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Vitality Test
Vitality Test
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Y
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There are several ways to obtain information about
the condition of a tooth¶s pulp and supporting
structures. Probably no one test is sufficient in it
self; the result of several test often have to be
obtained to have enough information to support a
likely diagnosis or perhaps a list of differential
diagnoses.
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¢ Yne of the most symptoms associated with the
symptomatic inflamed pulp is pain elicited by
thermal stimulation.
¢ Cold test may be used in differentiating between
reversible or irreversible pulpitis and in identifying
teeth with a necrotic pulp.
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¢ n testing if the pain lingers, that is taken as
evidence for irreversible pulpitis.
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¢ Cold as test for pulp vitality is probably not entirely
reliable since teeth with calcified pulp spaces may
have vital pulp, but cold stimuli may not be able to
excite the nerve endings owing to the insulating
effect of tertiary dentin .
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¢ Ms with cold test, there are some methods for heat
testing teeth have been suggested.
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¢ §lectric pulp tester uses electric excitation to
stimulate M delta fibers within the pulp.
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¢ Teeth that temporarily or permanently lose their
sensory function will be non responsive to §PT
however they will have intact vasculature.
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Êry the tooth to be tested by 2x2 gauze and isolate with
a cotton roll.
Cover the tip of the electrode with toothpaste or similar
electrical conductor.
f the tooth has a proximal metallic restoration it is
necessary to used a rubber dam to prevent electrical
conduction to adjacent teeth.
Clinician should explained the patient about the
sensation of heat or tingling felt during testing.
The patient should place a finger on the handle of the
testing device to serve a ³switch´.
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then the electrode is place on the dry enamel of the
tooth being tested on the middle 3rd of the facial surface
of the crown.
Current flow should increased slowly to allow the
patient time to respond before the attendant tingling
sensation becomes painful.
§ach tooth should be tested at least two or three times
and an average should be recorded.
For multi rooted teeth may need to be tested by placing
the electrode on more than one location.
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¢ Palpation testing is using a digital pressure to check
any tenderness in the oral tissue overlying
suspected teeth.
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¢ n this manner an
incipient swelling may
be detected before it is
clinically evident by
rolling the index finger
over the mucosa and
pressing it against the
underlying bone.
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¢ Tenderness noted upon percussing a tooth indicates
some degree of inflammation in the periodontal
ligament.
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¢ Percussion is not a test for pulp vitality.
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¢ Tooth mobility indicates the integrity of the
attachment apparatus (whether inflammation of the
periodontal ligament exists.)
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¢ M far more sensitive is to use a blunt, calibrated
probe to explore the attachment level in the gingival
sulcus around each tooth.
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¢ Pathways of the pulp 9th edition by: S. Cohen and R.C. Burns
Pages Ô 29
¢ §ndodontics ngle Bakland 5th ed. Êentistry, chapter 6
¢ http://www.acteongroup.com/prod_escl_list.aspx?id_menu=
37
¢ http://images.google.com.ph/images?hl=en&um=Ô&q=tooth
+palpation&sa=N&start=20&ndsp=20
¢ http://books.google.com.ph/books?id=aVÔk§f7mlckC&pg=PM
669&lpg=PM669&dq=percussion+of+teeth&source=bl&ots=T
JmHLNKuTV&sig=Ô7y48zbjzd6ÊÊTC§tjV9rYlM&hl=en&
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nSqf_HY2WkMMx7SFCQ&sa=&oi=book_result&ct=result
&resnum=Ô0#v=onepage&q=percussion%20of%20teeth&f=fa
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