title: Use of the cold test as a measure of pulpal anesthesia during endodontic therapy: a randomized, blinded, placebo-controlled clinical trial.
abstract: Soft tissue signs are inadequate to assess pulpal anesthesia during root canal therapy (RCT). The intention of this study was to determine if a negative response to cold testing is a more effective measure to assess pulpal anesthesia compared to soft tissues signs. Using a randomized, blinded, placebo-controlled design, subjects with baseline responsiveness to cold testing were enrolled. Test subjects achieved a negative response to cold testing prior to RCT. Control subjects were given a sham cold test after demonstrating soft tissue signs. Visual analog scale determined pain level. Unadjusted results showed 12% of test subjects experienced pain during RCT compared with 38% of control subjects (N = 83, p = .004, power = 84%). Multiple logistic regression controlled for confounders and effect modifiers, OR = .20 (p = .01). Subjects who achieved a negative response to the cold test were approximately 80% less likely to experience pain during RCT compared to subjects with soft tissue signs of anesthesia alone.
authors: Division of Endodontics, Harvard School of Dental Medicine, 188 Longwood Avenue, Boston, MA 02115, USA. grace_hsiao@post.harvard.edu
authors: Grace W
authors: GW
authors: Hsiao-Wu
authors: Srinivas M
authors: SM
authors: Susarla
authors: Robert R
authors: RR
authors: White
mesh_terms: D000328:Adult; D000367:Age Factors; D000766:Anesthesia, Dental; D000779:Anesthetics, Local / Q000008:administration & dosage*; D002045:Bupivacaine / Q000008:administration & dosage; D003080:Cold Temperature; D003782:Dental Pulp / Q000187:drug effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D006845:Hydrocarbons, Fluorinated; D008012:Lidocaine / Q000008:administration & dosage; D008297:Male; D010147:Pain Measurement; D010485:Periapical Periodontitis / Q000628:therapy; D010919:Placebos; D011671:Pulpitis / Q000628:therapy; D012388:Root Canal Irrigants / Q000627:therapeutic use; D012389:Root Canal Obturation; D018915:Root Canal Preparation / Q000295:instrumentation; D012390:Root Canal Therapy; D012737:Sex Factors; D004980:Ethane / Q000031:analogs & derivatives; D005466:Fluorocarbons
chemical_list: D000779:Anesthetics, Local; D002045:Bupivacaine; D006845:Hydrocarbons, Fluorinated; D008012:Lidocaine; D010919:Placebos; D012388:Root Canal Irrigants; C063006:norflurane; D004980:Ethane; D005466:Fluorocarbons