• Journal of the korean academy of Pediatric Dentistry
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• v.26 no.2
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• pp.310-316
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• 1999

In the traumatized teeth, the major complications are pulp necrosis, and root resorption. The factors influencing to prognosis are the state of root development, type of injuries, quality of fixation. There are good prognosis in the case of immature teeth, minor luxation injuries. To minimize of occurrence of these complication, it is very important to determine the pulp vitality. This can help us decide whether or not to treat the teeth endodontically. But, it is difficult to determine of pulp vitality in immature teeth or traumatized teeth. In this case, pulp vitality test was done periodically on the traumatized upper central incisors, and the results were different among cold test, electric pulp test, and laser Doppler flowmetry. The conclusions were obtained from this case can be summarized as follows; 1. Pulp vitality of traumatized teeth should be negative early, but with time going, pulp vitality could be recovered. 2. The positive response of pulp vitality test was detected earlier in laser Doppler flowmetry. 3. Between cold test and electric pulp test, cold test was more reliable in determining pulp vitality.

• Journal of the korean academy of Pediatric Dentistry
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• v.25 no.3
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• pp.562-568
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• 1998

Various diagnostic methods, such as electric pulp test, cold test, test cavity etc., have been used to determine the pulp vitality. At least two or more methods should be used with supplemental information to diagnose each case because using one method doesn't provide sufficient accuracy. These conventional methods have depended on nervous responses, but Laser Doppler Flowmeter determines the pulp vitality by measuring pulpal blood flow. In this case, we tested the vitality of the traumatized teeth with incomplete root apices and autotransplanted teeth with conventional methods and Laser Doppler Flowmeter. Conventional methods, such as electric pulp test and cold test can produce various responses according to the development state of the pulpal nerve and the sensory threshold of the patient. But, Laser Doppler Flowmeter has a lower false response rate than any other pulp vitality test methods and it can determine the vitality somewhat earlier than the other method.

• Restorative Dentistry and Endodontics
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• v.24 no.4
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• pp.560-569
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• 1999

Blood supply rather than nerve supply implies pulp vitality. To evaluate pulp vitality clinically, electric pulp test and thermal test which are based on sensory nerve response have been used in addition to many auxiliary data such as past dental history, visual inspection, radiographic examination, percussion, palpation and transillumination test. However, reactivity of the nerves to the stimulation is not synonymous with normalcy. Therefore measurement of pulpal blood flow using a laser Doppler flowmeter became a new trial to test the pulp vitality. The purpose of the present study was to evaluate normal pulpal blood flow level of maxillary teeth in adult to provide a guideline in determining the vitality of dental pulp. Pulpal blood flow was measured in maxillary central and lateral incisors, canines, first and second premolars and first molars of seventy nine adults of 22 - 30 years old using a laser Doppler flowmeter (PeriFlux 4001, Perimed Co., Stockholm, Sweden, 780 nm infrared laser, 1mW). For directly-made splints, silicone rubber impressions were taken directly from the mouth. For indirectly-made splints, alginate impressions were taken from the mouth and stone cast were made. After making depressions on the buccal surfaces of the cast teeth to indicate the hole positions, second impressions with vinyl polysyloxane putty were taken from the cast. Holes for the laser probes were made at the putty impressions 4mm above the gingival level. Laser probe (PF416 dental probe, 1.5mm) was inserted in the prepared hole and the splint was set in the mouth. After 10 minutes of patient relaxing, pulpal blood flow was recorded for 5 minutes on each tooth. The recorded flow was saved in the computer and calculated with a software 'Perisoft' version 5.1. Pulpal blood flow was also recorded in six teeth of five individuals with no response to electric pulp test and cold test, with periapical radiolucency, or with history of root canal treatment to compare with nonvital teeth. The difference between the mean flow values of each group of teeth were analyzed using one-way ANOVA and Duncan's Multiple Range test. The results were as follows: 1. The average pulpal blood flow values of all the tested teeth of each location were between 9 - 16 Perfusion Unit. Pulpal blood flow value was highest in maxillary lateral incisors, followed by first premolars, second premolars, canines, central incisors, and then first molars (p<0.01). 2. In six anterior teeth, indirectly-made splint group showed higher pulpal blood flow values than directly-made splint group (p<0.01). In posterior teeth, however, there was no significant flow value difference between directly-made splint group and indirectly-made splint one (p>0.05). 3. Teeth with vital pulps showed higher signal values than teeth with nonvital pulps (p<0.01), and the flow photographs showed heartbeat-synchronous fluctuations and vasomotions, while those were absent in non vital tooth.

• Journal of the korean academy of Pediatric Dentistry
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• v.40 no.2
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• pp.120-126
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• 2013

Preserving the pulp is important in the treatment of carious pulp exposure in young permanent teeth. Pulpotomy is a vital pulp therapy in which a portion of the coronal pulp tissue is surgically removed, and the remaining radicular tissue is covered with suitable material that protects the pulp from further injury and permits and promotes healing. It is important to develop biocompatible treatment directed at maintaining pulp vitality and increasing tooth longevity. Platelet-rich fibrin (PRF) has been referred to as a second-generation platelet concentrate. Two clinical cases in which PRF was applied as a medicament after pulpotomy of an immature permanent tooth are presented. After isolation, caries removal and pulpotomy with PRF was performed. A layer of mineral trioxide aggregate (MTA) was placed over the PRF, and the final restoration was performed. Postoperatively, the patient had no pain or discomfort, and follow-up radiographs revealed normal periodontal ligament space and trabecular bone pattern.

• Journal of the korean academy of Pediatric Dentistry
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• v.42 no.4
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• pp.291-301
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• 2015

This study compared the in vitro cell viability and differentiation potentials of human deciduous dental pulp cells (DPCs) on mineral trioxide aggregate (MTA)-like products (ProRoot MTA, RetroMTA and Endocem Zr). The experimental materials were prepared as circular discs, which were used to test the effects of the materials on the viability of human DPCs when placed in direct and indirect contact. Furthermore, the pH of the extracted materials was recorded, and their effect on cell differentiation potential was evaluated by evaluating the alkaline phosphatase (ALP) activity and Alizarin Red S staining of DPCs incubated with the test materials. In direct contact, the cell viability of human DPCs was higher with ProRoot MTA and RetroMTA than with Endocem Zr. However, when in indirect contact, the cell viability of human DPCs was generally higher in Endocem Zr than in ProRoot MTA and Retro MTA. With respect to pH, the alkalinity was lower for Endocem Zr than for the other test materials. The ALP activities of the cells were not enhanced by any of the experimental materials. Alizarin Red S staining of the tested human DPCs revealed that their differentiation potential was lower than for cells incubated with osteogenic induction medium. While there were differences in the responses of the human DPCs to the test materials, all displayed degrees of cytotoxicity and were unable to enhance either the viability or differentiation of human DPCs. However, Endocem Zr exhibited better cell viability and was less alkaline than the other test materials.

• Restorative Dentistry and Endodontics
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• v.36 no.2
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• pp.149-153
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• 2011

As the dental pulp is encased with a rigid, noncompliant shell, changes in pulpal blood flow or vascular tissue pressure can have serious implication for the health of pulp. Numerous studies have demonstrated that orthodontic force application may influence both blood flow and cellular metabolism, leading degenerative and/or inflammatory responses in the dental pulp. The aim of this case report is to present a case about tooth with chronic periapical abscess which showed normal vital responses. Excessive orthodontic force is thought to be the prime cause of partial pulp necrosis. Owing to remaining vital tissue, wrong dianosis can be made, and tooth falsely diagnosed as vital may be left untreated, causing the necrotic tissue to destroy the supporting tissuses. Clinician should be able to utilize various diagnostic tools for the precise diagnosis, and be aware of the endodontic-orthodontic inter-relationship.

• Journal of the korean academy of Pediatric Dentistry
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• v.33 no.3
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• pp.522-528
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• 2006

When tooth is displaced within the alveolar bone, it could apply pressure and rupture the apical vessels. Pulpal reaction in such case is affected by the stage of root formation, amount of intrusion and pulpal infection. Determining the need of pulp treatment depends on the pulp vitality. Therefore, periodic vitality tests, coronal color changes and radiographic root resorption signs should be observed through periodic post-trauma follow-up. Pulp necrosis, pulp canal obliteration, external root resorption, root ankylosis and marginal bone loss could result from periodontal injuries. Negative sign changes from positive signs of vitality tests suggest pulp necrosis. In this case, pulp treatment should be held before root resorption occurs. By comparing the following two cases, complications of intrusion and factors producing them could be confirmed, thus we propose to report these two cases.

• Restorative Dentistry and Endodontics
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• v.35 no.6
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• pp.492-496
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• 2010

Coronal discoloration is a common sequela to traumatic injuries. In subluxation cases, although the injury is not strong enough to rupture the apical vessels, discoloration may appear by tearing thin walls or occluding small capillaries. In absence of infection pulpal regeneration can occur, and as a result discoloration may completely or partially subside. But judging pulpal status by coronal discoloration can be dangerous and it may lead to unnecessary treatment. This case presents coronal discoloration and recovery following traumatic injury of maxillary anterior teeth. In diagnosing traumatized teeth routine cold tests or electric pulp tests are known to be unreliable, but with the aid of ultrasound doppler imaging, assessing pulp vitality of traumatized teeth can be more accurate.

• Journal of the korean academy of Pediatric Dentistry
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• v.43 no.2
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• pp.158-165
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• 2016

The purpose of this study was to analyze photoplethysmographic waveforms from pulse oximeter using raw data of red and infrared light and investigate the reference values of parameters (Height, Width50, Maximum slope, Minimum slope, Area) for evaluating pulpal blood flow in maxillary central incisors with normal pulp vitality in children. The study was performed in 30 pediatric patients, aged 7-16 years old, using pulse oximeter (MEKICS Co., Ltd, Korea) combined with a custom-made sensor. The raw data was obtained and recorded by custom-made software and analyzed by LabChart (v.7.3, ADInstruments, Germany) offline. In this study, we analyzed photoplethysmographic waveforms from pulse oximeter applied to maxillary central incisor for assessment of pulpal blood flow and suggested several reference values of young permanent maxillary central incisor with normal pulp. On average, the waveform of red light was higher, stiffer and wider than that of infrared light. Future studies about reference values for other normal teeth and the teeth with impaired pulp vitality are needed.

• Journal of the korean academy of Pediatric Dentistry
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• v.27 no.1
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• pp.103-107
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• 2000

Traditionally, EPT and thermal tests were used as diagnostic methods for pulp vitality test. The thermal and electrical stimulation tests are the methods to determine the vitality of a tooth based on its neuronal response. These have certain limitations, one of them is the difficulty of approaching the correct result in case of treatment of children. The reason is management problem caused by the unpleasant stimulation. Also, the response from patients are not objective, and false positive or false negative could be happened. Recently, laser doppler flowmetry and pulse oximeter which evaluate vascular integrity are introduced in an effort of overcoming to limitation of traditional methods. The principle of pulse oximeter is to and out level of oxygen saturation by ratio of the two pulses between emitted light and detected light penetrating them to the termination of body, such as ears or fingers. From this point of view, it can be applied to a tooth to determine its vitality. The objective of this study lies mainly on varifying pulse oximeter as a method of determining tooth vitality and providing basic data of its clinical implementation. The result of the research showed that level of oxygen saturation in vital teeth was average of 96.3% and 0.0% in pulpless teeth. As a comprehensive result, pulse oximeter could be an useful diagnostic equipment in determining of tooth vitality.