Influence of splints and temporary crowns upon electric and thermal pulp-testing procedures

Area of Science:

• Dentistry
• Endodontics
• Dental Materials

Background:

• Accurate pulp vitality testing is crucial for diagnosing dental conditions.
• Various dental restorations, including splints and temporary crowns, may interfere with pulp testing methods.
• Understanding these interferences is essential for reliable clinical diagnosis.

Purpose of the Study:

• To evaluate the influence of different dental splints and temporary crowns on the reliability of electric and thermal pulp testing procedures.
• To compare the efficacy of various pulp testing methods under different restorative conditions.

Main Methods:

• The study involved 20 patients with vital maxillary central incisors and unilateral pulp necrosis.
• Pulp testing utilized Bofors Pulp Tester, Siemens Sirotest, heated guttapercha, ice, and carbon dioxide snow (Odontotest).
• Tested splints included silver cap splint, acrylic cap splint, Hawley orthodontic plate, Saur's arch bar, orthodontic bands, and stainless steel crowns.

Main Results:

• Reliable electrometric pulp response required direct application of the tester on enamel, ideally the incisal edge.
• Metal splints or partial steel crowns did not affect the pain threshold when applied correctly.
• False positive reactions in pulp necrosis cases occurred when electrodes contacted metal touching adjacent vital teeth.
• Ice and heated guttapercha showed inconsistent responses; carbon dioxide snow was reliable except when applied on the incisal edge.

Conclusions:

• Direct application on enamel is key for reliable electric pulp testing, unaffected by most splints.
• Carbon dioxide snow offers a reliable thermal testing method, with specific application considerations.
• Careful technique and understanding potential interferences are vital for accurate pulp vitality assessment in restorative dentistry.