Accuracy of cold sensibility testing on teeth with full-coverage restorations: a clinical study

Area of Science:

• Endodontics
• Dental Diagnostics

Background:

• Accurate pulpal diagnosis is crucial for effective endodontic treatment.
• Teeth with full-coverage restorations (FCR) present unique challenges for pulp sensibility testing.

Purpose of the Study:

• To evaluate the reliability of the 1,1,1,2-tetrafluoroethane (Endo Ice) cold test for pulpal diagnosis in teeth with FCR.
• To investigate variables affecting the accuracy of this diagnostic method.

Main Methods:

• A retrospective analysis of 825 patients' data was conducted.
• Compared pulp sensibility test results between 425 teeth with FCR and 400 teeth with natural crowns (NC).
• Statistical analyses included chi-square, Fisher's exact, Cochran-Mantel-Haenszel, and Wilcoxon rank-sum tests.

Main Results:

• The cold test on FCR teeth showed high accuracy (86.6%), sensitivity (83.5%), and specificity (87.9%).
• Teeth with NC demonstrated significantly higher accuracy (91.5%) compared to FCR teeth (P=0.024).
• No significant differences were found regarding gender, tooth type, crown type, abutment presence, or recent analgesic use.

Conclusions:

• 1,1,1,2-tetrafluoroethane cold testing is a reliable diagnostic tool for FCR teeth, especially for symptomatic irreversible pulpitis.
• While less accurate than in NC teeth, its clinical utility remains high.
• Routine use of cold pulp sensibility testing is recommended for pulpal diagnosis.