Evaluation of variability of electric pulp response threshold in molars: an in vivo study
Keywords:Diagnosis, Endodontics, Molars, Pulp testing
Background: Electric pulp testers are widely used diagnostic tools in endodontics. Several factors can affect the result of electric pulp test like thickness of enamel and dentin, concentration of sensory fibres (A delta fibres), direction of dentinal tubules, pulp chamber size, neural elements etc. There are very few studies available in the literature which evaluated the variability of electric pulp response in molar teeth, which are more susceptible to caries. Hence aim of current study was proposed to evaluate response threshold in molars with respect to age and sex using electric pulp tester.
Methods: Fifty volunteers aged between 20 to 69 years were recruited. The human subjects were divided into 5 groups of 10 each (5 males and 5 females) based on age. EPT was used with appropriate electrolyte as a conducting media. Seven sites on each molar crown were tested which includes mesiobuccal cusp tip, mesiobuccal cuspal surface, mesiobuccal gingival surface, centre of the supporting cusps (palatal of maxillary molar and buccal of mandibular molar), distobuccal cuspal surface, distobuccal gingival surface and centre of the guiding cusps (buccal of maxillary molar and lingual of mandibular molars). Statistical analysed using descriptive statistics and independent sample t test.
Results: Mesiobuccal cusp tip showed lower response threshold values compared to other sites in all the groups. group 1 responded at lower threshold and group 5 at higher.
Conclusions: The optimum electrode placement site for electric pulp test in molars is the mesiobuccal cusp tip irrespective of age and sex.
Weisleder R, Yamauchi S, Caplan DJ, Trope M, Teixeira FB. The validity of pulp testing: a clinical study. J Am Dent Assoc. 2009;140:1013-7.
Jafarzadeh H, Rosenberg PA. Pulse Oximetry: review of a potential aid in endodontic diagnosis. J Endod. 2009;35:329-33.
Lin J, Chandler NP. Electric pulp testing: a review. Int Endod J. 2008;41:365-75.
Marshall J. Electricity as a therapeutic agent in the treatment of hyperaemia and congestion of the pulp and peridental membrane. Dent Cosmos. 1891;33: 969-73.
Narhi M, Virtanen A, Kuhta J, Huopaniemi T. Electrical stimulation of teeth with a pulp tester in the cat. Scand J Dent Res. 1979;87:32-8.
Petersson K, Soderstrom C, Kiani-Anaraki M, Levy G. Evaluation of the ability of thermal and electrical tests to register pulp vitality. Endod Dent Traumatol. 1999;15:127-31.
Seltzer S, Bender IB, Nazimov H. Differential diagnosis of pulp conditions. Oral Surg. 1965;19:38-43.
Batchelor PA and Sheiham A. Grouping of tooth surfaces by susceptibility to caries: a study in 5 to 16 year old children. BMC Oral Health. 2004;4(1):2.
Bender IB, 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(3):305-10.
Dummer PM, Tanner M, McCarthy JP. A laboratory study of four electric pulp testers. Int Endod J. 1986;19(4):161-71.
Olgart L. Excitation of intradental sensory units by pharmacological agents. Acta Physiol Scand. 1974; 92:48-55.
Byers MR. Dental sensory receptors. Int Rev Neurobiol. 1984;25:39–94.
Narhi MVO. The characteristics of intradental sensory units and their responses to stimulation. J Dent Res. 1985;64:564-71.
Lilja J. Sensory differences between crown and root dentin in human teeth. Acta Odontol Scand. 1980;38 (5):285-91.
Byers MR, Dong WK. Autoradiographic location of sensory nerve endings in dentin of monkey teeth. Anat Rec. 1983;205:441-54.
Dummer PM, Hicks R, Huws D. Clinical signs and symptoms in pulp disease. Int Endod J. 1980;13(1): 27-35.
Jacobson JJ. Probe placement during electric pulp-testing procedures. Oral Surg Oral Med Oral Pathol. 1984;58(2):242-7.
Deutsch AS, Musikant BL. Morphological measurements of anatomic landmarks in human maxillary and mandibular molar pulp chambers. J endod. 2004;30(6):388-90.
Lilja J. Innervation of different parts of the predentin and dentin in young human premolars. Acta Odontol Scand. 1979;37(6):339-46.
Lin J, Chandler N, Purton D, Monteith B. Appropriate electrode placement site for electric pulp testing first molar teeth. J Endod. 2007;33:1296-98.
Kalhoro FA, Rajput F, Sangi L. Selecting the appropriate electrode placement-site for electrical pulp testing of molar teeth. J Pak Dent Assoc. 2011; 20(03):135.
Filippatos CG, Tsatsoulis IN, Floratos S, Kontakiotis EG. The variability of electric pulp response threshold in premolars: a clinical study. J Endod. 2012;38(2):144-7.
Bargale SD, Padmanabh SK. Appropriate electrode placement site of electric pulp tester for the premolars: A clinical study. J Indian Soc Pedod Prev Dent. 2015;33(2):138.
Teitler D, Tzadlik D, Eidelman E, Chosack A. A clinical evaluation of vitality tests in anterior teeth following fracture of enamel and dentin. Oral Surg. 1972;34:649-52.
Nitzan DW, Michaeli Y, Weinreb M, Azaz B. The effect of aging on tooth morphology: a study on impacted teeth. Surg Oral Med Oral Pathol. 1986;61 (1):54-60.