DOI QR코드

DOI QR Code

Use of ultrasound Doppler to determine tooth vitality in a discolored tooth after traumatic injury: its prospects and limitations

  • Cho, Yong-Wook (Department of Conservative Dentistry, Oral Science Research Center, Yonsei University College of Dentistry) ;
  • Park, Sung-Ho (Department of Conservative Dentistry, Oral Science Research Center, Yonsei University College of Dentistry)
  • Received : 2013.09.04
  • Accepted : 2013.10.27
  • Published : 2014.02.28

Abstract

When a tooth shows discoloration and does not respond to the cold test or electric pulp test (EPT) after a traumatic injury, its diagnosis can be even more difficult due to the lack of proper diagnostic methods to evaluate its vitality. In these case reports, we hope to demonstrate that ultrasound Doppler might be successfully used to evaluate the vitality of the tooth after trauma, and help reduce unnecessary endodontic treatments. In all three of the present cases, the teeth were discolored after traumatic injuries and showed negative responses to the cold test and EPT. However, they showed distinctive vital reactions in the ultrasound Doppler test during the whole observation period. In the first case, the tooth color returned to normal, and the tooth showed a positive response to the cold test and EPT at 10 wk after the injury. In the second case, the tooth color had returned to its normal shade at 10 wk after the traumatic injury but remained insensitive to the cold test and EPT. In the third case, the discoloration was successfully treated with vital tooth bleaching.

Keywords

References

  1. Yoon MJ, Kim E, Lee SJ, Bae YM, Kim S, Park SH. Pulpal blood flow measurement with ultrasound Doppler imaging. J Endod 2010;36:419-422. https://doi.org/10.1016/j.joen.2009.12.031
  2. Abd-Elmeguid A, Yu DC. Dental pulp neurophysiology: part 2. Current diagnostic tests to assess pulp vitality. J Can Dent Assoc 2009;75:139-143.
  3. Ozçelik B, Kuraner T, Kendir B, Aşan E. Histopathological evaluation of the dental pulps in crown-fractured teeth. J Endod 2000;26:271-273. https://doi.org/10.1097/00004770-200005000-00004
  4. Aguiló L, Gandía JL. Transient red discoloration: report of case. ASDC J Dent Child 1998;65:346-348, 356.
  5. Andreasen FM. Pulpal healing after luxation injuries and root fracture in the permanent dentition. Endod Dent Traumatol 1989;5:111-131. https://doi.org/10.1111/j.1600-9657.1989.tb00348.x
  6. Malmgren B, Hübel S. Transient discoloration of the coronal fragment in intra-alveolar root fractures. Dent Traumatol 2012;28:200-204. https://doi.org/10.1111/j.1600-9657.2011.01073.x
  7. Andreasen FM. Transient apical breakdown and its relation to color and sensibility changes after luxation injuries to teeth. Endod Dent Traumatol 1986;2:9-19. https://doi.org/10.1111/j.1600-9657.1986.tb00118.x
  8. Cohenca N, Karni S, Rotstein I. Transient apical breakdown following tooth luxation. Dent Traumatol 2003;19:289-291. https://doi.org/10.1034/j.1600-9657.2003.t01-1-00191.x
  9. Cotti E, Campisi G, Ambu R, Dettori C. Ultrasound realtime imaging in the differential diagnosis of periapical lesions. Int Endod J 2003;36:556-563. https://doi.org/10.1046/j.1365-2591.2003.00690.x
  10. Rajendran N, Sundaresan B. Efficacy of ultrasound and color power Doppler as a monitoring tool in the healing of endodontic periapical lesions. J Endod 2007;33:181- https://doi.org/10.1016/j.joen.2006.07.020
  11. Lustig JP, London D, Dor BL, Yanko R. Ultrasound identification and quantitative measurement of blood supply to the anterior part of the mandible. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2003;96:625-629. https://doi.org/10.1016/j.tripleo.2003.08.015
  12. Yoon MJ, Lee SJ, Kim E, Park SH. Doppler ultrasound to detect pulpal blood flow changes during local anaesthesia. Int Endod J 2012;45:83-87. https://doi.org/10.1111/j.1365-2591.2011.01960.x
  13. Cohen S, Hargreaves KM. Pathways of the pulp. 9th ed. Louis: Mosby; 2006. p504-508.
  14. Ehrmann EH. Pulp testers and pulp testing with particular reference to the use of dry ice. Aust Dent J 1977;22:272-279. https://doi.org/10.1111/j.1834-7819.1977.tb04511.x
  15. Klein H. Pulp responses to an electric pulp stimulator in the developing permanent anterior dentition. ASDC J Dent Child 1978;45:199-202.
  16. Olgart L, Gazelius B, Lindh-Strömberg U. Laser Doppler flowmetry in assessing vitality in luxated permanent teeth. Int Endod J 1988;21:300-306. https://doi.org/10.1111/j.1365-2591.1988.tb01139.x
  17. Sasano T, Onodera D, Hashimoto K, Iikubo M, Satoh- Kuriwada S, Shoji N, Miyahara T. Possible application of transmitted laser light for the assessment of human pulp vitality. Part 2. Increased laser power for enhanced detection of pulpal blood flow. Dent Traumatol 2005;21: 37-41. https://doi.org/10.1111/j.1600-9657.2004.00280.x
  18. Gopikrishna V, Tinagupta K, Kandaswamy D. Comparison of electrical, thermal, and pulse oximetry methods for assessing pulp vitality in recently traumatized teeth. J Endod 2007;33:531-535. https://doi.org/10.1016/j.joen.2007.01.014
  19. Gopikrishna V, Tinagupta K, Kandaswamy D. Evaluation of efficacy of a new custom-made pulse oximeter dental probe in comparison with the electrical and thermal tests for assessing pulp vitality. J Endod 2007;33:411-414. https://doi.org/10.1016/j.joen.2006.12.003
  20. Jafarzadeh H, Rosenberg PA. Pulse oximetry: review of a potential aid in endodontic diagnosis. J Endod 2009;35: 329-333. https://doi.org/10.1016/j.joen.2008.12.006
  21. Heithersay GS, Hirsch RS. Tooth discoloration and resolution following a luxation injury: significance of blood pigment in dentin to laser Doppler flowmetry readings. Quintessence Int 1993;24:669-676.

Cited by

  1. Detection of pulsed blood flow through a molar pulp chamber and surrounding tissue in vitro pp.1436-3771, 2018, https://doi.org/10.1007/s00784-018-2530-y
  2. Detection of atrial fibrillation during pulpal blood flow assessment using Doppler ultrasound: a case report pp.1476-542X, 2018, https://doi.org/10.1259/dmfr.20170354
  3. Evaluation of microcirculation in the pulp of immature permanent teeth by ultrasound doppler after direct pulp capping with bioactive materials vol.17, pp.2, 2014, https://doi.org/10.24884/1682-6655-2018-17-2-26-29