tools in endodontics. Several factors can affect the result of electric pulp test like thickness of enamel and dentin, concentration of sensory fibres (A delta fibres), direction of dentinal tubules, pulp chamber size, neural elements etc. There are very few studies available in the literature which evaluated the variability of electric pulp response in molar teeth, which are more susceptible to caries. Hence aim of current study was proposed to evaluate response threshold in molars with respect to age and sex using electric pulp tester.</p><p><strong>Methods:</strong> Fifty volunteers aged between 20 to 69 years were recruited. The human subjects were divided into 5 groups of 10 each (5 males and 5 females) based on age. EPT was used with appropriate electrolyte as a conducting media. Seven sites on each molar crown were tested which includes mesiobuccal cusp tip, mesiobuccal cuspal surface, mesiobuccal gingival surface, centre of the supporting cusps (palatal of maxillary molar and buccal of mandibular molar), distobuccal cuspal surface, distobuccal gingival surface and centre of the guiding cusps (buccal of maxillary molar and lingual of mandibular molars). Statistical analysed using descriptive statistics and independent sample t test.</p><p><strong>Results:</strong> Mesiobuccal cusp tip showed lower response threshold values compared to other sites in all the groups. group 1 responded at lower threshold and group 5 at higher.</p><p><strong>Conclusions:</strong> The optimum electrode placement site for electric pulp test in molars is the mesiobuccal cusp tip irrespective of age and sex.</p>

Identification of the Ideal Reference Site and Pain Threshold Values for the Placement of Electric Pulp Testers in Permanent Upper and Lower Anterior Teeth: A Cross-Sectional Study

“…Conversely, a lack of reaction to the EPT stimulus suggests indirectly that pulp may be necrosed or nonvital. Therefore, the EPT is not the true determinant of pulp vitality, as it only offers information on the innervations of the dental pulp and not from the vascular supply [ 6 ]. Certain studies have found that the EPT has high specificity and varying sensitivity.…”

“…Multiple variables can influence the outcome of the electric pulp test, such as the thickness of enamel and dentin, the extent of sensory fibers (specifically A delta fibers), the orientation of dentinal tubules while the electrode tip is placed, the size of the pulp chamber, the presence of sclerotic dentin, the decrease in neural elements associated with aging, apprehension regarding electric shock, traumatic injuries, and immature tooth/teeth. Consequently, the presence of healthy pulp tissue may be misinterpreted as aberrant pulp tissue and vice versa [ 6 ].…”

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 EPT threshold value is influenced by various factors, one of which is the thickness of the enamel and dentine [ 12 ]. Numerous studies have been conducted to investigate the optimal locations on teeth that exhibit the lowest threshold of response, yielding diverse findings [ 13 , 14 ]. To the best of our knowledge, there is no information in the literature about the level of pain that the individual experienced at various reference sites.…”