Pulse Oximeter as a Diagnostic Tool for Assessing Pulpal Pathology: A Systematic Literature Review and Meta-Analysis

Pulse oximetry offers a more objective approach than traditional pulp sensibility tests, which can produce unreliable results-particularly in inflamed or traumatised teeth. We conducted a systematic review and meta-analysis of English-language analytical cross-sectional studies (2012-2024) assessing pulp oxygen saturation (%SpO₂) via pulse oximetry in mature permanent teeth with symptomatic pulpitis. Three reviewers independently screened and extracted data, and study quality was appraised using the Joanna Briggs Institute (JBI) checklist. Meta-analysis compared %SpO₂ levels between healthy pulp, reversible pulpitis (RP) and irreversible pulpitis (IP). All three included studies reported significantly lower %SpO₂ in inflamed pulp versus healthy controls: RP showed a mean difference (MD) of -7.37% (95% CI: -8.12 to -6.61), IP -11.29% (-11.99 to -10.58) and reversible versus IP differed by 3.92% (3.35-4.48; p < 0.00001). These findings suggest that pulse oximetry may enhance pulp vitality assessment when used alongside conventional methods. Trial Registration: PROSPERO (CRD42024572895).