Review of pulp sensibility tests. Part I: general information and thermal tests

Abstract

A major, and essential, part of the diagnostic process for pulp disease is the use of pulp sensibility tests. When diagnosing pulp pain, these tests can be used to reproduce the symptoms reported by the patient to diagnose the diseased tooth as well as the disease state. However, a major shortcoming with these tests is that they only indirectly provide an indication of the state of the pulp by measuring a neural response rather than the vascular supply, so both false positive and false negative results can occur. The relevant literature on pulp sensibility tests in the context of endodontics up to January 2009 was reviewed using PubMed and MEDLINE database searches. This search identified papers published between November 1964 and January 2009 in all languages. Thermal tests have been used as an integral part of dental examinations. Two types of thermal tests are available, one uses a cold stimulus and the other uses a hot stimulus, and each has various methods of delivery. If these tests are used properly, injury to the pulp is highly unlikely. A review of the literature regarding the rationale, indications, limitations, and interpretation of thermal tests, the value of these diagnostic tests, as well as a discussion of the important points about each of these tests is presented.