21/12/1434
Vitality Tests
Provide an adjunct to determining the state of pulp Results must be interpreted with caution False positive and false negative results are common
Vitality tests
Surrounding and contralateral teeth should also be tested Test should begin on a normal tooth Stimuli should be applied to normal enamel of the crown of the tooth Better results if more than one test is used ( heat and cold, or cold and electrical tests)
21/12/1434
21/12/1434
Cold Test
Involves using a refrigerant, such as endo-ice, ethyl chloride spray The middle third of the clinical crown for posterior teeth and the border between the coronal and middle thirds of the clinical crown for anterior teeth
21/12/1434
21/12/1434
21/12/1434
21/12/1434
The use of hot water, administered through an irrigating syringe under rubber dam isolation
21/12/1434
Disadvantages
May be difficult to use on posterior teeth because of limited access Excessive heating may result in pulp damage May result in a lingering pain, therefore heat tests should be applied for no more than 5 seconds Inadequate heating of the gutta-percha stick could result in the stimulus being too weak to elicit a response from the pulp
21/12/1434
10
21/12/1434
Between 0-40, the patient feels ache; vital pulp Between 4080,with abovementioned reaction, partially vital pulp 80, no mentioned reaction, non-vital pulp
11
21/12/1434
12
21/12/1434
Electrical conducting gel is present between the electrode and the tooth
13
21/12/1434
14
21/12/1434
15
21/12/1434
16
21/12/1434
False Positive
The test unhealthy tooth responds normally; Occur in anxious or young patients Contact with metal restorations (electric test) Inadequately dried teeth ( electric test) Multi rooted teeth with one vital root canal pulp In a root canal filled with pus or gas In a patient with low pain threshold
False Negative
Teeth with restorations ( heat and cold test) Teeth with secondary dentine Nerve supply to the pulp is damaged (e.g. trauma) In a patient with a high pain threshold Faulty technique or equipment
17
21/12/1434
Inconclusive Result
All teeth give similar responses: conflictive results If the results of two tests are inconclusive add a third test Consider cutting a diagnostic access cavity without local anaesthesia
18
21/12/1434
19
21/12/1434
A LDF probe applied to a sectioned tooth showing the passage of light via the enamel prisms and dentinal tubules to the pulp
A LDF trace showing signals from two teeth; the upper is from a vital tooth while the lower is from a nonvital tooth
20