Comparative evaluation of clinical diagnostic trials for pulpal status assessment and establishment of reference values in healthy young adults

Abstract

Introduction/Objective Traditional diagnostic methods for assessing pulp vitality are commonly used but lack precision and reliability, whereas recent advancements offer non-invasive alternatives, focusing on pulp tissue blood flow and oxygen saturation. This study was designed to evaluate and compare the reliability of all available clinical diagnostic methods for assessing pulp status and to establish reference values in healthy young individuals.

Methods This cross-sectional observational study enrolled 25 voluntary participants (27.8 ± 5.2 years old), with 150 upper front teeth. The participants were healthy individuals, non-smokers, with teeth having a mature apex, no or minimal restorations, being periodontally healthy, and with radiographically visible pulp chambers. Various diagnostic tests were conducted, including electric (EPT), cold (CPT), and hot pulp testing (HPT), laser Doppler flowmetry (LDF), and pulse oximetry (PO); the reference values were established.

Results Statistically significant differences were observed among all tooth groups (central incisors, lateral incisors, and canines) for EPT, LDF, and PO. In contrast, CPT and HPT showed no statistically significant differences between the tooth groups. The mean values across all patients were as follows: EPT – 17.7 ± 5.4, PO – 80.6 ± 1.8%, and LDF – 4.6 ± 1.6 perfusion units. Correlation analysis showed no significant relationships between the tests.

Conclusion Modern diagnostic techniques show promise in offering more reliable results. Establishing reference values is essential for improving diagnostic accuracy. These values will not only enhance clinical decision-making but also serve as a foundation for future investigations.

Keywords: clinical diagnostic methods; laser Doppler flowmetry; pulse oximetry; electric pulp testing; dental pulp