The Diagnostic Accuracy of Pulse Oximetry for Assessing Pulp Vitality: A Systematic Review

This review was performed to evaluate the diagnostic accuracy of pulse oximetry (PO) in patients with apical periodontitis (AP) or undergoing an endodontic treatment. Preferred Reporting Items for Systematic Reviews and Meta-Analysis-Diagnostic Test Accuracy (PRISMA-DTA) checklist was followed to carry out this review. The diagnostic potential of pulse oximetry for pulp vitality status was studied through databases like PubMed, Google Scholar, EBSCOhost from 2000 to 2024. Extraction or manual calculation of true-positive, false-positive, true-negative, false-negative, sensitivity, and specificity values were done. Quality assessment of diagnostic accuracy studies (QUADAS)-2 tool and RevMan ver. 5.3 qualitatively assessed the included studies. The included seven studies evaluated 654 teeth and reported a low risk of bias (ROB). The included studies evaluated the reliability, efficacy, and diagnostic ability of PO and compared it to other conventional pulp vitality and sensitivity tests like a cold test, thermal test, electric pulp test (EPT), spray, and rubber cups. Its overall sensitivity ranged from 81-100% (mean 95%) and overall specificity ranged from 94-100% (mean 99%). It was concluded that pulse oximetry overall is more reliable, superior, effective and has overall diagnostic efficacy in detecting the target condition compared to other conventional modalities.