Comparison of heat-testing methodology.
BACKGROUND
Patients with irreversible pulpitis occasionally present with a chief complaint of sensitivity to heat. To appropriately diagnose the offending tooth, a variety of techniques have been developed to reproduce this chief complaint. Such techniques cause temperature increases that are potentially damaging to the pulp. Newer electronic instruments control the temperature of a heat-testing tip that is placed directly against a tooth. The aim of this study was to determine which method produced the most consistent and safe temperature increase within the pulp. This consistency facilitates the clinician's ability to differentiate between a normal pulp and irreversible pulpitis.


METHODS
Four operators applied the following methods to each of 4 extracted maxillary premolars (for a total of 16 trials per method): heated gutta-percha, heated ball burnisher, hot water, and a System B unit or Elements unit with a heat-testing tip. Each test was performed for 60 seconds, and the temperatures were recorded via a thermocouple in the pulp chamber. Analysis of the data was performed by using the intraclass correlation coefficient.


RESULTS
The least consistent warming was found with hot water. The heat-testing tip also demonstrated greater consistency between operators compared with the other methods. Hot water and the heated ball burnisher caused temperature increases high enough to damage pulp tissue.


CONCLUSIONS
The Elements unit with a heat-testing tip provides the most consistent warming of the dental pulp.
Division of Endodontics, University of Minnesota School of Dentistry, Minneapolis, MN 55455, USA.
Mark M
MM
Bierma
Scott
S
McClanahan
Michael K
MK
Baisden
Walter R
WR
Bowles
D001641:Bicuspid / Q000502:physiology; D001831:Body Temperature / Q000502:physiology; D003782:Dental Pulp / Q000502:physiology; D003791:Dental Pulp Test / Q000295:instrumentation* / Q000592:standards; D055615:Electrical Equipment and Supplies; D004867:Equipment Design; D006171:Gutta-Percha; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D011671:Pulpitis / Q000175:diagnosis; D012449:Safety; D062125:Thermometry / Q000295:instrumentation; D013997:Time Factors; D014867:Water
D014867:Water; D006171:Gutta-Percha