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Reliability of electric pulp test and thermal pulp test for assessing pulpal response in patients undergoing orthodontic treatment – A systematic review - 13/11/24

Doi : 10.1016/j.ortho.2024.100952 
Divya Nangia 1, Isha Duggal 2, , Ajay Logani 3, Sidhartha Sharma 3, Ritu Duggal 4
1 Department of Conservative Dentistry and Endodontics, Sudha Rustagi College of Dental Sciences and Research, Haryana, India 
2 Department of Orthodontics, Maulana Azad Institute of Dental Sciences, New Delhi, India 
3 Department of Conservative Dentistry and Endodontics, Centre for Dental Education and Research, AIIMS, New Delhi, India 
4 Department of Orthodontics, Centre for Dental Education and Research, AIIMS, New Delhi, India 

Isha Duggal, Department of Orthodontics, 4th floor, Maulana Azad Institute of Dental Sciences, New Delhi, India.Department of Orthodontics, 4th floor, Maulana Azad Institute of Dental SciencesNew DelhiIndia

Highlights

The pulp response threshold increases after application of orthodontic force, peaking at about two or three months.
The reliability of the thermal pulp test was considered higher as compared to electric pulp test, irrespective of the orthodontic force type.
The pulp response threshold of smaller teeth (single-rooted) is affected to a greater magnitude and duration, as compared to large multi-rooted teeth.

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Summary

Objective

To assess the reliability of pulp sensibility tests in patients undergoing orthodontic treatment.

Background

The orthodontic force may cause transient changes in pulp vasculature leading to alteration in its response threshold. This may vary with the type, duration and magnitude of forces used. Thus, it is imperative to monitor the pulp sensibility and vitality of teeth during the course of orthodontic treatment.

Material and methods

Sources: PubMed, Web of Science, Embase, Scopus, Cochrane Central Register of Controlled trials, ClinicalTrials.gov, Clinical Trials Registry-India and OpenGrey. Randomized clinical trials and/or observational studies evaluating the pulp sensibility response of patients undergoing orthodontic treatment were included. Study characteristics, sample characteristics, methodology details, outcome assessment, and main results were recorded in excel sheet. The Newcastle-Ottawa scale (NOS) was used to assess risk of bias (ROB). Certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool.

Results

Thirteen observational studies were included. Total number of participants who underwent orthodontic treatment was 2956 (average age 17.53±3.81 years). The type and duration of orthodontic force was variable in the different studies. The pulp sensibility response was assessed using either Electric pulp test (EPT), or Thermal pulp test (TPT), or both. Pulp response threshold increased after application of orthodontic force, with number of negative responses peaking at about 2-3 months. Most of the studies presented with a high ROB. The certainty of evidence was considered low.

Conclusions

Based on limited comparative data, TPT was considered more reliable than EPT and that the pulp response threshold increased after application of orthodontic force, peaking at about two or three months. PROSPERO database (CRD42022307390).

Le texte complet de cet article est disponible en PDF.

Keywords : Pulp sensibility test, Orthodontic tooth movement, Dental pulp test, Pulp response threshold, Intrusion, Rapid maxillary expansion


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Vol 23 - N° 1

Article 100952- mars 2025 Retour au numéro
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