Laser light passage through restored and carious posterior teeth

Laser Doppler flowmetry (LDF) has been used to investigate pulpal blood flow as a means of pulp vitality testing. Transmission of laser light from the tooth surface to the pulp space may be influenced by caries and restorations. One hundred and twenty-two first and second molars that had caries into dentine, restorations or significant loss of coronal tissue were sectioned in half axio-bucco-lingually. The two sections were illuminated with a laser from their buccal and lingual aspects 2 mm coronal to the amelocemental junction. Light reaching the pulp space was recorded. Buccal and lingual illumination sites were equally effective for 67 teeth (55%). Buccal sites alone were effective for 35 teeth (29%), despite over one-third of these surfaces being restored or featuring enamel or dentine caries. A lingual position alone was effective for 20 teeth (16%). Caries affected light transmission, but for over half the teeth, the pulp could be illuminated from all four probe positions. No effect was found when the influence of mesial and distal restorations on transmission into the corresponding tooth section was examined. The pulp spaces of most (84%) restored, and carious posterior teeth could be illuminated by laser light from their buccal aspect and these teeth could potentially be vitality tested using LDF.