Agreement between Two Commonly Used Pulp Tests in Determining Pulp Vitality

Abstract

Background:

The pulp tissue is confined within hard tissue boundaries and cannot be examined directly for health evaluation. Hence, its assessment is usually based on sensibility tests. Accurate diagnosis of the pulpal status requires evaluation with combination of sensibility tests. The objective of this study was to assess the mutual agreement between the electric pulp test and cold test in determining pulp vitality.

Methods:

Total 106 patients, aged 18 to 30 years, attending the dental OPD of Operative Dentistry/Endodontics department; Dr. Ishrat-ul-Ibad Institute of Oral Health Sciences, Karachi were selected for the study. The cold and electric pulp tests were used to determine the presence or absence of tingling sensation. Teeth were marked as vital in presence and non-vital in absence of any tingling or painful response. Agreement between these two tests was calculated using SPSS-18. To calculate the mean and standard deviation, descriptive statistics were applied for quantitative variables. For qualitative variables, frequencies and percentages were calculated. Kappa statistics was applied for agreement between electric pulp and cold test.

Results:

The cold test showed that 70.8% of the teeth were vital and 29.2% were necrotic. The electrical pulp test showed that 74.5% were vital and 25.5% were necrotic. The outcome showed 83.0% agreement between the tests; with kappa value of 0.574 which provided sufficient agreement with p-value=0.000.

Conclusion:

There was a high agreement found between the cold test and electric pulp test. Assessment of pulp vitality would be more accurate when EPT and Endo frost are used in combination.