Relationship between the difference in electric pulp test values and the diagnostic type of pulpitis

Area of Science:

• Endodontics
• Dental Diagnostics

Background:

• Current American Association of Endodontists (AAE) criteria for pulpitis diagnosis rely on cold/heat tests.
• The diagnostic utility of the electric pulp test (EPT) for differentiating pulpitis types remains unclear.
• EPT is believed to have limitations in accurately assessing pulp vitality.

Purpose of the Study:

• To investigate the association between EPT value differences and the differential diagnosis of reversible pulpitis (RP) and symptomatic irreversible pulpitis (SIRP) in teeth affected by dental caries.
• To evaluate the effectiveness of EPT in distinguishing between RP and SIRP.

Main Methods:

• A cohort of 203 patients with caries-induced pulpitis was analyzed.
• Diagnoses of RP and SIRP were established using AAE criteria.
• EPT values of affected and control teeth were measured, and differences were calculated.
• Univariate and multivariate logistic regression analyses were employed to assess correlations.

Main Results:

• Statistical analysis in model 3 (adjusted for age, sex, and tooth type) showed a significant difference in EPT values between RP and SIRP (OR=1.025, P=0.035).
• However, the overall model accuracy, indicated by the area under the curve (AUC), was low across all tested models (ranging from 0.565 to 0.617).
• Analysis of EPT value differences as a categorical variable did not yield statistically significant results for differentiating RP from SIRP.

Conclusions:

• The difference in EPT values alone is insufficient for reliably differentiating between RP and SIRP in cases of dental caries.
• The diagnostic accuracy of EPT for distinguishing these pulpitis types requires further investigation and potential refinement.