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- 1Assessment of Reliability of Electrical and Thermal Pulp Testing Agents Fuss et al JOE 1986• DDM (dichlorodifluoromethane = -50C), CO2 (-78 c) and EPT are equally reliable as pulp tests in adults.
• EPT = DDM = CO2 for reliability. BUT- EPT not as reliable in young patients
• Cold used as recommended will not cause pulpal or hard tissue damage and as effective as
heat.
-CO2 snow is the most efficient cold test in testing more than three teeth consecutively without leaving the mouth. - 2why are carbondioxide dry ice -72 C and refrigerant spray -50 C) more effective than an ice stick (95% vs.30% accuracy respectively) (Fuss et al. 1986)?-DDM and CO2 snow produced a faster rate of temperature decrease in the region of the pulpodentinal border zone than did ice and ethyl chloride
- 3Assessment of Reliability of Electrical and Thermal Pulp Testing Agents Fuss et al JOE 1986-(DDM), with a temperature of -50°C, and CO2 snow produce a greater decrease in temperature than either ethyl chloride or ice.
-Application of the test agents to pulpless teeth did not elicit a response from adjacent teeth with vital pulps. - 4Why does carbon dioxide dry ice take a longer time to trigger a response than refrigerant spray? Fuss et al JOE 1986-The technique using DDM on a large cotton pellet provides a larger and more effective contact with the tooth or restoration surface when compared with CO2 snow.It is hypothesized that application of DDM affects a greater number of dentinal tubules and nerve fibers.
-DDM makes better contact with the tooth surface.Hypothesized that during the application of CO2 snow, a vapor layer may form and reduce thermal transfer to the tooth structure. - 5Adult Pulpal Diagnosis. I. Evaluation of the Positive and Negative Responses to Cold and Electrical Pulp Tests Peters et al JOE 1994-Adult untraumatized teeth do not respond to both the electrical and cold tests, there is a high probability that the tooth is pulpless.
-The only diseased or pulpless teeth that responded to cold were multirooted teeth .
-If the tooth doesn’t respond to cold test but response highly to electric test then the pulp may diseased and need further test. - 6What are the hypothesis of high incidence of false positive responses associated with electrical pulp tests-Conduction of the current to the tissues
-Current conducted to adjacent teeth
-Remenant of inflamed pulpal tissue present.
-The breakdown products associated with localized pulpal necrosis seem capable of conducting electrical current
-The calcified tooth structure may be capable of conducting an electrical current to vital tissue apical to an area of necrotic pulp - 7Appropriate Electrode Placement Site for Electric Pulp Testing First Molar Teeth Lin et al 2007The results of the present study confirm that the response threshold increased as the electrode was moved apically from the cuspal tip to the cervical region of the tooth.
- 8Cold Testing Through Full-Coverage Restorations Miller et al JOE 2004-Thermal testing of PFM and all-ceramic restorative systems can produce rapid intra-pulpal temperature reductions.
-TFE produces a significantly greater temperature decrease than CO 2 snow between 10 and 25 seconds of application in vitro. - 9Demonstration of a Possible Source of Error with an Electric Pulp Tester Myers JOE 1998-Ability of electrical current to pass from a non-vital tooth to a vital tooth through contacting class II restorations (false-positive).
-Using rubber dam interproximally can prevent the current from transfer between the teeth. - 10Evaluation of the ability of thermal and electrical tests to register pulp vitality Peterson et al Endodontics & Dental Traumatology 1999- The result indicated that the probability of non sensitive reaction represented a necrotic pulp was 89% for the cold test and 48% for the heat test and 88% for electrical test
- The result indicated that the probability of sensitive reaction represented a vital pulp was 90% for the cold test and 83% for the heat test and 84% for electrical test. - 11Safety of Electronic Apex Locators and Pulp Testers in Patients With Implanted Cardiac Pacemakers or Cardioverter /Defibrillators Wilson et al JOE 2006Based on the findings in this study
we conclude that EAL/ EPTs are safe for use in patients with ICP/ICDs. - 12Sensory response to thermal stimulation in human teeth Henry O. JOE 1980Sensory
response to thermal stimulation occurs
before there is a temperature
change in the region of the PDJ
where the sensory nerve endings are
located. - 13Sensory responses to both heat and cold preceded pulp surface temperature changesHensel and Mann
Sinfilarly, Van Hassel Ervin - 14in the cases of a small pulpal abscess, heat increases the pain and cold relieves the symptoms.Seltzer S et al
Oral Surg 1963 - 15Beveridge and BrownApplication of heat caused a 45 mm Hg rise in intrapulpal pressure and increased pulpal pulse When the heat is removed, the pressure returned to a level about 8 mm Hg higher than the initial pressure.
- 16Brannnstrom & Johnson 1970 Trowbridge et al 1980The hydrodynamic theory currently offers the best explanation for thermal response in intact teeth and exposed dentine
- 17Habit reference pain Hutchins & Reynolds 1947Pain referred from one tooth
to another or from the paranasal tissue into the teeth. - 18The A-d fibres respond to heat and cold and produce nociceptive responses that are interpreted by the brain as pain.Mengel et al.
1992) - 19Criteria cited for success in root canal therapy1- radiographic evidence of periradicular healing
2- absence of clinical signs and symptoms.
3- healing of a previously draining sinus tract
4- absence of spontaneous pain
5- absence of tenderness to percussion and palpation,
6- absence of thermal sensitivity (Gutmann 1992). - 20Possible cause of thermal sensitivity after RCT.
- 21Sinus tracts can heal and closure occurs after root-canal treatment.Grossman 1965
Stromberg et al 1972
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- Dentistry FlashCards sobre Sem título, criado por Areej Alblowi em 14-10-2016.
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- Areej Alblowi
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