Restorative Dentistry and Endodontics

The Korean Academy of Conservative Dentistry (대한치과보존학회)
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Reference values for pulp oxygen saturation as a diagnostic tool in endodontics: a systematic review and meta-analysis

  • Paula Lambert (Department of Endodontics, Graduate Program in Dentistry, Universidade Luterana do Brasil (ULBRA)) ;
  • Sergio Augusto Quevedo Miguens Jr (Department of Endodontics, Graduate Program in Dentistry, Universidade Luterana do Brasil (ULBRA)) ;
  • Caroline Solda (Department of Endodontics, Faculdade Meridional (IMED) School of Dentistry) ;
  • Juliana Tomaz Sganzerla (Department of Oral Diagnostic, Graduate Program in Dentistry, Universidade Luterana do Brasil (ULBRA)) ;
  • Leandro Azambuja Reichert (Department of Operative Dentistry, Universidade Federal do Rio Grande do Sul (UFRGS) School of Dentistry) ;
  • Carlos Estrela (Department of Endodontics, Graduate Program in Dentistry, Universidade Federal de Goias (UFG)) ;
  • Fernando Branco Barletta (Department of Endodontics, Graduate Program in Dentistry, Universidade Luterana do Brasil (ULBRA))
  • Received : 2020.01.08
  • Accepted : 2020.04.27
  • Published : 2020.11.30
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Abstract

Objectives: This systematic review aimed to identify mean oxygen saturation values (SpO2) using pulse oximetry in permanent maxillary anterior teeth. Materials and Methods: The MEDLINE, Scientific Electronic Library Online, Cochrane Central Register of Controlled Trials, EMBASE, and Literatura Latino Americana em Ciências da Saúde electronic databases were searched. Combinations and variations of "oximetry" AND "dental pulp test" were used as search terms. Studies reporting means and standard deviations of SpO2 values were included. Two reviewers independently extracted data following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. Heterogeneity was assessed using the I2 statistic, and all analyses were performed using R software. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool and the Newcastle-Ottawa scale. Results: Of the 251 studies identified, 19 met the eligibility criteria and were included (total sample, 4,541 teeth). In the meta-analysis, the mean SpO2 values were 84.94% (95% confidence interval [CI], 84.85%-85.04%) for the central incisors, 89.29% (95% CI, 89.22%-89.35%) for the lateral incisors, and 89.20% (95% CI, 89.05%-89.34%) for the canines. The studies were predominantly low-quality due to the high risk of bias associated with the index test, unclear risk regarding patient selection, and concerns about outcome assessment. Conclusions: Although most studies were low-quality, the oxygen saturation levels in normal pulp could be established (minimum saturation, 77.52%). Despite the risk of bias of the included studies, the reference values reported herein are clinically relevant for assessments of changes in pulp status.

Keywords

Acknowledgement

Andre Ferreira Azeredo Da Silva, a researcher at the Institute of Health Technology Assessment, contributed to the statistical analysis conducted as part of this study.

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