Diagnostic Accuracy of Electrical Pulp Testing Compared to the Thermal in Primary Teeth

Abstract

Aim: This study aimed to assess the diagnostic accuracy of electric pulp testing compared to thermal method in registering pulp status in primary molars. Subjects & Methods:Forty cooperative children with carious primary molars were included in the study. The cold test was carried out using Ethyl Chloride on cotton pellet and was applied to the middle third of the buccal surface until the child indicated that he had felt sensation. The heat test was carried out using heated gutta-percha. Before using the electric pulp tester (EPT) teeth were isolated and dried. The gold standard for pulp status was decided by direct inspection of the presence or absence of bleeding after access cavity had been done. Data were statistically described in terms of frequencies and percentages. Comparison between the different test results was done using McNemar test. Agreement was tested using kappa statistic. Accuracy was represented using the terms sensitivity, specificity, +ve predictive value, -ve predictive value, and accuracy. Comparing accuracy was done using Yates corrected Chi squared test. p values less than 0.05 was considered statistically significant. Results:The highest accuracy was found for EPT followed by heat and cold tests. The highest true negative response was recorded for EPT (47.5%), then heat and cold (35%) and (30%) respectively. Sensitivity for EPT, heat and cold was 84.2%, 94.74% and 84.21 respectively while, specificity was 90.48%, 66.67% and 57.14%. Conclusions:EPT can be used as a sensible test for diagnosing pulp status in primary teeth.

A Diagnostic Insight of Dental Pulp Testing Methods in Pediatric Dentistry

“…Sensibility pulp testing in children, although deemed reliable by some studies [ 34 , 35 , 36 , 37 ], highly depend on the child’s apprehension associated with the test itself [ 38 ]. In addition, invalid data might be obtained as a result of the often unreliable responses from children because of fear, management problems, and inability to understand or communicate accurately [ 17 , 39 ].…”