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多发性硬化症中的牙髓敏感性测试:疾病持续时间与感觉/运动关联——一项横断面研究

Pulp Sensitivity Testing in Multiple Sclerosis: Disease Duration and Sensory/Motor Associations-A Cross-Sectional Study.

作者信息

Owlia Fatemeh, Noori Fereshteh, Zarchi Marzieh Abutorabi, Kazemipoor Maryam

机构信息

Department of Oral and Maxillofacial Medicine School of Dentistry Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.

Department of Neurology School of Medicine Shahid Sadoughi University of Medical Sciences and Health Services, Yazd, Iran.

出版信息

Mult Scler Int. 2024 Sep 11;2024:6662518. doi: 10.1155/2024/6662518. eCollection 2024.

Abstract

This study explores a relatively unexplored aspect of multiple sclerosis (MS) by examining the sensitivity threshold of dental pulp as a potential indicator of neuropathy in MS patients. Building upon earlier research that focused on assessing the response to electrical pulp testing in MS patients who did not have a history of trigeminal neuralgia, this survey is aimed at delving into the relationship between MS duration and the threshold for stimulation in response to pulp sensitivity tests. This study encompassed a total of 124 maxillary central incisors from patients diagnosed with relapsing-remitting multiple sclerosis (RRMS). The participants were uniform in terms of age, falling within the 18-50 years range, and all had RRMS with no history of trigeminal neuralgia. The electric pulp sensitivity test was conducted on all samples, and the results of the electric pulp testing (EPT) were recorded according to the grade of the pulp tester that elicited a response. The threshold was considered reached when the patient first experienced a burning sensation after EPT application and the use of 1,1,1,2-tetrafluoroethane spray. Data analysis employed paired -tests, Fisher's exact test, and Spearman correlation, with a significance level set at < 0.05. Based on the study's findings, the average response value to EPT was 2.69 ± 1.17, while the response time to the cold test was 2.61 ± 1.03 s. There was no statistically significant difference in the response to the cold test based on age ( = 0.45). However, it was observed that the mean response time to the cold test was significantly longer among male participants ( = 0.001). No significant differences were identified in the pulpal response to EPT or the cold test between patients with and without sensory-motor involvement ( > 0.05). Furthermore, Spearman's analysis revealed a noteworthy positive correlation between the electrical pulp threshold and the time taken to respond to the cold test ( = 0.025, = 0.2). The utilization of the pulpal sensitivity test in MS patients holds promise for practical clinical use. Notably, individuals with a more extended duration of the disease exhibited a notably elevated threshold for both the EPT and the cold test conducted on their maxillary central incisors.

摘要

本研究通过检测牙髓的敏感性阈值,探索了多发性硬化症(MS)一个相对未被深入研究的方面,将其作为MS患者神经病变的潜在指标。基于早期聚焦于评估无三叉神经痛病史的MS患者对牙髓电测试反应的研究,本次调查旨在深入探究MS病程与牙髓敏感性测试刺激阈值之间的关系。本研究纳入了124颗来自复发缓解型多发性硬化症(RRMS)患者的上颌中切牙。参与者年龄均在18 - 50岁之间,且均为RRMS患者,无三叉神经痛病史。对所有样本进行了牙髓电敏感性测试,并根据引发反应的牙髓测试仪等级记录牙髓电测试(EPT)结果。当患者在应用EPT并使用1,1,1,2 - 四氟乙烷喷雾后首次出现灼痛感觉时,视为达到阈值。数据分析采用配对检验、Fisher精确检验和Spearman相关性分析,显著性水平设定为<0.05。基于研究结果,EPT的平均反应值为2.69±1.17,而冷测试的反应时间为2.61±1.03秒。基于年龄的冷测试反应无统计学显著差异(=0.45)。然而,观察到男性参与者的冷测试平均反应时间显著更长(=0.001)。有或无感觉运动受累的患者在牙髓对EPT或冷测试的反应方面未发现显著差异(>0.05)。此外,Spearman分析显示牙髓电阈值与冷测试反应时间之间存在显著正相关(=0.025,=0.2)。在MS患者中使用牙髓敏感性测试具有实际临床应用前景。值得注意的是,病程较长的个体在上颌中切牙进行的EPT和冷测试中表现出明显更高的阈值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef6a/11410405/3133b1000baa/MSI2024-6662518.001.jpg

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