Detection of pulsed blood flow through a molar pulp chamber and surrounding tissue in vitro

Knörzer, S; Hiller, K-A; Brandt, M; Niklas, Andreas; Putzger, J.; Monkman, Gareth J.; Danilov, Sergey; Ganichev, Sergey; Schulz, Irene; Schmalz, Gottfried

doi:10.1007/s00784-018-2530-y

Cited by 4 publications

(14 citation statements)

References 49 publications

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“…Pulse oximetry is based on the same technical principle but uses red and infrared light, allowing for the assessment of hemoglobin oxygen saturation. Laser Doppler flowmetry uses the Doppler frequency shift of laser light by reflection from moving erythrocytes to detect blood flow tissues 108,109 . The main problem of these various methods is the lack of spatial resolution and the interference with blood signals from the surrounding (mainly periodontal) tissues.…”

Section: Future Perspectivesmentioning

confidence: 99%

“…Recently, a promising method was proposed by which the pulsation of the blood can be assessed by different wavelengths. In an in vitro model in which blood flow through the dental pulp and through surrounding tissues was simulated and could be varied independently, signals mainly derived from the dental pulp could be recorded by a certain wavelength in the infrared area 108 (Fig. 5A-C).…”

Section: Future Perspectivesmentioning

confidence: 99%

“…Statistical analysis (Mann-Whitney U test) was performed at a significance level of a 5 0.05 separately for each wavelength and EC; all values were pairwise significantly different, except the pairs marked with equal letters. (C ) Example recordings of the vascular pressure signals from pulp (blue) and gingiva (red) at 940 nm before and after cessation of the pulsed circulation in the glass pulp model at 10 seconds 108 .…”

Section: Conclusive Remarksmentioning

confidence: 99%

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Clinical Perspectives of Pulp Regeneration

Schmalz

Widbiller

Galler

2020

Journal of Endodontics

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Introduction: A sound and vital pulp is an essential prerequisite for long-term tooth survival and preservation. However, current endodontic treatment concepts are based on the removal of inflamed or necrotic pulp tissue and the replacement by a synthetic biomaterial. Recently, total or partial pulp regeneration has been proposed as an alternative treatment concept. The aim of this review was to evaluate the current options of pulp treatment and regenerative approaches, both for immature and mature teeth, in a clinical context. Methods: Clinical success rates of classic treatment options such as pulpotomy or root canal filling after pulpectomy or the removal of necrotic tissue are compared with recent reports on regenerative approaches like revitalization or partial and total pulp regeneration. Results: Revitalization in immature teeth with pulp necrosis is an additional treatment option besides placing an apical plug, leading to clinically acceptable outcomes, although with low predictability regarding the completion of root formation. Coronal regeneration of the amputated pulp in immature teeth constitutes a promising scientific approach, but data from clinical studies are missing. Mature teeth display a reduced potential for regeneration. Regenerative procedures using cell transplantation or cell homing are mainly in the experimental phase with only 2 clinical studies on cell transplantation. In parallel to the further development of regenerative therapies, the classification of pulp diseases should be revised, and the diagnostic tools need improvement. Conclusions: The rethinking of current concepts for biology-based treatments and improved diagnostic concepts might postpone the point of root canal filling depending on the clinical situation.

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Section: Future Perspectivesmentioning

confidence: 99%

Section: Future Perspectivesmentioning

confidence: 99%

Section: Conclusive Remarksmentioning

confidence: 99%

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Clinical Perspectives of Pulp Regeneration

Schmalz

Widbiller

Galler

2020

Journal of Endodontics

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“…Knorzer et al . (2019) reported a new laboratory model for photoplethysmography, in which a hollow glass form was fitted into the pulp chamber and the root canals using a heat proofcast, enabling the entry of blood into one root (inner diameter: ca 0.1–0.15 mm) before passing through the coronal part (inner diameter: ca. 0.5 mm) and exit through the other root (inner diameter: ca 0.1–0.15 mm).…”

Section: Discussionmentioning

confidence: 99%

“…The signals detected from a tooth may be attributed to blood flow in the dental pulp, as well as the blood flow in the tissue surrounding the tooth (Knorzer et al . 2019). Up to 80% of the laser Doppler signal originates in the periodontal tissue.…”

Section: Discussionmentioning

confidence: 99%

A laboratory study to detect simulated pulpal blood flow in extracted human teeth using ultrasound Doppler flowmetry

et al. 2020

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AimTo develop a laboratory‐based tooth model of simulated blood flow in teeth and evaluate it using ultrasound Doppler flowmetry (UDF).MethodologyA laboratory‐based tooth model for UDF was created based on a microfluidic experimental model proposed by Kim & Park (2016 a,b). Twenty‐one maxillary or mandibular anterior human teeth within 1 month of extraction were used. Four holes were made in each tooth to fit 1.6‐mm diameter polytetrafluoroethylene (PTFE) tubes: at the apical foramen, palatal surface in the centre of the crown, palatal surface apical to the cementoenamel junction (CEJ) and the root centre. Fluid mimicking pulsating blood was pumped (pressure range: 0–200 mbar, flow rate range: 0–80 μL min−1) into the apical foramen via the PTFE tubes, which exited the tooth through the palatal surface in the centre of the crown (control group), palatal surface below the CEJ (group 1) and the palatal surface at the mid‐root level (group 2). An UDF transducer of 20 MHz was placed at a 60° angle to the labial surface of tooth and was used to measure the fluid flow velocity (Vs, Vas, Vm, Vam, Vd, Vad and Vakd). The flow velocity of the different groups was compared using the Wilcoxon signed‐rank test, with a 95% confidence level.ResultsUDF facilitated the detection of the simulated pulpal blood flow in the control group and group 1, but not in group 2. The mean and standard deviations of Vas, Vam and Vakd were 0.921 ± 0.394, 0.479 ± 0.208 and 0.396 ± 0.220 cm s−1, respectively, in the control group, and 0.865 ± 0.368, 0.424 ± 0.215 and 0.487 ± 0.279 cm s−1, respectively, in group 1. The pulpal blood flow values of the control group and group 1 were not significantly different (p > 0.05).ConclusionsThis laboratory study revealed that ultrasound Doppler flowmetry enabled the detection of simulated blood flow below the level of the CEJ but not at the mid‐root level.

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Exploring approaches to pulp vitality assessment: A scoping review of nontraditional methods

Afkhami,

Wright,

Chien

et al. 2024

Int Endodontic J

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IntroductionDiagnostic procedures for pulp vitality assessment are a crucial aspect of routine dental practice. This review aims to provide a comprehensive overview of nontraditional techniques and methodologies for assessing pulp vitality, specifically exploring promising approaches that are currently not used in dental practice.MethodsThe study protocol was registered a priori (https://osf.io/3m97z/). An extensive electronic search was conducted across multiple databases, including MEDLINE via PubMed, Scopus, Web of Science, and Embase. Inclusion criteria were guided by the research question based on the PCC model as follows: “What are the potential nontraditional techniques (Concept) for assessing pulp vitality (Population) in the field of endodontics or clinical practice (Context)?” Studies were included that explored possible approaches to pulp vitality assessment, utilizing a range of techniques, whilst any studies using traditional pulp tests (cold, heat, and electric stimulation) or well‐known methods (pulse oximetry and laser Doppler flowmetry) were excluded. Reviewers independently screened articles and extracted data. A patent search was also performed.ResultsOf 3062 studies, 65 were included that described nontraditional approaches for assessing pulp vitality. These included a range of optical diagnostic methods, ultrasound Doppler flowmetry (UDF), magnetic resonance imaging (MRI), terahertz imaging, tooth temperature measurements, as well as invasive methodologies, including 133xenon washout, radioisotope‐labelled tracers, hydrogen gas desaturation, intravital microscopy and fluorescent microspheres isotope clearance. The patent search included artificial intelligence and biomarkers methods.ConclusionsThis review provides details for potential innovative tests that may directly describe pulp vitality. Importantly, these methods range from clinically impractical through to promising methods that may transform clinical practice. Several nontraditional techniques have the potential to enhance diagnostic accuracy and could provide valuable insights into the assessment of pulp vitality in challenging clinical scenarios.

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Detection of pulsed blood flow through a molar pulp chamber and surrounding tissue in vitro

Abstract: The results show the need for clear differentiation of the spatial origins of blood flow signals of any vitality test method to be applied to teeth.

Cited by 4 publications

References 49 publications

Clinical Perspectives of Pulp Regeneration

Clinical Perspectives of Pulp Regeneration

A laboratory study to detect simulated pulpal blood flow in extracted human teeth using ultrasound Doppler flowmetry

Exploring approaches to pulp vitality assessment: A scoping review of nontraditional methods

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