ABSTRACT
BACKGROUND: An early determination of pulpal vitality is crucial with respect to a correct differential diagnosis of revascularisation or necrosis and its treatment. REVIEW: Sensibility tests (cold, heat, electrical pulp test) in combination with radiographs are commonly promoted. However these tests are arbitrary, based on sensations and therefore not always reliable. In such situations registration of pulpal blood flow will be advantageous. The most studied and well documented method for registration of blood circulation is laser Doppler flowmetry (LDF) which is typified as a non-invasive technique with direct and objective registrations. In this article blood flow, LDF and its characteristics, the advantages and disadvantages of the methods and the latest developments regarding LDF is described. CONCLUSION: Despite there being a low implementation of LDF in dentistry to date, this should become one of the basic techniques for clinical use in paediatric dentistry.
Subject(s)
Dental Pulp Test/methods , Dental Pulp/physiology , Laser-Doppler Flowmetry/methods , Adolescent , Anodontia/therapy , Bicuspid/abnormalities , Bicuspid/transplantation , Dental Pulp/blood supply , Female , Humans , Incisor/injuries , Laser-Doppler Flowmetry/instrumentation , Lasers, Gas , Lasers, Semiconductor , Mandible/surgery , Molar, Third/transplantation , Odontogenesis/physiology , Regional Blood Flow/physiology , Time Factors , Tooth Apex/physiology , Tooth Avulsion/therapy , Tooth Replantation/adverse effects , Transplantation, AutologousABSTRACT
An early determination of pulpal vitality is crucial with respect to a correct differential diagnosis of revascularisation or necrosis and its treatment. The use of sensibility tests (cold, heat, electrical pulp test) in combination with X-ray are commonly promoted. However these tests are arbitrary, based on sensations and therefore not always reliable. In such situation the registration of 'real' pulpal blood flow and hence pulp vitality will be more than an added value. The most studied and well documented method is laser Doppler flowmetry (LDF) as it is non invasive, direct and objective. In this article we describe blood flow, LDF and its characteristics, advantages and disadvantages of this method and the newest developments regarding LDF. Despite a low implementation of LDF in Belgium, this technique proved to belong indisputable to the basic assets of a dental clinic. A number of cases are described to demonstrate the efficacy and added value of LDF in assessing tooth vitality.
Subject(s)
Dental Pulp Necrosis/diagnosis , Dental Pulp Test/methods , Dental Pulp/blood supply , Laser-Doppler Flowmetry/statistics & numerical data , Anodontia/rehabilitation , Belgium , Bicuspid/transplantation , Child , Female , Humans , Molar, Third/transplantation , Tooth Avulsion/therapy , Young AdultABSTRACT
OBJECTIVE: The reliability of using 2 probes with laser Doppler signals when adjacent teeth are being measured simultaneously to determine pulpal blood flow is unknown. The purpose of this study was to determine whether 2 probes are more reliable than 1 in a single-tool assessment. STUDY DESIGN: Tooth pulp vitality was studied in 19 adults through use of laser Doppler flowmetry tests. In each subject, testing was carried out on 2 successive occasions with 2 probes positioned on the maxillary central incisors. RESULTS: Significant mean differences of 31% for blood flux and 96% for concentration were found between the 2 probes, although they shared equal coefficients of variation. The reproducibility for each probe was found to be consistent, and the probes were highly correlated with each other. Flux and concentration, however, were not systematically correlated. CONCLUSIONS: Simultaneous measurements with 2 probes were clearly more reliable. The necessity for a calibration control was evident.
