Adult Pulpal Diagnosis. I. Evaluation of the Positive and Negative Responses to Cold and Electrical Pulp Tests

Author(s): Peters D, Baumgartner J, Lorton L
Journal: Journal of Endodontics
Volume (number): 20, No. 10
Month, Year: October 1994
Major topic: Adult Pulp Diagnosis
Minor topic(s:
Type of Article: Clinical study
Main Purpose: To investigate the positive and negative responses of teeth to cold and the electric pulp tester.
Overview of method of research: 60 patients referred for endo treatment were evaluated. At first an FMX, complete oral exam, and charting to include restorations, carious lesions and perio conditon was done. Teeth with that were pulpless or pulpally diseased (teeth with root canal fillings RCF), teeth receiving root canal therapy(RCT) and teeth with radiolucencies at the apex (ARs) were identified. CO2 cold and pulp testers the Analytic and the Digilog were used and patients were instructed to raise their hand as so as a sensation was felt. 1488 teeth were included in the study and 95 were classified as RCF, RCT, or AR.
Findings: Of the 95 teeth only 6 responded to each of the three tests, and of the 1393 only one did not respond to any of the three tests. It was noted that false positives to electrical were seen throughout the mouth but false positives to cold were only seen in multi-rooted teeth.
Key points/Summary : For an adult nontraumatized tooth if there is no response to cold or electric pulp test than there is a good probability that the tooth is diseased or pulpless. If a tooth does not respond to cold and responds at a higher than tissue response with electrical the pulp is likely diseased and should be tested further. Multirooted teeth that were diseased or pulpless had a high probability of responding to cold only if there was viable tissue remaining. If only teeth that responded to a higher level of current above the tissue response were considered positive than the percentages of false positives would be closer to CO2. If a tooth does not respond to cold and the pt is 20-50 without trauma the tooth is likely diseased or pulpless. If a tooth does not respond to electrical but does respond to cold there is likely a problem with the electric pulp tester. It is possible for teeth that are pulpally diseased or pulpless to respond to an electrical level lower than tissue response.
Assessment of article: Good information