Bux Mohammed, Adam Mohammed
Oral and Maxillofacial Surgery, Royal Preston Hospital, Preston, UK.
Evid Based Dent. 2024 Sep;25(3):158-159. doi: 10.1038/s41432-024-01054-y. Epub 2024 Aug 20.
Determining the health the status of the pulp is crucial in treatment planning. Both sensibility and vitality testing techniques may be employed. Sensibility testing may be inaccurate in teeth with incomplete root apices. This study intends to compare the accuracy of cold testing (CT), electric pulp testing (EPT) and pulse oximetry (PO) in determining pulpal status of mature and immature anterior teeth.
20 mature and 20 immature maxillary permanent incisors of healthy 6-12-year-olds were included. Teeth were categorised as mature permanent central incisors, immature permanent central incisors, and a negative control group with endodontically treated incisors. Vitality and sensitivity tests were performed using EPT, CT, and PO, with measurements taken thrice per tooth. PO was measured with infant pulse oximetry probe sensors placed on the tooth surfaces and fingers. Descriptive statistics were computed, and data distribution was assessed using the Shapiro-Wilk test. The Spearman correlation coefficient analysed correlations between dental and finger SpO measurements, while the Kruskal-Wallis test with Dunn post-hoc analysis compared SpO2 and EPT measurements across tooth development stages, with a significance threshold set at p < 0.05.
SpO values were significantly higher in immature teeth compared to mature teeth (p < 0.05), and both were significantly higher than in the negative control group. There was no significant correlation between SpO values measured from fingers and teeth. EPT values were significantly higher in immature teeth compared to mature teeth (p < 0.001). The accuracy rate of PO, EPT, and cold tests was 100% in this study, with no false positive or negative responses in the control group. The SpO values in mature and immature vital teeth ranged between 80-92%.
PO is a reliable and non-invasive method for determining pulp vitality in both mature and immature teeth, comparable to traditional sensitivity tests like EPT and CT. PO can be considered an alternative vitality test, especially useful in paediatric dental patients due to its atraumatic and objective nature. Further studies with larger sample sizes and additional vitality tests like doppler flowmetry are recommended to enhance the clinical diagnosis of pulp vitality in anterior and posterior teeth.
确定牙髓的健康状况对于治疗计划至关重要。可采用感觉测试和活力测试技术。对于根尖未完全形成的牙齿，感觉测试可能不准确。本研究旨在比较冷测试（CT）、牙髓电活力测试（EPT）和脉搏血氧饱和度测定法（PO）在确定成熟和未成熟前牙牙髓状态时的准确性。
纳入20颗健康6至12岁儿童的成熟上颌恒切牙和20颗未成熟上颌恒切牙。牙齿分为成熟恒中切牙、未成熟恒中切牙以及经根管治疗的切牙作为阴性对照组。使用EPT、CT和PO进行活力和感觉测试，每颗牙齿测量三次。使用婴儿脉搏血氧饱和度探头传感器分别置于牙齿表面和手指上测量PO。计算描述性统计量，并使用Shapiro-Wilk检验评估数据分布。Spearman相关系数分析牙齿和手指SpO测量值之间的相关性，而Kruskal-Wallis检验及Dunn事后分析比较不同牙齿发育阶段的SpO2和EPT测量值，显著性阈值设定为p < 0.05。
与成熟牙齿相比，未成熟牙齿的SpO值显著更高（p < 0.05），且两者均显著高于阴性对照组。从手指和牙齿测量的SpO值之间无显著相关性。与成熟牙齿相比，未成熟牙齿的EPT值显著更高（p < 0.001）。本研究中PO、EPT和冷测试的准确率均为100%，对照组无假阳性或假阴性反应。成熟和未成熟活髓牙中的SpO值在80 - 92%之间。
PO是一种可靠的非侵入性方法，可用于确定成熟和未成熟牙齿的牙髓活力，与EPT和CT等传统感觉测试相当。PO可被视为一种替代的活力测试，因其无创和客观的特性，对儿童牙科患者尤其有用。建议进行更大样本量的进一步研究，并增加如多普勒血流测定等其他活力测试，以加强前后牙牙髓活力的临床诊断。
