Abstracts

Accurate assessment of the health of the dental pulp may be a diagnostic dilemma to the clinician. Special investigations, such as pulp vitality and sensibility testing, can assist the practitioner in attaining this diagnosis, but how accurate and reliable are these tests? Accurate assessment of the state of the health of the dental pulp is achieved through a detailed patient history, thorough clinical and radiographic examination and the use of special diagnostic tests. Pulp sensibility and vitality testing are special diagnostic tests that form a part of the clinician's armamentarium in assisting and guiding this diagnostic process in assessing the health of the dental pulp. This review critically appraised the literature related to pulp vitality and sensibility testing in order to determine the diagnostic accuracy of pulp tests with reference to a gold standard or control group.

They searched a variety of electronic databases for English language in vivo studies evaluating the accuracy of pulp sensibility and pulp vitality tests in human teeth. Only studies using a reference or ‘gold’ standard and providing sensitivity and specificity values or data allowing their calculation were considered. Study quality was assessed independently by two reviewers: 8 studies (4 cohorts and 4 case-controlled studies) were included. A variety of tests were evaluated, including, electric pulp tester (9 results from 8 studies), CO₂ Snow (4 from 3), Endo-Ice^® (4 from 3), ethyl chloride (4 from 3), laser doppler flowmeter (2 from 2), pulse oximetery (2 from 2), ice sticks (2 from 1), coolant (1 from 1) and heated gutta percha (1 result from 1 study).