The use of dental pulp tests in children with dental trauma: a national survey of the British Society of Paediatric Dentistry's members

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

doi:10.1038/sj.bdj.2019.99

Cited by 6 publications

(6 citation statements)

References 30 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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“…Reviewing these teeth at 43 months showed a lower response to sensibility testing. The results of sensibility tests should be interpreted with caution as, albeit very popular (Ghouth et al 2019 ), are subjective, therefore, have compromised accuracy, especially in the child population. Recent systematic reviews (Ghouth et al 2018 ; Mainkar and Kim 2018 ) showed high specificity (0.93) and low sensitivity (0.72) when using the EPT and moderate specificity (0.84) and sensitivity (0.87) for cold tests.…”

Section: Discussionmentioning

confidence: 99%

Revitalisation endodontic treatment of traumatised immature teeth: a prospective long-term clinical study

Nazzal

Ainscough

Kang

et al. 2019

Eur Arch Paediatr Dent

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Purpose Continuation of root development following revitalisation endodontics (RET) has been shown to be unpredictable with lower success rates in traumatised teeth. This study reports the outcomes for RET in traumatised teeth over a review period of 4 years. Methods A prospective uncontrolled study, where RET was performed on traumatised upper immature anterior teeth with necrotic pulps in 15 children (mean age = 8.3 years), was conducted. Patients were reviewed at 3, 9, 12, 24, and 48 months, where clinical and radiographic assessments were performed. At the last review appointment, patients and parents answered questions assessing their perception and acceptance of tooth colour change over time. McNemar's Exact test and linear mixed model assessment were used to assess changes in pulpal electrical response and radiographic evidence of continuation of root development over time, respectively. Results There was 83.3% healing with no significant changes in EPT responses, and no significant changes in root lengths, while significant changes in root widths (p < 0.05) and root apex widths (p < 0.001) were found over time. Twenty-five percent of patients and 33% of parents felt that there were changes in tooth colour following RET over time.Conclusion Within the limitations of this study, traumatised teeth treated using RET showed no significant root lengthening, however, acceptable periapical healing, slow thickening of root dentinal walls, and rapid development of apical closure were evident over a period of 43 months. Using Portland cement and omitting minocycline, did not eliminate crown colour change following RET.

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“…A systematic review revealed a high risk of bias in studies with such favourable results (33). Technological refinement to fabrication of probes for improving tests performance is mandatory and has been recommended in several studies (17,32,34).…”

Section: Discussionmentioning

confidence: 99%

Clinical comparison of sensitivity and specificity between sensibility and vitality tests in determining the pulp vitality of mandibular premolars

et al. 2021

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This clinical study was designed to compare cold pulp testing (CPT), heat pulp testing (HPT) and electric pulp test (EPT) with pulse oximetry (PO), flowmetry (FM) and thermometry (TM) in terms of sensitivity and specificity. Twenty premolar teeth in need of root canal treatment were included in the study. Pulp sensibility tests (CPT, HPT and EPT) along with vitality tests (PO, FM and TM) were performed. As the gold standard, the teeth were endodontically treated and pulp vitality was determined by direct visual observation. Sensitivity, specificity and accuracy values for each test were as follows: HPT 1,

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The use of dental pulp tests in children with dental trauma: a national survey of the British Society of Paediatric Dentistry's members

Cited by 6 publications

References 30 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

Revitalisation endodontic treatment of traumatised immature teeth: a prospective long-term clinical study

Clinical comparison of sensitivity and specificity between sensibility and vitality tests in determining the pulp vitality of mandibular premolars

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