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Pulpal tests may be conducted via stimulation of the sensory fibres within the pulp (sensitivity testing) or by assessing pulpal blood flow (vitality testing). All available techniques are reported to have limitations in terms of accuracy and reproducibility [ 1 ] and therefore require careful interpretation in clinical practice.
Pulp vitality tests are positive and it is possible to preserve a healthy vital pulp. Irreversible pulpitis, in contrast, is characterised by a constant severe pain that arises without provocation. Characteristics may include sharp pain upon thermal stimulus, lingering thermal pain, spontaneity, and referred pain.
Vitality Test Sensitivity to temperature stimuli, particularly cold, often indicates the presence of proximal or near-pulp cracks. A positive response to both cold stimulation and bite tests is suggestive of a cracked tooth (Mathew S et al.,2012)
The health of the dental pulp can be established by a variety of diagnostic aids which test either the blood supply to a tooth (Vitality Test) or the sensory response of the nerves within the root canal to specific stimuli (Sensitivity Test). Although less accurate, sensitivity tests, such as Electric Pulp Tests or Thermal Tests, are more ...
Pulpotomy is a vital pulp therapy; medicaments that can promote healing and preserve the vitality of the tooth should be placed after removal of the inflamed pulp. [ 12 ] In primary teeth medicaments such as formocresol, mineral trioxide aggregate , zinc oxide eugenol and calcium hydroxide can be used in pulpotomy.
In developing teeth, preserve pulp vitality by pulp capping or partial pulpotomy using calcium hydroxide In mature teeth, root canal treatment is usually performed Non-emergency: removal of loose fragment (following gingivectomy, surgery or via orthodontics), root canal treatment and restoration with post-retained crown
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Regenerative endodontics is founded by the seminal work by Dr. Ostby in the early 1960s. He hypothesized that the presence of blood clot within the root canal promotes healing of the pulp, hence maintaining the vitality of the pulp. This can be quite similar to the role of blood clot in other injury site in the healing process.