Abstract
The purpose of this study was to determine if gas tension and acidity levels could serve as biomarkers of pulp inflammatory status in primary dentition. The present study evaluated acidity level and blood partial pressures of O2 and CO2 collected from vital pulp chambers of 84 primary molars with deep carious lesions encroaching the pulp. Teeth were treated with pulpotomy or pulpectomy based on clinical judgement. Pulpectomy was performed when symptoms of spontaneous pain, difficulty in obtaining hemostasis and/or dark purple blood were present. Using a glass capillary, pulp chamber bleeding was collected and within ten minutes a neonate Astrup test was performed to determine blood gas module pH, pCO2, and pO2. Eighty-four children with one affected tooth participated in the study (37 girls and 47 boys). Age ranged between 3.5 to 9-years (average: 5.3 years). Seventy-one (84%) were treated with the aid of inhalation analgesia, conscious sedation or general anesthesia. Pulpotomy was performed on 58 teeth (69%). Teeth undergoing pulpectomy revealed significant higher level of CO2 partial pressure (P= 0.002). Acidity level values (pH) were also lower but none significantly in teeth with pulpectomy (P= 0.137). Higher pCO2 levels was found in pulps needing pulpectomy.
Highlights
The purpose of this study was to determine if gas tension and acidity levels could serve as biomarkers of pulp inflammatory status in the primary dentition
The present study evaluated acidity level and blood partial pressures of O 2 and CO 2 collected from vital pulp chambers of 84 primary molars with deep carious lesions encroaching the pulp
The present study evaluated the level of acidity and blood partial pressure of O2 and CO2 in samples drawn from pulp chambers of primary molars undergoing pulpotomy or pulpectomy
Summary
The purpose of this study was to determine if gas tension and acidity levels could serve as biomarkers of pulp inflammatory status in the primary dentition. Vital pulp therapy in primary teeth is indicated for extensive tooth decay approximating the pulp of asymptomatic teeth or teeth with signs of reversible pulpitis [1]. Pre-operative diagnostic methods of pulp status in primary teeth are primarily based on clinical signs and symptoms, pain history and radiographic assessment [2,3,4]. The success of vital pulp therapy strongly depends on the inflammatory status of the coronal and radicular pulp tissues [7]. While for healthy pulp tissue with inflammation confined to the coronal pulp, the recommended treatment is pulpotomy, for irreversible pulpitis the recommended treatment is pulpectomy [8]. Clinicians face the diagnostic difficulty of accurately assessing the inflammatory state of the pulp [3], a diagnosis that will determine tooth prognosis [3]. Endodontic diagnostics showed higher competence at identifying persons who were free of pulpitis than at identifying pulpitis-positive persons, with a danger of false-positive misclassifications [9]
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