Abstract
Purpose
Although electric pulp tests (EPT) may play a valuable diagnostic role in traumatized immature permanent teeth, the EPT threshold values which can be used as reference are not known. The aim of this study was to determine the average range of EPT threshold values in healthy permanent incisors according to their stage of root development.
Methods
A total of 1200 permanent incisors were examined in 273 children (142 girls, 131 boys) aged 6–12 years. Panoramic radiographs were used to group teeth according to the stage of root development. A digitest II pulp vitality tester (Parkell, Inc, Edgewood, NY) was used along with toothpaste as the conducting medium to determine sensibility on three different sites (incisal, middle and cervical third).
Results
In all teeth, mean EPT values showed a tendency to decrease along with advanced root development. Irrespective of the stage of root development, the lowest EPT values were obtained when measurements were made on the incisal third of the crown (p < 0.001). Mandibular incisors had lower mean response thresholds than their maxillary counterparts.
Conclusion
The present findings provide reference EPT threshold values according to stage of tooth development to monitor the post traumatic pulp status of permanent incisors.
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References
Andreasen FM, Andreasen JO, Tsukiboshi M. Examination and diagnosis of dental injuries. In: Andreasen JO, Andreasen FM, Andersseon L, editors. Textbook and Color Atlas of Traumatic Injuries to the Teeth. 4th ed. Oxford: Blackwell; 2007. p. 255–79.
Avery J. Repair potential of the pulp. J Endod. 1981;7:205–12. https://doi.org/10.1016/S0099-2399(81)80177-X.
Bargale SD, Padmanabh SKD. Appropriate electrode placement site of electric pulp tester for the premolars: A clinical study. J Indian Soc Pedod Prev Dent. 2015;33:138–42. https://doi.org/10.4103/0970-4388.155128.
Bastos JV, Goulart EMA, Souza Côrtes MI. Pulpal response to sensibility tests after traumatic dental injuries in permanent teeth. Dent Traumatol. 2014;30:188–92. https://doi.org/10.1111/edt.12074.
Bender I, Landau MA, Fonsecca S, Trowbridge HO. The optimum placement-site of the electrode in electric pulp testing of the 12 anterior teeth. J Am Dent Assoc. 1989;118:305–10. https://doi.org/10.14219/jada.archive.1989.0096.
Brandt K, Kortegaard U, Poulsen S. Longitudinal study of electrometric sensibility of young permanent incisors. Scand J Dent Res. 1988;96:334–8. https://doi.org/10.1111/j.1600-0722.1988.tb01564.x.
Chunhacheevachaloke E, Ajcharanukul O. Effects of conducting media and gender on an electric pulp test. Int Endod J. 2016;49:237–44. https://doi.org/10.1111/iej.12446.
Cooley RL, Robison SF. Variables associated with electric pulp testing. Oral Surg Oral Med Oral Pathol. 1980;50:66–73. https://doi.org/10.1016/0030-4220(80)90334-5.
Cortes MI, Marcenes W, Sheiham A. Impact of traumatic injuries to the permanent teeth on the oral health-related quality of life in 12–14-year-old children. Commun Dent Oral Epidemiol. 2002;30:193–8. https://doi.org/10.1034/j.1600-0528.2002.300305.x.
Crona-Larsson G, Bjarnason S, Norén JG. Effect of luxation injuries on permanent teeth. Endod Dent Traumatol. 1991;7:199–206. https://doi.org/10.1111/j.1600-9657.1991.tb00436.x.
Demirjian A, Goldstein H, Tanner J. A new system of dental age assessment. Hum Biol. 1973;45:211–27.
Fulling H, Andreasen J. Influence of maturation status and tooth type of permanent teeth upon electrometric and thermal pulp testing. Scan J Dent Rest. 1976;84:286–90. https://doi.org/10.1111/j.1600-0722.1976.tb00491.x.
Gutiérrez VMM, Ortega-pertuz AI. Comparison of Nolla, Demirjian and Moorrees methods for dental age calculation for forensic purposes. Revista Odontológica Mexicana. 2017;21(3):155–64.
Haavikko K. The formation and the alveolar and clinical eruption of the permanent teeth An Orthopantomographic Study. Suom Hammaslaak Toim. 1970;66:103–70.
Hannam A, Siu W, Tom J. A comparison of monopolar and bipolar pulp-testing. Dental J. 1974;40:124–8.
Jespersen JJ, Hellstein J, Williamson A, Johnson WT, Qian F. Evaluation of dental pulp sensibility tests in a clinical setting. J Endod. 2014;40:351–4. https://doi.org/10.1016/j.joen.2013.11.009.
Johnsen D. Innervation of teeth: qualitative, quantitative, and developmental assessment. J Dent Res. 1985;64:555–63. https://doi.org/10.1177/002203458506400410.
Klein H. Pulp responses to an electric pulp stimulator in the developing permanent anterior dentition. ASDC J Dent. 1978;45:199–202.
Lilja J. Sensory differences between crown and root dentin in human teeth. Acta Odontol Scand. 1980;38:285–91. https://doi.org/10.3109/00016358009033595.
Lin J, Chandler N, Purton D, Monteith B. Appropriate electrode placement site for electric pulp testing first molar teeth. J Endod. 2007;33:1296–8. https://doi.org/10.1016/j.joen.2007.08.006.
Mullaney TP, Howell RM, Petrich JD. Resistance of nerve fibers to pulpal necrosis. Oral Surg Oral Med Oral Pathol. 1970;30:690–3. https://doi.org/10.1016/0030-4220(70)90395-6.
Mumford JM. Path of direct current in electric pulp testing using one coronal electrode. Br Dent J. 1959;106:23–6.
Mumford J. Pain perception threshold and adaptation of normal human teeth. Arch Oral Biol. 1965;10:957–68. https://doi.org/10.1016/0003-9969(65)90089-0.
Mumford JM. Thermal and electrical stimulation of teeth in the diagnosis of pulpal and periapical disease. Proc R Soc Med. 1967;60:197–200.
Närhi M, Virtanen A, Kuhta J, Huopaniemi T. Electrical stimulation of teeth with a pulp tester in the cat. Scand J Dent Rest. 1979;87:32–8. https://doi.org/10.1111/j.1600-0722.1979.tb01937.x.
Nykanen R, Espeland L, Kvaal SI, Krogstad O. Validity of the Demirjian method for dental age estimation when applied to Norwegian children. Acta Odontol Scand. 1998;56:238–44. https://doi.org/10.1080/00016359850142862.
Schmitz AK, Vierhaus M, Lohaus A. Pain tolerance in children and adolescents: sex differences and psychosocial influences on pain threshold and endurance. Euro J Pain. 2013;17:124–31. https://doi.org/10.1002/j.1532-2149.2012.00169.x.
Udoye CI, Jafarzadeh H, Okechi UC, Aguwa EN. Appropriate electrode placement site for electric pulp testing of anterior teeth in Nigerian adults: a clinical study. J Oral Sci. 2010;52:287–92. https://doi.org/10.2334/josnusd.52.287.
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This study supported by Development Support Program (PYO.DIS.1904.15.009)of Ondokuz Mayis University, Samsun, Turkey.
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Turedi, I., Ulusoy, A.T. Evaluation of electric pulp test thresholds and correct probe tip placement site in developing incisors: a clinical study in 1200 teeth. Eur Arch Paediatr Dent 23, 449–454 (2022). https://doi.org/10.1007/s40368-022-00703-z
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DOI: https://doi.org/10.1007/s40368-022-00703-z