Pulpavitalitetstest

Pulpavitalitetstest is a dental diagnostic procedure used to determine whether the dental pulp is alive and has an adequate blood supply. It is used in endodontics to assess pulp status and guide treatment decisions, such as whether root canal therapy is indicated or whether a tooth can be managed conservatively after trauma.

Methods include thermal tests (cold and heat), electric pulp testing (EPT), and more objective measures such as laser Doppler flowmetry (LDF) and pulse oximetry. Cold tests use refrigerant spray on a moist cotton pellet; the patient reports sensation and onset time. Heat tests use a heated source; pain provoked by heat suggests vitality but may be unreliable in recently erupted or cracked teeth.

Electric pulp testing applies a small electrical stimulus via a probe; patient indicates feeling a tingling or sharp sensation. False positives or negatives can occur due to dentin thickness, existing restorations, or patient factors.

Objective methods like LDF and pulse oximetry assess blood flow or oxygen saturation in the pulp, offering more direct evidence of vitality but are less widely available and standardized.

Interpretation: A positive response generally indicates a vital pulp, whereas nonresponse may indicate necrosis or severely compromised pulp. However, results should be interpreted with clinical and radiographic findings, as tests do not reliably distinguish reversible from irreversible pulpitis and can yield inconclusive results in immature or recently traumatized teeth.

Limitations and considerations: test results are influenced by operator technique, patient cooperation, tooth anatomy, and restorations; some teeth may show reduced responses yet still have living tissue.

Pulpavitalitetstest is one element of comprehensive dental assessment and should be used in conjunction with clinical history, examination, and radiographs to determine appropriate treatment.