Laser Doppler for Accurate Diagnosis of Oehler’s Type III Dens Invaginatus: A Case Report

Abstract

In vital pulp therapy, pulp testing aids in the differential diagnosis and influences the treatment plan. Different from previous doppler flowmetry studies that only recorded waves and data, we report the first time, the use of a laser doppler blood flow monitor and imager with a colored image to present pulp vitality information in the dental field. We report here a case of Oehlers type IIIa dens invaginatus of the right upper lateral incisor in a 31-year-old girl, with the opening of the invagination near CDJ and a peri-invagination lesion sized 8 × 9 mm2. Cone beam computed tomography was used to verify specific spatial and stereoscopic data. After removing the source of infection, mineral trioxide aggregate was selected to fill the invagination. Laser doppler was scheduled for further assessment. After three years of regular follow-up, the patient’s clinical condition improved, the peri-invagination lesion healed, and the laser doppler and electric pulp test both showed a positive reaction. Laser doppler has successfully improved the diagnostic accuracy Thus, unnecessary interventions can be avoided while reducing the treatment time by preserving the vitality. However, further work is needed to resolve the limitations of laser doppler.

Assessment of Pulpal Status in Primary Teeth Following Direct Pulp Capping in an Experimental Canine Model

“…On the other hand, some studies found LDF to be an accurate vitality testing method to assess the pulpal vascularity changes of human primary teeth [ 35 ], while others reported the opposite [ 37 ]. Moreover, the LDF procedure is a lengthy and more sensitive technique compared to conventional pulp vitality tests [ 9 , 38 ], which makes it improper for routine use in children; however, it is reserved for research purposes and particular clinical situations such as trauma to the anterior teeth [ 39 ] or “dens invaginatus” [ 40 ]. In our study, LDF testing was limited to T0 and T1 (tests at T2 and T3 are not completed) due to the rapid growth of the canine specimens in the two-week time span of the study, which negatively impacted the adaptation of the stabilizing silicone impression.…”

A Diagnostic Insight of Dental Pulp Testing Methods in Pediatric Dentistry

“…In a study on traumatized teeth, Belcheva et al concluded that LDF is a useful monitoring tool for the revascularization of traumatized teeth and a reliable objective diagnostic indicator of pulp vitality [ 54 ]. A case report revealed the successful follow-up of pulpal status using LDF and EPT after vital pulp therapy performed in a dens invaginatus [ 55 ]. On the other hand, a study by Ghouth et al comparing the diagnostic accuracy of LDF to CPT with ethyl chloride and EPT in permanent incisors of 8 to 16 year-old patients concluded that LDF was unable to differentiate between teeth with vital and non-vital pulps and expressed reluctance about the clinical use of LDF technology in the current form, especially in children [ 56 ].…”