The diagnostic accuracy of laser Doppler flowmetry in assessing pulp blood flow in permanent teeth: A systematic review

Ghouth, Nahar; Duggal, M. S.; BaniHani, Alaa; Nazzal, Hani

doi:10.1111/edt.12424

Cited by 50 publications

(59 citation statements)

References 25 publications

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“…19 Andersson et al 20 The appropriate timing of endodontic treatment for immature teeth has been difficult to judge for dentists. It is difficult to balance pulp revascularization against the possibility of pulp necrosis and in- [21][22][23][24] In agreement with previous studies, the present study observed a diminished likelihood of PDL healing with longer extra-alveolar periods. 15,16 Additionally, prolonged non-physiologic storage time of the teeth was more important to prognosis than the total extra-alveolar period.…”

Section: Discussionsupporting

confidence: 87%

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A retrospective study of survival of 196 replanted permanent teeth in children

Wang

Qin

2019

Dental Traumatology

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Background/Aim The extra‐alveolar period and storage medium are important for the survival of replanted teeth. The aim of this study was to evaluate factors affecting the survival of replanted teeth in children. Material and Methods Complete dental records of avulsed teeth including age, gender, extra‐alveolar time, storage type and period, stage of root development, crown fracture, gingival laceration, alveolar fracture, antibiotics, and splint type and period were obtained. Kaplan‐Meier, Cox regression and chi‐square tests were used to analyse the risk factors affecting survival (P < 0.05). Results The study included 196 replanted teeth with a mean follow‐up period of 4.0 years. Forty‐two (21.4%), 45 (23.0%), and 109 teeth (55.6%) showed functional healing, inflammatory resorption and replacement resorption. The root resorption incidence of teeth with extra‐alveolar time longer than 30 minutes was higher vs teeth with a time of less than 30 minutes (P = 0.010). Physiologically stored replanted teeth showed lower incidence of root resorption (19/31, 61.3%) than those stored in non‐physiologic media (94/114, 82.5%) (P = 0.025). Root resorption incidence of teeth stored non‐physiologically within 30 minutes and then transferred to physiologic media (25/33, 75.8%) was similar to that of teeth stored physiologically (P = 0.127). Teeth stored non‐physiologically for longer than 30 minutes had a significantly higher root resorption incidence (99/113, 87.6%) than teeth stored non‐physiologically within 30 minutes (55/83, 66.3%) (odds ratio = 1.726, P = 0.001). Pulp canal obliteration occurred in five of the 56 immature teeth (8.9%) but two of them were later extracted because of replacement resorption. The survival of mature teeth (111/140, 79.3%) was significantly higher than that of immature teeth (39/56, 69.6%) (P = 0.007). Conclusions This study suggested that non‐physiologic storage within 30 minutes was critical for the periodontal healing of replanted teeth. Replanted immature teeth had lower survival rates than mature teeth.

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Section: Discussionsupporting

confidence: 87%

“…To avoid uncontrollable resorption, patients should be carefully reviewed. In addition, laser Doppler flowmetry might be helpful to assess the pulp state of immature teeth awaiting revascularization …”

Section: Discussionmentioning

confidence: 99%

A retrospective study of survival of 196 replanted permanent teeth in children

Wang

Qin

2019

Dental Traumatology

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“…LDF has been reported to be more accurate, in differentiating between teeth with vital and non-vital pulps, than other dental pulp tests (Ghouth et al 2018). Clinical studies have shown that LDF had higher sensitivity (81.8-100%) and specificity (100%) when compared to other pulp tests (Ingolfsson et al 1994, Evans et al 1999, Karayilmaz and Kirzioglu 2011.…”

Section: Introductionmentioning

confidence: 97%

“…Despite the reports of higher accuracy of LDF in assessing pulp vitality, these data are based on studies with a high level of bias, and major shortfalls in study designs using methodologies that may have resulted in over estimation of the diagnostic accuracy of LDF (Mejare et al 2012, Ghouth et al 2018. Also, there has been inconsistency among studies regarding the Flux cut-off threshold used, below which the pulp could be considered as non-vital.…”

Section: Introductionmentioning

confidence: 99%

A Diagnostic Accuracy Study of Laser Doppler Flowmetry for the Assessment of Pulpal Status in Children’s Permanent Incisor Teeth

Ghouth

Duggal

Kang

et al. 2019

Journal of Endodontics

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Aim: To assess whether laser Doppler flowmetry is more accurate than the conventional pulp sensibility tests (Electric pulp test and ethyl chloride) in assessing the pulp status of permanent anterior teeth in children and to identify the LDF's Flux cutoff threshold. Methodology: A cross-sectional cohort diagnostic accuracy study with randomisation was carried out in 8-16 year old children. Participants had one maxillary central or lateral incisor with either a completed root canal treatment or an extirpated pulp and a contra-lateral tooth with vital pulp. The outcome measures included the sensitivity, specificity and predictive values as well as the repeatability of all tests. Statistical analysis included the use of the Receiver Operating Characteristic (ROC) curve and contingency 2x2 tables. Kappa scores were used to assess the repeatability of EPT and ethyl chloride while inter-class correlation was used for LDF. Results: The study included 74 participants as determined by sample size calculation. A significant difference between the Flux values for teeth with vital and non-vital pulps was found. The best cutoff ratio for LDF was 0.6 yielding a sensitivity of 54 % and a specificity of 32 % which were lower than the values of electric pulp test (Sensitivity = 83.8-94.6 %, Specificity = 89.2-97.6 %) and ethyl chloride (Sensitivity = 81.1-91.9 %, Specificity = 73-81.1 %). The repeatability of LDF, EPT and ethyl chloride were 0.85, 0.86 and 0.81, respectively. Conclusion: Laser Doppler flowmetry was unable to differentiate between teeth with vital and non-vital pulps in children between the ages of 8-16 years, with an acceptable level of confidence. The results of this study showed that there was a high probability for false results. Further development of LDF in assessing pulpal blood flow would be required before it could be recommended for clinical use especially in children.

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“…Pulp diagnosis is complicated by the loss of sensibility caused by the traumatic injury and the difficulty of pulp sensibility tests in children. 3,4 Pulp vitality tests, such as using laser Doppler flowmetry (LDF), were shown to be more accurate than pulp sensibility tests, [5][6][7] especially after traumatic injuries. In case reports or case series, [8][9][10] LDF showed the onset of vitality signals in luxated teeth much sooner than sensibility | 325 FOUAD testing.…”

Section: Introductionmentioning

confidence: 99%

Microbiological aspects of traumatic injuries

Fouad

2019

Dental Traumatology

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After traumatic injuries to teeth, microorganisms may invade the compromised pulp tissue and initiate pulp infection and periapical inflammation. In addition to bone resorption that typically accompanies pulp necrosis, root resorption frequently occurs.Root resorption has several variants that may occur shortly after the trauma or at a later stage. The pathological changes seen after traumatic injuries to teeth are invariably linked to the presence of microbial irritants. The presence of bacterial biofilms in the dental pulp space can be treated with regenerative or therapeutic endodontic procedures. However, necrosis of periodontal ligament is usually terminal for the tooth involved. In this review, the sources of bacteria after traumatic injuries are discussed. The types and role of microorganisms involved in the pathogenesis of endodontic pathosis after traumatic injuries are presented, and contemporary approaches for the management of these conditions are reviewed. Contemporary antimicrobial strategies are discussed. The rationale for the use of systemic and topical antimicrobials is presented. Finally, novel approaches to the use of antimicrobial therapies, particularly in regenerative procedures, are reviewed.

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The diagnostic accuracy of laser Doppler flowmetry in assessing pulp blood flow in permanent teeth: A systematic review

Cited by 50 publications

References 25 publications

A retrospective study of survival of 196 replanted permanent teeth in children

A retrospective study of survival of 196 replanted permanent teeth in children

A Diagnostic Accuracy Study of Laser Doppler Flowmetry for the Assessment of Pulpal Status in Children’s Permanent Incisor Teeth

Microbiological aspects of traumatic injuries

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