Evaluation of the Two Commonly Used Pulp Tests for Assessing Pulp Vitality and Sensitivity

Abstract

Hard tissue boundaries are limited to pulp tissue and cannot be inspected directly for health evaluation so most of its evaluations are based on sensitivity testing. It is believed that electric pulp test (EPT) has some limitations in determining the vitality of the pulp. Therefore the objective in the current study was to see how well the electric pulp test and the cold test agreed in evaluating pulp vitality and sensitivity. Study Design, Place and Duration: This Observational/Retrospective study was carried from 1st March, 2021 to 31st December, 2021 at the Department of Dental Materials, Sardar Begum Dental College, Gandhara University, Peshawar. Methods: Total one hundred and eighteen patients of both genders had pulpits because of dental caries were included in this study. A range of ages were represented from 18 to 50 years old. As part of the informed written consent process, each patient was asked to provide demographic information such as their age, gender, and the type of teeth they had. Patients were equally categorized into two groups, Group I received electric pulp test and group II received cold test. Teeth were classified as vital if there was tingling or pain, and non-vital if there was no tingling or discomfort. Outcomes among both groups were calculated in terms of absence or presence of tingling sensation. Visual analog scale was used to determine pain score among enrolled cases. We used SPSS 23.0 version to analyze the data. Results: Among 118 patients, 67 (56.8%) were males and majority of the cases 60 (50.8%) were aged between 26-35 years, followed by age group 18-25 in 35 (29.7%) cases and 23 (19.5%) cases were between age group 36-45 years. Mandibular incisors were the most common tooth found in 47 (39.8%) cases followed by maxillary incisors 32 (27.1%) cases. By using visual analogue scale (VAS), we found that most of the patients had severe pain 90 (76.3%). The rate of vital teeth in group I was 45 (76.3%) and in group II vital teeth found in 41 (69.5%) while remaining tooth were necrotic among both groups 14 (23.7%) and 18 (30.5%). By Kappa’s statistics we found that overall frequency of vital teeth among all cases was 86 (72.9%). Conclusion: In assessing pulp viability and sensitivity, EPT and cold testing showed great concordance, according to this study. Electric pulp testers and cold testing currently satisfy the majority of the criteria for an ideal testing procedure and are still widely utilized diagnostic tools. When EPT and Endo frost are used together, a more precise assessment of pulp vitality can be made.