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Pulpal tests may be conducted via stimulation of the sensory fibres within the pulp (sensitivity testing) or by assessing pulpal blood flow (vitality testing). All available techniques are reported to have limitations in terms of accuracy and reproducibility [ 1 ] and therefore require careful interpretation in clinical practice.
Pulp sensibility tests are routinely used in the diagnosis of pulpitis. Pulp testing is combined with information taken from history, examination and other special investigations such as radiographs in order to reach a diagnosis. Pulp sensibility tests assess the pulp's sensory response to a stimulus. There are three general types:
The health of the dental pulp can be established by a variety of diagnostic aids which test either the blood supply to a tooth (Vitality Test) or the sensory response of the nerves within the root canal to specific stimuli (Sensitivity Test). Although less accurate, sensitivity tests, such as Electric Pulp Tests or Thermal Tests, are more ...
The accuracy of these tests has been reported as 86% for cold testing, 81% for electric pulp testing, and 71% for heat testing. Because of the lack of test sensitivity, a second symptom should be present or a positive test before making a diagnosis. Radiographs utilized to find dental caries and bone loss laterally or at the apex.
Any sensitivity testing of the pulp may provide a negative response, in which case it is important to continue monitoring until a pulpal response is received. [3] Radiographically, there are no unusual features to note in a subluxated tooth.
Thermal testing is a common and traditional way used to detect pulp necrosis. These tests can exist in the form of a cold or hot test, which aims to stimulate nerves in the pulp by the flow of dentine liquid at changes in temperature. The liquid flow leads to movement of the odontoblast processes and mechanical stimulation of pulpal nerves. [19]
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Conventional root canal therapy cleans and fills the pulp chamber with biologically inert material after destruction of the pulp due to dental caries, congenital deformity or trauma. Regenerative endodontics instead seeks to replace live tissue in the pulp chamber. The ultimate goal of regenerative endodontic procedures is to regenerate the ...