Epidermoid cyst in the right mandible: a case report and literature review / 口腔疾病防治

Objective@#To discuss the possible etiology, pathogenesis, clinical features, diagnosis and treatment of epidermoid cysts of the jaw and to provide a reference for clinical diagnosis and treatment.@*Methods@#A case of an epidermoid cyst in the right mandible with retained deciduous teeth and succedaneous impacted teeth was reviewed and analyzed in combination with the relevant literature.@*Results@#A patient presented with a mass in the right mandible that had persisted for 1 month after being found at imaging examination. Tooth 83 was retained, and tooth 43 was unerupted. Swelling was characterized by no obvious tenderness, fluctuation, or table tennis sensation and was observed in the lingual alveoli of teeth 83, 44, and 45. Imaging revealed a low-density shadow in the apex of teeth 83, 44, 45, and 46, approximately 1.9 cm × 2.6 cm × 1.6 cm in size, which wrapped around the dental crown of tooth 43. Preliminary diagnoses were as follows: right mandibular mass thought to be a dentigerous cyst; impacted tooth 43; and retained primary tooth 83. The mass in the right mandible was removed, and teeth 43 and 83 were extracted under intravenous and inhalation anesthesia. During the operation, the mass was observed to have a thin cyst wall and contained bean-like residue. Histopathological examination indicated an epidermoid cyst in the right mandible. At the 1-week follow-up examination, the patient reported no discomfort, and the surgical area showed good recovery. According to the literature, epidermoid cysts are benign cysts originating from ectopic ectodermal tissue that can occur throughout the body but rarely in the oral cavity and are even extremely rarer in the jaw. Epidermoid cysts of the jaw, which have no specific clinical manifestations, can be confused with odontogenic cysts such as dentigerous cysts and odontogenic tumors. Dental pulp tests and other techniques can serve as a reference for clinicians. The diagnosis is confirmed via histopathology. Surgical removal is a common treatment, with a good prognosis and a low recurrence rate.@*Conclusion@#The principle of treatment for an epidermoid cyst of the jaw is similar to that for a jaw cyst. The prognosis is good when the cyst is removed completely.

The Effect of Restoration Polymerization and Residual Dentine Thickness on Thermal Changes of Pulp Chamber of Immature Permanent Teeth

ABSTRACT Objective: To evaluate the pulpal temperature changes due to the polymerisation of resin and glass ionomer-based materials in dentine thicknesses in immature permanent teeth with open apices. Material and Methods: Forty extracted sound human third molar teeth with open apices were included. The width of the cavities prepared on the occlusal surface was 4×5 mm. The depth was 2 mm in the resin groups. 4 mm in the groups in which glass ionomer liner was applied before composite restoration. The coronal parts of the samples were then placed on an acrylic plate with three gaps for feeding-extraction needles and the thermocouple. The temperature changes were recorded. The data was analyzed by SPSS. Statistical significance was accepted as p<0.05. Results: The temperature increase in the group of 1 mm remaining dentin thickness revealed higher results than the values detected from the 2 mm group (1.01 °C) (p=0.00). The mean values (1.49 °C, 1mm) of temperature changes in only glass ionomer applied group were lower than the avarage values (2.210°C, 1mm) determined in the polymerization process of resin composites with light-emitting diode devices. Conclusion: In a remaining dentin thickness of 1 mm in teeth with open apices, using a glass ionomer liner might be a useful effort for protecting the pulp from the heat generated by polymerisation devices.

Does radiotherapy treatment alter the pulp condition in patients with head and neck cancer? A systematic review

Abstract The main purpose of this study was to answer the question: "Can radiotherapy cause changes in the dental pulp condition of patients treated with irradiation in the head and neck region?" Clinical observational studies in adults with head and neck cancer undergoing treatment with ionizing radiation, longitudinal or cross-sectional follow-up to measure oxygen saturation (SpO2), and/or pulp sensitivity test to cold stimulation, were considered eligible. A systematic literature search was performed in six different databases, including the gray literature, and in article references. Two independent evaluators selected the studies, extracted the data, recorded the data on electronic spreadsheets, and then evaluated the methodological quality using the Checklist for Quasi-Experimental Studies tool devised by JBI. The data were assessed qualitatively using the Synthesis Without Metanalysis (SWiM) guidelines. After removing the duplicate articles, carefully analyzing the titles and abstracts, and reading the papers in full, seven studies were included. Four of the studies evaluated applied the cold sensitivity test, two associated pulse oximetry and cold sensitivity, and only one used just pulse oximetry. Evaluation using the cold sensitivity test and pulse oximetry in the initial periods before radiotherapy showed a decrease in the sensitive response and in SpO2 levels during a maximum period of 1 year. However, analyses thereafter indicated a normal response in both tests from 5 to 6 years after the end of radiotherapy treatment. Radiotherapy causes changes in pulp behavior patterns in the short term; however, recovery and return to average values occurs after long periods.

Can non-carious cervical lesions depth affect clinical response in pain intensity and remaining dentin thickness?

Abstract Non-carious Cervical Lesions (NCCL) are dental tissue defects, non-related to caries, frequently observed in the dental practice. The aim of this study was to evaluate the effects of NCCL on dentin depth and thickness and the response to dental pain by means of clinical diagnostic tests. 86 teeth from 14 patients with NCCL were assessed by: depth of NCCL, clinical tests (evaporative stimulus, to detect pain levels of dentin hypersensitivity, cold thermal test to classify pulp health, percussive stimuli to evaluate the periradicular tissues and cone beam computed tomography (tomography to evaluate remaining dentin thickness (RDT). In terms of depth, the sample was divided into two groups: G1- teeth with NCCLs ≤1.0mm and G2- teeth with NCCLs between 1.1-2.0 mm. Dental pain data were compared by Mann-Whitney test and RDT by Student's t-test and correlations by the Pearson test (p<0.05). The depth of NCCL does not influence dental pain response to evaporative stimulus (p=0.129), cold thermal test (p = 0.125), vertical (p = 0.317) and horizontal (p = 0.119) percussion clinical diagnostic tests. However, G1 showed more RDT (p<0.001), and the correlation test showed that deeper NCCL presents smaller remaining dentin thickness (p=0.011/r=-0.273). In conclusion, tooth with NCCL up to 2mm-depth presents similar levels of pain for dentin hypersensitivity, pulp and periradicular tissue independent to NCCL depth, however, lesions with ≤1.0mm-depth showed greater RDT in tomographic findings.

Resumo Lesões Cervicais Não Cariosas (LCNC) são defeitos do tecido dentário, não relacionados à cárie, frequentemente observados na prática odontológica. O objetivo do estudo foi avaliar os efeitos da profundidade e espessura da dentina de LCNC na resposta à dor dentária por meio de testes de diagnóstico clínico. 86 dentes de 14 pacientes com LCNC foram avaliados por: profundidade da LCNC, testes clínicos (estímulo evaporativo, para detectar níveis de dor de hipersensibilidade dentinária, teste térmico frio para classificar a saúde pulpar, estímulos percussivos para avaliação do tecido perirradicular e tomografia computadorizada de feixe cônico (TCFC), para avaliação da espessura de dentina remanescente (EDR). Em termos de profundidade, a amostra foi dividida em dois grupos: G1- dentes com LCNCs ≤1,0mm e G2- dentes com LCNCs entre 1,1-2,0 mm. Os dados de dor dentária foram comparados pelo teste de Mann-Whitney e a EDR pelo teste t-Student e correlações pelo teste de Pearson (p <0,05). A profundidade da LCNC não influencia a resposta da dor dentária ao estímulo evaporativo (p = 0,129, teste térmico frio (p = 0,125), teste diagnóstico clínico de percussão vertical (p = 0,317) e horizontal (p = 0,119), porém o G1 apresentou maior EDR (p <0,001) e o teste de correlação mostrou que LCNC mais profunda apresenta menor EDR (p = 0,011 / r = -0,273). Conclusão: Dentes com LCNC de até 2mm de profundidade apresenta níveis semelhantes de dor para hipersensibilidade dentinária, pulpar e saúde perirradicular, independente da profundidade da LCNC. Entretanto, lesões com profundidade ≤1,0mmin apresentaram mais EDR nos achados tomográficos.

Effect of dental tissue thickness on the measurement of oxygen saturation by two different pulse oximeters

Abstract This study aimed to evaluate the influence of different dental tissue thickness on the measurement of oxygen saturation (SpO2) levels in high (HP) and low (LP) blood perfusion by comparing the values obtained from two different pulse oximeters (POs) - BCI and Sense 10. Thirty freshly extracted human teeth had their crowns interposed between the POs and an optical simulator, which emulated the SpO2 and heart beats per minute (bpm) at HP (100% SpO2/75 bpm) and LP (86% SpO2/75 bpm) modes. Afterwards, the palatine/lingual surfaces of the dental crowns were worn with diamond drills. The reading of SpO2 was performed again using the POs alternately through the buccal surface of each dental crown. Data were analyzed by the Wilcoxon, Mann-Whitney and Kendall Tau-b tests (α=5%). The results showed significant difference at the HP and LP modes in the SpO2 readouts through the different dental thicknesses with the use of BCI, and at the LP mode with the use of Sense 10, which had a significant linear correlation (p<0.0001) and lower SpO2 readout values in relation to the increase of the dental thickness. Irrespective of tooth thickness, Sense 10 had significantly higher readout values (p<0.0001) than BCI at both perfusion modes. The interposition of different thicknesses of enamel and dentin influenced the POs measurement of SpO2, specially at the low perfusion mode. The POs were more accurate in SpO2 measurement when simulated perfusion levels were higher.

Resumo Este estudo avaliou a influência de diferentes espessuras de esmalte e dentina na medição dos níveis de saturação de oxigênio (SpO2) em alta (HP) e baixa (LP) perfusão sanguínea, comparando os valores obtidos em dois oxímetros de pulso (OPs) diferentes, BCI e Sense 10. Trinta dentes recém-extraídos de humanos tiveram suas coroas interpostas entre os OPs e um simulador óptico, que simulava a SpO2 e os batimentos cardíacos por minuto (bpm) nos modos de HP (100% SpO2 / 75 bpm) e LP (86% SpO2 / 75 bpm). Após, as superfícies palatinas / linguais dos dentes foram desgastadas com brocas de diamantadas. A leitura da SpO2 foi realizada novamente usando os dois OPs alternadamente através da face vestibular de cada coroa dental. Os dados foram analisados ​​pelos testes Wilcoxon, Mann-Whitney e Kendall Tau-b (α = 5%). Os resultados mostraram diferença significativa nos modos HP e LP nas leituras de SpO2 através das diferentes espessuras dentárias com o uso do BCI, e no modo LP com o uso do Sense 10, que teve correlação linear significativa (p <0,0001) e menores valores de leitura de SpO2 em relação ao aumento da espessura dentária. Independentemente da espessura do dente, o Sense 10 apresentou valores de leitura significativamente maiores (p <0,0001) do que o BCI em ambos os modos de perfusão. A interposição de diferentes espessuras de esmalte e dentina influenciaram a mensuração da SpO2 pelos OPs, especialmente no modo de baixa perfusão. Os POs foram mais precisos na mensuração da SpO2 quando os níveis simulados de perfusão foram maiores.

Oximetría de pulso y su eficacia para diagnosticar vitalidad pulpar / Pulse oximetry and its use in diagnosing pulp vitality

Objetivo: Identificar y analizar en la literatura científica reciente el uso de la oximetría de pulso como método diagnóstico de vitalidad pulpar. Metodología: En este trabajo se llevó a cabo una revisión de la literatura en las plataformas de PubMed y Google Académico, en la cual se analizó el uso de la oximetría de pulso en el diagnóstico y monitoreo odontológico del estado pulpar. Resultados: Después de una exhaustiva revisión, y de acuerdo con los criterios de inclusión y exclusión, se analizaron 21 artículos. La mayoría de los trabajos consideran la oximetría de pulso un método alternativo de diagnóstico indoloro, seguro y eficaz; sin embargo, la adaptación de un instrumento de uso exclusivo odontológico es necesaria para una medición exacta de la saturación de oxígeno en la pulpa dental. Los avances tecnológicos en el campo clínico de la odontología nos han llevado a la búsqueda de nuevas técnicas diagnósticas clínicas para mejorar la atención y los tratamientos de los pacientes que acuden día con día a recibir una consulta odontológica. Conclusiones: En los últimos años la oximetría de pulso ha demostrado ser una herramienta de diagnóstico eficaz para el diagnóstico de la vitalidad pulpar. El análisis de los artículos incluidos en esta revisión concluye que la oximetría de pulso es una técnica innovadora que puede ser utilizada como una herramienta diagnóstica adyuvante en el diagnóstico de la vitalidad pulpar (AU)

Objective: To identify and analyze in the recent scientific literature the use of pulse oximetry as a diagnostic method for pulp vitality. Methodology: In this work, a literature review was carried out on the PubMed and Google Scholar platforms in which the use of pulse oximetry in the dental diagnosis and monitoring of pulp status was analyzed. Results: After an exhaustive review and in accordance with the inclusion and exclusion criteria, 21 articles were analyzed. Most of the studies consider pulse oximetry an alternative method of painless, safe and effective diagnosis, however, the adaptation of an instrument for exclusive dental use is necessary for an exact measurement of the oxygen saturation in the dental pulp. Technological advances in the clinical field of dentistry have led us to search for new clinical diagnostic techniques to improve the care and treatment of patients who come every day to receive a dental consultation. Conclusions: In recent years, pulse oximetry has proven to be an effective diagnostic tool for the diagnosis of pulp vitality. The analysis of the articles included in this review concludes that pulse oximetry is an innovative technique that can be used as an adjunct diagnostic tool in the diagnosis of pulp vitality (AU)

Accuracy of the dental pulp sensibility test using cold spray for the diagnosis of pulp diseases: an observational clinical study

The dental pulp sensibility test is one of the main auxiliary resources for the diagnosis of pulp pathologies, and its accuracy is still debatable. This cross-sectional observational study evaluated the accuracy of the pulp sensibility test (PST) using cold spray (1,1,1,2-tetrafluoroethane) for the diagnosis of pulp diseases and determined the effect of individual and clinical variables on the reliability of this test. The paper was designed following the STROBE statement. Sixty patients with indications for primary endodontic treatment were selected and examined from August 2017 to July 2018. Data collection was performed through interviews, clinical/radiographic examinations and the PST. The results of the cold test, along with data on sex, age, the tooth type regarding the root number, and the presence of restorations and caries, as well as the recent consumption of analgesics, were recorded. The presence of bleeding within the pulp chamber was used as the gold standard to compare with the clinical diagnosis and to identify the true-positive, false-positive, true-negative, and false-negative responses. The accuracy of PST achieved in subgroups of individual and clinical variables was compared using the chi-square test with a significance level of 5% (p < 0.05). The PST with the use of cold spray showed a sensitivity of 0.88, a specificity of 1.00, a positive predictive value of 1.00, a negative predictive value of 0.86, and an accuracy of 0.93. The accuracy of the cold spray was not affected by individual or clinical variables. The PST with the use of cold spray is an accurate and reliable method for determining the diagnosis of pulp diseases, especially in cases of pulp vitality or irreversible pulpitis.

Dental Pulpal Tissue Regeneration, Pulpal Vitality Testing, and Healing of Apical Lesions Following Stem Cell Transplant: A Systematic Review and Meta-Analysis

Abstract Objective: To analyze data obtained from animal and human studies using stem cells. Material and Methods: Medical Literature Analysis and Retrieval System Online (MEDLINE), PubMed, Cochrane Library, Embase, Information Sciences Institute (ISI), as well as Google Scholar were utilized and searched as available electronic databases to perform a systematic literature review of articles published between 2010 and 2019. The Endnote X9 for Windows was also employed to manage electronic titles and abstracts of the selected studies. Searches were conducted using keywords of "pulpal OR pulpal tissue OR pulpal vitality", "regeneration", "apical healing", "stem cells OR progenitor cells", and "mediated pulpal tissue". Consequently, 189 titles and abstracts endowed with potential relevance were discovered based on searches into manual and electronic sources. Ultimately, a total of six articles met the inclusion criteria in the present systematic review and meta-analysis. Results: Out of the six articles identified and selected, five studies were categorized as animal experiments and one article was nominated as a human clinical trial. The greatest bias risks were accordingly observed in the majority of animal examinations, but articles related to humans revealed decreased risks of bias, while the human clinical trial showed some concerns. Conclusion: Promising parameters testing functional pulp regeneration could be represented through stem cell transplants.

Expression of calcitonin gene-related peptide and pulp sensitivity tests in irreversible pulpitis

Abstract The aim of the present study was to identify the relationship between the expression of calcitonin gene-related peptide (CGRP) and the responses of pulp sensitivity tests in healthy pulps and irreversible pulps by performing a cross-sectional study on patients. Two hundred subjects were evaluated. A total of 75 subjects complied with the criteria. The participants were divided into two groups: a) Healthy pulp (subjects [n = 35] having posterior teeth with clinically normal pulp tissue), and b) Irreversible pulpitis (subjects [n = 40] having posterior teeth with irreversible pulpitis). All participants were evaluated using the following variables: a) medical and dental history, b) pulp sensitivity tests, c) expression of CGRP by the enzyme-linked immunosorbent assay (ELISA), and d) expression levels of mRNA CGRP and mRNA CGRP receptor genes. We determined that the responses of the cold test between 4 and ≥12 s presented a higher average of the expression of CGRP in the group having irreversible pulpitis (p = 0.0001). When we compared the groups with the value of the electrical impulse, we found statistically significant differences (p = 0.0001), observing positive responses to the test with electrical impulses of 7 to 10, with an average of 72.15 ng/mL of CGRP in the irreversible pulpitis group. High values of CGRP expression were observed in that group in the responses of pulp sensitivity.

Eficácia de dois agentes térmicos antes e após a realização da terapia periodontal, em dentes humanos / In vivo evaluation of two cold tests before and after the periodontal therapy

A determinação ou pressuposição da vitalidade pulpar assume no dia-a-dia papel de capital importância no diagnóstico clínico com vistas à indicação ou não da terapia endodôntica. O objetivo do presente estudo foi avaliar a eficiência clínica de dois recursos térmicos, a saber: o bastão de gelo e o gás refrigerante, na deter¬minação da vitalidade pulpar em dentes humanos antes e após a realização de terapia periodontal, incluindo raspagem e aplainamento radicular e/ou procedimentos cirúrgicos periodontais. Para tanto, foram incluídos 60 pacientes de ambos os sexos e faixa etária entre 21 a 64 anos de idade num total de 411 dentes indica¬dos à terapia periodontal e analisados em dois tempos, a saber, na condição pré e pós-terapia periodontal. Realizaram-se o exame do paciente e o exame radiográfico periapical. Foi feita a aplicação dos dois agentes térmicos, o bastão de gelo e gás refrigerante, para obtenção da resposta dolorosa pulpar antes dos procedimen¬tos periodontais. Após uma semana os pacientes retornaram para nova aplicação dos testes de sensibilidade pulpar, valendo-se dos mesmos procedimentos de testes que foram executados na primeira sessão de exame do paciente. Para saber se houve diferença significativa entre as proporções, utilizou-se o teste não paramétrico Qui-quadrado (c2) em nível de 95% de confiança. Concluiu-se que ocorreu um número maior de respostas positivas após os procedimentos periodontais para os dois testes, exceção notada no dente pré-molar (p>0,05), indicando que não existe diferença na frequência de respostas positivas e negativas tanto antes como após a terapia periodontal

The determination or presumption of pulp vitality assumes a central role in clinical diagnosis for the indica¬tion of endodontic therapy or not. The aim of this study was to evaluate the clinical efficiency of two thermal resources: the ice stick and the refrigerant gas in determining pulp vitality in teeth before and after periodontal therapy including scaling and root planning and/or periodontal surgical procedures. For this, 60 patients of both genders and age between 21 and 64 years old were included. A total of 411 teeth indicated for periodontal therapy were analyzed in two times, namely in the pre and post periodontal therapy condition. The patient's examination and periapical radiographic examination were performed. The two thermal agents were applied to obtain the pulpal pain response before the periodontal procedures. After one week, the patients returned to a new application of the pulp sensitivity tests using the same test procedures that were performed in the first patient examination session. To determine if there was a significant difference among the proportions, the non-parametric Chi-square test was used at a 95% confidence level. It was concluded that there was a higher num¬ber of positive responses after the periodontal procedures for the two tests, exceptions noted in the premolar tooth (p> 0.05), indicating that there is no difference in the frequency of positive and negative responses both before and after periodontal therapy

Selective alveolar corticotomy to intrude overerupted maxillary first molars: analysis of pulp vitality / Corticotomía alveolar selectiva para la intrusión de los primeros molares superiores extruidos: análisis de la vitalidad pulpar

The excessive and prolonged orthodontic treatment might result in loss of pulp vitality. Selective alveolar corticotomy is an alternative to accelerate the orthodontic treatment in adults. This study aimed to evaluate the impact of selective alveolar corticotomy associated with orthodontic intrusion on pulp vitality of overerupted maxillary first molars. Six individuals with extruded maxillary first molars were randomly selected to undergo corticotomy as coadjuvant therapy for intrusion. Pulp vitality was evaluated with thermal (Endo-Ice and Heated gutta-percha) and electric tests before the surgical procedure and after intrusion (90 days). The intrusion of all teeth was obtained (mean 2.26 ± 0.52 mm), and all teeth responded positively to pulp vitality tests before and after intrusion. This suggests that selective alveolar corticotomy did not promote pulp damage, and can be considered an effective and safe auxiliary method to intrusion of overerupted maxillary molars.

El tratamiento de ortodoncia prolongado puede provocar la pérdida de la vitalidad pulpar. La corticotomía alveolar selectiva es una alternativa para acelerar el tratamiento de ortodoncia en adultos. El objetivo del presente estudio fue evaluar el impacto de corticotomía alveolar selectiva asociada a la intrusión dental con ortodoncia en la vitalidad pulpar de los primeros molares superiores extruidos. Seis individuos con primeros molares superiores extruidos fueron seleccionados al azar para someterse a corticotomía como terapia adyuvante para la intrusión dental. La vitalidad pulpar se evaluó en ensayos térmicos (Endo-ice y gutapercha climatizada) y eléctrica antes del procedimiento quirúrgico y después de la intrusión (90 días). Se obtuvo la intrusión de todos los dientes (media 2,26 ± 0,52 mm) y todos los primeros molares respondieron positivamente a las pruebas de vitalidad pulpar, antes y después de la intrusión. Los resultados sugieren que la corticotomía alveolar selectiva no promueve daño pulpar y se puede considerar un método eficaz y seguro para ayudar a la intrusión de molares extruidos.

Validez de pruebas diagnósticas endodónticas aplicadas por estudiantes de pregrado de una universidad chilena / Validity of applied endodontic diagnostic tests for undergraduate students of a Chilean university

Para el éxito de un tratamiento endodóntico es fundamental un correcto diagnóstico pulpar. Existen controversias con respecto a la validez de los métodos diagnósticos comúnmente utilizados en la práctica diaria por el odontólogo para determinar la condición del estado pulpar. El objetivo fue determinar la validez de dos de las pruebas pulpares (de frío y calor) más comúnmente usadas por estudiantes de pregrado en pacientes que acuden a una clínica de endodoncia. Se realizó un estudio de corte transversal, en 49 pacientes (54 dientes) que acudieron para atención de endodoncia, y que cumplían con los criterios de selección de este estudio. La sensibilidad para la prueba de frío y calor fue 75,9% y para la prueba combinada (frío y calor) fue 69% versus sangrado cameral. La especificidad para la prueba de frío fue 80%, para la prueba de calor 76% y para la prueba combinada 84%. La prueba de frío o del calor por sí sola tiene mayor sensibilidad que aplicada de manera combinada. En cambio, se consiguió una mayor especificidad al combinar ambas pruebas diagnósticas, que por sí solas.

For successful endodontic treatment a correct diagnosis for pulp diseases is essential. Controversy exists regarding the validity of diagnostic methods commonly used in daily practice by the dentist to determine the condition of the pulp state. The aim of this study was to determine the validity of two thermal tests (cold and heat stimuli) most commonly used by undergraduates students in patients in patients treated in endodontic dental clinic. Cross-sectional study was performed in 49 patients (54 teeth) who needed endodontics treatment, and meeting the criteria of this study. Sensitivity to cold and heat test was 75.9% and the combined test (hot and cold) was 69%. The specificity for the cold test was 80%, for the heat test was 76%, and for the combined test 84%. The cold or heat test alone, shows more sensitivity than the combination. However, higher specificity was achieved by combining both tests.

Laser Doppler em Endodontia: revisão da literatura / Laser Doppler in Endodontics: literature review

O propósito deste trabalho foi revisar e discutir a literatura acerca do uso da fluxometria Laser Doppler (FLD) como método de diagnóstico em Endodontia. Consultou-se o banco de dados da PubMed e do Portal de Periódicos Capes, selecionando-se artigos publicados desde1986 até 2010. Os testes elétrico e térmico são considerados testes de sensibilidade, pois avaliam apenas a função sensorial do dente. A capacidadede avaliar a circulação sanguínea é uma exigência para que o teste seja considerado de vitalidade e a FLD é um método não-invasivo que apresenta esse requisito. Porém, diversos fatores podem influenciar nas suas medições, tais como o comprimento de onda do laser, a banda Doppler, a distância entre as fibras ópticas que compõem a sonda e o isolamento do dente. O uso deste método tem sido bem documentado na literatura e tem se mostrado bastante eficaz para distinguir dentes vitais de não-vitais. Apesar de seu alto custo e a dificuldade de uso na prática clínica interferirem na sua utilização em larga escala, as pesquisas que comprovam a importância e eficácia da FLD poderão contribuir, a médio e a longo prazo, para a popularização e redução de custos deste método, considerando, principalmente, os casos de envolvimento pulpar de origem traumática a que a população está constantemente submetida.

The objective of this study was to review the periodics and scientific journals regarding the use of Laser Doppler Flowmetry (LDF) as a method of diagnosis in Endodontics. In order to obtain data, a literature search was performed in the Capes Journals and PubMed database.The review was based on articles published from 1986 to 2010. Electrical and thermal tests are considered sensitivity tests, because they only assess the sensory function of the tooth. A test must assess the blood flow inside the dental pulp to be considered a vitality test. The LDF is a noninvasive method, which assess pulpal blood flow. Several factors may have an influence in the LDF measurements, such as wavelength of the laser, Doppler bandwidth, probe's optical fibers distance, and tooth isolation. The use of this method has been well documented in the literature and it has been proven very effective in distinguishing between non-vital and vital teeth. Due to its high cost and difficulty to use, this method is not considered friendly to use in the clinical setting, which interpose a more wide-scale use. Current research that proves the importance and effectiveness of the LDF may lead to the popularization and cost reduction of this method, especially when we consider the potential improvement in diagnosis for cases of traumatic pulpal involvement that are common occurrences in our population.

Avaliação da escolha dos testes de sensibilidade pulpar por clínicos gerais da cidade de Taubaté / Evaluation of the choice of pulp sensitivity tests by practitioners of Taubaté city

Introdução: A proposta desta pesquisa é avaliar os recursos complementares de que os clínicos gerais da cidade de Taubaté lançam mão na determinação da sensibilidade pulpar. Método: Foram entrevistados ao acaso 106 cirurgiões-dentistas da cidade de Taubaté valendo-se de um questionário elaborado pelo autor. Tais profissionais eram de diferentes épocas de graduação, portadores de especialidade ou não e de diversas faculdades de Odontologia. Os questionários apresentavam uma lista de testes com a seguinte pergunta: ?Qual ou quais os recursos suplementares mais utilizados na avaliação da sensibilidade pulpar deque você lança mão durante o exame do paciente??. Os dados foram organizados de modo a facilitar sua subdivisão em teste pelo frio, calor, elétrico, cavidade, anestesia e outros, permitindo estabelecer percentuais de utilização destes em função do número de citações. Resultados: Como inferência estatística utilizou-se teste binomial para proporção, sendo o nível de significância de 5%.Na comparação entre a proporção de clínicos gerais que utilizam guta-percha (90,56%) e bastão de gelo (77,35%) o teste apresentou pvalor<0,05 indicando que a proporção de clínicos gerais que usam guta-percha aquecida é maior do que aqueles clínicos que usam bastão de gelo. Conclusão: De posse dos resultados obtidos, concluiu-se que a guta-percha aquecida foi o recurso auxiliar preferido pelos clínicos gerais (90,56%) seguido do bastão de gelo (77,35%), gases refrigerantes 64,15%), jato de ar (41,5%), teste de anestesia (38,67%), teste de cavidade (31,13%), água fria (24,52%), brunidor aquecido (4,71%), teste elétrico (1,88%) e algodão embebido em álcool (0,94%).

Introduction: The purpose of this study is to assess which methods that the general practitioners of the Taubaté city used to determine the pulpal sensitivity. Method: Were interviewed 106 randomly dentists of Taubaté city making use of a questionnaire prepared by the author. These professionals were from different times of graduation, expert or not and from various dentistry colleges. The questionnaires presented a list of tests with the following question: which additional resources do you prefer during the evaluation of pulpal sensitivity during of the patient exam??. The data were organized to facilitate their subdivision: cold test, heat test, electric test, anesthesia test and cavity test, to establish rates of use of these depending on the number of citations. Results: Because of statistical inference was used the binomial proportion with the significance level of 5%. The proportion of general practitioners using heat gutta-percha (90.56%) and ice stick (77.35%) tests presented pvalue<0.05 indicating that the proportion of general practitioners using heat gutta-percha is higher than those clinicians that using ice stick. Conclusion: It was concluded that heat gutta-percha were the test preferred by practitioners (90.56%) followed by ice stick (77.35%), refrigerants (64.15%), air jet (41.5%), test of anesthesia (38.67%) test cavity (31.13%), cold water (24.52%), heated burnisher (4.71%), electrical test (1.88%) and alcohol swab (0.94%).

Avaliação da temperatura mínima alcançada por cinco gases refrigerantes / Lowest temperature reached by five cold spray gases

Introdução - O uso de gases refrigerantes é um método largamente utilizado no diagnóstico de possíveis alterações inflamatórias pulpares. O objetivo deste estudo foi avaliar a capacidade destes gases em atingir baixas temperaturas. Material e Métodos - Foram avaliados cinco gases refrigerantes (tetrafluoretano, hidrofluorcarbono, propano/butano e duas associações de butano, etanol, benzoato de sódio, água desmineralizada e mentol) com o auxílio de um termômetro eletrônico digital. Resultados - Após a análise dos resultados, utilizando o teste ANOVA (Tukey), ocorreram diferenças estatisticamente significantes (p<0,01) entre todos os grupos estudados, com exceção da comparação entre os gases hidrofluorcarbono e tetrafluoretano (p>0,05). Conclusão - O hidrofluorcarbono foi o gás que atingiu o menor nível de temperatura, seguido pelo tetrafluoretano e propano/butano.

Introduction - The cold spray gases are frequently used as a diagnosis method of possible pulpal inflammatory alterations. The objective of this study was to evaluate the capacity of these gases to reach low temperatures. Material and Methods - They were evaluated 5 cold spray gases (tetrafluorethane, hydrofluorocarbon, propane/butane and two associations of butane, ethanol, sodium benzoate, distilled water and menthol) with the assist of a digital electronic thermometer. Results - After the results analysis, using ANOVA (Tukey test), statistically significant differences (p<0,01) occurred among all of the studied groups, excepting the comparison between hydrofluorocarbon and tetrafluorethane gases. Conclusion - It was concluded that hydrofluorocarbon gas reached the lowest temperature level, following by tetrafluorethane and propane/butane gases.