The validity of pulp testing: a clinical study.
OBJECTIVE
In this article, the authors report on an in vivo study in which they assessed the validity of two commonly used cold pulp tests (carbon dioxide [CO(2)]and 1,1,1,2-tetrafluoroethane) and an electrical pulp tester (EPT) in determining pulp vitality by using direct inspection of the pulp as the reference standard.


METHODS
One hundred fifty patients undergoing endodontic therapy at the University of North Carolina School of Dentistry (Chapel Hill) undergraduate clinic participated in this study. Before routine endodontic treatment, the authors classified participants by means of EPT, CO(2) and tetrafluoroethane as having either vital or necrotic pulps. Students recorded true pulpal status (vital/necrotic) by observing blood within the pulp chamber after an access cavity was made. The authors calculated the sensitivity, specificity and positive and negative predictive values of each test and the test combinations to describe their validity and clinical usefulness.


RESULTS
Ninety-seven percent of teeth responding positively to all three tests contained vital pulps, whereas 90 percent of the teeth that failed to respond to any of the tests contained necrotic pulps. Ten percent of the teeth not responding to any of the tests contained vital pulps. For all other combinations of test results, 54 percent of teeth contained vital pulps, and 46 percent contained necrotic pulps.


CONCLUSIONS
These findings support the use of either of the cold tests and the EPT for diagnosis of pulpal status.


CONCLUSIONS
Cold test and EPT used in conjunction resulted in a more accurate method for diagnostic testing.
Weisleder
Rebeca
R
Department of Endodontics, School of Dentistry, University of North Carolina, Chapel Hill, NC 27599, USA. rebeca_weisleder@dentistry.unc.edu
Yamauchi
Shizuko
S
Caplan
Daniel J
DJ
Trope
Martin
M
Teixeira
Fabricio B
FB
D000293:Adolescent; D000328:Adult; D000368:Aged; D001769:Blood; D002245:Carbon Dioxide; D003080:Cold Temperature; D003782:Dental Pulp / Q000098:blood supply / Q000473:pathology; D003786:Dental Pulp Cavity / Q000473:pathology; D003790:Dental Pulp Necrosis / Q000175:diagnosis; D003791:Dental Pulp Test / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D004568:Electrodiagnosis / Q000295:instrumentation / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006845:Hydrocarbons, Fluorinated; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012015:Reference Standards; D018915:Root Canal Preparation / Q000379:methods; D012390:Root Canal Therapy; D012680:Sensitivity and Specificity; D055815:Young Adult; D004980:Ethane / Q000031:analogs & derivatives; D005466:Fluorocarbons
D002245:Carbon Dioxide; D006845:Hydrocarbons, Fluorinated; C063006:norflurane; D004980:Ethane; D005466:Fluorocarbons