Diagnostic Implications of Dental Interventions for Pulp Testing in Endodontics: A Scoping Review

To map and synthesize the evidence on how dental interventions and trauma-related conditions affect the outcomes and diagnostic reliability of pulp testing methods, including sensibility and vitality tests.

Original studies evaluating the effects of dental interventions or trauma-related conditions on pulp testing outcomes in human teeth.

PubMed (MEDLINE), Scopus, and Web of Science were searched, supplemented by grey literature and reference-list screening. The final search was conducted on July 1, 2026.

Studies assessing the effects of orthodontic, surgical, periodontal, traumatic, and restorative or aesthetic interventions on pulp sensibility or vitality test responses were included. Of 2,679 records identified, 78 studies were included.

Dental interventions and trauma-related conditions may transiently alter pulp test responses without indicating pulpal necrosis, producing false-negative sensibility results after disruption of pulpal neural activity or vascular supply. Cold testing was generally more reliable than electric pulp testing, particularly in traumatized and restored teeth. Pulse oximetry and laser Doppler flowmetry assess pulpal blood flow more directly and appear less affected by temporary neural impairment, but limited availability and cost restrict routine use. Gaps remain regarding long-term effects and standardized protocols. Test results should be interpreted together with clinical and radiographic findings.

Understanding how interventions and trauma influence pulp test responses can help clinicians avoid false diagnoses and unnecessary endodontic treatment, and select appropriate tests in challenging situations.

The protocol for this scoping review was prospectively registered with the Open Science Framework (OSF) (link masked for double-anonymized review).